Visualizing brain inflammation with a shingled-leg radio-frequency head probe for (19)F/(1)H MRI

Magnetic resonance imaging (MRI) provides the opportunity of tracking cells in vivo. Major challenges in dissecting cells from the recipient tissue and signal sensitivity constraints albeit exist. In this study, we aimed to tackle these limitations in order to study inflammation in autoimmune encephalomyelitis. We constructed a very small dual-tunable radio frequency (RF) birdcage probe tailored for (19)F (fluorine) and (1)H (proton) MR mouse neuroimaging. The novel design eliminated the need for extra electrical components on the probe structure and afforded a uniform -field as well as good SNR. We employed fluorescently-tagged (19)F nanoparticles and could study the dynamics of inflammatory cells between CNS and lymphatic system during development of encephalomyelitis, even within regions of the brain that are otherwise not easily visualized by conventional probes. (19)F/(1)H MR Neuroimaging will allow us to study the nature of immune cell infiltration during brain inflammation over an extensive period of time

The assessment of information technology maturity in emergency response organizations

[EN] In emergency response organizations, information technologies are not adequately explored. Sometimes, the mere adoption of new information technologies is not productive, as their efficient use depends on other interrelated technologies and the environment where they are installed. This work describes a model to help organizations understand their capability in respect to the adoption of these technologies. The model also helps the performing of the evaluation from different perspectives, making it suitable to collaborative evaluation. Using the proposed model, an organization can measure its maturity level in different aspects of the evaluation and guide the investment on its capabilities. Part of the model has been developed for emergency response organizations and the information technology dimension of the model has been applied to two fire department installations.Marcos R. S. Borges was partially supported by grants No. 560223/2010-2 and 480461/2009-0 from CNPq (Brazil). Work of José H. Canós is partially funded by the Spanish Ministerio. de Educación y Ciencia (MEC) under grant TIPEX (TIN2010–19859-C03-03). The cooperation between the Brazilian and the Spanish research groups was partially sponsored by the CAPES/MECD Cooperation Program, Project #169/ PHB2007-0064-PC.Santos, RS.; Borges, MRS.; Canos Cerda, JH.; Gomes, JO. (2011). The assessment of information technology maturity in emergency response organizations. Group Decision and Negotiation. 20(5):593-613. doi:10.1007/s10726-011-9232-zS593613205Bigley G, Roberts KH (2001) The incident command system: high reliability organizing for complex and volatile task environments. Acad Manag J 44(6): 1281–1299Chinowsky P, Molenaar K, Realph A (2007) Learning organizations in construction. J Manag Eng 23(1): 27–34Diniz VB, Borges MRS, Gomes JO, Canós JH (2008) Decision making support in emergency response. 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J Manag Inf Syst 14(1): 235–255King W, Teo T (1997) Integration between business planning and information systems planning: validating a stage hypothesis. Decis Sci 28(2): 279–307Lachner J, Hellwagner H (2008) Information and communication systems for mobile emergency response. Lecture notes in business information processing, vol 5. pp 213–224Lavoie D, Culbert A (1978) Stages in organization and development. Human Relat 31(5): 417–438Lindel MK, Prater C, Perry RW (2007) Emergency management. Wiley, New YorkLlavador M, Letelier P, Penadés MC, Borges MRS, Solís C (2006) Precise yet flexible specification of emergency resolution procedures. In: Proceedings of the information systems for crisis response and management (ISCRAM), pp 110–120Meissner A, Wang Z, Putz W, Grimmer J (2006) MIKoBOS: a mobile information and communication system for emergency response. In: Proceedings of the 3rd international ISCRAM conference, Newark, New JerseyNonaka I, Takeuchi H (1995) The knowledge creating company: how Japanese companies create the dynamics of innovation. Oxford University Press, OxfordOchoa S, Neyem A, Pino JA, Borges MRS (2007) Supporting group decision making and coordination in urban disasters relief efforts. J Decis Syst 16(2): 143–172Paton D, Flin R (1999) Disaster stress: an emergency management perspective. Disaster Prev Manag 8(4): 261–267Paulk MC, Weber C, Curtis B, Chrissis M (1995) The capability maturity model: guidelines for improving the software process. Addison-Wesley, ReadingQuarantelli EL (1997) Problematical aspects of the information/communication revolution for disaster planning and research: ten non-technical issues and questions. Disaster Prev Manag 6(2): 94–106Santos RS, Borges MRS, Gomes JO, Canós JH (2008) Maturity levels of information technologies in emergency response organizations. In: Proceedings of the international workshop on groupware, Omaha, Nebraska, USA. Groupware: design, implementation and use. Lecture notes in computer science, vol 5411. Springer, Berlin, pp 135–150Schoenharl T, Szabo G, Madey G, Barabasi AL (2006) WIPER: a multi-agent system for emergency response. In: Proceedings of the 3rd international ISCRAM conference, Newark, New JerseyTuroff M (2002) Past and future emergency response information systems. Commun ACM 45(4): 29–33Turoff M, Chumer M, Hiltz R, Clasher R, Alles M, Vasarhelyi M, Kogan A (2004a) Assuring homeland security: continuous monitoring, control and assurance of emergency preparedness. J Inf Technol Theor Appl (JITTA) 6(3): 1–24Turoff M, Chumer M, Vande Walle B, Yao X (2004b) The design of a dynamic emergency response management information system (DERMIS). J Inf Technol Theor Appl (JITTA) 5(4): 1–35Van der Lee MDE, Van Vugt M (2004) IMI—An information system for effective multidisciplinary incident management. In: Proceedings of the 1st international ISCRAM conference, Brussels, BelgiumYuan Y, Deltor B (2005) Intelligent mobile crisis response systems. Commun ACM 28(2): 95–98Zimmerman R, Restrepo CE (2006) Information technology (IT) and critical infrastructure interdependencies for emergency response. In: Proceedings of the 3rd international ISCRAM conference, Newark, New Jerse

Current CONtrolled Transmit And Receive Coil Elements (C2ONTAR) for Parallel Acquisition and Parallel Excitation Techniques at High-Field MRI

A novel intrinsically decoupled transmit and receive radio-frequency coil element is presented for applications in parallel imaging and parallel excitation techniques in high-field magnetic resonance imaging. Decoupling is achieved by a twofold strategy: during transmission elements are driven by current sources, while during signal reception resonant elements are switched to a high input impedance preamplifier. To avoid B0 distortions by magnetic impurities or DC currents a resonant transmission line is used to relocate electronic components from the vicinity of the imaged object. The performance of a four-element array for 3 T magnetic resonance tomograph is analyzed by means of simulation, measurements of electromagnetic fields and bench experiments. The feasibility of parallel acquisition and parallel excitation is demonstrated and compared to that of a conventional power source-driven array of equivalent geometry. Due to their intrinsic decoupling the current-controlled elements are ideal basic building blocks for multi-element transmit and receive arrays of flexible geometry

Phase III trial of postoperative cisplatin, interferon alpha-2b, and 5-FU combined with external radiation treatment versus 5-FU alone for patients with resected pancreatic adenocarcinoma – CapRI: study protocol [ISRCTN62866759]

After surgical intervention with curative intention in specialised centres the five-year survival of patients with carcinoma of the exocrine pancreas is only 15%. The ESPAC-1 trial showed an increased five-year survival of 21% achieved with adjuvant chemotherapy. Investigators from the Virginia Mason Clinic have reported a 5-year survival rate of 55% in a phase II trial evaluating adjuvant chemotherapy, immunotherapy and external-beam radiation. DESIGN: The CapRI study is an open, controlled, prospective, randomised multi-centre phase III trial. Patients in study arm A will be treated as outpatients with 5-Fluorouracil; Cisplatin and 3 million units Interferon alpha-2b for 5 1/2 weeks combined with external beam radiation. After chemo-radiation the patients receive continuous 5-FU infusions for two more cycles. Patients in study arm B will be treated as outpatients with intravenous bolus injections of folinic acid, followed by intravenous bolus injections of 5-FU given on 5 consecutive days every 28 days for 6 cycles. A total of 110 patients with specimen-proven R0 or R1 resected pancreatic adenocarcinoma will be enrolled. An interim analysis for patient safety reasons will be done one year after start of recruitment. Evaluation of the primary endpoint will be performed two years after the last patients' enrolment. DISCUSSION: The aim of this study is to evaluate the overall survival period attained by chemo-radiotherapy including interferon alpha 2b administration with adjuvant chemotherapy. The influence of interferon alpha on the effectiveness of the patients' chemoradiation regimen, the toxicity, the disease-free interval and the quality of life are analysed. Different factors are tested in terms of their potential role as predictive markers

Association of high risk human papillomavirus and breast cancer : a UK based study

Infection by human papillomaviruses (HPVs) has been implicated in the aetiology of a variety of cancers. Studies evaluating the presence of HPVs in breast cancer (BC) have generated considerable controversy. To date, most studies have focused on the presence of viral DNA in BC; however there are important gaps in evidencing the role of HPV persistence in the invasiveness of BC. While these studies have been conducted in several countries, none, on the presence and biological activity of high risk (HR) HPV in BC has been done in the UK. Hence, we aimed to investigate these gaps by screening a total of 110 fresh breast tissue specimens from UK patients for the presence of twelve HR-HPV types DNA using PCR and Sanger sequencing. Samples positive for HPV-DNA were screened for viral oncoprotein expression using western blot and dot blot. Data obtained showed the presence of HR-HPVs in 42% of breast tissues of which the viral activity was only confirmed in a number of invasive carcinomas (5/26). This finding, the first to report in the UK, suggests that the selective expression of viral oncoprotein in invasive cases may propose a role for HR-HPVs in the development of some types of BC

HPV-Related Nonkeratinizing Squamous Cell Carcinoma of the Oropharynx: Utility of Microscopic Features in Predicting Patient Outcome

Human papilloma virus (HPV) is an etiologic agent in a subset of oropharyngeal squamous cell carcinomas (SCCs). The aim of this study was to sub-classify SCC of the oropharynx based upon histologic features into nonkeratinizing (NK) SCC, keratinizing (K) SCC, and hybrid SCC, and determine the frequency of HPV and patient survival in each group. Patients with oropharyngeal SCC with a minimum of 2 years of clinical follow-up were identified from radiation oncology databases from 1997 to 2004. All patients received either up front surgery with postoperative radiation or definitive radiation based therapy. In situ hybridization (ISH) for high-risk HPV subtypes and immunohistochemistry for p16, a protein frequently up-regulated in HPV-associated carcinomas, were performed. Overall and disease-specific survival were assessed. Of 118 cases, 46.6% were NK SCC, 24.6% K SCC and 28.8% hybrid SCC. NK SCC occurred in slightly younger patients that were more often male. It more frequently presented with lymph node metastases and was surgically resected compared to K SCC. NK SCC was significantly more likely to be HPV and p16 positive than KSCC (P < 0.001) and to have better overall and disease-specific survival (P = 0.0002; P = 0.0142, respectively). Hybrid SCC was also more likely than K SCC to be HPV and p16 positive (P = 0.003; P = 0.002, respectively) and to have better overall survival (P = 0.0105). Sub-classification of oropharyngeal SCC by histologic type provides useful clinical information. NK SCC histology strongly predicts HPV-association and better patient survival compared to K SCC. Hybrid SCC appears to have an intermediate frequency of HPV-association and patient survival

Phase II study evaluating consolidation whole abdominal intensity-modulated radiotherapy (IMRT) in patients with advanced ovarian cancer stage FIGO III - The OVAR-IMRT-02 Study

<p>Abstract</p> <p>Background</p> <p>The prognosis for patients with advanced FIGO stage III epithelial ovarian cancer remains poor despite the aggressive standard treatment, consisting of maximal cytoreductive surgery and platinum-based chemotherapy. The median time to recurrence is less than 2 years, with a 5-years survival rate of -20-25%. Recurrences of the disease occur mostly intraperitoneally.</p> <p>Ovarian cancer is a radiosensitive tumor, so that the use of whole abdominal radiotherapy (WAR) as a consolidation therapy would appear to be a logical strategy. WAR used to be the standard treatment after surgery before the chemotherapy era; however, it has been almost totally excluded from the treatment of ovarian cancer during the past decade because of its high toxicity. Modern intensity-modulated radiation therapy (IMRT) has the potential of sparing organs at risk like kidneys, liver, and bone marrow while still adequately covering the peritoneal cavity with a homogenous dose.</p> <p>Our previous phase I study showed for the first time the clinical feasibility of intensity-modulated WAR and pointed out promising results concerning treatment tolerance. The current phase-II study succeeds to the phase-I study to further evaluate the toxicity of this new treatment.</p> <p>Methods/design</p> <p>The OVAR-IMRT-02 study is a single-center one arm phase-II trial. Thirty seven patients with optimally debulked ovarian cancer stage FIGO III having a complete remission after chemotherapy will be treated with intensity-modulated WAR as a consolidation therapy.</p> <p>A total dose of 30 Gy in 20 fractions of 1.5 Gy will be applied to the entire peritoneal cavity including the liver surface and the pelvic and para-aortic node regions. Organ at risk are kidneys, liver (except the 1 cm-outer border), heart, vertebral bodies and pelvic bones.</p> <p>Primary endpoint is tolerability; secondary objectives are toxicity, quality of life, progression-free and overall survival.</p> <p>Discussion</p> <p>Intensity-modulated WAR provides a new promising option in the consolidation treatment of ovarian carcinoma in patients with a complete pathologic remission after adjuvant chemotherapy. Further consequent studies will be needed to enable firm conclusions regarding the value of consolidation radiotherapy within the multimodal treatment of advanced ovarian cancer.</p> <p>Trial registration</p> <p>Clinicaltrials.gov: <a href="http://clinicaltrials.gov/ct2/show/NCT01180504">NCT01180504</a></p

Long-term survival of cancer patients compared to heart failure and stroke: A systematic review

<p>Abstract</p> <p>Background</p> <p>Cancer, heart failure and stroke are among the most common causes of death worldwide. Investigation of the prognostic impact of each disease is important, especially for a better understanding of competing risks. Aim of this study is to provide an overview of long term survival of cancer, heart failure and stroke patients based on the results of large population- and hospital-based studies.</p> <p>Methods</p> <p>Records for our study were identified by searches of Medline via Pubmed. We focused on observed and relative age- and sex-adjusted 5-year survival rates for cancer in general and for the four most common malignancies in developed countries, i.e. lung, breast, prostate and colorectal cancer, as well as for heart failure and stroke.</p> <p>Results</p> <p>Twenty studies were identified and included for analysis. Five-year observed survival was about 43% for all cancer entities, 40-68% for stroke and 26-52% for heart failure. Five-year age and sex adjusted relative survival was 50-57% for all cancer entities, about 50% for stroke and about 62% for heart failure. In regard to the four most common malignancies in developed countries 5-year relative survival was 12-18% for lung cancer, 73-89% for breast cancer, 50-99% for prostate cancer and about 43-63% for colorectal cancer. Trend analysis revealed a survival improvement over the last decades.</p> <p>Conclusions</p> <p>The results indicate that long term survival and prognosis of cancer is not necessarily worse than that of heart failure and stroke. However, a comparison of the prognostic impact of the different diseases is limited, corroborating the necessity for further systematic investigation of competing risks.</p