РЕКОМЕНДАЦІЇ ЩОДО ЗАБЕЗПЕЧЕННЯ БЕЗПЕКИ МОБІЛЬНИХ ПРИСТРОЇВ

В даній статті розглянуті деякі проблеми безпеки мобільних пристроїв та надані рекомендації щодо їх запобігання

Total Pelvic Exenteration for Primary and Recurrent Malignancies

Contains fulltext : 81087.pdf (publisher's version ) (Open Access)INTRODUCTION: Complete resection is the most important prognostic factor in surgery for pelvic tumors. In locally advanced and recurrent pelvic malignancies, radical margins are sometimes difficult to obtain because of close relation to or growth in adjacent organs/structures. Total pelvic exenteration (TPE) is an exenterative operation for these advanced tumors and involves en bloc resection of the rectum, bladder, and internal genital organs (prostate/seminal vesicles or uterus, ovaries and/or vagina). METHODS: Between 1994 and 2008, a TPE was performed in 69 patients with pelvic cancer; 48 with rectal cancer (32 primary and 16 recurrent), 14 with cervical cancer (1 primary and 13 recurrent), 5 with sarcoma (3 primary and 2 recurrent), 1 with primary vaginal, and 1 with recurrent endometrial carcinoma. Ten patients were treated with neoadjuvant chemotherapy and 66 patients with preoperative radiotherapy to induce down-staging. Eighteen patients received IORT because of an incomplete or marginal complete resection. RESULTS: The median follow-up was 43 (range, 1-196) months. Median duration of surgery was 448 (range, 300-670) minutes, median blood loss was 6,300 (range, 750-21,000) ml, and hospitalization was 17 (range, 4-65) days. Overall major and minor complication rates were 34% and 57%, respectively. The in-hospital mortality rate was 1%. A complete resection was possible in 75% of all patients, a microscopically incomplete resection (R1) in 16%, and a macroscopically incomplete resection (R2) in 9%. Five-year local control for primary locally advanced rectal cancer, recurrent rectal cancer, and cervical cancer was 89%, 38%, and 64%, respectively. Overall survival after 5 years for primary locally advanced rectal cancer, recurrent rectal cancer, and cervical cancer was 66%, 8%, and 45%. CONCLUSIONS: Total pelvic exenteration is accompanied with considerable morbidity, but good local control and acceptable overall survival justifies the use of this extensive surgical technique in most patients, especially patients with primary locally advanced rectal cancer and recurrent cervical cancer

Spatiotemporal modeling of microbial metabolism

Background Microbial systems in which the extracellular environment varies both spatially and temporally are very common in nature and in engineering applications. While the use of genome-scale metabolic reconstructions for steady-state flux balance analysis (FBA) and extensions for dynamic FBA are common, the development of spatiotemporal metabolic models has received little attention. Results We present a general methodology for spatiotemporal metabolic modeling based on combining genome-scale reconstructions with fundamental transport equations that govern the relevant convective and/or diffusional processes in time and spatially varying environments. Our solution procedure involves spatial discretization of the partial differential equation model followed by numerical integration of the resulting system of ordinary differential equations with embedded linear programs using DFBAlab, a MATLAB code that performs reliable and efficient dynamic FBA simulations. We demonstrate our methodology by solving spatiotemporal metabolic models for two systems of considerable practical interest: (1) a bubble column reactor with the syngas fermenting bacterium Clostridium ljungdahlii; and (2) a chronic wound biofilm with the human pathogen Pseudomonas aeruginosa. Despite the complexity of the discretized models which consist of 900 ODEs/600 LPs and 250 ODEs/250 LPs, respectively, we show that the proposed computational framework allows efficient and robust model solution. Conclusions Our study establishes a new paradigm for formulating and solving genome-scale metabolic models with both time and spatial variations and has wide applicability to natural and engineered microbial systems

CyberKnife stereotactic radiotherapy as monotherapy for low- to intermediate-stage prostate cancer: Early experience, feasibility, and tolerance

Purpose: The CyberKnife (CK), a linear accelerator mounted on a robotic device, enables excellent dose conformation to the target and minimizes dose to surrounding normal tissue. It is a very suitable device for performing hypofractionated stereotactic body radiotherapy as monotherapy for low- to intermediate-risk prostate cancer patients. We report our early experience using this technique. Materials and Methods: Between June 2008 and June 2009, 10 patients underwent CK monotherapy as treatment for their prostate cancer (stage ≤T2b, Gleason score (GS) ≤7, initial PSA ≤15μg/L). The prescribed dose was 38 Gy in four daily fractions of 9.5 Gy. The International Prostate Symptom Score and Radiation Therapy Oncology Group symptom scale were prospectively administered before and at 0.5, 1, 2, 3, 6, and 12 months. Results: Median age of the patients was 71 years (range, 66-76). Three patients had stage T2a and 7a T1c disease, one patient had GS of 7, and all others had GS of 6. Median follow-up was 5.1 months. Median initial PSA was 8.3 ng/mL (range, 1.3-13.6 ng/mL). Median planning target volume delineated on computed tomography after matching with the magnetic resonance imaging scan was 107 cc (range, 42-158 cc). The median V100 of the prostate was 95.8% (range, 94.8-97.2). The D95 of the prostate was 38.3 Gy (range, 38.1-38.8 Gy). The constraints for the bladder, rectum, and urethra were well met. The International Prostate Symptom Scores after 3 months were stable compared with the pretreatment scores. Urinary and bowel Radiati

Microsatellite Analysis of Voided-Urine Samples for Surveillance of Low-Grade Non-Muscle-Invasive Urothelial Carcinoma: Feasibility and Clinical Utility in a Prospective Multicenter Study (Cost-Effectiveness of Follow-Up of Urinary Bladder Cancer Trial [CEFUB])

Background: Microsatellite analysis (MA) of voided-urine samples has been promoted as an alternative for cystoscopy surveillance (UCS) of patients with low-grade non-muscle-invasive papillary urothelial carcinoma (UC). Objective: To assess the feasibility and clinical utility of MA on voided-urine samples in a routine setting to detect or predict bladder cancer recurrences. Design, setting, and participants: We evaluated 228 patients monitored by MA of voided-urine samples and synchronous UCS who participated in a longitudinal prospective study in 10 hospitals. Follow-up started after diagnosis of a primary or recurrent pTa, pT1, grade 1 or grade 2 papillary UC. Measurements: Clinico-pathological parameters and fibroblast growth factor receptor 3 (FGFR3) gene mutation status of the inclusion tumour were determined. MA outcome was analysed in 1012 urine samples during a mean follow-up of 41 mo. Poor DNA quality prevented MA in 19% (197/1012) of the samples, leaving 815 visits for a cross-sectional analysis of sensitivity and specificity. We determined the predictive value (PPV) in a longitudinal analysis for 458 series with persistent MA results. Factors influencing diagnostic quality of MA were investigated. Kaplan-Meier analysis was performed to relate MA results to recurrence. Results and limitations: Cross-sectional sensitivity and specificity of MA for detection of a recurrence were 58% (49/84) and 73% (531/731), respectively. One pT1 grade 3 UC was missed. In a longitudinal analysis, the 2-yr risk to develop a recurrence reached 83% if MA outcome was persistently positive and 22% when MA was persistently negative. PPV of MA was higher with wild-type FGFR3 gene status and smoking habits. All four upper urinary tract tumours detected were preceded by a positive MA test. Conclusions: Consecutive positive MA results are a strong predictor for future recurrences, but sensitivity needs to be improved, for example, by patient selection and testing of additional genetic markers in urine samples. (C) 2008 European Association of Urology. Published by Elsevier B.V. All rights reserved

Early expression of natriuretic peptides and SERCA in mild heart failure: association with severity of the disease

BACKGROUND: We investigated changes in genetic expression of atrial and brain natriuretic peptides (ANP and BNP) and sarcoplasmic reticulum Ca(2+)-ATPase (SERCA) in patients with stable mild to moderate chronic heart failure (CHF), since data on this topic were primarily obtained in end-stage CHF. METHODS: We studied tissue from 25 patients with idiopathic dilated cardiomyopathy (IDC) in New York Heart Association (NYHA) class II (n=12) and III-IV (n=13). Myocardial tissue from normal hearts (n=10) served as controls. Messenger RNA (mRNA) expression of ANP, BNP, and SERCA was isolated, and correlated with severity of CHF, left ventricular function (LVEF), peak oxygen uptake (peak VO(2)), and wedge pressure. RESULTS: A significant trend for gradual changes in mRNA expression according to increasing NYHA class was found for ANP, BNP (P <0.0001) and SERCA (P=0.04), with a marked increase in patients with more advanced CHF (ANP and BNP: P <0.01 vs. controls; SERCA: NS) and less pronounced changes in patients with mild CHF. mRNA of ANP and BNP correlated strongly with LVEF (-0.621 and -0.621, respectively, both P <0.01) and peak VO(2) (-0.625 and -0.555, respectively, both P <0.01) and, to a lesser extent, with wedge pressure (0.440 and 0.488, respectively, both P <0.05). SERCA correlated most strongly with wedge pressure (-0.623, P <0.01), and weak, non-significant correlations with LVEF and peak VO(2) were found. CONCLUSIONS: Genetic expression of ANP, BNP, and SERCA is progressively altered in proportion to the severity of CHF, although this is more marked for ANP and to a lesser extent BNP, than for SERCA. These changes support the concept that already early in CHF, genetic expression is affected, which has implications for the understanding of the pathophysiology of CH

Destruction of Tar in a Novel Coandă Tar Cracking System

The main objective of this research program was to develop and test a small-scale system that used a novel Coandă burner for tar destruction through partial oxidation. An experimental rig consisting of a tar injector, in which wood pellets were pyrolyzed, and a Coandă tar cracking unit was designed, constructed, and operated to determine the effectiveness of the unit. The experimental program was divided into two phases, so that comparisons of the tar composition with and without treatment could be made. In the first phase, wood pellets were pyrolyzed at a range of temperatures between 500 and 800 °C and the pyrolysis products (gas, tar, and char) were analyzed. Increasing the temperature from 500 to 700 °C caused an increase in the production of hydrogen, methane, and carbon dioxide. As the pyrolysis temperature increased from 500 to 800 °C, there was a decrease in the yield of gravimetric tar in the sampled gas from 67.2 to 15.7 g/nm3. This reduction can be attributed to higher pyrolysis temperature, causing an increase in thermal cracking and depolymerization reactions, which, in turn, promotes production of permanent gas species. In the second phase, the gas produced in the first phase was treated in sub-stoichiometric conditions in the Coandă tar cracker. When the yield of tar species found in the treated and untreated gases is compared when the pyrolysis temperature of the tar injector was set at 800 °C, benzene was reduced by 95%, toluene was reduced by 96%, naphthalene was reduced by 97.7%, and the gravimetric tar yield was reduced by 86.7%. The Coandă tar cracker was shown to be effective at significantly reducing the tar content in the product gas. The reduction can be attributed to the high flame temperature (>1000 °C) and the addition of oxygen, which leads to the formation of free radicals, causing tar destruction