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1.
Am J Surg ; 216(3): 438-443, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29656991

RESUMO

BACKGROUND: The purpose of this study was to identify the predictive factors for ypN0 status in tumors with good pathologic response to chemoradiotherapy (CRT). METHODS: A retrospective chart review was conducted on patients at two tertiary cancer center who underwent rectal resection after good response to CRT between 2000 and 2013. RESULTS: No preoperative treatment (oxaliplatin use, radiotherapy boost of 5,4 Gy, delay CRT-surgery) impacted on the ypN status. In the multivariate analysis, only a ypT<3 (HR 7.5 [2,9-19.5]) was significant and no lymphovascular invasion (HR 8,9 [1.6-49.8]) was limited to significance.The best model predicting the ypN0 status used only the ypT status<3. The major part (92.2%) of patients with ypT0-2 tumors had no LN invasion. CONCLUSION: The risk of lymph node involvement metastases was only 7.8% for the patients with an ypT0-2 status. A fullthickness transanal resection coud be the futur treatment of these patients.


Assuntos
Adenocarcinoma/secundário , Linfonodos/patologia , Estadiamento de Neoplasias/métodos , Neoplasias Retais/diagnóstico , Adenocarcinoma/diagnóstico , Adenocarcinoma/terapia , Idoso , Quimiorradioterapia Adjuvante , Colectomia/métodos , Feminino , Humanos , Laparoscopia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Prognóstico , Neoplasias Retais/terapia , Estudos Retrospectivos
2.
Rev Sci Instrum ; 87(11): 11D622, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27910442

RESUMO

Gain can vary across the active area of an x-ray framing camera by a factor of 4 (or more!) due to the voltage loss and dispersion associated with pulse transmission in a microstripline-coated microchannel plate. In order to make quantitative measurements, it is consequently important to measure the gain variation ("flat field"). Moreover, because of electromagnetic cross talk, gain variation depends on specific operational parameters, and ideally a flat field would be obtained at all operating conditions. As part of a collaboration between Lawrence Livermore National Laboratory's National Ignition Facility and the Commissariat à l'Énergie Atomique, we have been able to evaluate the consistency of three different methods of measuring x-ray flat fields. By applying all three methods to a single camera, we are able to isolate performance from method. Here we report the consistency of the methods and discuss systematic issues with the implementation and analysis of each.

3.
Rev Sci Instrum ; 87(9): 093501, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27782554

RESUMO

Streak cameras are widely used to record the spatio-temporal evolution of laser-induced plasma. A prototype of picosecond X-ray streak camera has been developed and tested by Commissariat à l'Énergie Atomique et aux Énergies Alternatives to answer the Laser MegaJoule specific needs. The dynamic range of this instrument is measured with picosecond X-ray pulses generated by the interaction of a laser beam and a copper target. The required value of 100 is reached only in the configurations combining the slowest sweeping speed and optimization of the streak tube electron throughput by an appropriate choice of high voltages applied to its electrodes.

4.
Rev Sci Instrum ; 87(3): 033706, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27036783

RESUMO

The Laser Megajoule (LMJ) facility located at CEA/CESTA started to operate in the early 2014 with two quadruplets (20 kJ at 351 nm) focused on target for the first experimental campaign. We present here the first set of gated x-ray imaging (GXI) diagnostics implemented on LMJ since mid-2014. This set consists of two imaging diagnostics with spatial, temporal, and broadband spectral resolution. These diagnostics will give basic measurements, during the entire life of the facility, such as position, structure, and balance of beams, but they will also be used to characterize gas filled target implosion symmetry and timing, to study x-ray radiography and hydrodynamic instabilities. The design requires a vulnerability approach, because components will operate in a harsh environment induced by neutron fluxes, gamma rays, debris, and shrapnel. Grazing incidence x-ray microscopes are fielded as far as possible away from the target to minimize potential damage and signal noise due to these sources. These imaging diagnostics incorporate microscopes with large source-to-optic distance and large size gated microchannel plate detectors. Microscopes include optics with grazing incidence mirrors, pinholes, and refractive lenses. Spatial, temporal, and spectral performances have been measured on x-ray tubes and UV lasers at CEA-DIF and at Physikalisch-Technische Bundesanstalt BESSY II synchrotron prior to be set on LMJ. GXI-1 and GXI-2 designs, metrology, and first experiments on LMJ are presented here.

5.
Rev Sci Instrum ; 85(11): 11D620, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25430196

RESUMO

Commissariat à l'Énergie Atomique et aux Énergies Alternatives has developed the ARGOS X-ray framing camera to perform two-dimensional, high-timing resolution imaging of an imploding target on the French high-power laser facility Laser MegaJoule. The main features of this camera are: a microchannel plate gated X-ray detector, a spring-loaded CCD camera that maintains proximity focus in any orientation, and electronics packages that provide remotely-selectable high-voltages to modify the exposure-time of the camera. These components are integrated into an "air-box" that protects them from the harsh environmental conditions. A miniaturized X-ray generator is also part of the device for in situ self-testing purposes.

6.
Rev Sci Instrum ; 79(10): 10F301, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19044614

RESUMO

The diagnostic designs for the Laser Megajoule (LMJ) will require components to operate in environments far more severe than those encountered in present facilities. This harsh environment will be induced by fluxes of neutrons, gamma rays, energetic ions, electromagnetic radiations, and, in some cases, debris and shrapnel, at levels several orders of magnitude higher than those experienced today on existing facilities. The lessons learned about the vulnerabilities of present diagnostic parts fielded mainly on OMEGA for many years, have been very useful guide for the design of future LMJ diagnostics. The present and future LMJ diagnostic designs including this vulnerability approach and their main mitigation techniques will be presented together with the main characteristics of the LMJ facility that provide for diagnostic protection.

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