Postoperative radiation for squamous cell carcinoma metastatic to cervical lymph nodes from an unknown primary site: outcomes and patterns of failure

BACKGROUND: This retrospective study assesses the outcomes and patterns of failure in patients with squamous cell carcinoma metastatic to cervical lymph nodes from an unknown primary site treated with combined surgery and postoperative radiotherapy. METHODS: One hundred thirty-six patients with squamous cell carcinoma metastatic to cervical lymph nodes from an unknown primary source were treated postoperatively with radiotherapy at the University of Texas M. D. Anderson Cancer Center between the years 1968 and 1992. Stage distribution was: N1, 31 patients; N2a, 49; N2b, 25; N2c, 3; N3, 18; and Nx, 10. Thirty-nine patients had excisional biopsies only, 64 patients underwent modified neck dissections, and 33 had radical neck dissections. Extracapsular extension was present in 87 cases. Fifty-nine patients had multiple nodes involved. The median duration of follow-up for surviving patients was 8.7 years. RESULTS: Twelve patients, all with extracapsular nodal disease, developed regional relapse. The 5-year actuarial rates of regional relapse in patients with and without extracapsular nodal disease were 16% and 0%, respectively (p = .004). Nine patients (22%) with extracapsular disease and multiple nodes relapsed compared with three patients (7%) with extracapsular disease and a solitary node (p = .02). None of the patients treated with excisional biopsy and radiotherapy relapsed regionally. No statistically significant relationship between dose, treatment duration, time interval between surgery, and the start of radiotherapy and relapse was detected. The 2-, 5-, and 10-year actuarial disease-specific survival rates were 82%, 74%, and 68%, respectively. Fourteen patients developed cancers in head and neck mucosal sites; six of these cancers were located in unirradiated tissues. CONCLUSIONS: Relapse occurred infrequently in patients treated with excisional biopsies and postoperative radiotherapy. Extracapsular extension and multiple nodes were associated with worse regional control and disease-specific survival. These results appear consistent with those expected for patients with advanced neck disease and a known primary site, and the absence of a primary site should not exclude patients from studies aiming to improve outcomes in patients with extensive neck disease from a head and neck squamous cell cancer. We continue to recommend radiation to the necks and pharyngeal axis for patients suspected of having residual microscopic disease following surgery for squamous cell carcinoma metastatic to the neck from an unknown primary site.     

Potential reasons for software employees in small companies toleave their present company

Three hundred fifty-nine software professionals in 11 software companies of different size categories were studied in terms of potential reasons for leaving their present company. The most important reasons for the sample as a whole were salary, more experience, more interesting and challenging work, need for a change, and promotion. Those people in the companies with less than 50 people were significantly more likely to want to leave to run their own company, go to a more successful company, or obtain an equity stake, or because their present company was getting too large. Those in larger companies were significantly more likely to want to leave to obtain promotion, because the present company were getting too large, or to obtain more challenging work. These results support previous findings and also suggest that research criteria for smaller companies should include characteristics associated with the effects of different organizational size. The implications for managers suggest that the particular demands of those with a small-organization rather than a large-organization mentality need to be taken into account     

Teaching severely self-abusive and aggressive autistic residents to exit to fire alarms

Fifty-two case-hardened, severely self-abusive and aggressive autistic and retarded students, living in six different community residences, were trained to exit their residences, without the presence or assistance of staff, when a fire alarm sounded at night. On a pretest, prior to an 11-week period of intensive environmental and behavioral interventions, only 25% of the students exited within 2 1/2 minutes and independent of staff assistance. At posttest, 100% exited successfully, in a mean evacuation time of 60 seconds. The study was conducted at the Behavior Research Institute (BRI).     

Seminar planning guidelines. As I see it

Small local chapter groups can present quality cost effective regional seminars. Key components are dedication of members, teamwork, and a sense of direction. The following guidelines and information can provide a framework for planning and coordinating a seminar.     

Excretion of a radiolabelled anticancer biodegradable polymeric implant from the rabbit brain

The elimination of a clinically used anticancer biodegradable polymer implant (Gliadel) in the rabbit brain was studied. The implant is composed of N,N-bis(2-chloroethyl)-N-nitrosourea (BCNU) (1.6 wt%) dispersed in a copolyanhydride matrix of 1,3-bis(p-carboxyphenoxypropane) (CPP) and sebacic acid (SA) in a 20:80 molar ratio. Four groups of rabbits were implanted with wafers loaded with BCNU, one in a 14C-SA-labelled polymer, another in a 14C-CPP-labelled polymer and two groups with 14C-BCNU in a non-labelled polymer, one for BCNU disposition study and one for residual drug study. In the rabbits implanted with the 14C-SA-labelled polymer, approximately 10% of the radioactivity was found in the urine and 2% in the faeces, and about 10% remained in the device 7 d after implantation. In contrast, only 4% of the radioactivity of the 14C-CPP-labelled polymer was found in urine and faeces during this period. However, a drastic increase in the CPP excretion was found after 9 d, and at 21 d, 64% of the implanted 14C-CPP was found in the urine and faeces, and 29% was still in the recovered wafers. Approximately 50% of the BCNU in the wafers was released in 3 d, and over 95% was released after 6 d in the rabbit brain. This study demonstrates that BCNU-loaded polyanhydride is biodegradable and is excreted from the body primarily through the renal system. The water-soluble components SA and BCNU were rapidly excreted, while the insoluble CPP was gradually eliminated after a lag time of 9 d.     

3-D Reconstruction of the Heart from Few Projections: A Practical Implementation of the McKinnon-Bates Algorithm

The implementation of a method for improving the quality (by reducing artifacts) of images reconstructed from small numbers of projections is described. The technique is based on an algorithm originally proposed by McKinnon and Bates [1] and includes enhancements suggested by Heffernan and Robb [2]. Emphasis is placed on practical aspects of algorithm implementation, including important noise-suppressing refinements not previously incorporated into the algorithm. The efficacy of the method is demonstrated using actual X-ray projection data of the intact beating heart recorded with the Mayo Clinic's dynamic spatial reconstructor. The implications of improved "stop-action" reconstruction of the heart are considered in the context of additional objectives, including automatic object recognition and definition, and improved four-dimensional reconstruction of the beating heart.     

A constant-volume gas pump for gas electrodes

A pump suitable for use with gas electrodes, in which recirculation of the gas is necessary, is described. The system to which the cell with the gas electrode and the pump are connected does not change its volume when the pump is in operation. The pump works as follows: an embolus, consisting of a Tefloncoated magnetic stirring bar, placed inside a glass tube having an internal diameter slightly larger than the diameter of the bar, is moved from the outside with a permanent magnet, which in turn is moved horizontally along the tube by means of a mechanical assembly driven by an electric motor. The motion of the embolus is accompanied by the closing and opening of glass valves which allow the gas to circulate in the desired direction. The pump, used in conjunction with a vacuum line, operates from pressures as low as 60 Torr to above atmospheric pressure. The operation of the pump is unaffected by organic gases and most inorganic gases.     

Numerical simulations of failure behavior around a circular opening in a non-persistently jointed rock mass under biaxial compression

Pre-existing discontinuities change the mechanical properties of rock masses,and further influence failure behavior around an underground opening.In present study,the failure behavior in both Inner and Outer zones around a circular opening in a non-persistently jointed rock mass under biaxial compression was investigated through numerical simulations.First,the micro parameters of the PFC^3D model were carefully calibrated using the macro mechanical properties determined in physical experiments implemented on jointed rock models.Then,a parametrical study was undertaken of the effect of stress condition,joint dip angle and joint persistency.Under low initial stress,the confining stress improves the mechanical behavior of the surrounding rock masses;while under high initial stress,the surrounding rock mass failed immediately following excavation.At small dip angles the cracks around the circular opening developed generally outwards in a step-path failure pattern;whereas,at high dip angles the surrounding rock mass failed in an instantaneous intact rock failure pattern.Moreover,the stability of the rock mass around the circular opening deteriorated significantly with increasing joint persistency.     

买张扩展卡 USB3.0带回家

USB3.0的理论带宽为4.8GB/s,也就是说,它拥有500MB/s左右的理论双向传输速度,比USB2.0快10倍以上。随着厂商们的积极投入,USB3.0接口设备的价格也逐渐下降,目前一款USB3.0接口的移动硬盘售价大概在600元上下。     

应用为王 价值优先——技嘉全新主板应用技术详解

主板是所有主机内部硬件的载体,所以说每个硬件跟它都有非常密切的联系。如果主板只能提供芯片组原有的基本功能,那么一线大厂和普通的通路厂商就没有任何区别了。主板要给用户带来的是一套整体的解决方案,它不仅要利用主板自身的功能和特点,更应该高效、合理地结合插在主板上的各种硬件,更方便、更高效、更人性化地为它的用户服务。