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PURPOSE: Despite aggressive surgery and postoperative radiation therapy, only 30% of patients who have advanced, potentially resectable carcinomas of the head and neck survive for 5 years. In the hope of improving this situation we studied the effect of postoperative radiotherapy delivered concurrently with cisplatin. METHODS AND MATERIALS: Patients who had Stage IV tumors and/or involved surgical margins received 60 Gy in 30 fractions over 6 weeks plus 100 mg/m2 of cisplatin on radiotherapy days 1, 23 and 43. Fifty-two patients participated in this trial and 51 were evaluated. Forty-three (84%) patients had pathologic T3 or T4 disease, 43 (84%) had Stage IV disease, and 27 (53%) had histologically involved surgical margins. RESULTS: Severe and life-threatening toxicities occurred in 20% and 12% of patients, respectively; the most common drug-related toxicities were leukopenia, anemia, nausea, and vomiting. Seventeen patients (43%) remain alive with no evidence of disease. Four patients (8%) died with no evidence of neoplastic disease, and one patient has died of a second independent malignancy. By actuarial analysis at 3 years, 48% of patients are alive, 81% have locoregional control of disease, and 57% are free of distant metastases. CONCLUSIONS: Based on comparison with similar patients treated in a prior Radiation Therapy Oncology Group/Intergroup trial (RTOG), we conclude that postoperative radiotherapy with concurrent cisplatin may improve locoregional control rates and should be prospectively tested.  相似文献   
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Predicting crack growth under cyclic loading in applications usually requires the efficient extraction of stress intensity factors from finite element analyses of mixed mode situations. Two approaches to this end are examined: one, a competitive fitting procedure using crack-flank displacement data, the other, a path independent integral which can readily distinguish between modes. A protocol is established for comparing the two on a set of about forty test problems which have exact solutions. Analysis is via quarter point elements on a common sequence of three successively refined meshes for each problem. Results show that the path independent integral is more consistently accurate and reliably convergent, yet comparable in implementation effort.  相似文献   
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The blind mole rat, Spalax, is a subterranean rodent with atrophied, subcutaneous eyes. Whereas most of the visual system is highly degenerated, the retino-hypothalamic pathway in this species has remained intact. Although Spalax is considered to be visually blind, circadian locomotor rhythms are entrained by the light/dark cycle. In the present study we used anterograde tracing techniques to demonstrate retinal afferents to the suprachiasmatic nucleus (SCN) and immunohistochemistry to examine the distribution of neuropeptides that are known to be involved in the regulation or expression of circadian rhythmicity. Based on the localization of retinal afferents and neuropeptides, the SCN can be divided into two subdivisions. The ventral region, which receives retinal afferents, also contains vasoactive intestinal polypeptide (VIP)-containing neurons, and fibers that are immunopositive to neuropeptide Y (NPY) and serotonin (5-HT). The dorsal region contains vasopressinergic neurons, but this latter cell population is extremely sparse compared to that described in other rodents. The dorsal region is also characterized by numerous VIP-immunoreactive fibers. The presence of NPY and 5-HT fibers suggests that the SCN receives afferent projections from the intergeniculate leaflet and from the raphe nuclei, respectively. These neuroanatomical results, together with previous studies of behavior, visual tract tracing, and immediate early gene expression, confirm that an endogenous clock and the capacity for light entrainment of circadian rhythms are conserved in the blind mole rat.  相似文献   
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Two studies examined the relationship between the content of a self-threat and the attractiveness of available self-affirmations (C. M. Steele, 1988). After self-threat was induced by means of a cognitive dissonance procedure, participants' choices for affirmations were examined in order to explore whether the attractiveness of a given affirmation depends on its relevance to the threatened domain of the self-concept. The authors hypothesized that when faced with a threat to a specific self-conception or standard, individuals may forego affirmations within the threatened self-concept domain in favor of affirmations of unrelated, compensatory domains. Both studies supported this hypothesis and further suggested that such selective self-affirmation can lead individuals to modify their self-concepts by identifying with self-aspects that justify dissonant behavior and by disidentifying with the standards that such behavior violates. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   
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Two near-infrared spectroscopy (NIRS) methods are available for measuring changes (Delta) in total cerebral hemoglobin concentration (CHC): 1) a continuous measurement of the changes in total hemoglobin concentration (Delta[Hb]tot) and 2) the difference between two absolute measurements of CHC, each derived from a small, controlled change in inspired O2 fraction. This paper investigates the internal consistency of these two methods by using an experimental and theoretical comparison. NIRS was used to measure [Hb]tot in five newborn piglets before and after a change in arterial PCO2. Delta[Hb]tot demonstrated a low coefficient of variation of 2.8 +/- 2.8 (SD) % which allowed changes in CO2-cerebral blood volume reactivity to be clearly discriminated. However, a high coefficient of variation of 22.8 +/- 3.5% on the DeltaCHC measurements obscured any CO2 reactivity changes. A theoretical analysis demonstrates the effects of optical pathlength, background absorption, scatter, and blood vessel diameter on both methods. For more accurate monitoring of CHC, individual measurements of optical pathlength and more accurate pulse oximetry are required.  相似文献   
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Awareness of fast transient events in the electrical power environment has increased with the release of related test standards (ANSI C37.90.1 and IEC 801-4) and with increased usage of solid state circuits in utility equipment. Reliable measurement of the fast transient test waveforms and repeatable performance of test setups are persistent problems for equipment manufacturers and users. The construction, characterization, and usage of two high voltage test dividers for measurement of fast transient test waveforms are described. Measurements on a C37.90.1 (SWC) test generator are presented along with tutorial background. Proposals for changes to the ANSI C37.90.1 specification are included  相似文献   
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Comments on K. S. Pope and V. A. Vetter's (see record 1992-25072-001) survey results on ethical dilemmas faced by members of psychology organizations. The author notes 2 specific concerns about psychology organizations accepting financial sponsorship from organizations that financially benefit from the sponsorship: the potential for a conflict of interest and the financial burden on the clients of psychology organizations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   
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