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Search Results: 1 - 10 of 19835 matches for " André Buchali "
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Influence of the Radiation Dose to Salivary Glands on Xerostomia in Patients with Head and Neck Carcinomas  [PDF]
André Buchali, Christina Schr?der, Dietrich Sidow, Eyck Blank
Journal of Cancer Therapy (JCT) , 2013, DOI: 10.4236/jct.2013.41028
Abstract:

Purpose: Investigation of the influence of radiation dose to salivary glands on xerostomia in patients with head and neck cancers. Methods: From October 2002 to December 2011, 548 patients with head and neck carcinomas were treated in our department using intensity modulated radiotherapy (IMRT). 325 patients were eligible for analysis more than 1 year after irradiation. Xerostomia was evaluated according to the criteria of Radiation Therapy and Oncology Group (RTOG) and xerostomia related questionnaire. For statistical analysis grade 1 and 2 were recorded as mild and grade 3 and 4 as severe xerostomia. The dosimetric values for absolute mean dose, biological equivalent mean dose (EQD2), the relative organ volume not exceeding 20 Gy, 25 Gy and 30 Gy (V20, V25, V30) for all 4 major salivary glands or for both parotid glands only were used for analysis. V20 revealed the best discrimination between both patient groups (with vs. without xerostomia), compared to parameters V25 and V30. Therefore the volume of the salivary glands receiving less than 20 Gy (V < 20Gy) was analyzed additionally. Mann-Whitney-U-test, Kruskal-Wallis-test and logistic regression were used in statistical analysis. Results: A TD 50 can be determined for the occurrence of xerostomia more than one year after radiotherapy for both parotid glands of 19.3 Gy for the mean dose absolute, 11.2 Gy for the mean dose EQD2, 38.2% for V20, 26.8% for V25, 18.7% for V30, 34.9 ml for V < 20Gy. For all major salivary glands theses values were 25.7 Gy for the mean dose absolute, 15.6 Gy for the mean dose EQD2, 51.3% for V20, 41.1% for V25, 33.9% for V30 and 34.8 ml for V < 20Gy. Conclusions: The identification of a tolerance dose for the salivary glands for treatment planning appears to be difficult, as the dose-response correlation only shows a flat slope. Additionally, a large interindividual variability seems to exist. We could not found any threshold dose for development of xerostomia.

Is There a Future for 74 Gy Radiation Treatment of NSCLC after RTOG 0617? A Comparison of the RTOG Study Results with Our Own Department’s 74 Gy NSCLC Cohort  [PDF]
Christina Schr?der, Eyck Blank, Dietrich Sidow, Rita Engenhart-Cabillic, André Buchali
Journal of Cancer Therapy (JCT) , 2015, DOI: 10.4236/jct.2015.68071
Abstract: Background and Purpose: There have been a number of different efforts trying to improve the outcome of NSCLC patients treated with radiotherapy (RT). Contrary to most expectations, the long awaiting results of the RTOG 0617 trial didn’t show any benefit of dose escalation to 74 Gy. In this unicentric retrospective analysis we compare the RTOG 0617 result with the outcome of our own 74-Gy-NSCLC cohort. Methods and Material: Since October 2009, 80 patients with NSCLC were treated with 74 Gy in 37 fractions, of which 69 patients were eligible for a retrospective analysis of local and distant failure, survival time and treatment related toxicity. A subgroup analysis was done for patients with a possible follow-up of at least 18 month. Results: Complete local remission could be achieved in 18 patients (26.1%); 26 patients (37.7%) had a partial remission and 3 patients (4.4%) a stable local disease. Local failure occurred in 12 patients (17.3%). Distant failure occurred in 27 patients (39.1%). The median survival time was 43.7 weeks (95% CI: 25.2 - 62.3 weeks). 5 patients (6.3%) developed RT induced side effects. As for the analyzed subgroup, a complete or partial local remission could be achieved in 29 patients (61.7%). Local failure occurred in 11 patients (23.4%) and 20 patients (42.6%) developed distant metastases. The 18-month overall survival was 38.3% and the median survival time was 51.7 weeks (95% CI: 27.2 - 76.3 weeks). Conclusion: The results of this retrospective analysis indicate that 74 Gy total radiation dose might not lead to results as bad as indicated by the RTOG 0617 trial. It might therefore be a suitable treatment concept for people with NSCLC.
The Survival of Head and Neck Carcinoma Patients Depends on Secondary Causes of Death  [PDF]
André Buchali, Winfried Huhnt, Ina Maekelburg, Sophia Rohrberg, Dietrich Sidow, Eyck Blank, Christina Schroeder, Achim Franzen
Journal of Cancer Therapy (JCT) , 2017, DOI: 10.4236/jct.2017.813102
Abstract: Purpose: The study aimed to analyse causes of death and differential survival after multimodal treatment of head and neck carcinoma patients. Methods and Materials: Between September 2000 and December 2015, 935 patients received a multimodal treatment of head and neck carcinoma. Of these, 562 patients (60.1%) underwent a resection of the primary tumour and a postoperative radio- or radiochemotherapy and 373 patients (39.9%) received definitive radio- or radiochemotherapy. The median follow-up was 21.0 months (0.5 - 175.4 months). Results: At the endpoint of the investigation, 465 patients (49.7%) were alive. The median survival of all patients was 44.8 months (0.5 - 164.3 months). A total of 470 patients (50.3%) died. The causes of death were divided into five groups: 22 patients (2.4%) died of therapy-associated complications with a median of 2.2 months (1.6 - 3.3 months). The 160 patients (17.1%) with intercurrent death, 117 patients (12.5%) with deaths from locoregional progression with or without metastasis, and 86 patients (9.2%) with deaths from metastasis without locoregional recurrence showed comparable survival curves with a median survival of 13.3 months, 13.6 months, and 14.4 months. Eighty-five patients (9.1%) died from second malignant diseases and controlled treated head and neck carcinomas with a median survival of 34.5 months (P < 0.001). Conclusion: Despite a locoregional control and metastasis-free survival of 78.3% patients, only 49.7% of the patients were alive, due to a high rate of intercurrent and second malignant diseases. The short median survival rate is mainly due to the tumours (locoregional and or distant progression) and intercurrent causes of death, with the second malignant diseases leading to death later on.
Correlation between the Changes in Lung Function and Lung Density Changes in Patients Following Radio- (Chemo-) Therapy for Thoracic Carcinomas  [PDF]
Christina Schroeder, Rita Engenhart-Cabillic, Sven Kirschner, Eyck Blank, André Buchali
Journal of Cancer Therapy (JCT) , 2019, DOI: 10.4236/jct.2019.103021
Abstract: Purpose: In this analysis we focused on the correlation of patients’ lung function (PFT) data and lung density changes (ΔHU) detected in follow-up CTs. Material and Methods: PFT and lung function data were available for 58 patients 12 weeks and 47 patients 6 months after radio- (chemo-) therapy for thoracic carcinomas (NSCLC, SCLC and esophageal carcinoma). The follow-up CT scans were matched with the planning CT scans of each patient and then subtracted to calculate ΔHU for each voxel using customized research software. PFT data regarding e.g. vital capacity (VC), total lung capacity (TLC) and diffusion capacity for carbon monoxide (DLCO) were collected before and at several follow-up appointments after treatment. Results: 12 weeks after therapy there was a statistically significant correlation between difference in DLCO and the maximum ΔHU as well as the difference in TLC and the minimum ΔHU. 6 months after treatment there was a significant correlation between the difference in VC and DLCO with numerous lung density parameters, e.g. the mean and median lung density changes and the 75th percentile of ΔHU. There was no significant correlation between the PFT parameters FEV1, pCO2 and pO2 and any lung density parameter at any follow-up appointment. Conclusion: There is a significant correlation between DLCO and ΔHU 6 months after treatment that most likely reflects the underlying pathological mechanisms in terms of the development of fibrotic lung tissue after RT. The relevance of the significant correlations 12 weeks after RT is questionable.
How Safe Are Reduced Doses per Fraction in Target Volumes of 2nd to 4th Order in the Simultaneous Integrated Boost Irradiation Technique in Head and Neck Carcinoma Patients?  [PDF]
A. Buchali, C. Schroeder, C. Boerrnert, I. Maekelburg, W. Huhnt, A. Franzen
Journal of Cancer Therapy (JCT) , 2015, DOI: 10.4236/jct.2015.62023
Abstract:

Aim: The simultaneous irradiation of target volumes of different total dose levels using intensity modulated radiotherapy leads to reduced doses per fraction and longer treatment times in target volumes of 2ndto 4thorder. Does the thereby caused reduced biological effectiveness induce an increased recurrence risk? The current work deals with the problem of recurrences of patients with head and neck carcinomas treated either with an intensitiy (IMRT) or with a volumetric modulated (VMAT) irradiation technique. Methods: From October 2002 to September 2014, 699 patients with carcinomas of the head and neck were irradiated using IMRT or VMAT. The median follow up of the patients was 21.9 months (2 to 145 months). Primary tumor regions (1storder target volume) of 565 patients were treated with doses per fraction of 2 Gy. Accordingly, further 133 target volumes of the primary tumor received reduced doses per fraction. In 1 patient, the lymphatic drainage was treated solely without irradiation of the primary region. For the lympatic drainage, 854 1storder target volumes were treated with a dose per fraction of 2 Gy. Reduced doses per fraction were applied to further 1780 target volumes. Results: 54 of 699 patients developed a recurrence in the primary tumor region after radio-(chemo) therapy, 4 patients developed a recurrence of the primary tumor and a unilateral recurrence of the lymphatic drainage, 2 patients a recurrence of the primary tumor and a bilateral lymph node recurrence. 18 patients showed an isolated unilateral recurrence and additionally 2 patients a bilateral recurrence of the lymphatic drainage. 619 patients stayed recurrence free. In primary tumor regions, receiving a dose per fraction of 2 Gy 55 patients (9.7%) developed a recurrence, whereas in target volumes receiving a reduced dose per fraction 5 patients (3.8%) developed a recurrence (p < 0.001). In lympatic drainage target volumes receiving a dose per fraction of 2 Gy, 25 target volumes (2.9%) developed a recurrence, whereas in target volumes receiving a reduced dose per fraction, 5 patients (0.3%) developed a recurrence (p = 0.001). Conclusion: The recurrence risk in target volumes of 2ndto 4thorder was not increased due to reduced doses per fraction

Experimental Demonstration of Capacity Increase and Rate-Adaptation by Probabilistically Shaped 64-QAM
Fred Buchali,Georg B?cherer,Wilfried Idler,Laurent Schmalen,Patrick Schulte,Fabian Steiner
Mathematics , 2015,
Abstract: We implemented a flexible transmission system operating at adjustable data rate and fixed bandwidth, baudrate, constellation and overhead using probabilistic shaping. We demonstrated in a transmission experiment up to 15% capacity and 43% reach increase versus 200 Gbit/s 16-QAM.
Post-Formal Thought in Gerontagogy or Beyond Piaget  [PDF]
André Lemieux
Journal of Behavioral and Brain Science (JBBS) , 2012, DOI: 10.4236/jbbs.2012.23046
Abstract: Jean Piaget, one of the most influential theorists in developmental psychology, assumed that formal thought, characterized by the development of an individual’s logical capacities, was the last stage of adult thinking. In this article, we review how the brain evolved, describing its main structures, and examining each cerebral hemisphere’s specific functions. Evidence is also provided for the production of new neurons and new connections between them, forcing a revision of old theories about the decline of intellectual functions in the elderly. We then consider Jones’ theories X and Y, and the different definitions of intelligence (fluid vs. crystallized, and qualitative vs. quantitative), and how these perspectives have influenced the way we see intelligence. Evidence supporting the addition of another stage, named post-formal thought, is examined in the context of gerontagogy. Dialectical thought characterizes this stage, and developing wisdom is its main goal. We examine the two basic principles of dialectical thought, namely the principle of contradiction and the principle of relativity of everything. It is suggested that the learning of wisdom should be the focus of future university programs to educate the elderly.
The History of the Basal Ganglia: The Contribution of Karl Friedrich Burdach  [PDF]
André Parent
Neuroscience & Medicine (NM) , 2012, DOI: 10.4236/nm.2012.34046
Abstract:

It took many centuries for the basal ganglia (BG) to be recognized as specific brain entities involved in the control of psychomotor behavior. Andreas Vesalius (1514-1564) was the first to delineate this set of structures, but he did not name them nor payany attention to their functional significance. This was left to the English physician Thomas Willis (1621-1675), who used the term corpus striatum (striated or chamfered body) to designate the largest BG constituent, which he considered a major sensorimotor integration center. Willis’s pioneering description influenced markedly some 18th and 19th centuries scholars, particularly the German physician and anatomist Karl Friedrich Burdach (1776-1847). Burdach’s insightful studies of the human brain are summarized in a three-volume treatise entitled Vom Baue und Leben des Gehirns (1819-1826). This landmark opus provides a description of the BGwhose originality has largely been overlooked. Burdach’s careful investigation allowed him to differentiate the caudate nucleus from the putamen, which he respectively termed Streifenhügel (elongated hillock) and Schale (shell). He also called the putamen Linsenkern (lens-shaped nucleus), a term that he admittedly borrowed from his compatriot Johann Christian Reil (1759-1813). He further identified a paler structure (blasser Klumpen) within the inner portion of the lentiform nucleus that he called globus pallidus, and correctly identified its inner and outer segments (innern und ?ussern Theil). He aptly pointed out that the major BG nuclei are separated from one another by fibers fascicles that he termed inner and ?ussre Capsel (internal and external capsules). Burdach also referred to the substantia nigra (schwarzgraue Schicht or stratum nigrum) and claustrum (Vormauer), but gave full credit to the French anatomist Félix Vicq-d’Azyr (1748-1794) for their discovery. Although Burdach did not comment much on BG function, his anatomical description was sufficiently cogent to be still in use two centuries after its inception.

Louis Pierre Gratiolet (1815-1865) and His Contribution to the Study of Cerebral Convolutions in Primates  [PDF]
André Parent
Neuroscience & Medicine (NM) , 2014, DOI: 10.4236/nm.2014.51001
Abstract:

Louis Pierre Gratiolet (1815-1865) was one of the first modern anatomists to pay attention to cerebral convolutions. Born in Sainte-Foy-la-Grande (Gironde), he moved to Paris in 1834 to study medicine, as well as comparative anatomy under Henri de Blainville (1777-1850). In 1842, he accepted de Blainville’s offer to become his assistant at the Muséum dhistoire naturelle and progressively abandoned medicine for comparative anatomy. He undertook a detailed study of brains of human and nonhuman primates and soon realized that the organizational pattern of cerebral convolutions was so predictable that it could serve as a criterion to classify primate groups. He noted that only the deepest sulci exist in lower primate forms, while the complexity of cortical folding increases markedly in great apes and humans. Gratiolet provided the first cogent description of the lobular organization of primate cerebral hemispheres. He saw the insula as a central lobe around which revolved the frontal, parietal, temporal (temporo-sphenoidal) and occipital lobes. He correctly identified most gyri and sulci on all brain surfaces, introduced the term plis de passage for some interconnecting gyri, and provided the first description of the optic radiations. In the early 1860s, Gratiolet fought a highly publicized battle against Paul Broca (1824-1880) on the relationship between brain and intelligence. Gratiolet agreed that the brain was most likely the seat of intelligence, but he considered human cognition far too subtle to have any direct relationship with

Procedural Utility in the Work Place, Evidence from Mexico  [PDF]
André Vargas
Theoretical Economics Letters (TEL) , 2014, DOI: 10.4236/tel.2014.49104
Abstract: The concept of Utility usually refers to the satisfaction a person acquires by consuming, in general under circumstances bonded to income, and the price of goods. In a psychological vision of personal well-being, happiness and its components, consider the fact that people can value anything. This notion has led to the study of Procedural Utility, that means people not only value the outcome of something, but also values the process and conditions in which the outcome is achieved. Procedural Utility can be obtained from various economic procedures in which individuals are part of, e.g. Work and consumption among others. Evidence has been found that in the work place the fact of being attached to hierarchy generates negative Procedural Utility because it disrupts psychological precepts that determine happiness, well-being, or utility [1]. In other cases it has been found that the process on how a wage cut is done must be considered [2]. In the light of this phenomena, I’ll discuss the concept of Procedural Utility and analyze empirical evidence for the Mexican case with “Instituto Nacional de Estadistica y Geografía” INEGI’s self-reported well-being survey (BIARE), with the finality to give suggestions on possible applications of processes to improve the worker’s satisfaction.
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