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The court The game is played on a volleyball court 18 meters (59 feet) long and 9 meters (29.

5 feet) wide, divided into two 9 m × 9 m halves by a one-meter (40-inch) wide net placed so that the top of the net is 2.43 meters (7 feet 11 5/8 inches) above the center of the court for men's competition, and 2.24 meters (7 feet 4 1/8 inches) for women's competition (these heights are varied for veterans and junior competitions). There is a line 3 meters from and parallel to the net in each team court which is considered the "attack line". This "3 meter" (or 10 foot) line divides the court into "back row" and "front row" areas (also back court and front court). These are in turn divided into 3 areas each: these are numbered as follows, starting from area "1", which is the position of the serving player: After a team gains the serve (also known as siding out), its members must rotate in a clockwise direction, with the player previously in area "2" moving to area "1" and so on, with the player from area "1" moving to area "6". The team courts are surrounded by an area called the free zone which is a minimum of 3 meters wide and which the players may enter and play within after the service of the ball.[9] All lines denoting the boundaries of the team court and the attack zone are drawn or painted within the dimensions of the area and are therefore a part of the court or zone. If a ball comes in contact with the line, the ball is considered to be "in". An antenna is placed on each side of the net perpendicular to the sideline and is a vertical extension of the side boundary of the court. A ball passing over the net must pass completely between the antennae (or their theoretical extensions to the ceiling) without contacting them.

Volleyball Court Dimensions The Volleyball court is 60 feet by 30 feet in total. The net in placed in the center of the court, making each side of the net 30 feet by 30 feet. Center Line A center line is marked at the center of the court dividing it equally into 30 feet squares, above which the net is placed. Attack Line An attack line is marked 10 feet of each side of the center line. Service Line A service line, the area from which the server may serve the volleyball, is marked 10 feet inside the right sideline on each back line. The Net The net is placed directly above the center line, 7 feet 4 inches above the ground for women and 8 feet above the ground for men. Poles Volleyball poles should be set at 36 feet apart, 3 feet further out from the sidelines. Ceiling Height The minimum ceiling height should be 23 feet, though they should preferably be higher.

Facilities & Equipment Used in Volleyball

History    The patient underwent a biopsy of the supraclavicular lymph node.D. the patient was noted to have chylous drainage from the biopsy site and injury to thoracic duct was suspected. As noted by Top End Sports. All lines are painted white. She also complained of weight loss.Learn the regulation standards for the popular sport of volleyball. a competition ball must measure approximately 25 to 27 inches (64 to 67cm) in circumference and weigh 9 to 10 oz. non-tender Ext: No edema. requiring ER visit. EOMI. (260 to 280g). the ceiling of the indoor facility must be at least 23 feet high. Net poles are positioned 36 feet apart. These symptoms subsequently worsened. the net is 7 feet 4 inches high for the women's game and 8 feet high for the men's game. Ball A competition volleyball will fall in the range of 25 to 27 inches in circumference. Volleyball is a popular NCAA and Olympic sport. no rubs Lungs: clear to auscultation Abdomen: Soft. Further evaluation with CT scan revealed a mediastinal mass and left supraclavicular lymphadenopathy. Court 1. alcohol or drug abuse FH: Non-contributory Physical Exam         T:98. good pulses . night sweats. Measuring from the ground to the top.5 psi. fever and chills. anicteric sclerae Neck: Discharging wound from left supraclavicular area Heart: RRR. It should be inflated to a pressure of approximately 4. no smoking. History     PMH: Polycystic ovary disease Meds: None SH: patient was a housekeeper. The facilities and equipment used in collegiate and world class competition must meet regulation standards. Primary Mediastinal B-Cell Lymphoma Case Presentation and Review Ali Moussa. M. The entire in-play area of the court measures 60 by 30 feet and is painted a light color. where a CXR was done and revealed a mediastinal mass. Net The net should be positioned 8 feet high for a men's game. but it's preferable to be higher. H&P     25 year old Hispanic female presented with 2 month history of chest discomfort and SOB.0 BP:128/78 P:98 RR:12 General: Obese Hispanic female in NAD HEENT: PERRL. She underwent reexploration and injury to thoracic duct was repaired. Two days later. NO HSM.According to the International Federation of Volleyball (FIVB) rulebook.

6-12% of all diffuse large cell lymphoma cases. L14. Primary Mediastinal B-Cell Lymphoma       Uncommon type of B-cell lymphoma. However. Nodular thickening of the pericardium. M5.5 Patholgy    Diffuse infiltrate of neoplastic lymphoid cells. Other names: Diffuse histiocytic lymphoma with sclerosis. Population of CD19/CD20/CD22 positive lymphocytes with loss of surface expression of both kappa and lambda immunoglobulin light chain.1 Tbil 0. Radiographic Findings    CT chest: 12 x 6 x 11 cm heterogenous mass in the anterior mediastinum displacing the great vessels. The patient was treated with ESHAP and subsequently peripheral stem cell collection. repeat Gallium scan showed uptake in the mediastinal area. Female predominance.Lab Findings        WBC 9. Hospital Course   The patient underwent 7 cycles of CHOP with decrease in the size of the mediastinal mass. . which are partially surrounded by bands of fibrous tissue.     2-3% of all non-Hodgkin’s lymphoma cases.7 Ca 8. CT abdomen and pelvis: no lymphadenopathy. Predominant involvement of the mediastinum. Bone marrow aspirate & biopsy: no tumor infiltration. Lack of diffuse lymphadenopathy.6 Hct 40.5 Alk Phos 78 LDH 2733 β-2 microglobulin <0. Superior vena cava syndrome.0        Uric acid 5.9 Alb 2. Later on she will undergo transplantation. Young median age (30-40).0 Plt 244 Cr 0.1 N78. small amount of ascites. Gallium scan: Positive for uptake in hilar and mediastinal areas. E2 Hgb 13.8 TP 4. mediastinal large cell lymphoma with sclerosis.

CD10. Missense point mutations of P53 (3 of 16). PMBCL often display an aggressive pattern of hematogenous dissemination. which may be related to PMBCL lymphomagenesis.Primary Mediastinal B-Cell Lymphoma Histopathology       Uniformly large cell lymphoma. Exhibit rearranged IG heavy and light chain genes. cough. CD20. CD22). Often associated with areas of necrosis. At relapse. Β2-Microglobulin . Negative: TDT. CD15. Express B-cell markers (CD19. 12q. Major feature is presence of broad bands of dense fibrosis. Clinical Features       Median age 30-40 Female predominance Median time to diagnosis 4-6 weeks Chest pain. Low serum β2-microglobulin. CD5. but it is speculated to be involved in membrane signaling. CD3. Frequent gains involving chromosomes 2p. and Xq. dyspnea 90-95% SVC syndrome 50-60% B symptoms 20-30% Clinical Features        Elevated LDH 40-80% Splenomegaly is rare Pleural effusion 50% Supraclavicular adenopathy 30-35% Stage I/II 80-85% Bone marrow involvement <10% CNS involvement <5% Clinical Features     Bulky disease is found in 70-80%. No bcl-2 rearrangement was found (20-25% in DLCL). 9p. Molecular Biology      1 of 16 cases had bcl-6 rearrangement (40-45% in DLCL). Molecular Biology   Recently MAL gene expression was demonstrated in 8/12 cases of PMBCL (no MAL in DLCL). Local mediastinal relapse frequently accompanies distant extranodal dissemination. Role of MAL is unknown. No EBV association.

Median survival time after relapse was 7 months. stage III or IV). reported treatment outcome for a large (N=106) cohort of PMBCL treated with CHOP at 4 European institutions: 1-Bulky disease was present in 73%. XRT to the mediastinum: 30-36 Gy. stage I-II 84%. 3-Pericardial and pleural effusion was present in 36% and 35%. These antigens are required for tumor cell recognition by cytotoxic T lymphocytes. 35% had refractory disease. Overall survival was 82% at 96 months. HDCT is the preferred salvage treatment or as front-line consolidation in patients with poor prognostic factors (bulky disease. median age 31. . Role of Transplantation   Because of unsatisfactory results of conventional chemotherapy salvage in patients refractory to treatment or relapsed. Decreased MHC class I has been suggested as an escape mechanism from immune control. use of high dose chemotherapy (HDCT) has been advocated. salvage therapy included second line chemotherapy with or without transplantation. PR 42%). All patients received MACOP-B. Most relapses occurred within 18 months of diagnosis and were predominantly intrathoracic. only 7 non-responders. CR 86%. Italian Study       50 pts: 30F. median survival was 10 months. Treatment A study by Lazzarino et al. Early studies suggested that PMBCL are a highly aggressive subgroup of NHL with poorer prognosis.      65% had response (CR 23%. β2-microglobulin is the light chain common to MHC class I. Lazzarino et al. Of those who responded. 20M.    Cells exhibit defects in the expression of MHC class I antigens. 49 (77%) received consolidative XRT to the mediastinum. For the non-responders. Lazzarino et al.     Relapse rate for responders was 28%. 82% for the responders. 3 year survival rates for the entire series was 50%. pleural or pericardial effusion. More recent studies demonstrated that PMBCL is a curable disease. Gallium-scan negativity was an important prognostic factor in restaging patients treated for PMBCL.   2-SVC was present in 47%. No significant difference between patients who received or did not receive consolidative XRT. respectively. Treatment    Response to treatment varies among series as the result of small numbers of patients.

Transplantation    Popat et al. BEAC. 5 yr survival was 57%. 12 primary refractory disease. 1 toxic death. Consider HDCT/SCT: survival benefit may not be limited to patients with chemosensitive relapse.   PMBCL was associated with significantly better 5-year overall survival as compared to diffuse large B-cell lymphoma (56% vs 35%). CBV. TBC.6%. 58% for primary refractory disease. Sehn et al. The prominent production of stroma with abundant fibrosis is a peculiar property (seen also in nodular sclerosis HD). 6 chemoresistant relapse. 46 CR (88%).     34 patients with PMBCL underwent transplantation: 4 CR.6% and overall survival rate was 78. and 27% for first relapse). . Disease status at the time of transplant (83% for first response. mediastinal localization was 1 of 3 factors associated with improved survival (the other 2 being LDH level and stage). Interestingly. 5 failures. Outcome of patients who have complete response is very good. Popat et al. Role of XRT remains to be defined. described the outcome of 31 patients with PMBCL: 14 had induction failures. 3 courses of double CHOP-like regimen was given. 11 first relapse. median age 40. Conditioning regimen: CBV. then 40 Gray XRT. 19M. 42% had previously undergone XRT. Conclusion   It is probably appropriate to consider CHOP the standard first line chemotherapy. Sehn et al. 8 PR. 10 yr disease free survival was 73. stage II.     Predictive factors for progression free survival were: Chemosensitive disease (75% vs 33%). 9 relapses. ASH 1999      52 pts: 33F. Conclusion     PMBCL is a uncommon type of NHL. 18 patients received XRT. Conditioning regimens included BEAM. 11 had chemosensitive relapse. After initial surgery. Administration of XRT did not affect survival. but also as consolidation for patients with poor risk factors and with primary refractory disease.