Development of a systems theoretical procedure for evaluation of the work organization of the cockpit crew of a civil transport airplane

To achieve optimum design for the man machine interface with aircraft, a description of the interaction and work organization of the cockpit crew is needed. The development of system procedure to evaluate the work organization of pilots while structuring the work process is examined. Statistical data are needed to simulate sequences of pilot actions on the computer. Investigations of computer simulation and applicability for evaluation of crew concepts are discussed

Die frühe Endoprotheseninfektion: Therapie durch Spülung, Jet-Lavage oder lokale Antibiotika : Welche ist die Therapie der Wahl? : eine Metaanalyse über 575 Patienten

Periprothetische Infektionen nach Implantation einer Hüft- und Kniegelenksendoprothese werden in frühe und späte Infektionen unterteilt. Frühe PPI werden als das Auftreten einer Infektion innerhalb von 6 Wochen nach der primären Operation definiert. Ziel der Therapie bei frühen PPI ist, die Prothese unter Verwendung von Spülung, Jet-Lavage oder lokaler Antibiotikatherapie zu erhalten. Bisher besteht jedoch noch keine Evidenz für den Einsatz dieser Verfahren. Ziel dieser Arbeit ist es, ihre Erfolgsraten zu bewerten. Dazu wurde eine systematische Literaturrecherche durchgeführt. Eingeschlossen wurden nach 1990 veröffentlichte klinische Studien, die Erfolgs- oder Misserfolgsraten in der Behandlung früher PPI veröffentlichten. Mittels Metaanalyse und Scheffé-Test wurde untersucht, ob einzelne Behandlungskonzepte Vorteile bieten. Durch die systematische Literaturrecherche wurden 575 Patienten über 10 Studien hinweg identifiziert. Die Erfolgsraten waren je nach verwendetem Verfahren unterschiedlich: Die Spülung ohne Jet-Lavage zeigte einen Behandlungserfolg von 49,48%. Wurde jedoch eine Jet-Lavage eingesetzt, stieg die Erfolgsrate auf 78,26%. In 55% der Fälle wurden lokale Antibiotika erfolgreich eingesetzt. Die Analyse verglich die drei Interventionen, wobei sich kein signifikanter Unterschied in der Verwendung der drei Methoden zeigte. Selbst die Kombination lokaler Antibiotika mit einer Spülung bzw. Jet-Lavage führt nicht zu signifikant höheren Erfolgsraten. Die betrachteten Studien zeigten unterschiedliche Konzepte der Methodik sowie voneinander abweichende Ergebnisse. Da keine der Interventionen einen signifikanten Vorteil aufwies, lässt sich aus den bisher durchgeführten Studien keine evidenzbasierte Empfehlung abgegeben, ob die Verwendung einer Spülung, Jet-Lavage oder der Einsatz lokaler Antibiotika respektive deren Kombination einen Therapievorteil bei frühen PPI zeigen

Assessment of various strategies for 18F-FET PET-guided delineation of target volumes in high-grade glioma patients

Purpose: The purpose of the study is to assess the contribution of 18F-fluoro-ethyl-tyrosine (18F-FET) positron emission tomography (PET) in the delineation of gross tumor volume (GTV) in patients with high-grade gliomas compared with magnetic resonance imaging (MRI) alone. Materials and methods: The study population consisted of 18 patients with high-grade gliomas. Seven image segmentation techniques were used to delineate 18F-FET PET GTVs, and the results were compared to the manual MRI-derived GTV (GTVMRI). PET image segmentation techniques included manual delineation of contours (GTVman), a 2.5 standardized uptake value (SUV) cutoff (GTV2.5), a fixed threshold of 40% and 50% of the maximum signal intensity (GTV40% and GTV50%), signal-to-background ratio (SBR)-based adaptive thresholding (GTVSBR), gradient find (GTVGF), and region growing (GTVRG). Overlap analysis was also conducted to assess geographic mismatch between the GTVs delineated using the different techniques. Results: Contours defined using GTV2.5 failed to provide successful delineation technically in three patients (18% of cases) as SUVmax < 2.5 and clinically in 14 patients (78% of cases). Overall, the majority of GTVs defined on PET-based techniques were usually smaller than GTVMRI (67% of cases). Yet, PET detected frequently tumors that are not visible on MRI and added substantially tumor extension outside the GTVMRI in six patients (33% of cases). Conclusions: The selection of the most appropriate 18F-FET PET-based segmentation algorithm is crucial, since it impacts both the volume and shape of the resulting GTV. The 2.5 SUV isocontour and GF segmentation techniques performed poorly and should not be used for GTV delineation. With adequate setting, the SBR-based PET technique may add considerably to conventional MRI-guided GTV delineatio

11C-acetate PET in the early evaluation of prostate cancer recurrence

Purpose: The first aim of the study was to investigate the diagnostic potential of 11C-acetate PET in the early detection of prostate cancer recurrence. A second aim was the evaluation of early and late PET in this context. Methods: The study population comprised 32 prostate cancer patients with early evidence of relapse after initial radiotherapy (group A) or radical surgery (group B). The median PSA of group A (n=17) patients was 6ng/ml (range 2.6-30.2) while that of group B (n=15) was 0.4ng/ml (range 0.08-4.8). Pelvic-abdominal-thoracic PET was started 2min after injection of 11C-acetate and evaluated after fusion with CT. Results: Group A: Taking a SUVmax≥2 as the cut-off, PET showed local recurrences in 14/17 patients and two equivocal results. Distant disease was observed in six patients and an equivocal result was obtained in one. Endorectal MRI was positive in 12/12 patients. Biopsy confirmed local recurrence in six of six (100%) patients. PET was positive in five of the six patients with biopsy-proven recurrences, the result in the remaining patient being equivocal. Group B: Among the 15 patients, visual interpretation was positive for local recurrences in five patients and equivocal in four. One obturator lymph node was positive. Endorectal MRI was positive in 11/15 patients and equivocal in two. Positional correlation of positive/equivocal results on PET and endorectal MRI was observed in seven of nine patients. PSA decreased significantly after salvage radiotherapy in 8/14 patients, providing strong evidence for local recurrence. PET of the eight patients responding to RT was positive in three and equivocal in two. Conclusion: 11C-acetate PET was found to be valuable in the early evaluation of prostate cancer relapse. Optimising scanning time and use of modern PET-CT equipment might allow further improvemen

Diagnostic and prognostic correlates of preoperative FDG PET for breast cancer

Purpose: To explore the preoperative utility of FDG PET for the diagnosis and prognosis in a retrospective breast cancer case series. Methods: In this retrospective study, 104 patients who had undergone a preoperative FDG PET scan for primary breast cancer at the UZ Brussel during the period 2002-2008 were identified. Selection criteria were: histological confirmation, FDG PET performed prior to therapy, and breast surgery integrated into the primary therapy plan. Patterns of increased metabolism were recorded according to the involved locations: breast, ipsilateral axillary region, internal mammary chain, or distant organs. The end-point for the survival analysis using Cox proportional hazards was disease-free survival. The contribution of prognostic factors was evaluated using the Akaike information criterion and the Nagelkerke index. Results: PET positivity was associated with age, gender, tumour location, tumour size >2 cm, lymphovascular invasion, oestrogen and progesterone receptor status. Among 63 patients with a negative axillary PET status, 56 (88.9%) had three or fewer involved nodes, whereas among 41 patients with a positive axillary PET status, 25 (61.0%) had more than three positive nodes (P < 0.0001). In the survival analysis of preoperative characteristics, PET axillary node positivity was the foremost statistically significant factor associated with decreased disease-free survival (hazard ratio 2.81, 95% CI 1.17-6.74). Conclusion: Preoperative PET axillary node positivity identified patients with a higher burden of nodal involvement, which might be important for treatment decisions in breast cancer patient

Endoscopic imaging of Cerenkov luminescence

We demonstrate feasibility of endoscopic imaging of Cerenkov light originated when charged nuclear particles, emitted from radionuclides, travel through a biological tissue of living subjects at superluminal velocity. The endoscopy imaging system consists of conventional optical fiber bundle/ clinical endoscopes, an optical imaging lens system, and a sensitive low-noise charge coupled device (CCD) camera. Our systematic studies using phantom samples show that Cerenkov light from as low as 1 µCi of radioactivity emitted from 18F-Fluorodeoxyglucose (FDG) can be coupled and transmitted through conventional optical fibers and endoscopes. In vivo imaging experiments with tumor bearing mice, intravenously administered with 18F-FDG, further demonstrated that Cerenkov luminescence endoscopy is a promising new tool in the field of endoscopic molecular imaging

History of the rare cancer network and past research.

Approximately, twenty years ago, the Rare Cancer Network (RCN) was formed in Lausanne, Switzerland, to support the study of rare malignancies. The RCN has grown over the years and now includes 130 investigators from twenty-four nations on six continents. The network held its first international symposium in Nice, France, on March 21-22, 2014. The proceedings of that meeting are presented in two companion papers. This manuscript reviews the history of the growth of the RCN and contains the abstracts of fourteen oral presentations made at the meeting of prior RCN studies. From 1993 to 2014, 74 RCN studies have been initiated, of which 54 were completed, 10 are in progress or under analysis, and 9 were stopped due to poor accrual. Forty-four peer reviewed publications have been written on behalf of the RCN