Breast-conserving surgery for non-palpable breast cancer: relationship of lumpectomy resection margins measurements between remote perioperative ultrasound and postoperative histopathology

Purpose: Tumour-free resection margins (RMs) are mandatory in breast-conserving surgery. On-site intraoperative ultrasound (US)-guided tumour resection with extemporaneous histopathological assessment of RMs has been described. Remote intraoperative US assessment of RMs is an alternative. The purpose of this study was to evaluate the relationship of lumpectomy RMs measurements between remote intraoperative US and postoperative histopathology.Methods and Materials: In a retrospective IRB-approved review of 100 consecutive lumpectomies performed between October 2009 and April 2011 for presumed non-palpable breast cancer, 71 women (mean age 63.8years) were included. Twenty-nine patients were excluded because of absence of cancer at histopathology and/or incomplete data. Measurements of lumpectomy minimal RMs and tumour maximal diameter obtained on remote intraoperative US and postoperative histopathology were compared.Results: Minimal RMs were 0.35±0.32 (mean±SD) and 0.35±0.32cm on remote intraoperative US and postoperative histopathology, respectively. No significant difference was found between these measurements (p=0.37). Tumour maximal diameter was 1.02±0.51 (mean±SD) and 1.33±0.74cm on remote intraoperative US and postoperative histopathology, respectively. US measurements were significantly smaller (p<0.001). The 71 breast carcinoma (CA) consisted of: invasive canalar (n=49), invasive lobular (n=11), in situ (n=3) and other types of CA (n=8). Twenty-nine patients had intraoperative re-excision (24 without residual CA), while 16 patients were re-operated due to insufficient histopathological RMs (12 without residual CA).Conclusion: Good correlation of minimal RMs between remote intraoperative US and postoperative histopathology warrants use of both techniques in a complementary manner. Remote intraoperative US is helpful in taking rapid decision of re-excision and maintaining low re-operation rate after breast-conserving surgery for non-palpable cancer.

MS Measurements

RMS measuring device is a nonlinear device consisting of linear and nonlinear devices. The performance of rms measurement is influenced by a number of factors; i) signal characteristics, 2) the measurement technique used and 3) the device characteristics. RMS measurement is not simple, particularly when the signals are complex and unknown. The problem of rms measurement on high crest-factor signals is fully discussed and a solution to this problem is presented in this thesis. The problem of rms measurement is systematically analized and found to have mainly three types of errors: (1) amplitude or waveform error 2) Frequency error and (3) averaging error. Various rms measurement techniques are studied and compared. On the basis of this study the rms -measurement is reclassified three categories: (1) Wave-form-error-free measurement (2) High-frequncy-error measurement and (3) Low-frequency error-free measurement. In modern digital sampled-data systems the signals are complex and waveform-error-free rms measurement is highly appreciated. Among the three basic blocks of rms measuring device the squarer is the most important one. A squaring technique is selected, that permits shaping of the squarer error characteristic in such a way as to achieve waveform-errob free rms measurement. The squarer is designed, fabricated and tested. A hybrid rms measurement using an analog rms computing device and digital display combines the speed of analog techniques and the resolution and ease of measurement of digital techniques. An A/D converter is modified to perform the square-rooting operation. A 10-V rms voltmeter using the developed rms detector is fabricated and tested. The chapters two, three and four analyse the problems involved in rms measurement and present a comparative study of rms computing techniques and devices. The fifth chapter gives the details of the developed rms detector that permits wave-form-error free rms measurement. The sixth chapter, enumerates the the highlights of the thesis and suggests a list of future projects

New measurements of radial velocities in clusters of galaxies

Redshifts for 100 galaxies in 10 clusters of galaxies are presented based on data obtained between March 1984 and March 1985 from Calar Alto, La Palma, and ESO, and on data from Mauna Kea. Data for individual galaxies are given, and the accuracy of the velocities of the four instruments is discussed. Comparison with published data shows the present velocities to be shifted by + 4.0 km/s on average, with a standard deviation in the difference of 89.7 km/s, consistent with the rms of redshift measurements which range from 50-100 km/s.

Advances in continuously profiling the thermodynamic state of the boundary layer: integration of measurements and methods

This paper describes advances in ground-based thermodynamic profiling of the lower troposphere through sensor synergy. The well-documented integrated profiling technique (IPT), which uses a microwave profiler, a cloud radar, and a ceilometer to simultaneously retrieve vertical profiles of temperature, humidity, and liquid water content (LWC) of nonprecipitating clouds, is further developed toward an enhanced performance in the boundary layer and lower troposphere. For a more accurate temperature profile, this is accomplished by including an elevation scanning measurement modus of the microwave profiler. Height-dependent RMS accuracies of temperature (humidity) ranging from 0.3 to 0.9 K (0.5–0.8 g m−3) in the boundary layer are derived from retrieval simulations and confirmed experimentally with measurements at distinct heights taken during the 2005 International Lindenberg Campaign for Assessment of Humidity and Cloud Profiling Systems and its Impact on High-Resolution Modeling (LAUNCH) of the German Weather Service. Temperature inversions, especially of the lower boundary layer, are captured in a very satisfactory way by using the elevation scanning mode. To improve the quality of liquid water content measurements in clouds the authors incorporate a sophisticated target classification scheme developed within the European cloud observing network CloudNet. It allows the detailed discrimination between different types of backscatterers detected by cloud radar and ceilometer. Finally, to allow IPT application also to drizzling cases, an LWC profiling method is integrated. This technique classifies the detected hydrometeors into three different size classes using certain thresholds determined by radar reflectivity and/or ceilometer extinction profiles. By inclusion into IPT, the retrieved profiles are made consistent with the measurements of the microwave profiler and an LWC a priori profile. Results of IPT application to 13 days of the LAUNCH campaign are analyzed, and the importance of integrated profiling for model evaluation is underlined.

The effect of acoustic mode on time-resolved temperature measurements in a Rijke-tube pulse combustor

Radial profiles are reported of average and rms temperature in a propane flame for the first, second, and third acoustic modes at four different axial positions above the burner in a Rijke-tube combustor. Selected plots of the power spectral density (PSD) of temperature fluctuations are also reported. These radial profiles are then compared to similar ones made in the same flame, but in the absence of the acoustic field. Visual observations and photographs of the flame showed a remarkable change in flame height and structure with the onset of acoustic oscillations. This reduction in flame length, caused by the enhanced mixing due to the acoustic velocity fluctuations, gave rise to higher and lower average and rms temperatures near or well above the burner, respectively. In general, the PSD plots had a broad frequency content. The general trend was a decrease in magnitude with an increase in frequency. All cases presented broad-band peaks at around 5 Hz related to the flame flickering phenomenon. Preferred frequencies were observed in the oscillating PSD plots related to the fundamental frequency as well as subharmonics in the tube. (C) 2000 Elsevier B.V. Ltd. All rights reserved.

A numerical study of temperature effects on hot wire measurements inside turbulent channel flows

A way to investigate turbulence is through experiments where hot wire measurements are performed. Analysis of the in turbulence of a temperature gradient on hot wire measurements is the aim of this thesis work. Actually - to author's knowledge - this investigation is the first attempt to document, understand and ultimately correct the effect of temperature gradients on turbulence statistics. However a numerical approach is used since instantaneous temperature and streamwise velocity fields are required to evaluate this effect. A channel flow simulation at Re_tau = 180 is analyzed to make a first evaluation of the amount of error introduced by temperature gradient inside the domain. Hot wire data field is obtained processing the numerical flow field through the application of a proper version of the King's law, which connect voltage, velocity and temperature. A drift in mean streamwise velocity profile and rms is observed when temperature correction is performed by means of centerline temperature. A correct mean velocity pro�le is achieved correcting temperature through its mean value at each wall normal position, but a not negligible error is still present into rms. The key point to correct properly the sensed velocity from the hot wire is the knowledge of the instantaneous temperature field. For this purpose three correction methods are proposed. At the end a numerical simulation at Re_tau =590 is also evaluated in order to confirm the results discussed earlier.

Repeatability of ocular aberration measurements in patients with keratoconus

Purpose: To explore the repeatability of lower-order and higher-order ocular aberrations measured in patients with keratoconus. Methods: The IRX-3 (Imagine Eyes, Paris, France) aberrometer was used to record lower-order and higher-order aberrations in 31 eyes of 31 patients with keratoconus. Four monocular measurements were taken consecutively for each patient. The aberrometry data were analysed up to the 5th Zernike order for a 4-mm pupil diameter. The data were evaluated using repeated-measures anova and Friedman analyses. Repeatability was analysed using within-subject standard deviation (SW) and the repeatability limit (r) calculated as 1.96 ×√2×Sw. Results: Of the 11 aberration terms evaluated, the repeatability of Z (2,0) (mean= 1.36μm; SW=0.09μm; r=0.26μm); Z (2,±2) RMS (mean=1.05μm; SW= 0.09μm; r=0.24μm) and Z (4,0) aberrations (mean=0.34μm; SW=0.09 μm; r=0.24μm) showed the highest variability. In contrast, Z (3,±1) RMS aberrations (mean=0.85μm; SW=0.06μm; r=0.16μm) and Z (4,±2) RMS aberrations (mean=0.40μm; SW=0.07μm; r=0.18μm) showed comparatively better repeatability. Conclusions: The lower-order and higher-order aberrations measured in this group of keratoconic patients showed higher levels of variability compared to previous investigations of visually-normal subjects. These results may be of interest to eyecare practitioners involved in the design and fitting of aberration-controlling contact lenses for patients with keratoconus. © 2011 The College of Optometrists.

Effects Of Misalignments In The Retinal Nerve Fiber Layer Thickness Measurements With Spectral Domain Optical Coherence Tomography.

Purpose. To investigate misalignments (MAs) on retinal nerve fiber layer thickness (RNFLT) measurements obtained with Cirrus(©) SD-OCT. Methods. This was a retrospective, observational, cross-sectional study. Twenty-seven healthy and 29 glaucomatous eyes of 56 individuals with one normal exam and another showing MA were included. MAs were defined as an improper alignment of vertical vessels in the en face image. MAs were classified in complete MA (CMA) and partial MA (PMA), according to their site: 1 (superior, outside the measurement ring (MR)), 2 (superior, within MR), 3 (inferior, within MR), and 4 (inferior, outside MR). We compared RNFLT measurements of aligned versus misaligned exams in all 4 sectors, in the superior area (sectors 1 + 2), inferior area (sectors 3 + 4), and within the measurement ring (sectors 2 + 3). Results. RNFLT measurements at 12 clock-hour of eyes with MAs in the superior area (sectors 1 + 2) were significantly lower than those obtained in the same eyes without MAs (P = 0.043). No significant difference was found in other areas (sectors 1 + 2 + 3 + 4, sectors 3 + 4, and sectors 2 + 3). Conclusion. SD-OCT scans with superior MAs may present lower superior RNFLT measurements compared to aligned exams.

Vertical Bone Measurements From Cone Beam Computed Tomography Images Using Different Software Packages.

This article aimed at comparing the accuracy of linear measurement tools of different commercial software packages. Eight fully edentulous dry mandibles were selected for this study. Incisor, canine, premolar, first molar and second molar regions were selected. Cone beam computed tomography (CBCT) images were obtained with i-CAT Next Generation. Linear bone measurements were performed by one observer on the cross-sectional images using three different software packages: XoranCat®, OnDemand3D® and KDIS3D®, all able to assess DICOM images. In addition, 25% of the sample was reevaluated for the purpose of reproducibility. The mandibles were sectioned to obtain the gold standard for each region. Intraclass coefficients (ICC) were calculated to examine the agreement between the two periods of evaluation; the one-way analysis of variance performed with the post-hoc Dunnett test was used to compare each of the software-derived measurements with the gold standard. The ICC values were excellent for all software packages. The least difference between the software-derived measurements and the gold standard was obtained with the OnDemand3D and KDIS3D (-0.11 and -0.14 mm, respectively), and the greatest, with the XoranCAT (+0.25 mm). However, there was no statistical significant difference between the measurements obtained with the different software packages and the gold standard (p> 0.05). In conclusion, linear bone measurements were not influenced by the software package used to reconstruct the image from CBCT DICOM data.

Metodologia para analise cinematica de volumes respiratorios parciais de nadadores

Universidade Estadual de Campinas . Faculdade de Educação Física

Measurements of jaw movements and TMJ pain intensity in patients treated with GaAlAs laser

The aim of this study was to evaluate the effectiveness of low-level laser therapy (LLLT) on the improvement of the mandibular movements and painful symptoms in individuals with temporomandibular disorders (TMD). Forty patients were randomly divided into two groups (n=20): Group 1 received the effective dose (GaAlAs laser ? 830 nm, 40 mW, 5J/cm2) and Group 2 received the placebo application (0 J/cm2), in continuous mode on the affected condyle lateral pole: superior, anterior, posterior, and posterior-inferior, twice a week during 4 weeks. Four evaluations were performed: E1 (before laser application), E2 (right after the last application), E3 (one week after the last application) and E4 (30 days after the last application). The Kruskal-Wallis test showed significant more improvements (p<0.01) in painful symptoms in the treated group than in the placebo group. A significant improvement in the range of mandibular movements was observed when the results were compared between the groups at E4. Laser application can be a supportive therapy in the treatment of TMD, since it resulted in the immediate decrease of painful symptoms and increased range of mandibular movements in the treated group. The same results were not observed in the placebo group.

Adhesion of an endodontic sealer to dentin and gutta-percha: shear and push-out bond strength measurements and SEM analysis

The use of an adequate method for evaluation of the adhesion of root canal filling materials provides more reliable results to allow comparison of the materials and substantiate their clinical choice. The aims of this study were to compare the shear bond strength (SBS) test and push-out test for evaluation of the adhesion of an epoxy-based endodontic sealer (AH Plus) to dentin and gutta-percha, and to assess the failure modes on the debonded surfaces by means of scanning electron microscopy (SEM). Three groups were established (n=7): in group 1, root cylinders obtained from human canines were embedded in acrylic resin and had their canals prepared and filled with sealer; in group 2, longitudinal sections of dentin cylinders were embedded in resin with the canal surface smoothed and turned upwards; in group 3, gutta-percha cylinders were embedded in resin. Polyethylene tubes filled with sealer were positioned on the polished surface of the specimens (groups 2 and 3). The push-out test (group 1) and the SBS test (groups 2 and 3) were performed in an Instron universal testing machine running at crosshead speed of 1 mm/min. Means (±SD) in MPa were: G1 (8.8±1.13), G2 (5.9±1.05) and G3 (3.8±0.55). Statistical analysis by ANOVA and Student's t-test (a=0.05) revealed statistically significant differences (p<0.01) among the groups. SEM analysis showed a predominance of adhesive and mixed failures of AH Plus sealer. The tested surface affected significantly the results with the sealer reaching higher bond strength to dentin than to gutta-percha with the SBS test. The comparison of the employed methodologies showed that the SBS test produced significantly lower bond strength values than the push-out test, was skilful in determining the adhesion of AH Plus sealer to dentin and gutta-percha, and required specimens that could be easily prepared for SEM, presenting as a viable alternative for further experiments.

Estimativas do teor de umidade empregando o método GPR: uma avaliação comparativa em experimentos de laboratório e campo

Este trabalho faz uma análise das estimativas de teores de umidade obtidas com o método Ground Penetrating Radar (GPR) comparativamente às determinadas com os métodos Time Domain Reflectometry (TDR) e gravimétrico. Os dados foram obtidos em dois experimentos diferentes: um experimento controlado em laboratório buscando reproduzir um meio homogêneo onde foram obtidas as medidas de umidade com GPR (antenas de 1 GHz) e TDR, e outro experimento de campo onde foram obtidos dados com GPR (antenas de 200 MHz) e de amostras de solos do local. Para a obtenção das estimativas a partir do método GPR foram analisados os eventos relativos à onda de transmissão direta entre as antenas, onda refratada criticamente e onda refletida em interfaces com diferentes propriedades elétricas.O GPR mostrou-se sensível às variações de umidades presentes nos dois experimentos e apresentou boa correlação com os dados obtidos com TDR (REQM de0,007 m³m-3) e das amostras (REQM de 0,039 m³m-3).

VUV spectral line emission measurements in the TCABR tokamak

The study of tokamak plasma light emissions in the vacuum ultraviolet (VUV) region is an important subject since many impurity spectral emissions are present in this region. These spectral emissions can be used to determine the plasma ion temperature and density from different species and spatial positions inside plasma according to their temperatures. We have analyzed VUV spectra from 500 Å to 3200 Å wavelength in the TCABR tokamak plasma including higher diffraction order emissions. There have been identified 37 first diffraction order emissions, resulting in 28 second diffraction order, 24 third diffraction order, and 7 fourth diffraction order lines. The emissions are from impurity species such as OII, OIII, OIV, OV, OVI, OVII, CII, CIII, CIV, NIII, NIV, and NV. All the spectra beyond 1900 Å are from higher diffraction order emissions, and possess much better spectral resolution. Each strong and isolated spectral line, as well as its higher diffraction order emissions suitable for plasma diagnostic is identified and discussed. Finally, an example of ion temperature determination using different diffraction order is presented.

Psychophysical measurements of luminance and chromatic spatial and temporal contrast sensitivity in Duchenne muscular dystrophy

In children with Duchenne muscular dystrophy, color vision losses have been related to dystrophin deletions downstream of exon 30, which affect a dystrophin isoform, Dp260, present in the retina. To further evaluate visual function in DMD children, we measured spatial, temporal, and chromatic red-green and blue-yellow contrast sensitivity in two groups of DMD children with gene deletion downstream and upstream of exon 30. Psychophysical spatial contrast sensitivity was measured for low, middle, and high spatial frequencies with achromatic gratings and for low and middle frequencies with red-green and blue-yellow chromatic gratings. Temporal contrast sensitivity was also measured with achromatic stimuli. A reduction in sensitivity at all spatial luminance contrasts was found for the DMD patients with deletion downstream of exon 30. Similar results were found for temporal luminance contrast sensitivity. Red-green chromatic contrast sensitivity was reduced in DMD children with deletion downstream of exon 30, whereas blue-yellow chromatic contrast sensitivity showed no significant differences. We conclude that visual function is impaired in DMD children. Furthermore, we report a genotype-phenotype relationship because the visual impairment occurred in children with deletion downstream but not upstream of exon 30, affecting the retinal isoform of dystrophin Dp260.