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Uterine cervix carcinoma: pathologic characteristics, treatment and follow-up evaluation
Amouzegar Hashemi F,Esmati E,Kalaghchi B
Tehran University Medical Journal , 2008,
Abstract: Background: Carcinoma of the uterine cervix is the sixth most common malignant neoplasm in women. Early stage diagnosis of uterine cervix carcinoma increases the cure rate of disease. Radiotherapy, with or without concurrent chemotherapy, is one of the most effective treatment modality in cervical carcinoma. After radiotherapy, accurate and regular follow-up results in early diagnosis and effective treatment of recurrence. The aim of this study is the assessment of the pathologic characteristics, setting and indications for postoperative radiotherapy and outcome of patients at the last follow-up.Methods: In this retrospective study, we evaluated 346 cases of cervical carcinoma had received radiotherapy in radiation oncology department of the Cancer Institute of Imam Khomeini Hospital, Tehran, Iran, from 1995 to 2001.Results: The age of the study group ranged from 26 to 78 years (mean=50.5, SD=11). Of these patients, 30.4% were in the early stage and 69.6% had advanced stage disease. Squamous cell carcinoma comprised 92.2% of the cases and 6.4% adenocarcinoma. Radical radiotherapy was the most frequent radiotherapy setting and adjuvant radiotherapy (post-op) was the second. A considerable number of patients did not come back for follow-up, and 43.7% were followed for a short time.Conclusion: Accurate presurgical clinical staging and surgical treatment by an expert gynecologic oncologist can reduce expose the patients to risks of two modality treatments (surgery and radiotherapy). According to our results, patients do not pay enough attention to disease follow-up. An acceptable training plan with emphasis on regular follow-up, is recommended.
Concurrent Chemoradiation With Weekly Gemcitabine and Cisplatin in Locally Advanced Cervical Cancer
Amouzegar Hashemi F,Hamed Akbari E,Kalaghchi B,Esmati E
Tehran University Medical Journal , 2011,
Abstract: Background: More than 80 years, the standard treatment of locally advanced cervical cancer was radiotherapy. However, based on several phase III randomized clinical trials in the past decade, concurrent cisplatin-based chemoradiotherapy is the current standard of treatment for this disease. Gemcitabine has potent radiosensitizing properties in preclinical and clinical trials, so it can be utilized simultaneously with radiation.Methods: Thirty Women with untreated invasive squamous-cell carcinoma of the cervix of stage IIB to stage IVA were enrolled in the study in Radiation Oncology department of Imam Khomeini Hospital in Tehran from September 2009 to September 2010. Sixty mg/m2 gemcitabine followed by 35 mg/m2 cisplatin were concurrently administered with radiotherapy to the whole pelvic region on day one of each treatment week for five weeks One and three months after treatment, patients underwent a complete physical examination and MRI to determine the response to treatment.Results: The mean age of the participants was 58.13±11.83 (29-78) years. After 3 months of treatment, 73.3% had complete and 26.7% had partial response to treatment. Grade 3 anemia was seen in 10%, grade 3 thrombocytopenia in 3.3% and grade 3 leukopenia in 10% of the patients.Conclusion: According to the positive results of this study in stage IIB, further phase II and III clinical trials are suggested to evaluate the role of chemoradiation by gemcitabine in advanced cervical cancers.
Comparing the effects of conventional and hypofractionated radiotherapies on early skin toxicity and cosmetic outcomes after breast cancer conserving surgery
F Amouzegar Hashemi,B Kalaghchi,AR Sebzari,P Haddad
Tehran University Medical Journal , 2012,
Abstract: Background: The high number of breast cancer patients who receive radiation therapy after surgery has caused many to think about a shorter period of radiotherapy, which can significantly reduce the radiotherapy machine time, labor hours, and fewer patient visits. This study was designed to evaluate the acute skin effects and cosmetic outcomes of short course radiotherapy in early-stage breast cancer in comparison with the conventional treatment method.Methods: Fifty-two patients with operable breast cancer (pT1-3pN0M0) who underwent breast conservation surgery in Tehran Cancer Institute during January 2011 to January 2012, were randomly assigned to undergo radiotherapy by either receiving conventional treatment (dose: 50 Gy in 25 fractions) with subsequent electron boost or a short-course hypofractionated radiotherapy (dose: 42.5 Gy in 16 fractions) and a subsequent electron boost.Results: There were no skin changes during the first or the second week of treatment in the two groups. Cutaneous complications began after the third week as grade 1 skin toxicity after termination of the short-course radiotherapy but there were no difference in complication rate after four weeks of treatment. Six months and one year after treatment, there were no differences in terms of skin complications or cosmetic outcomes between the two groups.Conclusion: Although the use of a whole-breast irradiation with a hypofractionated schedule was associated with desirable outcomes, in term of skin toxicity and cosmetics, but longer follow-up periods with larger sample sizes are needed to confirm these results.
Medium dose rate brachytherapy for patients with cervical carcinoma; early result of a prospective study
Amouzegar Hashemi F,Zahedi F,Farhan F,Kalaghchi B
Tehran University Medical Journal , 2009,
Abstract: "nBackground: Treatment of cervical carcinoma is routinely performed with Low Dose Rate (LDR) brachytherapy, but Brachytherapy in our department is done with Medium Dose Rate (MDR) due to the technical characteristics of the machine available here. Thus we decided to evaluate the results of this treatment in our department in a prospective study. "nMethods: Between March 2006 and July 2008, 140 patients with histologic diagnosis of cervical carcinoma referred to Tehran Cancer Institute; were treated with external beam radiotherapy (44-64 Gy to whole pelvis) and MDR brachytherapy (8-30 Gy to Point A) with a dose rate of 2.2±0.3 Gy/h. "nResults: 121 patients were followed up for a median time of 18 months (range: 9-39 m). There were 11%(6/54) local recurrence for surgery and adjuvant radiotherapy group; 25%(16/65) for radical radiotherapy group, and 19%(23/121) for all patients. Rectal and bladder complications incidence for all patients were 10%(12/121) and 13%(16/121) respectively. High grade complication was shown only in one patient in radical radiotherapy group. In this study 3-years disease free survival and overall survival were 73% and 92% respectively, and disease stage (p=0.007) and overall treatment time (p=0.05) were the significant factors affecting disease free survival. "nConclusions: Results of this series suggest that the use of external beam radiotherapy and MDR brachytherapy with about 20% dose reduction in comparison with LDR can be an acceptable technique with regard to local control and complications.
Chemoradiation in Nasopharyngeal Carcinoma: A 6-Year Experience in Tehran Cancer Institute
Bita Kalaghchi,Ali Kazemian,Farnaz Amouzegar Hashemi,Mehdi Aghili
Acta Medica Iranica , 2011,
Abstract: To determine the addition of value of neoadjuvant, concurrent and adjuvant chemotherapy to radiation in the treatment of nasopharyngeal carcinoma with regard to the overall survival (OS) and disease free survival (DFS) within a six year period in Tehran cancer institute. Files of all patients with nasopharyngeal carcinoma treated by radiotherapy with or without concurrent chemotherapy in a curative setting in Tehran cancer institute during the period of 1999-2005 were retrospectively reviewed.. A total of 103 patients with nasopharyngeal carcinoma had been treated during the study period with radiotherapy or chemoradiotherapy in our institute. There were 29 (28.2%) females and 74 (71.8%) males. The median age at the time of radiotherapy was 47 years old (range 9-75 years). The patients were followed 2 to 76 months with a median follow-up of 14 months. Time of first recurrence after treatment was 3-44 months with a median of 10 months.. Survival in 2 groups of patients treated with radiotherapy alone or chemoradiation did not have a significant difference (P>0.1). Two-year survival in patients treated with or without adjuvant chemotherapy and had local recurrence after treatment did not have significant difference (P>0.1). Two-year survival in patients with or without local recurrence after treatment did not have significant difference (P>0.1). A beneficial affect or a survival benefit of adjuvant/neoadjuvant chemotherapy and concurrent chemoradiation was not observed in Iranian patients.
Cutaneous Metastasis of Gastrointestinal Cancer
Omranipour Ramesh,Halaj Mofrad Hamid Reza,Fereidouni Forozandeh,Kalaghchi Bita
Acta Medica Iranica , 2009,
Abstract: Occurrence of cutaneous metastasis of gastrointestinal cancer is uncommon, with a reported frequency of less than 5 percent.They can occur as the first sign of disease recurrence in a treated patient or as a sign of terminal disseminated cancer or rarely as the first manifestation of an occult malignancy. The cases reported here represent three different manifestation of cutaneous metastasis of gastrointestinal cancers.
Estimating the incidence of lung cancer attributable to occupational exposure in Iran
Alireza Mosavi-Jarrahi, Mohammadali Mohagheghi, Bita Kalaghchi, Yasaman Mousavi-Jarrahi, Mohammad Noori
Population Health Metrics , 2009, DOI: 10.1186/1478-7954-7-7
Abstract: Nationwide exposure to each of the mentioned carcinogens was estimated using workforce data from the Iranian population census of 1995, available from the International Labor Organization (ILO) website. The prevalence of exposure to carcinogens in each industry was estimated using exposure data from the CAREX (CARcinogen EXposure) database, an international occupational carcinogen information system kept and maintained by the European Union. The magnitude of the relative risk of lung cancer for each carcinogen was estimated from local and international literature. Using the Levin modified population attributable risk (incidence) fraction, lung cancer incidence (as estimated by the Tehran Population-Based Cancer Registry) attributable to workplace exposure to carcinogens was estimated.The total workforce in Iran according to the 1995 census identified 12,488,020 men and 677,469 women. Agriculture is the largest sector with 25% of the male and 0.27% of female workforce. After applying the CAREX exposure estimate to each sector, the proportion exposed to lung carcinogens was 0.08% for male workers and 0.02% for female workers. Estimating a relative risk of 1.9 (95% CI of 1.7–2.1) for high exposure and 1.3 (95% CI 1.2–1.4) for low exposure, and employing the Levin modified formula, the fraction of lung cancer attributed to carcinogens in the workplace was 1.5% (95% CI of 1.2–1.9) for females and 12% (95% CI of 10–15) for males. These fractions correspond to an estimated incidence of 1.3 and 0.08 cases of lung cancer per 100,000 population for males and females, respectively.The incidence of lung cancer due to occupational exposure is low in Iran and, as in other countries, more lung cancer is due to occupational exposure among males than females.With the rise in the incidence of occupational lung cancer, information is increasingly available for developing countries to use as a tool to combat the preventable causes of this disease. One source of such information is the
The Mélange of Innovation and Tradition in Maltese Law: The Essence of the Maltese Mix?
B Andò
Potchefstroom Electronic Law Journal/Potchefstroomse Elektroniese Regsblad , 2012,
Abstract: Aim of this paper is to provide valuable insights into the Maltese legal system with a special focus on private law. The assumption is that this legal system is the byproduct of the "mixing" of innovation and tradition, resulting from the interaction of English law and continental law. A major role in the development of the system is played by courts. Some examples (moral damages and pre-contractual liability) are considered which highlight the importance of the function displayed by Maltese judges. KEYWORDS: Tradition; English law; continental law; hybridity; mixed legal systems; Maltese courts; moral damages; pre-contractual liability; lacunae
PROBLEMS OF FLIGHT PERSONNEL PREPARATION FOR MODERN AIRCRAFTS П ДГОТОВКА ЛЬОТНОГО СКЛАДУ НА СУЧАСН ПОВ ТРЯН СУДНА П ДГОТОВКА ЛЬОТНОГО СКЛАДУ НА СУЧАСН ПОВ ТРЯН СУДНА
B. Харченко,О. Ал?кс??в,Д. Бабейчук,М. Повознюк
Proceedings of National Aviation University , 2011,
Abstract: At present, the problem who can and who should solve the question concerning the preparationand recurrent training of pilots of Ukrainian civil aviation is not solved. The necessity of updatingof aircraft’s park in aviation branch and aircraft operation, which was ripened 10 years ago,demands a corresponding infrastructure. It is necessary to understand, that the pilots ready toperform the flights on modern aircrafts, will not appear by themselves, therefore the real actions onmodernization of existing system of aircrew and the aviation personnel preparation as a whole arerequired. Main objective of this work is the determination of the basic components concerning thesolving of the problematic questions on preparation of aircrew on modern types of aircrafts. Duringthe problem analysis it was specified that the present development of system of aircrew preparationin Ukraine is not perfect, and does not correspond the ICAO and EU requirements, therefore needsan immediate intervention at the highest State level. Trainings are not complex, as do not containthe elements of selection of aircrew members cooperation. Programs of recurrent training ofaircrew, courses of pilots training flight preparation were not reconsidered for many years Розглянуто проблему п дготовки п лот в цив льно ав ац Уккра ни, яка на сьогодн нев дпов да вимогам ICAO та С. Визначено основн складов п дготовки льотного складу насучасн пов трян судна.Ключов слова: аеронав гац йне обслуговування, керована множина, керован об’ кти,рад олокац йне та рад онав гац йне забезпечення польот в, системи керування пов трянимрухом. Розглянуто проблему п дготовки п лот в цив льно ав ац Уккра ни, яка на сьогодн нев дпов да вимогам ICAO та С. Визначено основн складов п дготовки льотного складу насучасн пов трян судна.
METHOD OF SYNTHESIS OF PROBLEM QUALITY OF THE COMPLEX NONLINEAR DYNAMIC SYSTEM CONTROL МЕТОД ГАРАНТОВАНОГО ОЦ НЮВАННЯ ОБЛАСТ ПОВН СТЮКЕРОВАНОГО СТАНУ СКЛАДНО НЕЛ Н ЙНО ДИНАМ ЧНО СИСТЕМИ МЕТОД ГАРАНТОВАНОГО ОЦ НЮВАННЯ ОБЛАСТ ПОВН СТЮ КЕРОВАНОГО СТАНУ СКЛАДНО НЕЛ Н ЙНО ДИНАМ ЧНО СИСТЕМИ
С. Павлова,B. Павлов,В. Чеп?женко
Proceedings of National Aviation University , 2011,
Abstract: Substantially nonlinear objects function at limitations of arbitrary kind. These limitations are not necessarily convex areas. For such objects the construction of area of the fully the fully-controlled state area is a serious problem. In the article it has been suggested to replace this task the task of the fully-controlled state area estimation from within. The secure estimation method of the fully-controlled state area has been developed for this purpose. Other dynamic system has been used as a tester (measure) of the fully-controlled state area. Construction and estimation of controllability and accessibility area of this dynamic system well methodically validate and deserved researchers confession. The descriptions concordance requirements of this new object with properties of initial object must be executed and provide property of immersion of new object in an initial object. Possibility is thus opened on the the fully-controlled state area of new object to define the the fully-controlled state area of the initial system На основ процедури мерсування м рних об’ кт в у вих дний об’ кт розроблено методгарантованого оц нювання област повн стю керованого стану.On the basis of procedure of immersion of the measuring objects in an initial object the secureestimation method of the fully controlled state area has been developed.На основе процедуры иммерсирования мерных объектов в исходный объект разработанметод гарантированного оценивания области полностью управляемого состояния. Показано, що для стотно нел н йних об’ кт в, що функц онують в умовах наявност обме-жень дов льного виду, як не обов’язково опуклими областями, побудова област повн стюкерованого стану проблематична. Запропоновано зам нити це завдання оц нюванням област повн стю керованого стану зсередини. Для цього розроблено метод гарантовано оц нюванняобласт повн стю керованого стану. Як вим рника (м ра) област повн стю керованого станувикористана нша динам чна система, п
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