Histopathological evaluation of recurrent goiter.

The recurrent goiter is the regrowth of thyroid tissue after thyroidectomy. An inadequate surgical removal of the thyroid gland, lack of substitution therapy and pathological stimulation of the thyroid growth can all promote the recurrence. The aim of this study was to find the connection between the histopathological findings during the first and second operation and the recurrence of goiter. The study group consisted of 29 women and 1 man. The mean time to recurrence was 15 years. The most frequent histopathological finding during the first and second operation was struma nodosa. According to our observations different histopathological findings were found in 63.4% cases after primary and secondary thyroidectomy. Some genetic investigations showed that nodules in recurrent goiters did not derive from nodules left during the first operation but from a group of cells which had high growth potential. Thus, not only the operation technique and substitution after operation are key factors of successful therapy of goiter, but also other factors which stimulate the re-growth of thyroid tissue

RESPIRATORY SOUNDS AS A SOURCE OF INFORMATION IN ASTHMA DIAGNOSIS

Around 300 million people all over the world at all age level suffer from asthma [1]. Patients with this disease have primarily difficult breathing with wheezing in respiratory sounds, cough and feeling of constricted chest. Therefore their physical activity is strongly limited [2]. Nowadays, there are several methods for asthma diagnosis, for example spirometry, measuring of peaks of expiratory velocity or measuring of bronchial reactivity. Although these methods are sufficiently reliable in most cases, they have also some imperfections, which are obvious especially by diagnosing of badly collaborating patients, e.g. small children aged up to three years. These infants can’t provide operations required for diagnosis, so results performed diagnosis are not reliable. For this reason, there is an idea of developing non invasive method of asthma diagnosis and other pulmonary diseases that would not need collaboration of patient [3]. One of the most probably working usable principles is comparison of air flow in airways of healthy and ill person. The difference of the air flow is caused by bronchial obstruction and constriction of airways of patient. There are other sounds and wheezing in the respiratory sounds detectable during breathing as a typical manifestation of the disease [4]. These phenomena can be detected by hearing of sound or by harmonic analysis

Effect of Statistical Fluctuation in Monte Carlo Based Photon Beam Dose Calculation on Gamma Index Evaluation

The gamma-index test has been commonly adopted to quantify the degree of agreement between a reference dose distribution and an evaluation dose distribution. Monte Carlo (MC) simulation has been widely used for the radiotherapy dose calculation for both clinical and research purposes. The goal of this work is to investigate both theoretically and experimentally the impact of the MC statistical fluctuation on the gamma-index test when the fluctuation exists in the reference, the evaluation, or both dose distributions. To the first order approximation, we theoretically demonstrated in a simplified model that the statistical fluctuation tends to overestimate gamma-index values when existing in the reference dose distribution and underestimate gamma-index values when existing in the evaluation dose distribution given the original gamma-index is relatively large for the statistical fluctuation. Our numerical experiments using clinical photon radiation therapy cases have shown that 1) when performing a gamma-index test between an MC reference dose and a non-MC evaluation dose, the average gamma-index is overestimated and the passing rate decreases with the increase of the noise level in the reference dose; 2) when performing a gamma-index test between a non-MC reference dose and an MC evaluation dose, the average gamma-index is underestimated when they are within the clinically relevant range and the passing rate increases with the increase of the noise level in the evaluation dose; 3) when performing a gamma-index test between an MC reference dose and an MC evaluation dose, the passing rate is overestimated due to the noise in the evaluation dose and underestimated due to the noise in the reference dose. We conclude that the gamma-index test should be used with caution when comparing dose distributions computed with Monte Carlo simulation

The importance of preoperative elevated serum levels of CEA and CA15-3 in patients with breast cancer in predicting its histological type.

It is not known whether in patients with breast cancer the occurrence of elevated serum tumour markers depends on its histological type. The aim of the study was to assess relationship between breast cancer histological type and the presence of increased serum levels of CEA and CA 15-3. The study population was 428 patients (all women, mean age 52.5 years), treated at The Department of Surgery of Wroclaw Medical University from 2005 to 2008 due to breast cancer. All of them had their preoperative CA 15-3 and CEA serum concentrations measured. According to the TNM system, 21% of patients were in stage I, 32.5% in stage II, 46.5% in stage III of the disease. In patients with ductal type of the cancer the elevated serum levels of CEA and CA 15-3 were observed in 48.7% and 42.2%, in lobular type in 42.4% and 52.5%, and in non-ductal/tubular types in 48.1% and 40.4% (p=N/S). Stepwise logistic regression analyses showed that ductal breast cancer is related to elevated CEA and normal CA 15-3 serum levels. The histological types of breast cancer are not significantly related to elevated serum levels of CEA and/or CA 15-3

Religion, Partisanship, and Attitudes Toward Science Policy

We examine issues involving science which have been contested in recent public debate. These “contested science” issues include human evolution, stem-cell research, and climate change. We find that few respondents evince consistently skeptical attitudes toward science issues, and that religious variables are generally strong predictors of attitudes toward individual issues. Furthermore, and contrary to analyses of elite discourse, partisan identification is not generally predictive of attitudes toward contested scientific issues

Prognostic value of CA 19-9 level in resectable pancreatic adenocarcinoma.

The prognosis in patients with pancreatic cancer is poor and some authors describe it as a lethal disease. At the time of diagnosis only 14% of patients could be surgically treated and up to 30% of them die within 12 months. Therefore, further clinical investigations on preoperative patient qualification are needed. A total of 81 patients were included into the study. The CA 19-9 concentration was measured before surgery by an automated, commercially available enzyme immunoassay in Axsym analyzer (Abott Diagnostics Laboratory). A value of 37 U/ml was used as the upper limit of normal levels. Tumors were staged according to the Union Against Cancer (UICC) of 2004 and graded during the histological evaluation according to the G0-G4 scale. All patients were monitored every three month via outpatient clinic visits. In the case of missing visit we contacted the families to establish the cause. We assessed perioperative, 12 month, 2 year and 5 year survival. Twelve moth, 2 year and 5 year survival were assessed in the whole studied population and in the group of patients with the exception of these who died during the perioperative period. The total five year survival was 6%. The median time of survival was 467 days (range: 163 - 586 days). The perioperative period was survived by 91.4% patients, 12 months were survived by 71.6% patients, 2 years were survived by 35.8% patients, 5 years were survived by 6.2% patients. The serum Ca 19-9 level was above the normal limit in 80.5% patients. ROC curve analysis revealed that CA 19-9 level of more than 106 U/ml was linked to 2 year survival with 79.3% sensitivity and 74.5% specificity. Preoperative level of CA 19-9 below 106U/ml represents a predictive factor of 2- and 5-year survival, independent of other factors, such as lower size of the tumor, absence of metastases to lymph nodes, female gender of patients. After exclusion of the patients who died in the perioperative period, no relationship could have been disclosed between preoperative CA 19-9 levels and one year survival. The observation points to the chance that patients with higher levels of CA 19-9 harbour micrometastases, the development of which is sufficiently slow to allow for a one-year survival of the patients but which increase the risk of death after two and five years

Comparative Study of Bi-Te-Se-S Mineralizations in Slovak Republic and Transcarpathian Region of Ukraine. Part 1. Localities, Geological Situation and Mineral Associations

Comparative analysis of telluride occurrences found in the territory of Slovakia and Transcarpathians (Ukraine) has shown that there is distinct difference between the mode of Au-Ag-Bi-Te-Se mineralization of these regions. But within the area of distribution of neovolcanites Bi-Te-Se-S mineralization is generally represented by similar mineralogical phases. In the Transcarpathian region bismuth tellurides (tsumoite, pilsenite, joseites, native bismuth and poorly studied sulpho-selenotellurides of bismuth) were found only in metasomatites as secondary quartzites of the Vyghorlat-Guta ridge area. (Il'kivtsy, Podulky, Smerekiv Kamin'). The similar mineralization have been also found in some neovolcanites of Slovakia (Poruba pod Vigorlatom, Remetska Hamra).Порівняльний аналіз проявів телуридів на території Словаччини і Закарпаття (Україна) показав, що існує помітна відмінність в характері Au-Ag-Bi-Te-Se мінералізації цих регіонів. Але в областях розвитку неовулканітів Bi-Te-Se-S мінералізація представлена в основному аналогічними мінеральними фазами. Телуриди вісмуту (цумоїт, пильзеніт, жозеїти, самородний бісмут і маловивчені сульфо-селено-телуриди бісмуту) знайдені на території Закарпаття тільки в метасоматитах типу вторинних кварцитів Вигорлат-Гутинського пасма (Ільківці, Подулки, Смереків Камінь). Подібна мінералізація встановлена в деяких неовулканітах Словаччини (Poruba роd Vigorlatom, Remetska Hamra).Сравнительный анализ проявлений теллуридов на территории Словакии и Закарпатья (Украина) показал, что существует заметное различие в характере Au-Ag-Bi-Te-Se минерализации этих регионов. Но в областях развития неовулканитов Bi-Te-Se-S минерализация представлена в основном аналогичными минеральными фазами. Теллуриды висмута (цумоит, пильзенит, жозеиты, самородный висмут и малоизученные сульфо-селенотеллуриды висмута) найдены на территории Закарпатья только в метасоматитах типа вторичных кварцитов Выгорлат-Гутинской гряды (Ильковцы, Подулки, Смерекив Каминь). Подобная минерализация установлена в некоторых неовулканитах Словакии (Poruba pod Vigorlatom, Remetska Hamra)

Towards real-time 4D radiation dosimetry on an MRI-Linac

4D radiation dosimetry using a highly radiation-sensitive polymer gel dosimeter with real-time quantitative magnetic resonance imaging (MRI) readout is presented as a technique to acquire the accumulated radiation dose distribution during image-guided radiotherapy on an MRI-Linac. Optimized T 2-weighted Turbo-Spin-Echo (TSE) scans are converted into quantitative ΔR 2 maps and subsequently to radiation dose maps. The concept of temporal uncertainty is introduced as a metric of effective temporal resolution. A mathematical framework is presented to optimize the echo time of the TSE sequence in terms of dose resolution, and the trade-off between temporal resolution and dose resolution is discussed. The current temporal uncertainty achieved with the MAGAT gel dosimeter on a 1 T MRI-Linac is 3.8 s which is an order of magnitude better than what has been achieved until now. The potential of real-time 4D radiation dosimetry in a theragnostic MRI-Linac is demonstrated for two scenarios: an irradiation with three coplanar beams on a head phantom and a dynamic arc treatment on a cylindrical gel phantom using a rotating couch. The dose maps acquired on the MRI-Linac are compared with a treatment plan and with dose maps acquired on a clinical 3 T MRI scanner. 3D gamma map evaluations for the different modalities are provided. While the presented method demonstrates the potential of gel dosimetry for tracking the dose delivery during radiotherapy in 4D, a shortcoming of the MAGAT gel dosimeter is a retarded dose response. The effect of non-ideal radiofrequency pulses resulting from limitations in the specific absorption rate or B1-field inhomogeneity on the TSE acquired ΔR 2 values is analysed experimentally and by use of computational modelling with a Bloch simulator