Preoperative prediction of optimal cytoreductive therapy with patients with carcinoma of ovaries and ovarian tubes in the late stage

UVOD: Problem u postavljanju rane dijagnoze predstavlja nedostatak specifičnih simptoma za ovu bolest. Posebno nepovoljan faktor u lečenju predstavlja činjenica da se karcinom jajnika i/ili jajovoda otkriva veoma kasno, u momentu kada je bolest već uznapredovala i kada su manje šanse za uspešnije lečenje ovih pacijentkinja. Svega 30% pacijentkinja ima dijagnostikovanu bolest u prvom stadijumu kada su i mogućnosti za izlečenje veće. Neprimetan i tih rast ovarijalnih tumora, nepristupačnost ovarijuma pri fizikalnom pregledu rezultira visokim stadijumima bolesti u momentu postavljanja dijagnoze, najčešće III i IV stadijum. Citoreduktivna hirurgija je zlatni standard u lečenju uznapredovalog karcinoma jajnika i ima za cilj uklanjanje svakog makroskopski vidljivog tumorskog ognjišta, gde je procenat petogodišnjeg preživljavanja za ove pacijentkinje 80%. CILjEVI: Glavni ciljevi istraživanja su bili: Utvrditi postojanje graničnih preoperativnih serumskih koncentracija tumorskih markera CA125 i HE4, koje bi u najvećem broju slučajeva predstavljale predikciju optimalne primarne citoreduktivne hirurgije kod odmaklih stadijuma epitelijalnog karcinoma jajnika i primarnog karcinoma jajovoda. METOD: Istraživanje je dizajnirano kao prospektivna studija, koja obuhvata uzorak od 150 pacijentkinja, koje su operisane od karcinoma jajnika, FIGO stadijuma III ili IV, u Klinikama za ginekologiju i akušerstvo KC Kragujevac i Narodni front u Beogradu, u periodu 01.01.2015. do 01.10.2016.godine. Kod svih pacijentkinja su urađene preoperativne laboratorijske analize, preoperativno merene vrednosti Ca125 i HE4, sprovedene ankete operativnih timova nakon izvedenog operativnog zahvata, pregledani postoperativni patohistološki nalazi i nalazi onkološkog konzilijuma. Isključujući faktori su bili: histopatološki utvrđen borderline karcinomi, rekurentni ovarijalni tumori, metastatski ovarijalni tumori, pacijentkinje koje su pre citoreduktivne hirurgije tretirane neoadjuvantnom hemoterapijom, kao i pacijentkinje kod kojih se nije slagao stadijum bolesti po FIGO klasifikaciji između intraoperativnog nalaza i nalaza onkološkog konzilijuma. REZULTATI: U grupi sa optimalnim citoreduktivnim zahvatom statistički značajno više bilo je ispitanica mlađih od 50 godina 64.7%. U posmatranoj grupi ispitanica operisanih od epitelijalnog karcinoma ovarijuma i primarnog karcinoma jajovoda, učestalost ispitanica starijih i mlađih od 50 godina nije se statistički značajno razlikovala (χ2-test; p=0,744) i bila je približno ista: 48,7% je bilo mlađe od 50 godina a 51,3% starije od 50 godina. Prosečne vrednosti HE4 bile su 608,31+245,85, (medijana 551,5), a Ca 125 622,59+228,01 (medijana 640,75). Ispitanice sa ascitom većim od 1000 ml bile su statistički značajno više zastupljene od ispitanica sa ascitom manjim od 1000 ml (χ2-test; p=0,009): 60% ispitanica iz ove grupe imalo je ascit veći od 1000 ml, a 40% ascit manji od 1000 ml. Zastupljenost ispitanica sa i bez limfadenektomije, nije se statistički značajno razlikovala (χ2-test; p=0,191): oko 55% ispitanica imalo je limfadenektomiju, a oko 45% nije. Statistički značajna razlika uočena je između ispitanica sa pozitivnim i negativnim nalazom u izvađenim limfnim žlezdama (χ2-test; p=0,000): pozitivan nalaz imalo je 36% ispitanica, a 19,3% negativan. Statistički značajna razlika uočena je i u zastupljenosti ispitanica sa različitim veličinama rezidualnog tumora (χ2-test; p=0,000): ispitanice sa rezidualnim tumorom veličine od 0-1cm (45,3%) i veličine od 2-10cm (39,3%) bili su statistički značajno više zastupljene od ispitanica sa rezidualnim tumorom veličine 11-20cm (11,3%) i većim od 20cm (4,0%). Statistički značajna razlika uočena je i u lokalizaciji rezidualnog tumora (χ2-test; p=0,000). ZAKLjUČCI: Značajni prediktori (ne) mogućnosti izvođenja optimalne citoredukcije su starost, HE4, Ca125, FIGO stadijum, količina ascita, histološki gradus, limfadenektomija i PH limfnih žlezda.INTRODUCTION: The problem in early diagnosis is the deficiency of specific symptoms of this illness. The fact that the ovarian cancer is discovered very late, at the moment when the illness is at a late stage, is unfavourable factor and the chances of successful treatment are diminished. Only 30% of the patients are diagnosed in the early stages when the chances of cure are higher. Usually unnoticed and quiet growth of ovarian cancer,the inaccess of ovaries during physical examination all result in high stadium of illness,usually III or IV. Cytoreductive surgery is the golden standard in treating ovarian cancer in the late stage. Its goal is to remove every microscopically visible tumor cell with five years survival in 80% of the patients. GOALS: The main goals in the research were: to establish the existence of marginal preoperative serum concentration of tumor markers CA125 and HE4, which would in most case represent the prediction of optimal primary cytoreductive surgery in the late stages of epithelial ovarian cancer and primary carcinoma of ovarian tubes. METHODOLOGY: The research was designed as a prospective study which comprised a sample of 150 patients, operated from ovarian carcinoma FIGO stages III or IV at Kragujevac Clinic for gynecology and obstetrics and Belgrade Narodni Front Clinic from 01.01.2015. to 01.10.2016. All the patients had preoperative lab analysis done, preoperative values Ca125 and HE4, the polls of the operating teams after the procedure finished, all the postoperative pathohistological results and tests checked by the oncological consilium. The excluding factors were: histopathological borderline carcinoma, recurrent ovarian tumor, metastatic ovarian tumor, the patients who were treated by chemotherapy before surgery as well as the patients whose stage of illness did not correspond to FIGO classifications between intraoperative results and the results of oncological consilium. RESULTS: In the group with optimal cytoreductive surgery there were statistically considerably more patients younger than 50 years of age- 64.7% . The observed group of patients operated from epithelial ovarian cancer and primary carcinoma of ovarian tubes, the frequency of patients younger than 50 years of age was not very different (χ2-test; p=0,744) and it was approximately the same: 48.7% was younger than 50 years of age, and 51.3% older than 50 years of age. The average of HE4 was 608,31+245,85, (mediana 551,5), and Ca 125 622,59+228,01 (mediana 640,75). The patients with ascit higher than 1000 ml were statistically more present than the patients with ascit less than 1000 ml (χ2-тест; p=0,009): 60% of the patients from this group had ascit more than 1000 ml, and 40% ascit less than 1000 ml. The number of patients of with or without lymphadenectomia, was not statistically much different (χ2-тест; p=0,191): around 55% of patients had lymphadenectomia, and around 45% did not. Statistically important difference was observed between the patients with positive and negative results in extracted lymph nodes (χ2-тест; p=0,000): 36% had positive results, and 90.3% negative. Statistically important difference was noticed in the number of patients with different sizes of the residual tumor (χ2-тест; p=0,000): the patients with the residual tumor size from 0-1 cm (45.3%) and size from 2-10 cm (39.3%) were statistically more numbered than those with residual tumor size 11-20 cm (11.3%) and larger than 20 cm (4%). Statistically important difference was noticed in the position of the residual tumor (χ2-тест; p=0,000). CONCLUSION: Important predictors of (im)possibility of performing optimal cytoreduction were: the age, HE4, Ca125, FIGO stadium, the amount of ascit, histological grade, lymphadenectomia and PH of lymph nodes

Fractals, Materials and Energy Technologies

World’s perennial need for energy yields the whole spectra of technological challenges and scientific tasks. An important stream in finding new solutions leads over materials characterized by precise microstructural architecture based on fractal geometry/analysis covering wide size ranges down to nano scale. Having such a deep geometric hierarchy opens new possibilities in energy storage capacities supported by fractal resources. These novel ideas are natural continuation of some early fractal applications have been used as a tool in energy research, applying on diverse energy technologies, from photovoltaics to fuel cells and carbon capture. All three items that are essential regarding energetic questions, free energy stocks location, energy harvesting and short/ long term energy storage have their specific common points with fractal nature. Also, the concept of energy as physical objects property, share some features characteristic to fractal objects. In other words, fractal, as a crucial concept of modern theoretical-experimental physics is tightly connected with the process of cultivating the wild energy as well. Here, the above items will be discussed. The term “geometry” as it is custom in plain language, understands “shape” rather than the science of geometry. In this sense, “geometry” describes property of hierarchy that is more present in every day’s life than we are usually aware of. Just note that all our senses often convey information on the quality of some matter by absorbing certain hierarchical order. The touch feeling of smooth or rough surface, olfactory or taste data differ by energetic level that generates according to geometry of particles or clusters that follow fractal patterns. Adjusting specific, a priori constructed fractal micro or nano architecture make the energetic flow more effective by decrease losses made by non-conformal geometry

Electrical Characteristics of Ho doped BaTiO3 Ceramics

In this paper, electrical characteristics of Ho2O3 doped BaTiO3 ceramics were shown, using new method for measuring samples. The BaTiO3 doped samples were sintered at 1320°C for 4 hours. The concentration of the additives were from 0.05 to 1.0 at% Ho. The density was ranged from 83% to 91% of theoretical density (TD). The samples of BaTiO3 ceramics doped with Ho2O3 are characterized by spherical and irregular polygonal grains. The average grain size for samples doped with low content of Ho2O3 (0.05 at% Ho) ranged from 10 μm to 30 μm. An increase in dopant concentration causes a decrease in the average grain size in the investigated samples. So it is for samples doped with 1.0 at% Ho, grain size range between less than 1 mm – 2 mm. The variation of dielectric permittivity with temperature were measured in the temperature range from 30°C to 180°C and the frequency range from 100 Hz to 1 MHz. For measurement electrical characteristic a new method was used, which implemented to automate the sampling and to enable measurement without a human factor. The software application is connected via USB communication to a microcontroller, which measures the temperature in the furnace. When the temperature reaches the defined value, the microcontroller sends information to the software application. Then the application through GPIB communication activates the LCR meter, which measures the defined parameters of the tested samples. Based on parameters such as dielectric constant (εr), tangent losses (tan δ) and impedance, the characteristics of the tested samples were determined. Using the Curie-Weiss law and modified Curie-Weiss law, based on the measured values of the parameters, the Curie constant and the exponent of nonlinearity were determined

Curie-Weiss Law Fractal Corrections and Clausius-Mossotti Equation

The Clausius–Mossotti relation emerged as a combination of the analysis of indices of refraction (by Rudolf Clausius) and the relationship between the dielectric constants of two different media (Ottaviano-Fabrizio Mossotti). Since it connects dipole’s polarizability with the electric permittivity of a material made of those dipoles, it is one of the fundamental relationship that can be derived from Maxwell’s conductivity equation. Also, it is tightly connected both the Curie and Curie–Weiss laws which are correlation relations. Using fractal approach in Curie–Weiss equation and fractal correction applied recently by the authors, the Clausius–Mossotti relation is also subjected to modification with respect to ferroelectric materials fractal nature. The correction is operationally performed by introducing fractal correction factor a0 > 1, as a multiplier to the usual dielectric constant er to gain the bigger value a0er. This shows that the Clausius–Mossotti relation is also “permeated” by fractal nature being inherited from the material’s morphology. Our experiments were carried out on BaTiO3-ceramics as characteristic representative of perovskites but the conclusions can be applied on any other ceramics materials as well as on thin film layers and coating in general. By shapes control and contact surfaces numbers on the entire BaTiO3-ceramic sample level, the control over structural properties of these ceramics can be done, with the aim of correlation between material electronic properties and corresponding microstructure. The fractal correction has wide consequences on many phenomena like PTC, ferroelectrics, ferromagnetics, piezo- and optoelectronic properties as well as electrochemical thermodynamic and fluid dynamics parameters

CHARACTERISTICS OF CURCUMIN DYE USED AS A SENSITIZER IN DYE-SENSITIZED SOLAR CELLS

Dye-sensitized solar cells are the closest mankind has come to replicating nature’s photosynthesis. The type of a dye influences the efficiency of these cells. In this paper we studied curcumin dye as a sensitizer in dye-sensitized solar cells and compared it with most often used cyanidin. The results have shown that curcumin has higher efficiency and higher absorption in the visible part of the spectrum compared to cyanidin. Simulation models of dye molecules, curcumin and cyanidin, are deprotonated upon adsorption on the titanium dioxide surface. The energy levels obtained from the calculation indicate a higher probability of electron transition from molecule to titanium dioxide surface in case of curcumin than in case of cyanidin. Based on these results, we concluded that curcumin dye has better properties as sensitizer in dye-sensitized solar cells

Quantitative metallography modern metods

This paper has been concerned with the classical Stereological targets V, S, L, and N only, namely with so-called first-order properties. Stereology is now drifting rapidly toward second-order methods, aimed at quantifying spatial pattern for the elements of a structure (e.g. clustering, repulsion, etc., between the elements) as well as the nature and degree of association between different structures. Second-order statistical methods are widely available for point patterns. Important devices for the second-order analysis of cells and organelles when regarded as points in space have recently been devised. Analogous methods extend to higher dimensional quantities such as surface areas and volumes

Fractal nature Heywang model correction and Brownian motions

Ceramics grains contacts are essential for understanding complex dielectric properties of electronic ceramics materials. Since the actual contact surface is an irregular object, the theory of fractal sets is applied. Also, the Heywang model of intergranular capacity are introduced as a basic idea for relations with fractal structure. The BaTiO3-ceramics has fractal form in, at least, two levels: shapes and distributions of grains and intergranular contacts. Using fractal modeling approach, reconstruction of microstructure, like shapes of grains or intergranular contacts can be successfully done. Furthermore, the area of grains surface is calculated by using fractal correction that expresses the irregularity of grains surface through fractal dimension. It is known that BaTiO3 and similar ceramics have fractal nature based on three different phenomena. First, there is process of Brownian-fractal motions inside the material during sintering in the form of flowing micro-particles –ions, atoms, electrons which is an essentially fractal phenomena. This motion has fractal structure and can be undergo the process of fractal modification. Second, there are so called “negative space” made of pores and intergranular space. Being extremely complex, the pore space plays an important role in microelectronic, PTC and other phenomena. Third, ceramic grains have fractal shape seeing as a contour in cross section or as grain’s surface. These triple factors, in combination, make the microelectronic environment of very peculiar electro-static and dynamics microelectronic environment. In order to obtain an equivalent circuit model, which provides a more realistic representation of the electronic materials electrical properties, in this article an intergranular contacts model for the BaTiO3 electrical properties characterization were determined and implemented. Considering obtained results, the directions of possible BaTiO3-ceramics materials properties prognosis are determined according to the correlations synthesisstructure- properties

Material characterization SEM modern methods

Detailed analysis was carried out and systematization of methods used in the characterization of materials using SEM. We analyzed its operation. Attention was paid to its major parts. Specially to the electron gun and lens. Also, comparisons of forming character oprickim microscope and SEM. In further analysis we have studied differences between EDS and WDS.. The EDS features measurement with a small probe current, short-time acquisition of spectra, etc. WDS features a high energy (wavelength) resolution, detection of trace elements. Most SEMs are equipped with an EDS, whereas a WDS is generally used as an Electron Probe Microanalyzer (EPMA) that mainly performs elemental analysis

New trends in the development of battery

Among civilized priorities and challenges for humanity, energy occupies the most important and certainly the most attractive place in terms of research as well as in scientific and technological developments. The question of energy, in relation trinity energy-materials-information (EMI) is directly correlated with the triad of the synthesis (the technological process of obtaining materials)- structure of- material properties (srb. sinteza-struktura-svojstva materijala (SSS)). Storage of energy (electricity, heat, cooling energy ...) is an important issue and a weak point in the energy sector. Fossil fuels provide the internal storage of energy which is not the case for wind, solar, etc. The nanostructure of materials can be a useful for the storage of heat or for the isolation of heat storage. Storing electrochemical energy is widely applied, especially in portable devices, which are mainly related to the battery. Li, as the material is the most used because it is the lightest metal and has a very high energy density. Due to the lack of lithium in the United States, and the world, new research substitute lithium for magnesium ions, for already listed battery system. These studies are done at the Illinois State University, in Chicago. After the commercialization of lithium-ion battery research for the cathode active material concentrates on lithium that contains at the forefront the transition-metal oxides with a 4V class high electromotive force because it can serve as a lithium of carbonic negative electrode. Unfortunately all classes 4V rechargeable cathode: LiCoO2, LiNiO2, LiMn2O4, have a core problem of costs and environmental impact, because their cathodes include the use of rare metals such as redox center. The problems become more serious, especially for the most expensive LiCoO2, with further expansions of the market for electric vehicles, which are expected in the near future