Medullary thyroid carcinoma: genetic advances, treatment recommendations, and the approach to the patient with persistent hypercalcitoninemia

Medullary thyroid cancer is a tumor of the thyroid C cells that occurs in sporadic and hereditary clinical settings. Genetic testing of at-risk individuals is available and has been applied to patient management. Plasma calcitonin levels are a sensitive marker for the presence of disease. Surgery offers the best hope for cure and also is an effective modality for managing metastatic and recurrent disease.     

Throughput of a satellite channel communication

Summary The throughput of a satellite channel communication is depending upon the link protocol. It is well known that the classical HDLC protocol is inadequate when applied to satellite links instead of short terrestrial links. Several modifications have been proposed to overcome this problem. The present paper gives an analysis and evaluation of a new class of protocols called Virtual Subchannel schemes which splits the satellite link into several components; these subchannels are assigned for transmission in cyclic order and are controlled independently of each other by the classical HDLC procedure.     

Finite canonical rewriting systems for congruences generated by concurrency relations

WhenC is a concurrency relation on alphabet , then ^*/= _C is a free partially commutative monoid. Here we show that it is decidable in polynomial time whether or not there exists a finite canonical rewriting systemR on such that the congruences _R ^* generated byR and = _C induced byC coincide. Further, in case such a systemR exists, one such system can be determined in polynomial time.     

Catalytic steam gasification of graphite: Effects of calcium,strontium, and barium with and without sulfur

Alkaline earths strongly catalyze steam gasification of graphite. The catalytic effect increases in the order Ca < Sr < Ba. Reaction rates of graphite impregnated with 0.3 at.% Ba are 500 times larger than those of pure graphite. Catalysis is due to the participation of additional reaction sites, not to a lowering of the true activation energy. It follows from kinetic data, electron microscopic observations, and theoretical considerations that the efficiency of the catalysts is closely related to their ability to coat a carbon surface and to continue contact with carbon atoms emerging from the bulk. In the presence of sulfur, severe, but not complete, catalyst deactivation occurs. This poisoning is to a large degree reversible.     

Einfluß von Lösungsmitteln auf den Partikeldurchmesser von Dispersionen anionischer Polyurethanionomerer

Aqueous dispersions of anionic polyurethanes were prepared by reaction of polyethers, 1,6-hexamethylene diisocyanate, 1,2,4-benzenetricarboxylic acid anhydride and triethyl amine. Formation of the dispersion was achieved by phase reversal or by precipitation. Phase reversal occurred when the solution or the melt of the polymer was treated with water, while precipitation took place when the solution was stirred into water. The amount of acetone used has an effect on the mean particle diameter, D?_T, obtained by turbidity measurements. There was an optimal acetone concentration at which D?_T reached a minimum. A similar effect was observed when tetrahydrofuran, 2-butanone or acetonitrile were used as solvents instead of acetone. When the dispersion was formed by precipitation, only adequately diluted acetonic solutions formed colloidal dispersions, while concentrated solutions gave dispersions with a broad particle size distribution.     

Solving multicolumn equilibrium stage operations by total linearization

An efficient, reliable and easily programmed method for solving systems of equilibrium stage separation devices is described. The method is an extension of an algorithm developed by Ishii and Otto⁽⁹⁾ for single columns. It solves all equations simultaneously, takes advantage of the basic tridiagonal matrix form form of the linearized steady state equations and can handle configurations which include distillation columns, absorbers and reboiled absorbers. The solution for a thermally coupled distillation system is presented.     

Computing presentations for subgroups of polycyclic groups and of context-free groups

Algorithms for solving uniform decision problems for algebraic structures crucially depend on the chosen finite presentations for the structures under consideration. Rewriting techniques have been used very successfully to solve uniform decision problems, when the presentations considered involve finite, noetherian, and ()-confluent rewriting systems. Whenever the class of algebraic structures considered is closed under the operation of taking finitely generated substructures, then the algorithms for solving the uniform decision problems can be applied to the substructures as well. However, since these algorithms depend on the form of the presentations, this involves the task of constructing a presentation of a certain form for a substructure given a presentation of this form for the structure itself and a finite set of generating elements for the substructure.This problem, which has received a lot of attention in algebra, is here investigated from an algorithmic point of view. The structures considered are the following two classes of groups, which have been studied extensively before: the polycyclic groups and the context-free groups.Finitely generated context-free groups can be presented by finite, monadic, and -confluent string-rewriting systems. Due to their nice algorithmic properties these systems provide a way to effectively solve many decision problems for context-free groups. Since finitely generated subgroups of context-free groups are again contextfree, they can be presented in the same way. Here we describe a process that, from a finite, monadic, and -confluent string-rewriting system presenting a context-free groupG and a finite subsetU ofG, determines a presentation of this form for the subgroup U ofG that is generated byU. For finitely presented polycyclic groups we obtain an analogous result, when we use finite confluent PCP2-presentations to describe these groups.This work was performed while this author was visiting at the Fachbereich Informatik, Universität Kaiserslautern, during his sabbatical 1991/92     

Three-year outcome after balloon aortic valvuloplasty. Insights into prognosis of valvular aortic stenosis

BACKGROUND: To identify predictors of long-term outcome after balloon aortic valvuloplasty, we analyzed data on 674 adults (mean age, 78 +/- 9 years; 56% were women) undergoing this procedure at 24 clinical centers who had a mean initial increase in aortic valve area of 0.3 cm2. METHODS AND RESULTS: Baseline data included clinical, echocardiographic, and catheterization variables. Follow-up data included mortality, cause of death, rehospitalization, 6-month echocardiography, and functional status. Kaplan-Meier curves and log-rank tests were used to evaluate survival in subgroups. Multivariate Cox regression models were used to identify independent predictors of survival. Overall survival was 55% at 1 year, 35% at 2 years, and 23% at 3 years, with the majority of deaths (70%) classified as cardiac by an independent review committee. Rehospitalization was common (64%), although 61% of survivors at 2 years reported improved symptoms. Echocardiography at 6 months (n = 115) showed restenosis from the postprocedural valve area of 0.78 +/- 0.31 cm2 to 0.65 +/- 0.25 cm2 (P < .0001). With stepwise multivariate analysis, sequentially adding clinical, echocardiographic, and catheterization variables, the overall model identified independent predictors of survival as baseline functional status, baseline cardiac output, renal function, cachexia, female gender, left ventricular systolic function, and mitral regurgitation. Baseline and postprocedural variables were examined to identify which subgroup of patients has the best outcome after aortic valvuloplasty. A "lower-risk" subgroup (28% of the study population), defined by normal left ventricular systolic function and mild clinical functional limitation, had a 3-year survival of 36% compared with 17% in the remainder of the study group. CONCLUSIONS: Long-term survival after balloon aortic valvuloplasty is poor with 1- and 3-year survival rates of 55% and 23%, respectively. Although survivors report fewer symptoms, early restenosis and recurrent hospitalization are common.     

Autoradiographic assessment of blood flow heterogeneity in the hamster heart

OBJECTIVE: Provide regional flow measurement in the hearts of small mammals using a new, higher-resolution technique based on the deposition of a molecular marker. METHODS: We determined the instantaneous extraction and retention of the "molecular microsphere" radiolabeled desmethylimipramine in retrogradely perfused hamster hearts. In a separate series of experiments, autoradiography was used to measure regional myocardial deposition densities in hamster hearts of about 0.5 g with spatial area resolution of 16 x 16 microns. RESULTS: Radiolabeled desmethylimipramine is almost 100% extracted during a single transcapillary passage and is retained in the tissue for many minutes. Autoradiographic images demonstrated a spatial flow heterogeneity with standard deviations of 31 +/- 4% of the mean flow (N = 5) in 16 x 16 x 20-micronm3 voxels. This is equivalent to the projections made using fractal relationships from cruder observations obtained with microspheres in the hearts of baboons, sheep, and rabbits. CONCLUSIONS: Autoradiography using a molecular deposition marker provides quantitative information on myocardial flow heterogeneities with resolution at the size of cardiac myocytes. Because the regions resolved are smaller than the volume of regions supplied by single arterioles, the results must slightly exaggerate the true heterogeneity of regional flows.