A randomized trial of cisplatin, etoposide and bleomycin (PEB) versus carboplatin, etoposide and bleomycin (CEB) for patients with 'good-risk' metastatic non-seminomatous germ cell tumors

BACKGROUND: Cisplatin-based combination chemotherapy will cure 70% to 80% of patients with metastatic non-seminomatous germ cell tumors but is associated with the possibility of severe neuro-, oto- and nephro-toxicities. Carboplatin, a cisplatin analogue, is an active drug in testicular cancer with a more favourable spectrum of side effects. In a randomized trial, the German Testicular Cancer Study Group compared a combination regimen of carboplatin, etoposide and bleomycin (CEB) to standard cisplatin, etoposide and bleomycin (PEB) chemotherapy for patients with 'minimal-' and moderate-disease' non-seminomatous germ cell tumors, according to the Indiana University classification. PATIENTS AND METHODS: PEB was given for three cycles at standard doses (given days 1-5), and the CEB regimen consisted of carboplatin (target AUC of 5 mg/ml x min) on day 1, etoposide 120 mg/m2 on days 1 to 3 and bleomycin 30 mg on days 1, 8 and 15. Four cycles of CEB were given, with the omission of bleomycin in the fourth cycle. Thus, the cumulative doses of etoposide and bleomycin applied in the two treatment arms were comparable. Fifty-four patients were entered on the trial, 29 were treated with PEB and 25 with CEB chemotherapy. Patients were stratified according to disease extent (minimal versus moderate) and the degree of tumor marker elevation. Thirty-two patients (59%) belonged to the group with minimal disease and low markers. RESULTS: No significant difference in response to chemotherapy was seen between the two arms, with CR rates of 81% for the PEB arm and 76% for CEB treatment. However, more patients treated with CEB (32% versus 13%) have relapsed after therapy, and 4 patients (16%) have died of disease progression after CEP in contrast to 1 (3%) after PEB therapy. The first interim analysis of negative events (relapse, vital tumor at secondary resection, death from disease and therapy-associated death) showed a significantly higher rate after CEB than after PEB therapy, and the trial was terminated early. After a median follow-up of 33 months for all patients, the calculation of negative events is still significantly in favour of PEB-treated patient, particularly since three late relapses > 2 years have been observed in the CEB arm (P = 0.03). CONCLUSION: This randomized trial demonstrates that even with the use of adequate doses of etoposide and full-dose bleomycin, carboplatin cannot altogether replace cisplatin in patients with testicular cancer. Treatment with the PEB regimen remains the standard approach in patients with 'good-risk' non-seminomatous germ cell tumors.     

Investigation for long wavelength fir laser lines for EPR studies: New lines from CH2=CF2

The results described in this work are part of a systematic search for long wavelength laser lines to be used in high magnetic field EPR applications and in plasma diagnostic. Four new far-infrared laser lines of CH₂ = CF₂ (1,1 difluoroethylene), optically pumped by a waveguide CO₂ laser, have been discovered and characterized in wavelength, polarization relative to the pumping radiation and offset relative to the CO₂ center frequency. New measurements of polarization and offset of 5 already known laser lines are also reported. A table of all of the known CO₂ pumped FIR laser lines from this molecule is given.     

Empowering a society of future users of information technology: a longitudinal study of an application in early education

This paper presents a six-year study of the use of computers in a Greek primary school, based on the premise that, in contrast to current technocentric views regarding the use of information technology in the Greek educational system, computers can be used as tools for self-enhancement. The aim of the school project was to infuse a child-centred pedagogy, through the learning of Logo programming, into the whole of the school's society, i.e. all children and all teachers. Within this context, we have identified and explored how children may learn programming through a process of forming ‘naive’ or locally applicable theorems concerning key programming ideas such as the use of primitives, structuring a problem by means of writing procedures, and constructing and working with generalised notional objects by means of defining procedures with variable inputs. We discuss the emerging interrelated educational and technological aspects concerning this kind of learning, and then set these against the challenge to exploit the developing technology further in order to design expressive media of increasing flexibility and power, and to focus on specific learning domains.     

Tree-structured piecewise linear adaptive equalization

The use of a tree-structured piecewise linear filter as an adaptive equalizer is proposed. In the tree equalizer, each node in a tree is associated with a linear filter restricted to a polygonal domain, and each subtree is associated with a piecewise linear filter. A training sequence is used to adaptively update the filter coefficients and domains at each node, and to select the best subtree and corresponding piecewise linear filter. The tree-structured approach offers several advantages. First, it makes use of standard linear adaptive filtering techniques at each node to find the corresponding conditional linear filter. Second, it allows for efficient selection of the subtree and corresponding piecewise linear filter of appropriate complexity. Overall, the approach is computationally efficient and conceptually simple. Numerical experiments are performed to show the advantages of tree-structured piecewise linear and piecewise decision feedback equalizers over linear, polynomial, and decision feedback equalizers for the equalization of channels with severe intersymbol interference     

Accurate and efficient computation of dielectric losses inmulti-level, multi-conductor microstrip for CAD applications

An approach to accurate and efficient computation of dielectric losses in complex microstrip structures is proposed. It can be used in lieu of lossy, full-wave solutions to provide accurate and efficient data for the CAD of multilevel, multiconductor MIC and MMIC structures. Results that are as accurate as lossy full-wave techniques over a wide range of frequencies, including the dispersive region, are obtained. In addition to providing accurate results, the method is up to three times faster, depending on the number and type of substrates or superstrates. Results for various multiconductor, multilevel structures that compare well with the lossy, full-wave approach and require significantly less computer time to compute are shown     

Noninvasive real-time multipoint temperature control for ultrasoundphased array treatments

A method for noninvasively estimating spatiotemporal temperature changes in samples using diagnostic ultrasound, and using these as inputs to a multipoint ultrasound phased array temperature controller, is presented in this paper. This method is based on a linear relationship between the apparent tissue echo pattern displacements and temperature, as seen along A-lines acquired with diagnostic ultrasound when the sample is heated by external heating fields. The proportionality constant between echo displacement and temperature is determined by the local change in speed of sound due to temperature and the linear coefficient of thermal expansion of the material. Accurate estimation of the displacements and proportionality constant yields accurate calibrated high-resolution (1 mm spatial, sub-°C) noninvasive sample temperature estimates. These are used as inputs to a multipoint temperature controller, capable of controlling ultrasound phased array treatments in real-time. Phantom and in vitro results show that the noninvasively estimated temperature values can effectively be used to control ultrasound hyperthermia treatments, almost replacing invasive thermocouple measurements. The mathematical background and assumptions of the noninvasive temperature estimator and the controller are presented in this paper, together with experimental results showing estimator and controller performance and limitations. To the best of our knowledge, this paper presents the first demonstration of real-time treatment control based entirely on noninvasive temperature estimates     

A vibrating-tube densimeter for fluids at high pressures and temperatures

A vibrating U-tube apparatus has been developed for determining the densities of pure fluids and fluid mixtures at 10-200 MPa and 323-773 K. Measured parameters areP,T, andr (period of vibration). Fluids are injected into the U-tube at constantP andT. Three or more reference fluids are used to calibrate the response of the instrument. Fluid mixtures are produced by pumping pure fluids into T-junctions on the upstream side of the U-tube using high accuracy syringe pumps. An automated syringe pump is used to maintainP at setpoint ±0.01 MPa.T is controlled to ±0.01 K using a closed-loop, electronic signal amplification/feedback system. For mixtures, a statistically significant number of measurements of r are obtained to account for the effects of small heterogeneities in fluid composition (generally <0.005X;). Typically, density data for 15 fluids can be obtained in a 6- to 8-h period. Considering all of the potential sources of error in the experimentation, conservative estimates of uncertainty are as follows:P, ±0.02 MPa;T, ±0.05 K;p (pure fluids), ±0.0005g.cm^–3; andp (fluid mixtures), ±0.0005-0.0010g-cm^–3.Paper presented at the Twelfth Symposium on Thermophysical Properties, June 19–24, 1994, Boulder, Colorado, U.S.A.     

A histological and histomorphometrical evaluation of screw-type calciumphosphate (Ca-P) coated implants; an in vivo experiment in maxillary cancellous bone of goats

The bone response to different calcium phosphate (Ca-P) coated implants was evaluated in a goat animal model. Two types of plasma spray coatings were applied to a commercially pure titanium (cpTi) tapered, conical screw-design implant (BioComp^®); hydroxyapatite (HA-PS) and a dual coating, consisting of FA and HA (FA/HA-PS). In addition an amorphous RF magnetron sputter coating (Ca-P-a) and uncoated implants were investigated. Forty-eight implants were inserted in the maxilla of 12 adult female goats. After implantation periods of 3 and 6 months, the bone implant interface was evaluated histologically and histomorphometrically. After both implantation periods all plasma spray coated implants were maintained. On the other hand three Ca-P-a and two cpTi implants were lost. Histological examination revealed a better bone response to both plasma spray coated implants. Histomorphometrical evaluation confirmed this finding. At 3 and 6 months significantly higher percentages of bone contact (p<0.001, ANOVA) were measured for both plasma spray coated implants than for the cpTi and Ca-P-a implants, while no significant difference (p<0.05) existed between both implantation periods. Degradation of both plasma spray coatings was observed. Supported by the results, it is concluded that, although Ca-P coatings can improve the performance of dental implants, the presence of a Ca-P coating is not the only important factor for bone healing around implants placed in low density trabecular bone.     

Optimization of the properties obtained by quenching in martensitic stainless steels X30-40Cr13 and X40-60CrMoV14

An experimental study of the effects produced by different parameters of the heat-quenching cycle permitted the optimization of the properties typical of these martensitic stainless steels: hardness and corrosion resistance. The results obtained demonstrate that the heating temperatures currently used in industrial quenching treatment of these steels should be modified.