Opportunities for integrating underground railways into low carbon urban energy networks: A review

Cities demand vast amounts of energy for their everyday operation, resulting in significant degradation of energy in the form of heat in the urban environment. This leads to high cooling requirements in cities, while also presenting the opportunity to reuse such waste heat in order to provide low-carbon heating for buildings and processes. Among the many potential energy sources that could be exploited in urban areas, underground railway tunnels are particularly attractive, as the operation of the trains produce considerable amounts of heat throughout the year. This paper reviews how secondary energy sources in urban areas can be integrated into heating and cooling networks, with emphasis on underground rail tunnels. This involves investigating potential urban waste heat sources and the existing state-of-the-art technologies that could be applied to efficiently recover this secondary energy, as well as analyzing how district heating and cooling networks have been a key mechanism to allow for a smooth transition from current fossil fuel based to future low-carbon energy sources

191. Biopsja węzła wartowniczego w operacyjnym raku gruczołu piersiowego – doświadczenia własne

Do chwili obecnej w przypadku raka piersi usunięcie układu chłonnego pachy jest obowiązkowym elementem postępowania chirurgicznego. Zajęcie węzłów chłonnych w przypadku raka piersi jest jednym z czynników rokowniczych jak i wpływa na podjęcie dalszego leczenia uzupełniającego i dlatego usunięcie pachowych węzłów chłonnych jest bardzo ważnym elementem leczenia operacyjnego raka piersi. Technika biopsji węzła wartowniczego (WW) rozwinęła się w przypadkach czerniaka złośliwego skóry i ma na celu precyzyjną ocenę stanu całego dorzecza węzłów chłonnych przy użyciu barwnika Paten Blau V, radioizotopu Tc99 ręcznej sóndy gamma kamery oraz małoinwazyjnej techniki chirurgicznej.Materiał i metodaW okresie od sierpnia 1998 roku do września 2003 roku w I Oddziale Chirurgii Onkologicznej Wielkopolskiego Centrum Onkologii w Poznaniu poddano biopsji WW 400 pacjentek z operacyjnym rakiem piersi. U wszystkich chorych klinicznie nie stwierdzano powiększonych węzłów chłonnych. Wiek pacjentek wahał się od 35 do 70 lat ze średnią wieku 55,2 lat. W przeddzień operacji podawano podskórnie w okolicę guza z czterech wkłuć Nannocoloid znaczony Tc99 w stężeniu 1 mCi zawarty w 4 mililitrach roztworu. Dnia następnego rano wykonywano limfoscyntygrafię celem wykonania mappingu węzła/węzłów wartowniczych. Następnie na sali operacyjnej podawano 1 do 2 mililitrów barwnika Patent Blau V w ten sam sposób, co radiokoloid. Przy użyciu ręcznej sondy gamma kamery identyfikowano miejsce największego wychwytu znacznika w pasze (tzw. Hot, Spot), które zaznaczano. Po odsłonięciu tkanki tłuszczowej pachy uwidaczniano wybarwione drogi chłonne, wzdłuż których dokonywano identyfikację wybarwionego węzła chłonnego. Następnie przy użyciu ręcznej sondy Navigator potwierdzano największy wychwyt promieniowania nad wybarwionym węzłem, w takim przypadku powyższy węzeł chłonny uważany był jako WW i przesyłany do pracowni patologicznej. Po identyfikacji WW chora poddawana była standardowej operacji (mastectomia lub BCT) wraz z limfadenektomią pachową jako nieodłącznym elementem procedury chirurgicznej.WynikiWW udało się zidentyfikować w 97% chorych. W przypadku 7 pacjentek nie udało się odnależć WW. Z pośród chorych z definiowanym WW przerzuty stwierdzono w 20% przypadków, w pozostałej części badanej grupy WW nie zawierał komórek nowotworowych, co stanowi 80% badanej populacji. W badanej grupie chorych stwierdzono 2 przypadki wyniku fałszywie ujemnego. W większoścr przypadków (87,1%) WW występował jako pojedynczy tylko u 2 pacjentów stwierdzono podwójny węzeł chłonny a u jednej chorej WW występował jako potrójny, ogółem mnogie WW wynosiły 2,88% populacji.WnioskiBiopsja WW jest bezpieczną metodą pozwalającą na ocenę dorzecza pachowych węzłów chłonnych w operacyjnym raku piersi. Wyniki nasze potwierdzają w pełni wyniki innych badaczy w Europie i na Świecie

54. Lymphatic mapping and sentinel lymphnode Biopsy in breast cancer patients in clinical stage T1-T2 NO MO

The authors report the feasibility an accuracy of intraoperative sentinel lymphnode biopsy (SLN) in patients with operable breast cancer to test the hypothesis that the histologic characteristic of SLN predicts the histologic status of remaining lymph nodes in the axilla. In between August 1999 and May 2000 to SLN biopsy there were 124 patients enrolled with median age of 55,2 years of age. All patients had operable breast cancer and all axillary lymphnodes were clinically negative.A day before surgery 4 cc of Nannocol marked with Tc99 was injected subcutuanesly nearby the tumor bed and an hour later the lymphoscyntygraphy was performed to achieve axillary lymphnodes mapping. Then immediately prior to surgery Blue Dye Patent Blau V was injected in the same manner as the radiological marker. Then with the use of hand – held gamma probe the hotspot was defined and marked. Five to ten minutes later first cut was performed over marked hotspot. After visualization of stained lymph vassals the SLN was traced and confirmed with high dose output (using the Neoprobe) and then was harvested for histologic examination. After this all patients were submitted for regular lymphadenectomy regardless main surgery type (mastectomy or BCT).Employing above method we were able to define SLN in 93,3%, only in 6,7% of our patients identification failed. In the group with defined SLN we found cancer cells deposits only in 20%. And in that group remaining lymphnodes had cancer metastasis in almost 80%. We had two cases of false negative results but still our specify rate was over 97%.In conclusion we think that SLN biopsy is quite safe and efficient method to evaluate axillary lymphnodes status in patients with operable early stage breast cancer. Our findings are also confirmed by other authors world wide

Loss of estrogen receptor beta expression correlates with shorter overall survival and lack of clinical response to chemotherapy in ovarian cancer patients

Background: Estrogen receptor beta (ERβ) belongs to a large family of nuclear receptors. Recent studies have suggested that ERβ in contrast to ERα might act as a tumour suppressor in ovarian cancer (OVCA). Materials and Methods: Expression of ERβ was detected by immunocytochemistry in 11 OVCA cell lines and by immunohistochemistry in 43 (41 FIGO stage III) OVCA specimens prepared before chemotherapy and 30 specimens from the same group after chemotherapy. Cisplatin sensitivity in the 11 cell lines was also analysed. Results: No significant correlations between cisplatin-sensitivity and expression of ERβ was found in the cell lines. In the cases which responded well to chemotherapy (complete response) ERβ expression at preliminary laparotomy (PL) was significantly higher (p=0.0004) than in those with progressive disease. Kaplan-Meier analysis revealed that the patients with higher ERβ expression (>30% of cells) at PL had an increased overall survival time and progression-free time (p=0.00161 and p=0.03255, respectively) than the patients with lower ERβ espression. Significantly shorter overall survival time characterized the cases with lower immunoreactivity score of ERβ expression at secondary cytoreduction (SCR) (p=0.00346). Conclusion: The loss of ERβ expression in ovarian tumours may be a feature of malignant transformation

An Integrated TCGA Pan-Cancer Clinical Data Resource to Drive High-Quality Survival Outcome Analytics

For a decade, The Cancer Genome Atlas (TCGA) program collected clinicopathologic annotation data along with multi-platform molecular profiles of more than 11,000 human tumors across 33 different cancer types. TCGA clinical data contain key features representing the democratized nature of the data collection process. To ensure proper use of this large clinical dataset associated with genomic features, we developed a standardized dataset named the TCGA Pan-Cancer Clinical Data Resource (TCGA-CDR), which includes four major clinical outcome endpoints. In addition to detailing major challenges and statistical limitations encountered during the effort of integrating the acquired clinical data, we present a summary that includes endpoint usage recommendations for each cancer type. These TCGA-CDR findings appear to be consistent with cancer genomics studies independent of the TCGA effort and provide opportunities for investigating cancer biology using clinical correlates at an unprecedented scale. Analysis of clinicopathologic annotations for over 11,000 cancer patients in the TCGA program leads to the generation of TCGA Clinical Data Resource, which provides recommendations of clinical outcome endpoint usage for 33 cancer types

Intraoperative Multispectral Fluorescence Imaging for the Detection of the Sentinel Lymph Node in Cervical Cancer: A Novel Concept

PURPOSE: Real-time intraoperative near-infrared fluorescence (NIRF) imaging is a promising technique for lymphatic mapping and sentinel lymph node (SLN) detection. The purpose of this technical feasibility pilot study was to evaluate the applicability of NIRF imaging with indocyanin green (ICG) for the detection of the SLN in cervical cancer. PROCEDURES: In ten patients with early stage cervical cancer, a mixture of patent blue and ICG was injected into the cervix uteri during surgery. Real-time color and fluorescence videos and images were acquired using a custom-made multispectral fluorescence camera system. RESULTS: Real-time fluorescence lymphatic mapping was observed in vivo in six patients; a total of nine SLNs were detected, of which one (11%) contained metastases. Ex vivo fluorescence imaging revealed the remaining fluorescent signal in 11 of 197 non-sentinel LNs (5%), of which one contained metastatic tumor tissue. None of the non-fluorescent LNs contained metastases. CONCLUSIONS: We conclude that lymphatic mapping and detection of the SLN in cervical cancer using intraoperative NIRF imaging is technically feasible. However, the technique needs to be refined for full applicability in cervical cancer in terms of sensitivity and specificity

Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin