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Light shelves provide a function to control direct sunlight and introduce daylight into indoor spaces. Also, chilled water flowing in the light shelf can mitigate local cooling demands in perimeter zones. Therefore, in this study, a thermally activated light shelf (TALS) system was proposed, and the TALS’s radiative cooling capacity was evaluated. To do this, a mock-up chamber was developed using prototypes of TALS systems based on panel configurations. It is included: ‘Insulated’ (INS), ‘Air layer’ (ARL), and ‘Air layer with fans’ (ARF), which were designed to increase thermal insulation, natural convection, and forced convection in the TALS panels, respectively. The experiment showed that the ARL and ARF increased cooling capacity by 29% and 57% compared to the INS. Natural convective heat transfer and fan-forced airflow in the TALS's air cavity contributed to improving cooling capacity. With the INS and ARL, the air temperature was recorded at 28.6°C, which requires additional space cooling. The ARF reduced air temperature up to 2.0°C because the TALS cavity fans expedited convective heat transfer and mixing air between the cavity and test chamber. The results of this study could be used to estimate TALS cooling capacity and propose an optimal design in buildings.

This study explores the effects of heating demand and hot water temperature on energy efficiency in a domestic gas boiler (DGB). Mock-up experiments were conducted using two types of boilers with different capacities (i.e., 11.6 kW and 23.3 kW of non-condensing boilers, 16.3 kW of condensing boiler) for comparative analysis. As results, for space heating, the efficiencies of non-condensing boilers (i.e., 11.6 kW and 23.3 kW) and condensing boiler (i.e., 16.3 kW) decreased by 12-44%, 15-46%, and 2-22% respectively as the heating load ratios were changed from 100%-25%. When the supply hot water temperature settings decreased from 55℃ to 45℃, the efficiencies were reduced by 13.6% (11.6 kW) and 53.3% (23.3 kW). For the condensing boiler, an efficiency reduction rate was 16.7% as the hot water temperatures dropped from 45℃ to 35℃. Also, since the boiler capacity depends on domestic hot water (DHW) load, the daily heating demands of space heating and DHW load were analyzed. In the results, reducing the lower limit of heating output could be more effective in improving the boiler efficiency for space heating. To provide sufficient DHW demand, it is required to maintain the upper limit of the heating output.

We have compared the efficiency of the detection for lymphocyte abnormalities using the LH 750 analyzer according to standard CLSI recommendations (Clinical and Laboratory Standards Institute) and three new rules dedicated to abnormal lymphocyte recognition. These new rules are defined by combining quantitative and qualitative criteria. They improve the detection of lymphocytes with abnormal morphology with an efficiency of 97.7% as compared to 81% with the standard protocol and a sensitivity of 92.8% compared to 23% initially. Regarding the detection of large granular lymphocytes, the new rules demonstrate an efficiency of 97.6%, a specificity of 81.8% and a specificity of 98.2%. These new criterias, which can be easily implemented in the settings of the automatic counter improve the technical efficiency of the validation process with an expected decrease of the number of manual slide reviews.

Purpose: To evaluate the outcome of patients treated for soft tissue sarcoma using three different post-operative radiotherapy schedules., Methods and Materials: Between 1990 and 2003, 89 patients (median age 50.8 years) presenting with soft tissue sarcoma (located to the limbs for 66 of them) underwent post-conservative-surgery radiotherapy. Pathology was liposarcoma in 35 cases and 54 others tumors. Tumors grades (FNCLCC classification) were 1, 2, 3 or unknown in 29, 32, 19 and 9 cases, respectively. Surgery was considered as complete in 68 patients. Irradiation was normofractionated (NF) in 62 cases, hyperfractionated (BF) in 19 cases and hypofractionated (HF) in 8 cases. For all the patients, median delivered dose was 61 Gy [34-76 Gy]., Results: Median follow-up of alive patients was 73,8 months [3-184]. Five-year local control (LC) and overall survival (OS) rates were 85.5 and 71.2% respectively. According to multifactorial analysis, favourable prognostic factors were for local control, complete surgery (P=0.0075) and for overall survival, complete surgery (P=0.0267), grade 1 tumor (P=0.012) and absence of distant recurrence (P=0.0488). There was no statistical evidence of difference for the five-year LC and OS rates between the patients who received NF, BF or HF. There were few complications and there were comparable in the three groups., Conclusions: This retrospective serie showed similar results for all the schedules. There is no evidence to recommend bifractionation. Hypofractionation should be used only in selected patients with poor performans status.

Purpose of the Study: Post-radiation shaft fractures of long bones are uncommon. Late or partial healing increases the risk of stress fracture. Different fixation techniques have been proposed. Treatment of radiated bone is difficult. We report a series of 6 nonunions of the proximal femur after radiotherapy., Material and Methods: Three patients had true fractures of irradiated bones several years after radiotherapy for bone or soft tissue tumors. Three other patients had pathological fractures or malignant osteolysis related to a myeloma and treated by osteosynthesis and post-operative radiotherapy., Results: Treatment required a total of 19 surgical procedures. There were nine stress fractures of ostheosynthesis material involving locked nails, cervicodiaphyseal nails and plates. There were no vascularized grafts in this series. At last follow-up the pathological fracture had healed in three cases, was stable but not healed in two, and required prosthetic reconstruction in one., Conclusion: We emphasize the importance of rigorous patient selection for radiotherapy and the possible preventive effect of osteosynthesis in certain cases with a high risk of secondary fracture of an irradiated bone. Vascularized grafts may be useful for refractory nonunion and may be proposed as first line treatment for post-radiation fractures.

Thirty-seven breast/ovarian or breast-only cancer families selected on a regional basis have been analyzed for mutations at BRCA1. By combining direct sequence analysis and protein truncation test, mutations were detected in 14 families (38%). We found seven different mutations, two of which have not been described before. Mutations at BRCA1 were present in 60% of breast/ovarian and 32% of breast-only cancer families. Mutations were frequent in families with at least one breast cancer case before age 40 (44%) and/or one bilateral breast cancer case (54%). Two mutations, namely 3600del11 and G1710X, are frequent in the population native from northeastern France. Oriented BRCA1 analysis should facilitate carrier detection in breast and/or ovarian cancer families stemming from this French area.

From 1981 to 1985, 428 patients presenting with an epidermoid carcinoma of the hypopharynx and/or larynx were treated with a curative intent by surgical resection and postoperative irradiation. Two-thirds of the tumours were T3 and 60% of patients presented with a clinical node involvement. The rates of local failure were 8%, 18% and 13%, respectively, for cancers of the larynx, of the piriform sinus and of the posterior wall; the rates of regional failure were 8%, 23% and 13%, respectively. There is no head and neck site with either a high or low risk of recurrence after resection, but the capsular rupture remains a factor of poor prognosis. The survival rate at 5 years of the whole series is 38%, for laryngeal localisation it reaches 62%. The risk of metastases is related to the node involvement and the interval between surgery and irradiation.

In a series of 224 patients treated between 1980 and 1992 for hypopharyngeal carcinoma by surgery and post postoperative radiotherapy we found an overall 54% incidence of elevated TSH levels. Decreased FT4 levels were associated in about one-third of the patients. When thyroidectomy was performed, 71% of the patients developed thyroid dysfunction. Most TSH abnormalities (45%) occurred within two years of treatment. Nevertheless, long-term followup is indicated since those complications may be delayed. Hormonal replacement therapy is recommended for patients with elevated TSH.

From October 1988 to July 1990, 18 patients with marginally resectable non-small cell cancer (10 stage IIIa and 8 stage IIIb) were entered in a phase-II trial combining induction therapy with a subsequent thoracotomy. Induction therapy included 2 courses of chemotherapy (5-FU and cisplatinum) and radiotherapy (30 Gray in split course). Partial response was observed in 10 patients, and minimal response in 3. Thoracotomy disclosed unresectability in 3 patients. Fifteen complete resections consisted in 1 lobectomy and 14 pneumonectomies. There were no operative deaths (30 days). Postoperative recovery was uneventful in 3 patients with exploratory thoracotomy and in 1 patient with lobectomy. Following pneumonectomy, we observed 2 bronchopleural fistulae and 1 empyema. On pathology, 10 patients were stage IIIa, and 3 were stage I, whereas no residual tumor was found in 2 patients. During follow-up, local recurrence occurred in 2, and metastases in 8. On December 31st, 1993, 3 patients were alive at 44, 52, and 62 months respectively. Nine patients had died from cancer, and 3 from unrelated causes. Estimated survival was 66.7% at 1 year, 33.3% at 3 years, and 20% at 5 years. We conclude that induction therapy allowed satisfactory resection for marginally resectable tumors. Operative morbidity was increased in this group. However, the 5-year survival was similar to resectable stage IIIa cancer.

Thymomas is a rare disease. Staging systems and surgical adjuvant treatments remain controversial. We retrospectively reviewed the outcome and the prognostic factors in a series of 149 patients with non metastatic thymomas treated in ten French cancer centers between 1979 and 1990. Patients were staged according to the "GETT" classification derived from that of Masaoka. There were 13 stage I patients, 46 stage II, 58 stage III and 32 stage IV. Surgery consisted of complete resection in 63 patients, partial resection in 31 patients and biopsy alone in 55 patients. All patients received postoperative radiation therapy and 74 were given postoperative chemotherapy. Median follow-up was 7.7 years. Local control was obtained in 117 patients (78.5%) and was influenced by the extent of surgery (p < 0.0001). Metastases occurred in 26 patients. Seven patients developed grade 3-4 pulmonary and heart complications. One patient developed a malignant lymphoma after 24 cycles of chemotherapy. Disease-free survival (DFS) rates were of five years 92%, 75%, 60%, 39% and 48% in stage I, II, IIIA, IIIB and IVA patients, respectively. After complete resection, partial resection and biopsy alone, these rates were 74%, 60% and 38%, respectively. With a multivariate analysis, DFS rates were influenced by the extent of surgery (p < 0.001) and by chemotherapy (p < 0.001). Three other factors could predict a worse DFS: young age (p < 0.006), stages III-IV (p < 0.04) and mediastinal symptoms (p < 0.001), "GETT" staging correlated well with local control and survival. After complete resection, a 50 Gy postoperative radiation therapy can be recommended in patients with invasive thymomas. Despite a 65% local control rate after partial resection or biopsy alone in this series, a higher dose of radiation (> 60 Gy) must be evaluated. Despite the benefit of the chemotherapy in this retrospective and multicentric study, the role of this treatment remains to be assessed.

Between January 1980 to December 1985, 248 patients with advanced squamous cell carcinoma of the pyriform sinus were retrospectively analysed. Criteria for inclusion in the study were the following: no previous treatment and treatment combining total pharyngolaryngectomy and postoperative radiotherapy. Mean follow up was 5 years with a minimum of 3 years. Seventy-one patients had a local regional recurrence (27.4%). Clinical staging at presentation and residual tumor at the primary site after surgery were factors significantly associated with higher local failure rates. The 5 year survival rate was 33% and the median survival time was 32 months (plateau was reached after the 6th year). The most frequent severe complication observed was pharyngeal stenosis occurring in 6% of the cases. This study confirms the poor prognosis of squamous cell carcinoma of the pyriform sinus, in spite of the combination of radical surgery and high dose postoperative radiotherapy.

Objectives: With effective screening programmes, the global incidence of in situ ductal carcinoma of the breast has risen to 15%, representing 20 to 30% of the mammographically detected T0 tumours. Prognosis is generally good in these tumours, but treatment has in the past, paradoxically, relied on extensive surgery. We report our experience with conservative radiosurgery performed in such cases from 1980 to 1990., Methods: There were 86 patients with a mean age of 52 years. Initial TNM classification was T0 = 57, T1 = 17, T2 = 9 and Tx = 3. All underwent limited surgery (quadrantectomy: 17; lumpectomy: 69) and 49 had axillary dissection. All received breast irradiation with scar boost (46-50 Gy + 10-14 Gy with classical fractionation). Thirty one postmenopausal women received adjuvant tamoxifen. The quality of the resection was good in 77 cases, doubtful or incomplete in 9. In one case axillary nodal involvement was found. The histological subtype was clearly identified in 63 cases. With a median follow-up of 58 months, 3 local relapses occurred (3.4%), at 27, 48 and 52 months respectively. One was in situ and two invasive. All were clinical lesions (2 T1 and 1 T2); two had incomplete or doubtful excision and all received less than 60 Gy on the tumour bed. All had mastectomy. Two are alive and well but one developed multiple metastasis. Five other women had subsequent surgery for suspicion of local relapse but all had benign disease. One developed contralateral disease 20 months later. Two women died subsequently due to a second cancer., Conclusion: These results confirm the importance of the excision quality and suggests a possible dose-effect in the control of in situ ductal carcinoma by radiotherapy. The recent results of the B-17 NSBAP trial also conclude that the radiosurgical conservative treatment, for limited in situ ductal carcinoma, is a reasonable alternative to mastectomy.

The authors report a case of hypothyroid hypertrophic myopathy consecutive to mantle irradiation for Hodgkin's disease. A rise in TSH level is frequent after mantle irradiation and it justifies prolonged monitoring of these patients' thyroid function, in view of the risk of patent hypothyroidism and perhaps cancer. The patient's age, the pre-irradiation lymphography and the chemotherapy associated with radiotherapy are all factors that influence the incidence of thyroid dysfunction, but there is no agreement concerning their relative importance. Hypertrophic myopathies due to hypothyroidism are rare, and their dramatic clinical presentation contrasts with an almost normal muscle histology. Alterations of energy metabolism and changes in the properties of myosin induced by hormonal deficiency account for the muscular weakness of these patients. On the other hand, the mechanism of muscle hypertrophy remains controverted, the most probable theory being and increase in the number of myotubes. Following irradiation, notably for Hodgkin's disease, the frequency of hypothyroidism requires a regular and systematic laboratory follow-up. Replacement therapy must be instituted if the basal TSH level increases, even if the T4 level is normal.

The ability of tumor cells to initiate coagulation, platelet aggregation and subsequent thrombotic alterations is believed to facilitate metastatic process. The mechanisms by which tumor cells develop thrombotic events in malignancy are discussed. We have examined the procoagulant activity and the modifications of rheologic platelet functions induced by 3 human mammary tumor cell lines (MCF-7, ZR-75-1, BT-20) using a laser-thromborheometer. According to experimental conditions, these 3 tumor cell lines aggregate platelets via a thrombin-dependent mechanism. Moreover, MCF-7 cells also induce ADP-like platelet aggregation. These data suggest the existence of several mechanisms of mammary tumor cell-induced platelet aggregation.

Variations of four enzymatic activities (aldolase, aspartate aminotransferase, creatine kinase and lactate dehydrogenase) were followed in human plasma for four days after head injury. Univariate analysis showed that each plasma enzyme activity significantly differed as early as 72 h after head injury according to the clinical evolution (survival or death). Multivariate analysis performed with these four tests allowed us to correctly divide, in terms of survival or death, 75 to 91% of unselected patients (n = 280). Combining these four tests increased discriminant power in severe head injury. Most of the patients who were misclassified according to their biochemical data received phenobarbital for treatment. Valuable prognostic information may thus be obtained by daily determinations of four enzymatic activities.

A new method for quantitative study of the release of ATP during platelet aggregation is described. The measures have been done by bioluminescence with ADP, collagen, arachidonic acid as inducing agents in 20 normal subjects. Different characteristics of quality of the method have been evaluated to define it as a "routine" test. The results, expressed in moles (M) of ATP by 1 X 10(6) platelets, are different according to the various inducing agents. In association with the study of the platelet aggregation this method should allow to have a better understanding of the anomalies of platelet functions in different diseases, and, may be, to define states of platelet "activation" as done by the study of the release of beta-thromboglobulin and of platelet factor 4.

The authors have investigated 910 post-mortem examinations of different primary cancers. Fifty-one cases (5.6% of the autopsies) presented cancer lesions of the heart. They have found the accuracy of clinical and paraclinical diagnostics by comparing them with autopsy findings in case of pericardial lesions, but very rarely in case of myocardial location.

In 85 patients presenting with various cancers, changes in the frequencies of plasma fibronectin and of the carcino-embryonic antigen (CEA) were compared and the results were correlated with the degree of extension. Forty-six percent of patients with mammary adenocarcinoma had plasma fibronectin values higher than the age-related limit range, but only 18% had an increase in CEA. In patients with secondary metastases, the highest values were significantly different from those found in controls. In these cases, fibronectin was present in abnormal concentrations in more than 80% of the patients, and CEA in 50%. Positive fibronectin values were less frequent in other cancers, except those of the genital tract. Neither fibronectin nor CEA are organ-specific, yet these two tumoral markers differ in the frequency with which they appear, notably in patients with mammary carcinoma.

Used in 13 cases of advanced gynecological and gastrointestinal carcinoma, pelvic exclusion using a suspension of the small intestine above the pelvis using absorbable material. The low-level of morbidity, value in dosimetric estimation, perfect feasibility and low cost of this technique should lead to its more widespread use whilst strictly respecting its indications. Nuclear magnetic resonance has been found to be a particularity novel and valuable method of post-operative investigation in visualisation and assessment of resorption of the polyglactine 910 trellis. Results in this series are analyzed at the end of a 5 to 14 month follow-up period and compared with data from experimental and clinical studies in the recent world literature.

An automated method for lactat determination on centrifugal analyser is described. The measurements have been done by end-point method during 300 seconds. A reagent blank is introduced in each run and its absorbance is deduced from those of the tests. The suitability of the method is assessed, particularly the sensitivity (detection limit) and the accuracy by checking the recovery. The results obtained by the automated and the manual method are well correlated.

A comparative study of the heterogeneity of the platelets volumes has been carried out in 9 patients with primary myeloid splenomegaly on their admission to hospital and during the evolution of their disease and in 40 healthy controls. The measurements were performed using a Coulter S-Plus system and different indexes have been calculated to better define the distribution of platelet volume. Platelet size distribution measurements demonstrated a double peculiarity in myeloid splenomegaly: an excessive microcytosis associated with a semi-linear and non log-normal distribution of macrothrombocyte volume. These data may be used as a good marker for the diagnosis of primary myeloid splenomegaly.

An automated method for ethanol determination on Gemsaec centrifugal fast analyser is described. The measurements have been done by a non linear two-point kinetic method during 10 minutes. The suitability of the proposed method has been evaluated by determination of the detection limit and the recovery. The method is applicated to whole blood and to plasma with and without initial perchloric acid deproteinization. Similar results are obtained for the different samples.