The authors report their experience on six male patients and one female patient (age range: 58–76 years, median: 67) with facial tumours involving the anterior skull base, undergoing craniofacial ...resection between January 1992 and May 1994 at the Division of Surgical Oncology in the Tumor Institute, Genoa. Three patients had squamous carcinom and adenocarcinoma of the nasal fossa; two patients had squamous carcinoma rT4NO and adenocarcinoma rT4NO
1 of the maxillary sinus; one patient had squamous carcinoma of the eyelid, and another had squamous carcinoma of the internal chantus. Four patients had had previous radiotherapy, another underwent pre-operative chemoradiotherapy, and only two patients had not been treated before.
A proper craniofacial tumour resection was performed in three patients; one patient had a left maxillectomy with ethmoidectomy and orbital exenteration; one patient underwent maxillectomy, resection of the medial and inferior wall of the orbit, ethmoidectomy, and orbital exenteration; one patient underwent maxillectomy, ethmoidectomy, and mucosectomy of the sphenoidal sinus, and one patient had total ethmoidectomy. As for reconstruction procedures of the anterior skull base, lyophilized dura with galeal pericranial flap was commonly used. A myocutaneous flap transposition (transverse rectus abdominis and latissimus dorsi myocutaneous flap) was used in two patients for the reconstruction of the resected tissues and bones of maxillary and orbital regions.
Post-operative complications included intraoperative liquorrhea in one patient; one case of early and serious pneumocephalus; flap necrosis occurred following transposition of latissimus dorsi. Median hospital stay was 34 days. After a median follow-up of 18 months (range: 3 to 34 months) five of seven patients (71.4%) are alive and disease-free at 15, 17, 18, 30 and 34 months from surgery.
Zero degree Cherenkov calorimeters for the ALICE experiment De Falco, A.; Arnaldi, R.; Chiavassa, E. ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
09/2008, Letnik:
595, Številka:
1
Journal Article
Recenzirano
Odprti dostop
The collision centrality in the ALICE experiment will be determined by the Zero Degree Calorimeters (ZDCs) that will measure the spectator nucleons energy in heavy ion collisions. The ZDCs detect the ...Cherenkov light produced by the fast particles in the shower that cross the quartz fibers, acting as the active material embedded in a dense absorber matrix. Test beam results of the calorimeters are presented.
The aim of this study is to evaluate the impact of CT and MRI staging on the RT plan analyzing the patterns of spread of nasopharyngeal tumours.
Pre-treatment CT and MRI examinations of 28 patients ...(28–65 years old, mean age 42; 16 men, 12 women) with primary nasopharyngeal cancer were retrospectively evaluated.
CT and MRI in clinically known or suspected nasopharyngeal cancer showed in all cases the extent and spread of the pathologic tissue; consequently the Americal Joint Committee on Cancer (AJCC) staging system for primary nasopharyngeal tumours was strictly respected.
Imaging permitted in all cases a good evaluation of neck nodes; retropharyngeal, junctional, jugulo-digastric and accessory spinal lymph nodes were correctly staged on the basis of size, density-intensity, shape and contrast enhancement.
The impact of non- and minimally-invasive diagnostic imaging techniques on head and neck diseases is well known. Clinical evaluation of the nasopharynx and nearby deep fascial planes is hard and fiberoptic examination detects only mucosal surfaces of the organ. Consequently prognosis and therapy of nasopharyngeal carcinomas depend on CT and MR staging both of the primary site and neck nodes. The RT beam and portals are focused on the basis of imaging and the results of the therapy may be correctly investigated only by the comparative analysis of the first follow-up examination with pre-treatment morphological data.
Nasopharyngeal Carcinomas Roncallo, F.; Turtulicp, I.; Sanguineti, G. ...
Rivista di neuroradiologia,
08/1999, Letnik:
12, Številka:
4
Journal Article
Recenzirano
Current treatment of nasopharyngeal carcinomas includes radiation therapy (RT) alone or combined with chemotherapy and neck dissection. Consequently all patients with nasopharyngeal carcinomas are ...treated with RT. To evaluate the CT and MRI appearance of nasopharyngeal carcinomas treated with RT and the ability of CT and MRI to differentiate persistent or residual tumour from radio-induced changes of head and neck tissues.
Post-treatment CT and MRI examinations of 28 patients with primary nasopharyngeal cancers treated with RT (6000–7500 cGy) were retrospectively evaluated.
We divided the patients in three groups on the basis of the differences in the CT and MRI appearance of the primary tumours treated with RT 1. Responders (9 patients): complete resolution of tumour or reduction in tumour size = or > 75%; 2. Non-Responders (8 patients): persistent tumour or residual mass with reduction in tumour size = or < 50%; 3. Partial Responders: (11 patients) persistent residual mass with reduction in tumour size from 50% to 75% or persistent asymmetry of the mucosal surface.
There are some points to analyse in the interpretation of CT and MRI imaging of post-treated nasopharynx:
Transient changes of irradiated soft tissues are more prominent during the first three months after RT (increased en-hancement of the pharyngeal mucosa and thickening of the pharyngeal walls). Persis-tent changes are subgrouped in 1. Soft tissue changes: a. Glandular (major salivary glands scialoadenitis and fatty degeneration); b. Deep (reticulation and fibrous degeneration of pre- and post-styloid parapharyngeal fat; c. Visceral (retraction of the pharyngeal wall and distorsion of lateral recess); d. Nervous (radio-induced damage of the CNS such myelopathy and radionecrosis. 2. Bone tissue changes: a. Fatty degeneration of bone marrow of the skull base; b. Sclerosis of the cortical bone of the basisphenoid. 3. Sinonasal changes: Reactive chronic sinusitis. Perineural-perivascular spread and skull base erosion is indicative of a poor outcome. The patients of the third group may also be followed with seriated CT because they have a significant percentage of recurrence.
The effects of two anxiolytic beta-carboline derivatives, ZK 93423 and ZK 91296, on the binding of gamma-3Haminobutyric acid (3HGABA) to brain membrane preparations from rat cerebral cortex were ...examined. ZK 93423 concentration-dependently enhanced the specific binding of 3HGABA, with a maximal increase of 45% above control at a 50 microM concentration. A less pronounced increase was induced by diazepam and by the partial agonist ZK 91296. Scatchard plot analysis revealed that the effect of ZK 93423 was due to an increase in the total number of high- and low-affinity GABA binding sites. The action of ZK 93423 was mediated by benzodiazepine recognition sites since it was blocked by the benzodiazepine antagonists Ro 15-1788 and ZK 93426 at concentrations that failed to modify 3HGABA binding on their own. Moreover the stimulatory effect of ZK 93423 on 3HGABA binding was also blocked by the beta-carboline inverse agonist ethyl beta-carboline-3-carboxylate. These results are consistent with the view that ZK 93423 and ZK 91296, similarly to benzodiazepines, exert their pharmacological effects by enhancing the GABAergic transmission at the level of the GABA/benzodiazepine receptor complex.
By exploiting the triple-well option available in a deep-submicron CMOS process, we developed monolithic active pixel sensors (MAPS) with the unique features of full analog signal processing and ...digital functionality implemented at the pixel level. After briefly reviewing the results achieved with the first prototype chip, we report on the extensive measurements on the second prototype, containing both single-channel sensors, with an improved noise figure, and an
8
×
8
pixel array. For the pixel having a collecting electrode area of
900
μ
m
2
we measured an equivalent noise charge of about 40 electrons. Using the
Fe
55
5.9
keV line, we obtained a Signal-to-noise (S/N) ratio of about 30. The pixel matrix
(
50
×
50
μ
m
2
)
has been successfully readout up to 30
MHz. Through noise scans, an expected significant threshold dispersion has been measured.
The measurements presented in this paper confirm the capability of our MAPS, based on the deep n-well concept, to be operated as ionizing radiation detectors and suggest a series of improvements we are already implementing in the design of the next prototype chip.
No single biomarker can predict the risk for malignant trasformation of precancerous lesions of the head and neck. Micronucleus frequency, nuclear p53 accumulation and mitotic index were determined ...in proliferating basal cells using paraffin-embedded specimens from normal, dysplastic and malignant tissues. p53 accumulation was detected by immunohistochemistry using pAb 1081 and pAb 240 antibodies. Micronuclei were scored in the same cell population and classified for the presence/ absence of p53 accumulation in the main nucleus. Fifty-three carcinomas and 15 precancerous lesions were studied. Both micronuclei and p53 accumulation were found in precancerous lesions, suggesting that they are early events in head and neck squamous cell carcinoma progression. The two biomarkers were not related to each other: indeed, micronucleus frequency was higher in p53-negative than in p53-positive cells. Three patients with precancerous lesions later developed carcinomas; all three cases showed high frequencies of both micronuclei and cells accumulating p53 protein.
Cryosurgery is safely employed for the treatment of skin precancerous and malignant lesions of the head and neck in selected patients. The case of a 101-year-old female patient with advanced ...malignant melanoma of the facial skin, undergoing cryosurgery, is reported in order to assess the feasibility and tolerability of the technique, as well as the biological implications of cryosurgical treatment in this specific neoplasm.
A 101-year-old woman, with a large (pT4b N0 M0) cutaneous melanoma of the facial skin on the right cheek, was treated at the Division of Surgical Oncology of the National Cancer Research Institute, Italy, from June to August 2003. The treatment was accomplished by means of serial cryosurgical applications which were performed within three months; the bulk of the lesion was cryotreated with a liquid nitrogen cryoprobe, while the residual disease was treated with a nitrous protoxide cryoprobe, by means of the insertion technique. The treatment was well tolerated, with a good aesthetic result, and the patient is recurrence- and distant-disease-free two years after the initial cryosurgical application.
Cryosurgery is feasible in the treatment of head and neck melanoma, mostly for mucosal melanomas and cutaneous lesions in anatomically critical sites, as well as in high-risk surgical patients. Here, a good aesthetic result was obtained in a very elderly patient with a large cutaneous melanoma of the facial skin, avoiding skin flap transposition for tissue repair and postoperative complications (e.g., serious bleeding or postoperative pain), with a satisfactory functional and oncological outcome at two years.
ALICE is the dedicated heavy-ion experiment at the LHC collider. It will also collect proton-proton and proton-nucleus data as reference to study the onset of the transition to the Quark-Gluon Plasma ...state predicted by the Standard Model. The ALICE experimental setup essentially consists of a central barrel for particle tracking and identification, a forward spectrometer for muon detection and forward rapidity detectors to provide the triggers and to characterize the event. Among the forward detectors, the Zero Degree Calorimeter (ZDC) will measure the centrality in nucleus-nucleus and in proton-nucleus collisions. In A-A interactions the observable most directly correlated to the geometry of the collision is the energy carried forward by non interacting (spectator) nucleons. In p-A collisions the centrality evaluation relies instead on the detection of the so called “slow” nucleons emitted by the nucleus. In both cases the simulation results show that the ZDC can be used to trigger on centrality with good accuracy over the whole centrality range. The ZDC will also provide an estimate of the beam luminosity in A-A collisions by measuring the rate of neutron emission in electromagnetic dissociation processes.
Invasion of the mandible is found in 22% to 29% of advanced (Stage III-IV) head and neck cancers; only an aggressive surgical technique, such as Commando's operation with subsequent reconstruction of ...tissue defects, can give a chance of cure to these patients. The reconstruction is feasible both by means of microsurgical free-tissue transfers or with alloplastic materials and myocutaneous flaps. Between 1982 and 1991, 34 patients in Stage III (n = 6; 17.7%) and IV (n = 28; 82.3%) head and neck cancers underwent Commando's operation with different types of reconstruction in 30 patients: pectoralis myocutaneous flap (n = 9), osteo-myocutaneous flap with the underlying segment of the fifth rib (n = 2), myocutaneous flap plus prosthesis (n = 17), or prosthesis alone (n = 2). Two different prostheses were implanted: the linear A-O mandibular reconstruction plate (n = 13), and the Dumbach titanium cage (n = 6). In the group of patients in which the linear A-O mandibular reconstruction plate was used there were four cases of prosthesis dislodgement and major exposure and one case of prosthesis breakage while in patients who were given the Dumbach titanium cage there were four cases of major exposure. Prosthesis removal was required in five and two patients with linear A-O and Dumbach titanium cage prosthesis, respectively. Median survival was 14 months with 28% five-year survival. In our experience, metallic prostheses with a shape and arrangement that allow a distribution of traction forces on a wider surface, with screws drilled in nonaligned points of the mandible, seem to be more reliable as they reduce the risk of dislodgement and breakage.
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