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     

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.     

Reference range and repeatability of a combined intestinal permeability and function test in clinically healthy Irish setter dogs

We investigated the influence of nutrition and exercise interventions within cognitive/behavioral and public health formats on weight and blood lipid profiles in obese children. Compliance was also examined as well as the relationship of the compliance measures with clinical outcome variables. Three conditions were compared over 16 sessions: nutrition and eating-habit change followed by exercise (NE), exercise followed by nutrition and eating-habit change (EN), and an information control (INFO). NE and EN were presented in a cognitive/ behavioral framework which focused on the development of self-regulation whereas the INFO condition received the same material in a public health/educational model. NE and EN participants evidenced modest, yet significant, reductions in weight and blood lipids, and the impact of these two interventions endured at a five-year follow-up. In contrast, INFO participants displayed stable weight and blood lipids during the course of the program, and most remained morbidly obese at follow-up. Improved nutrition, increased physical activity and fitness were significantly correlated with weight and lipid reductions.     

Midlife aging, open-ended planning, and laboratory measures of executive function.

The frontal lobes show early signs of structural and functional change in the course of adult aging. The 1st study of the current article examined whether midlife aging influences open-ended planning, a skill that is particularly sensitive to frontal lobe damage. There were no midlife declines in the ability to carry out variants of the T. Shallice and P. Burgess (1991) Six Elements and Multiple Errands Tests. Younger adults were more likely to break individual task rules. In a 2nd experiment, middle-aged adults performed worse than young adults did on laboratory executive tests sensitive to frontal lobe damage—Self-Ordered Pointing and the Wisconsin Card Sorting Test (N. M. Fristoe, T. A. Salthouse, & J. L. Woodard, 1997). In spite of changes in novel executive test performance, real-world executive skills appear to be spared in midlife aging. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Structural and dielectric properties of parylene-VT4 thin films

58% semi-crystalline thin parylene-VT4 (–H₂C–C₆F₄–CH₂−)_n films, have been investigated by dielectric spectroscopy for temperature and frequency ranges of [−120 to 380 °C] and [0.1–10⁵ Hz] respectively. The study comprises a detailed investigation of the dielectric constant, dielectric loss and AC conductivity of this fluoropolymer. Dielectric behavior of parylene-VT4 is represented by a low dielectric constant with values in the range of 2.05–2.35 while the dielectric losses indicate the presence of two relaxation processes. Maxwell−Wagner−Sillars (MWS) polarization at the amorphous/crystalline interfaces with activation energy of 1.6 eV is due to the oligomer orientation. Electrical conductivity obeys to the well-known Jonscher law. The plateau in the low frequency part of this conductivity is temperature-dependent and follows an Arrhenius behavior with activation energy of 1.17 eV (deep traps) due to the fluorine diffusion. Due to its thermal stability with a high decomposition temperature (around 400 °C under air and 510 °C under nitrogen) and due to its good resistivity at low frequency (10¹⁵–10¹⁷ Ω m⁻¹), parylene-VT4 constitutes a very attractive polymer for microelectronic applications as low k dielectric. Moreover, when parylene-VT4 is subjected to an annealing, the dielectric properties can be still more improved.     

20号花园 可带走的花园

是否我们可以自己设计一下明日的花园,设计一下使生物多样性更加丰富的环境呢？请想象一下在一个世界里每个公民都有机会关注自己的微生境。从屋顶露台到停车场、从郊外花园到工业垃圾场——对于一只袋子来说,每一个空间都是不小的,即使只有一棵树及其相关的生态系统。与其面对日渐消减的生物多样性而感到困顿,     

Grain Refinement of Aluminium by Master Alloy AlTi6C1

For the grain refinement of super pure aluminium and commercial pure aluminium,Al-Ti-C master al-loy is better than Al-Ti alloy.It was shown by scanning electron microscope(SEM)and electron-probe mi-croanalyser(EPMA)that when the amount of titanium added is less than 0.15%,grain refinement of superpure aluminium is due to TiC particles rather than peritectic reaction.In addition,the presence of impurityelements in commercial pure aluminium plays an important role in grain refinement.The process of grain re-finement of aluminium by TiC is discussed in light of the TiC thesis.     

Change in optic disk topography after trabeculectomy

PURPOSE: To investigate the relationship between optic disk topography and intraocular pressure before and after trabeculectomy with confocal scanning laser ophthalmoscopy. METHODS: The eyes of 49 consecutive patients undergoing trabeculectomy at a university-based glaucoma practice underwent preoperative and postoperative imaging using a confocal scanning laser ophthalmoscope (Heidelberg Retina Tomograph). Three images of one eye of each patient were obtained with a 15-degree field of view. Preoperative images were obtained approximately 2 months before surgery (mean +/- SD, 2.4 +/- 1.6 months). Postoperative images were obtained at least 3 months after surgery (mean, 4.5 +/- 2.6 months). RESULTS: Mean preoperative intraocular pressure, postoperative intraocular pressure, and percent change in intraocular pressure respectively were 23.1 +/- 6.8 mm Hg, 12.7 +/- 7.1 mm Hg, and 43.8% +/- 29.9%. A significant association (P < .01) was found between percent decrease in intraocular pressure and decreases in cup area, cup volume, and cup/disk area ratio as well as between percent decrease in intraocular pressure and increases in rim area, rim volume, mean height contour, retinal cross-section area, and height in contour. Between 11.7% and 31.2% of the variability (R2) in these parameters was explained by the percent change in intraocular pressure. Topography changes were more strongly associated with percent change than with mean change in intraocular pressure. We found no association between percent decrease in intraocular pressure and reference plane height or maximum cup depth. CONCLUSIONS: Changes in optic nerve topography were associated with reduction in intraocular pressure after trabeculectomy.