Dynamic Contrast Enhanced Computed Tomography Measurement of Perfusion in Hepatic Cancer

ABSTRACT In recent years, the incidence and mortality rate for hepatocellular carcinoma (HCC) have increased due to the emergence of hepatitis B, C and other diseases that cause cirrhosis. The progression from cirrhosis to HCC is characterized by abnormal vascularization and by a shift from a venous to an arterial blood supply. A knowledge of HCC vascularity which is manifested as alterations in liver blood flow may distinguish among different stages of liver disease and can be used to monitor response to treatment. Unfortunately, conventional diagnostic imaging techniques lack the ability to accurately quantify HCC vascularity. The purpose of this thesis was to validate and assess the diagnostic capabilities of dynamic contrast enhanced computed tomography (DCE-CT) and perfusion software designed to measure hepatic perfusion. Chapter 2 described a study designed to evaluate the accuracy and precision of hepatic perfusion measurement. The results showed a strong correlation between hepatic artery blood flow measurement with DCE-CT and radioactive microspheres under steady state in a rabbit model for HCC (VX2 carcinoma). Using repeated measurements and Monte Carlo simulations, DCE-CT perfusion measurements were found to be precise; with the highest precision in the tumor rim. In Chapter 3, we used fluorine-18 fluoro-2-deoxy-D-glucose (FDG) positron emission tomography and DCE-CT perfusion to determined an inverse correlation between glucose utilization and tumor blood flow; with an R of 0.727 (P \u3c 0.05). This suggests a limited supply of oxygen (possibly hypoxia) and that the tumor cells were surviving via anaerobic glycolysis. in In Chapter 4, hepatic perfusion data showed that thalidomide caused a reduction of tumor perfusion in the responder group during the first 8 days after therapy, P \u3c 0.05; while perfusion in the partial responder and control group remained unchanged, P \u3e 0.05. These changes were attributed to vascular remodeling and maturation resulting in a more functional network of endothelial tubes lined with pericytes. The results of this thesis demonstrate the accuracy and precision of DCE-CT hepatic perfusion measurements. It also showed that DCE-CT perfusion has the potential to enhance the functional imaging ability of hybrid PET/CT scanners and evaluate the efficacy of anti-angiogenesis therapy

Introductory programming: a systematic literature review

As computing becomes a mainstream discipline embedded in the school curriculum and acts as an enabler for an increasing range of academic disciplines in higher education, the literature on introductory programming is growing. Although there have been several reviews that focus on specific aspects of introductory programming, there has been no broad overview of the literature exploring recent trends across the breadth of introductory programming. This paper is the report of an ITiCSE working group that conducted a systematic review in order to gain an overview of the introductory programming literature. Partitioning the literature into papers addressing the student, teaching, the curriculum, and assessment, we explore trends, highlight advances in knowledge over the past 15 years, and indicate possible directions for future research

Improved Food Distribution Facilities for Central North Carolina

Excerpts from the report: This study was undertaken at the request of the North Carolina State Department of Agriculture, the Raleigh Produce Dealers Association, and food industry representatives. The request stemmed from or reflected a realization that improvements are required in existing distribution facilities for the wholesale food firms located in the counties surrounding Raleigh and for farmers, wholesalers, and other allied firms now located on the Raleigh State Farmer's Market. The study includes both the wholesale food distribution system serving central North Carolina and the growers and users of the Raleigh State Farmer's Market. An 11-county study area is defined for the wholesale food distribution portion of the study. This portion covers 175 wholesale food firms located throughout the study area. The study area defined for the farmers' market includes approximately 1,700 farmers in 24 counties. The objectives of this report are to: • Analyze the wholesale food and farmers' market operations in central North Carolina and identify facilities that should be replaced. • Determine the kinds and numbers of facilities required and the amount of land needed to provide for the development of a wholesale food distribution center and farmers' market to serve the region. • Estimate the costs and potential benefits associated with the construction of a wholesale food distribution center and farmers' market

Improved Food Distribution Facilities for Southern New Jersey

Excerpts from the report: Southern New Jersey wholesalers, industry trade groups, local governments, and the New Jersey Department of Agriculture requested the assistance of the Agricultural Marketing Service (AMS), U.S. Department of Agriculture (USDA), in determining the need for new food wholesale and processing facilities to serve the southern portions of the State. This request was prompted by a general concern that new and more modern facilities were needed to assist the area food industry in maintaining a high level of competitive service to the region. Based on consultation among study cooperators, the 10 southernmost counties in New Jersey were delineated as the study area. These counties are Atlantic, Burlington, Camden, Cape May, Cumberland, Gloucester, Mercer, Monmouth, Ocean, and Salem. For this study, food firms in southern New Jersey were categorized into 12 defined groups. To the extent possible, each firm was identified based on the single most important type of food product in the company's overall annual sales. These categories are: (1) bakery product firms, (2) beverage companies, (3) candy wholesalers and processors, (4) dairy product firms, (5) egg wholesalers, (6) food product companies, (7) frozen food wholesalers, (8) fruit and vegetable firms, (9) grocery companies, (10) meat wholesalers and processors, (11) poultry companies, and (12) seafood firms. The objectives of this study were: • Develop a general overview of the regional food industry in southern New Jersey. • Identify firms needing new facilities. • Develop designs for new facilities to solve the identified deficiencies in existing facilities. • Evaluate potential locations for new facilities. • Estimate the potential benefits and costs associated with both existing and planned facilities to evaluate some of the merits of relocating firms to more modern facilities