Organ preservation in anal and rectal cancers

For the past 10 to 15 years, radiation therapy and chemotherapy have played an increasingly important role in the treatment of various gastrointestinal malignancies, most prominently in anal and rectal cancer. Critical issues in the care of patients with anal and rectal cancer include not only local control and survival but organ preservation as well. For patients with carcinoma of the anal canal, external-beam irradiation with 5-fluorouracil and chemotherapy with mitomycin C have replaced surgery as primary therapy. Current studies are optimizing this therapy. In contrast, the management of distal rectal cancer is in evolution. Although the abdominoperineal resection has been long regarded as the definitive treatment of distal rectal cancer, it is associated with substantial morbidity (loss of anorectal function with a permanent colostomy and a high incidence of sexual and genitourinary dysfunction). As an alternative, treatment programs utilizing sphincter-preserving procedures with radiation therapy and chemotherapy are under active investigation. In selected patients, these strategies appear promising, and there have been reports of satisfactory local control and survival, as well as preservation of sphincter integrity.     

Gyrotron coaxial cylindrical resonators with corrugated innerconductor: Theory and experiment

Gyrotron coaxial resonators with a longitudinally slotted inner cylinder are examined analytically using a surface impedance model, from which expressions for the electromagnetic field, ohmic quality (Q) factor, and characteristic equation of the transverse eigenvalues χ _m,p are obtained. The major attributes of such resonators are expressed by the dependence of χ_m,p on the parameter C-defined as the ratio of the outer to inner radii of the coaxial structure. In that connection, the effect of the corrugation parameters on χ_m,p is particularly investigated on the basis of an expression derived for the slope function dχ_m,p,p/dC. It is shown that the χ_m,p(C) curve may either exhibit oscillatory behavior or present a flat portion over a wide range of C depending on the corrugation parameters chosen. The theory is checked against experiment in which resonant frequencies and total Q factors were measured for TE modes operating in the range of 8-16 GHz in a coaxial cavity with 40 slots. Good agreement is found in that the magnitude of the relative error in frequency is less than 0.5%. Corrugated coaxial resonators prove to be relevant to megawatt gyrotrons where highly selective cavities are required to ensure high conversion efficiency     

A predictive model for matrix and analyte effects in electrospray ionization of singly-charged ionic analytes

In electrospray ionization (ESI), droplets with a surface excess charge are created. The rate of production of surface excess charge is a constant and is equal to the rate of ion production. The ions appearing in the mass spectrum are postulated to be those that formed the surface excess charge at the time of droplet formation (or their collision products). An equilibrium model based on competition among the ions in the solution for the limited number of excess charge sites has been developed. This model accurately predicts the response curves of singly-charged ionic analytes as a function of the concentration of electrolyte and other analytes and provides an explanation for the selective effectiveness of ESI. At low concentrations of total analyte (micromolar and less), the response curves are linear, indifferent to the presence of other low concentration analytes, and suppressed by electrolyte concentrations in excess of the minimum required. At higher analyte concentrations, the response becomes independent of analyte concentration but highly affected by the presence of other analytes.     

Response of Plasmodium falciparum to chloroquine and Fansidar in vivo and chloroquine and amodiaquine in vitro in Uganda

The response of P. falciparum to chloroquine and pyrimethamine-sulfadoxine in vivo and chloroquine and amodiaquine in vitro was investigated in parasitaemic school children from six locations. Mean parasite sensitivity to chloroquine at day 7 was 74% (range 61-97) with parasite clearance rates between 2-3 days and complete defervescence in 85% of febrile children. Sensitivity declined in the four sites followed up to day 14 to 45% (range 37-53). Parasites were significantly more sensitive to pyrimethamine/sulfadoxine at 5/6 sites (100% day 7) but 5% of subjects became parasitaemic by day 14. In vitro isolates were significantly less sensitive to chloroquine than to amodiaquine with a mean 99% effective concentration of 348 mumol/L compared to 6.44 mumol/L. Clearly the role of chloroquine as the primary therapy for uncomplicated P. falciparum malaria should be reconsidered especially in the light of increasing disease severity and resurgence. Amodiaquine may be suitable alternative with pyrimethamine/sulfadoxine as second line and for more severe malaria prior to referral. The cost of alternative antimalarials and the dynamic and deteriorating pattern of resistance are powerful arguments for more objective slide diagnosis to minimise drug pressure and a regular drug sensitivity surveillance system. We believe that the latter should concentrate on measuring clinical drug efficacy in symptomatic outpatients rather than in asymptomatic children while the former needs more pragmatic and economical strategies possibly centred on seasonality and risk.     

Coupling GIS with Hydrologic and Hydraulic Flood Modelling

Geographic Information Systems (GIS) have been recognised as a powerful means to integrate and analyse data from various sources in the context of comprehensive floodplain management. As part of this comprehensive approach to floodplain management, it is very important to be able to predict the consequences of different scenarios in terms of flooded areas and associated risk. Hydrologic and hydraulic modelling plays a crucial role and there is much to gain in incorporating these modelling capabilities in GIS. This is still a rather complex task and research is being done on the full integration of these models. Interfacing between these models and GIS may be a very efficient way of overcoming the difficulties and getting very good results in terms of engineering practice. This paper presents results based on the use of Intergraph GIS coupled with Idrisi GIS. Using these two systems substantially increased the flexibility of using GIS as a tool for flood studies. A lumped (XSRAIN) and a distributed (OMEGA) hydrologic models were used to simulate flood hydrographs. The well known HEC-2 Hydraulic model was used to compute flooded areas. These models were applied in the Livramento catchment with very good results. The computation of flooded areas for different flood scenarios, and its representation in GIS, can be used in the assessment of affected property and associated damages. This is a very useful GIS-based approach to floodplain management.     

Compulsory notification of cysticercosis in Ribeir?o Preto-SP, Brazil

Cysticercosis is a severe public health problem in several regions of Asia, Africa and Latin America. Epidemiologic studies based on the frequency of cases observed in specialized neurology, neurosurgery and computed tomography services, at autopsy and in seroepidemiologic studies do not permit the determination of the true prevalence of the disease in the population. The objective of the present study was to investigate the prevalence of cysticercosis by compulsory notification. The coefficient of prevalence was 54 cases/100,000 inhabitants in the municipality of Ribeir?o Preto. The results also indicated that cysticercosis is not under control in our region since 21% of cases presented the active form of the disease. Compulsory notification proved to be a valuable resource for the epidemiologic study of cysticercosis, also permitting the mapping of more affected areas for a better direction of prevention strategies.