Advanced head and neck cancer: Long-term results of chemo-radiotherapy, complications and induction of second malignancies

Background: Chemo-radiotherapy is superior to radiotherapy alone in the treatment of advanced, inoperable head and neck cancer. The long-term treatment results, the induction of second malignant tumors, and other long-term toxicities are not well defined. Patients and Methods: 100 consecutive patients with advanced head and neck cancer who were treated at our center were studied. Treatment results, survival, the occurrence of late complications, and second malignant tumors (SMT) were investigated. 78 patients were treated with a protocol combining cisplatinum, 5-fluorouracil, folinic acid and hyper-fractionated irradiation. 22 patients were treated with other chemo-radiotherapy protocols. The relative risk of developing an SMT was compared with that within the normal population. Results: The cumulative total probability of survival was 51.1% at 2 years and 38.7% at 4 years. The probability of relapse-free survival was 39.9% at 2 years and 36.7% at 4 years. A total of 7 patients developed SMT (4 cases of lung cancer, 2 colon cancers, 1 skin cancer). After 6 years, a cumulative risk of SMT of 8.7% was observed. The relative risk of developing an SMT was significantly increased (4.45-fold in males) compared with a normal population. 13 of 38 evaluable patients (34.2%) had severe late complications like fibrosis of soft tissues, nerve lesions, or were dependent on tracheal cannulas. Conclusions: The treatment results and long-term prognoses in our population of unselected high-risk patients are unsatisfactory, but comparable to those from multicenter studies. About 35% of patients become long-term (> 4 years) survivors. SMT generally occur early, have a poor prognosis and, most likely, are not treatment-related. Approximately 30% of long-term survivors have severe, often incapacitating late effects. The treatment and - if possible - prevention of these late effects is important for the quality of life of patients who survived advanced head and neck cancer

Spontaneous bleeding in a patient with malignant lymphoma: A case of acquired hemophilia

Background: Acquired hemophilia is a rare condition which can be associated with lymphoproliferative disease. Case Report: Eleven yea rs after the diagnosis of immunocytoma had been made, a 72-year-old man developed a high-titer factor VIII inhibitor. At this time, the lymphoma was without significant progress and there was no paraprotein in the serum. Partial thromboplastin time (PTT) was 83 a, factor-VIII clotting activity was <1%, and inhibitor level was 50.4 Bethesda units. The patient presented with spontaneous hematomas in the skin and musculature of the extremities. Following combination chemotherapy with cyclophosphamide, vincristine and prednisolone (COP), there was a prompt disappearance of the inhibitor and normalization of coagulation; however, the patient developed serious infectious complications. When the inhibitor recurred he was treated with low-dose cyclophosphamide and prednisolone. This time there was a more delayed response, but the inhibitor disappeared again completely. Two months after cessation of therapy, there was again relapse. Conclusion: Causal relationship between lymphoma and acquired hemophilia remains speculative. At least in some cases of factor VIII inhibitors associated with malignant disease, immunosuppressive therapy may be sufficient to suppress the inhibitor

Von Bezold assimilation effect reverses in stereoscopic conditions

Lightness contrast and lightness assimilation are opposite phenomena: in contrast, grey targets appear darker when bordering bright surfaces (inducers) rather than dark ones; in assimilation, the opposite occurs. The question is: which visual process favours the occurrence of one phenomenon over the other? Researchers provided three answers to this question. The first asserts that both phenomena are caused by peripheral processes; the second attributes their occurrence to central processes; and the third claims that contrast involves central processes, whilst assimilation involves peripheral ones. To test these hypotheses, an experiment on an IT system equipped with goggles for stereo vision was run. Observers were asked to evaluate the lightness of a grey target, and two variables were systematically manipulated: (i) the apparent distance of the inducers; and (ii) brightness of the inducers. The retinal stimulation was kept constant throughout, so that the peripheral processes remained the same. The results show that the lightness of the target depends on both variables. As the retinal stimulation was kept constant, we conclude that central mechanisms are involved in both lightness contrast and lightness assimilation

Does Perceptual Belongingness Affect Lightness Constancy?

Scientists have shown that two equal grey patches may differ in lightness when belonging to different reflecting surfaces. We extend this investigation to the constancy domain. In a CRT simulation of a bipartite field of illumination, we manipulated the arrangement of twelve patches: six squares and six diamonds. Patches of the same shape could be placed: (i) all within the same illumination field; or (ii) forming a row across the illumination fields. Furthermore, we manipulated proximity between the innermost patches and the illumination edge. The patches could be (i) touching (forming an X-junction); or (ii) not touching (not forming an X-junction). Observers were asked to perform a lightness match between two additional patches, one illuminated and the other in shadow. We found better lightness constancy when the patches of the same shape formed a row across the fields, with no effect of X-junctions

MALTA monolithic pixel sensors in TowerJazz 180 nm technology

Depleted Monolithic Active Pixel Sensors are of highest interest at the HL-LHC and beyond for the replacement of the Pixel trackers in the outermost layers of experiments where the requirement on total area and cost effectiveness is much bigger. They aim to provide high granularity and low material budget over large surfaces with ease of integration. Our research focuses on MALTA, a radiation hard DMAPS with small collection electrode designed in TowerJazz 180 nm CMOS imaging technology and asynchronous read-out. Latest prototypes are radiation hard up to 2 × 1015 1 MeV neq/cm2 with a time resolution better than 2 ns

Testbeam results of the Picosecond Avalanche Detector proof-of-concept prototype

The proof-of-concept prototype of the Picosecond Avalanche Detector, a multi-PN junction monolithic silicon detector with continuous gain layer deep in the sensor depleted region, was tested with a beam of 180 GeV pions at the CERN SPS. The prototype features low noise and fast SiGe BiCMOS frontend electronics and hexagonal pixels with 100 μm pitch. At a sensor bias voltage of 125 V, the detector provides full efficiency and average time resolution of 30, 25 and 17 ps in the overall pixel area for a power consumption of 0.4, 0.9 and 2.7 W/cm2, respectively. In this first prototype the time resolution depends significantly on the distance from the center of the pixel, varying at the highest power consumption measured between 13 ps at the center of the pixel and 25 ps in the inter-pixel region

Picosecond Avalanche Detector — working principle and gain measurement with a proof-of-concept prototype

The Picosecond Avalanche Detector is a multi-junction silicon pixel detector based on a (NP)drift(NP)gain structure, devised to enable charged-particle tracking with high spatial resolution and picosecond time-stamp capability. It uses a continuous junction deep inside the sensor volume to amplify the primary charge produced by ionizing radiation in a thin absorption layer. The signal is then induced by the secondary charges moving inside a thicker drift region. A proof-of-concept monolithic prototype, consisting of a matrix of hexagonal pixels with 100 μm pitch, has been produced using the 130 nm SiGe BiCMOS process by IHP microelectronics. Measurements on probe station and with a 55Fe X-ray source show that the prototype is functional and displays avalanche gain up to a maximum electron gain of 23. A study of the avalanche characteristics, corroborated by TCAD simulations, indicates that space-charge effects due to the large primary charge produced by the conversion of X-rays from the ^55Fe source limits the effective gain

20 ps Time Resolution with a Fully-Efficient Monolithic Silicon Pixel Detector without Internal Gain Layer

A second monolithic silicon pixel prototype was produced for the MONOLITH project. The ASIC contains a matrix of hexagonal pixels with 100 {\mu}m pitch, readout by a low-noise and very fast SiGe HBT frontend electronics. Wafers with 50 {\mu}m thick epilayer of 350 {\Omega}cm resistivity were used to produce a fully depleted sensor. Laboratory and testbeam measurements of the analog channels present in the pixel matrix show that the sensor has a 130 V wide bias-voltage operation plateau at which the efficiency is 99.8%. Although this prototype does not include an internal gain layer, the design optimised for timing of the sensor and the front-end electronics provides a time resolutions of 20 ps.Comment: 11 pages, 11 figure