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UK PubMed Central (United Kingdom)

In many radiotherapy clinics, geometric uncertainties in the delivery of 3D conformal radiation therapy and intensity modulated radiation therapy of the prostate are reduced by aligning the...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundThe purpose of this study was to analyze the radiotherapy (RT) quality assurance (QA) assessment in Japan Clinical Oncology Group (JCOG) 0202, which was the first trial...Full Text Available

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The quality insurance in radiotherapy in the frame of highly complex technical process as Intensity modulated radiotherapy (I.M.R.T.) needs independent control of the delivered dose to the patient. Actually, up to now, most of the radiotherapy treatments rely only on computed dosimetry through a rather complicated series of linked simulation tool. This dosimetry approach requires also qualified treatment means based on cautious quality insurance procedures. However, erroneous parameters could be difficult to detect and systematical errors could happen leading to radiotherapy accidents. In this context, in vivo dosimetry has a critical role of final control of the delivered dose. As many beam incidences and ports are used for any photon therapy treatment, external control could be very tedious and time consuming. Therefore, innovations are needed for in vivo dosimetry to provide ergonomic and efficient ...

UK PubMed Central (United Kingdom)

Background:The non-surgical management of non-melanoma skin cancers is an area requiring clinical investigation. Radiotherapy has a role in treatment for a defined subset...Full Text Available

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Carcinoma en cuirasse of the breast, which invades the skin via lymphatics and may encase the entire thorax and abdomen, is poorly controlled by surgery, chemotherapy, or conventional irradiation. Palliation of patients with breast carcinoma en cuirasse is a difficult clinical problem which must be effectively managed over extended periods due to the indolent nature of this disease. The management of three cases is reported, and the new technique of rotational subtotal skin electron-beam therapy (SSEBT) is presented. (author).

International Nuclear Information System (INIS)

To compare clinical effectiveness of Viabil-covered stents versus uncovered metallic Wallstents, for palliation of malignant jaundice due to extrahepatic cholangiocarcinoma, 60 patients were enrolled in a prospective and randomized study. In half of the patients a bare Wallstent was used, and in the other half a Viabil biliary stent. Patients were followed up until death. Primary patency, survival, complication rates, and mean cost were calculated in both groups. Stent dysfunction occurred in 9 (30%) patients in the bare stent group after a mean period of 133.1 days and in 4 (13.3%) patients in the covered stent group after a mean of 179.5 days. The incidence of stent dysfunction was significantly lower in the covered stent group (P = 0.046). Tumor ingrowth occurred exclusively in the bare stent group (P = 0.007). Median survival was 180.5 days for the Wallstent and 243.5 days for the Viabil group (P = 0.039). Complications and mean cost were ...

UK PubMed Central (United Kingdom)

This article is a story of networking of palliative care at the corporate level. This gives an insight that if you have will and dedication then you can imagine and make it true that networking can...Full Text Available

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Bone metastases at the thoracic and lumbar segment of the spine are usually presented with painful sensation and medullar compression. The treatment is based on the clinical and neurological conditions of the patient and the degree of tumor invasion. In the present study, 32 patients with spinal metastasis of thoracic and lumbar segment were prospectively analyzed. These patients were treated by decompression and internal stabilization followed by radiotherapy or irradiation with external immobilization. The election of the groups was in accordance with the tumor radiotherapy sensitivity, clinical conditions, spinal stability, medullar or nerve compression and patient's decision. The Frankel scale and pain visual test were applied at the moment of diagnosis and after 1 and 6 months. The surgical group had better results with preserving the ambulation longer and significant reduction of ...

International Nuclear Information System (INIS)

The incidence of hilar cholangiocarcinoma is very rare worldwide. Radical resection is the only prognostic factor for long survival in patients with hilar cholangiocarcinoma. Postoperative radiation therapy can improve local control and survival rates for patients with palliative resection, but it remains controversial in patients with radical resection. Biliary drainage can effectively release bile duct obstruction for the majority of patients with locally advanced disease, and may even prolong survival when combined with radiation therapy. Radiation therapy includes extrernal beam therapy alone, external beam therapy with intraluminal brachytheapy and new radiation technique, such as three dimentional conformal therapy and intensity modulated radiation therapy. The propective randomized clinical study is needed for further investigation in the role of combined modality therapy especially for hilar cholangiocarcinoma. (authors)

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To evaluate the efficacy of newly designed covered and non-covered coated colorectal stents for colonic decompression. Twenty-six patients, (15 palliative cases and 11 preoperative) underwent treatment for the relief of colorectal obstruction using metallic stents positioned under fluoroscopic guidance. In 24 of the 26, primary colorectal carcinoma was diagnosed, and in the remaining two, recurrent colorectal carcinoma. Twenty-one patients were randomly selected to receive either a type A or type B stent; for the remaining five, type C was used. Type A, an uncovered nitinol wire stent, was lightly coated to ensure structural integrity. Type B (flare type) and C (shoulder type) stents were polyurethane covered and their diameter was 24 and 26mm, respectively. The rates of technical success, clinical success, and complications were analyzed using the chi-square test, and to analyse the mean period of patency, the Kaplan-Meier method was used. ...

International Nuclear Information System (INIS)

Three cases of primitive suprasellar germinomas are reported: the tumors show typical clinical signs (diabetes insipidus, disfunctions), but CT findings are not so specific. It is very important to reach a correct diagnosis based on clinical and radiological findings, because of very high radiosensibility of the tumor. The accuracy of preoparative diagnosis has been enhanced by CT in addition to conventional neuroradiological examinations. Due to the possible risk of meningeal spreading following biopsy, some authors prefer to avoid biopsy and to treat directly the patient by radiotherapy; a rapid reduction of the tumor size at the dose of 30 Gy suggest a possible germinoma.

International Nuclear Information System (INIS)

The implementation of a three-dimensional conformal radiotherapy facility in the radiotherapy department of the Heinrich Heine University is described. Complex radiotherapy techniques with commercially available networked systems are introduced to improve clinical work. Over 18 month we have gained clinical experience with a PHILIPS Multileaf Collimator (MLC) mounted on a SL 25 linear accelerator. For a limited period the MLC was used as a conventional blocking device. The standard MLC-shapes are controlled with a stand-alone computer system. In addition, a three-dimensional treatment planning system (3-D-TPS / TMS-Radix, Helax AB) based on convolution/superposition algorithms was recently installed. Treatment optimization is achieved using static field arrangements with complete volumetric computerized tomographic patient data for 3-D-TPS. Conformal adaptation of the 95%-isodose to ...

UK PubMed Central (United Kingdom)

Goals of workThe goal of this study was to evaluate, at a population level, the association between specialized palliative care services (SPCS) and short- and long-term caregiver...Full Text Available

Science.gov (United States)

Two patients who developed large intracranial vessel occlusion after standard radiation therapy for brain tumor are described. This form of vascular occlusion is usually seen in patients who have previously been treated by radiotherapy for intracranial tumor who then develop a relatively acute change in neurologic status. Histology of the lesion mimics accelerated focal arteriosclerosis. The clinical and radiographic manifestations of one case were highly atypical. The vasculopathy became evident shortly after termination of radiation therapy for a fourth ventricular ependymoma, and the angiographic picture stimulated a diffuse arteritis. The second patient was more typical, with clinical symptoms developing 12 years after radiation therapy for an oligodendroglioma. Occlusion of a proximal vessel that had been included in the radiation port was demonstrated radiographically and confirmed by pathologic examination. The ...

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We wanted to determine the technical and clinical efficacy of using a PTFE-covered self-expandable nitinol stent for the palliative treatment of malignant biliary obstruction. Thirty-seven patients with common bile duct strictures caused by malignant disease were treated by placing a total of 37 nitinol PTFE stents. These stents were covered with PTFE with the exception of the last 5 mm at each end; the stent had an unconstrained diameter of 10 mm and a total length of 50 80 mm. The patient survival rate and stent patency rate were calculated by performing Kaplan-Meier survival analysis. The bilirubin, serum amylase and lipase levels before and after stent placement were measured and then compared using a Wilcoxon signed-rank test. The average follow-up duration was 27.9 weeks (range: 2 81 weeks). Placement was successful in all cases. Seventy-six percent of the patients (28/37) experienced adequate palliative drainage for ...

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We wanted to evaluate the long-term results of a dual expandable nitinol stent for the palliative treatment of malignant gastroduodenal strictures. The dual stent consists of two stents; an outer partially nylon covered stent and an inner bare nitinol stent. The outer stent was placed into the stricture and this was followed by coaxial placement of the inner bare stent. Using fluoroscopic guidance, dual expandable stents were placed in 86 patients with inoperable malignant gastroduodenal strictures. The technical and clinical success, the complication, survival and the stent patency were evaluated during the follow-up period. Stent placement was technically successful in 83 of the 86 patients. After stent placement, 74 of the 85 patients showed improvement of their symptoms. During the mean follow-up period of 133 days, 24 patients (28%) developed recurrent symptoms due to incomplete expansion (n=1), stent migration (n=4), food impaction (n=2), ...

International Nuclear Information System (INIS)

... pathological changes patients radiation protection radiotherapy diseases

International Nuclear Information System (INIS)

MRI provides a non-invasive diagnostic tool complementing echocardiography on one hand, and showing advantages over echocardiography, on the other hand, especially after corrective procedures. The multiple different MRI sequences need to be adapted to examinations of children and patients with congenital heart disease (CHD), and can be used to detect morphologic changes, blood-flow in the heart and thoracic vessels and diastolic or systolic function of myocardium. Several factors determine the success of the examination of a complex congenital heart disease or a postoperative situs. Pediatric radiologists and radiologists experienced in congenital heart diseases have to work in close cooperation. Echocardiography should be performed before MRI. The results of prior examinations and the clinical history of the patients, including possible palliative or reconstructive operations, must be available before MRI to guide the planning of the ...

International Nuclear Information System (INIS)

Single photon emission computed tomography (SPECT) of lung perfusions permits to map functioning lung parenchyma with higher sensitivity than CT. Delivering higher radiations doses it used to increase local control in lung carcinoma; this strategy is based on radiobiological and clinical studies. Lung parenchyma is a dose-limiting tissue in patients irradiated for lung cancer. Functional mapping based on SPECT and CT findings permits to design radiation beams such as to minimize irradiation of functioning lung.

International Nuclear Information System (INIS)

Lung cancer staging according to the TNM system is based on morphological assessment of the primary cancer, lymph nodes and metastases. All aspects of this important oncological classification are measurable with MRI. Pulmonary nodules can be detected at the clinically relevant size of 4-5 mm in diameter. The extent of mediastinal, hilar and supraclavicular lymph node affection can be assessed at the same time. The predominant metastatic spread to the adrenal glands and spine can be detected in coronal orientation during dedicated MRI of the lungs. Search focused whole body MRI completes the staging. Various additional MR imaging techniques provide further functional and clinically relevant information during a single examination. In the oncological context the most important techniques are imaging of perfusion and tumor motion. Functional MRI of the lungs complements the pure staging and improves surgical approaches and ...

UK PubMed Central (United Kingdom)

The treatment of locally advanced rectal cancer including timing and dosage of radiotherapy, degree of sphincter preservation with neoadjuvant radiotherapy, and short and long term effects of radiotherapy...Full Text Available

International Nuclear Information System (INIS)

From 1964 to 1973 at the Institute of Oncology and Radiobiology, Havana City, 18 clinical histories were studied, all of them from patients with Erwing's sarcoma, histologically diagnosticated by biopsy. Age, sex, race, traumatism background, hemogram disturbances, radiographic signs, primary tumor localization, and early treatment, were exposed. Early treatment in 14(83%) patients as radiotherapy. Local recurrence or metastasis was presented in 10(55,5%) patients during the two first years following attack treatment. Five (35,7%) patients was the survival rate within five years starting early treatemt. After five years, three (21,4%) patients were alive: for 18 and 14 year, and 64 month period; two patients died at 62 and 64 months. It is concluded that this survival may be increased by initial behaviour enclosed at the technologic therapeutic patterns of the the Institute of Oncology and Radiobiology, of Havana City. (author).

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In order to consider some procedures to prevent errors in radiotherapy based in learned lessons of accidental expositions and in accordance with information contained in international reports elaborated by International Atomic Energy Agency (IAEA) and of the data base availability by the European group Radiation Oncology Safety Information System (ROSIS) on the events, a research of the occurred errors was performed. For the evaluation of the incidents a data base based in the ROSIS and added plus a parameter was created 'type of error'. All the stored data make possible the evaluation of the 839 incidents in terms of frequency of the type of error, the process of detention, the number of reached patients and the degree of severity. Of the 50 types of found errors, the type of error more frequently was 'incorrect treatment coordinate', confirmed with the data of literature and representing 28,96 por cent of the total of the ...

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The technical complexity of intraoperative radiotherapy (IORT) requires modification of the standard physical and dosimetric methods used in external electron beam therapy. At the National Cancer Institute, a number of technical innovations have been integrated into ongoing clinical studies of IORT. These include: (1) an electron beam applicator system that is significantly different from other IORT systems and includes customized squircle applicators; (2) peripheral dose shields; (3) a modified surgical table replacing the standard radiation treatment couch; and (4) routine use of multiple IORT fields that necessitates field matching. The IORT applicator system and related devices and techniques are dosimetrically characterized in detail both for use in the IORT program and in order to illustrate many useful facets of electron dosimetry.

British Library Electronic Table of Contents (United Kingdom)

Adaptive radiation therapy for liver cancer has the potential to reduce normal tissue complications and enable dose escalation, allowing the potential for tumor control in this challenging site. Using adaptive techniques to tailor treatment margins to reflect patient-specific breathing motions and image-guidance techniques can reduce the high dose delivered to surrounding normal tissues while ensuring that the prescription dose is delivered to the tumor. Several treatment planning and delivery techniques have been developed for use in the liver, including a margin to encompass the full breathing motion, mean position techniques, which evaluate the probability of tumor location during breathing, breath hold, gating, and tracking. Patient selection, clinical workflow, and quality assurance m...

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Perforated thermoplastic masks are used to provide patients immobilization. This procedure inserts a material in the path of the radiation beam, that attenuates and modifies the beam fluence and flatness. The present study evaluates the increase in skin dose as a result of using thermoplastic masks. Relative doses were measured on the surface of a solid water phantom, in the presence and absence of masks. These masks were stretched according to deformation patterns observed in clinical routine. The measurements were obtained with a plane-parallel chamber (Markus type 23343) and radiochromic film (EBT Gafchromic) for 6MV X-rays from a linear accelerator, and for a radiation beam from a cobalt therapy unit. The results showed that thermoplastic masks, whose thickness varied between 2 and 3 mm, increased the dose on the surface by a factor of 3. Due to the variations in the skin dose distribution, clinical procedures were suggested to minimize ...

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Background: the authors report on the conception and first clinical application of a donut-shaped high-dose configuration for proton therapy (PT). This approach allows one to intensify target volume dose coverage for targets encompassing a critical, dose-limiting structure - like here, the cauda equina -, whilst delivering minimal dose to other healthy structures surrounding the target, thereby reducing the integral dose. Methods and results: intensity-modulated PT methods (IMPT) for spot scanning were applied to create and deliver a donut-shaped high-dose configuration with protons, allowing treating > 75% of the target with at least 95% of the prescribed dose of 72.8 CGE, whilst restricting dose to the cauda equina to 60-65 CGE. Integral dose was lower by a factor of 3.3 as compared to intensity-modulated radiotherapy with photons (IMXT). Conclusion: IMPT and spot scanning technology allow a potentially clinically ...

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We wanted to evaluate the usefulness of a new type of a complex expandable nitinol stent that was designed to reduce the stent's propensity to migration during the treatment of malignant gastroduodenal obstructions. Two types of expandable nitinol stent were constructed by weaving a single thread of 0.2mm nitinol wire in a tubular configuration: an uncovered stent 18mm in diameter and a covered stent 16mm in diameter. Both ends of the covered stent were fabricated by coaxially inserting the covered stent into the tubular uncovered stent and then attaching the two stents together with using nylon monofilament. Under fluoroscopic guidance, the stent was placed in 29 consecutive patients (20 men and 9 women, mean age: 65 years) who were suffering with malignant gastric outlet obstruction (n=20), duodenal obstruction (n=6) or combined obstruction (n=3). Clinical improvement was assessed by comparing the food intake capacity before and after the procedure. The ...

International Nuclear Information System (INIS)

This work describes an experimental verification of the two-photon dose calculation engines available on the Helax-TMS (version 6.1) commercial radiotherapy treatment planning system. The performance of the pencil beam convolution and the collapsed cone superposition algorithms was examined for 4, 6, 15 MV beams, under a range of clinically relevant irradiation geometries. Comparisons against measurements were carried out in terms of absolute dose, thus assessment of the accuracy of monitor unit (MU) calculations was also carried out. Results show that both algorithms agree with measurement to acceptable tolerance levels in most cases in homogeneous water-equivalent media irradiated under full scatter conditions. The collapsed cone algorithm slightly overestimates the penumbra width and this is mainly due to discretization effects of the fluence matrix. The accuracy of this algorithm strongly depends on the resolution of the patient density ...

International Nuclear Information System (INIS)

Purpose: To report our clinical experiences with on-board imager (OBI) kV image verification for cranial stereotactic radiosurgery (SRS) and radiotherapy (SRT) treatments. Methods and Materials: Between January 2007 and May 2008, 42 patients (57 lesions) were treated with SRS with head frame immobilization and 13 patients (14 lesions) were treated with SRT with face mask immobilization at our institution. No margin was added to the gross tumor for SRS patients, and a 3-mm three-dimensional margin was added to the gross tumor to create the planning target volume for SRT patients. After localizing the patient with stereotactic target positioner (TaPo), orthogonal kV images using OBI were taken and fused to planning digital reconstructed radiographs. Suggested couch shifts in vertical, longitudinal, and lateral directions were recorded. kV images were also taken immediately after treatment for 21 SRS patients and on a weekly basis for 6 SRT ...

International Nuclear Information System (INIS)

Purpose: An inverse treatment planning algorithm for tomotherapy is described. Methods and Materials: The algorithm iteratively computes a set of nonnegative beam intensity profiles that minimizes the least-squares residual dose defined in the target and selected normal tissue regions of interest. At each iteration the residual dose distribution is transformed into a set of residual beam profiles using an inversion method derived from filtered backprojection image reconstruction theory. These 'residual' profiles are used to correct the current beam profile estimates resulting in new profile estimates. Adaptive filtering is incorporated into the inversion model so that the gross structure of the dose distribution is optimized during initial iterations of the algorithm, and the fine structure corresponding to edges is obtained at later iterations. A three dimensional, kernel based, convolution/superposition dose model is used to compute dose during each iteration. Results: Two ...

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In this article, the author presents the principles, applications and advantages of proton and heavy ion beams used for radiotherapy.

CERN Document Server

Determination of absorbed dose in a patient irradiated by beams of x or gamma rays in radiotherapy procedures

UK PubMed Central (United Kingdom)

A ten week old girl who had previously undergone a palliative procedure for the hypoplastic left heart syndrome had unrelieved aortic coarctation that did not respond to standard balloon dilatation....Full Text Available

UK PubMed Central (United Kingdom)

AIM: To evaluate the efficacy of self expandable metallic stents (SEMS) in patients with malignant esophageal obstruction and fistulas.METHODS: SEMS were implanted in the presence of fluoroscopic...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundLung volume reduction surgery is effective at improving lung function, quality of life, and mortality in carefully selected individuals with advanced emphysema. Recently,...Full Text Available

International Nuclear Information System (INIS)

The document reports the main issues discussed during the first course-debate on quality controls in radiotherapy, held in Rome in December 3-4, 1998 and May 3-5 1999 in collaboration between the Istituto Superiore di Sanita' and the Istituto Regina Elena. The points considered critical to the quality assurance in radiotherapy by the participants are presented in relation to the total radiotherapy procedure.

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No abstract prepared.

UK PubMed Central (United Kingdom)

The aim of this study is to compare the dosimetry results that are obtained by using Convolution, Superposition and Fast Superposition algorithms in Conventional Radiotherapy, Three-Dimensional Conformal...Full Text Available

International Nuclear Information System (INIS)

Background: Some former retrospective studies have suggested that patients with Ewing's sarcoma might have a very high risk for developing secondary sarcomas if treated with radiotherapy. We have evaluated the risk of second malignancies (SM) in patients treated in the German Cooperative Ewing's Sarcoma Studies CESS 81 and CESS 86. Materials and methods: From January 1981 through June 1991, a total number of 674 patients was registered in the two multicentric Ewing's sarcoma trials CESS 81 (1981 through 1985) and CESS 86 (1986 through June 1991). The systemic treatment consisted in both studies of a four-drug-chemotherapy (VACA= vincristine, actinomycin D, cyclophosphamide and adriamycin; or VAIA= vincristine, actinomycin D, ifosfamide and adriamycin) and a total number of four courses, each lasting nine weeks, was recommended by the protocol. Local therapy was either complete surgery or surgery plus postoperative radiotherapy with 36-46Gy or ...

International Nuclear Information System (INIS)

Background and purpose: stereotactic radiosurgery (SRS) and also fractionated stereotactic radiotherapy (SRT) offer high local control (LC) rates (> 90%). This study aimed to evaluate three-dimensional (3-D) tumor volume (TV) shrinkage and to assess quality of life (QoL) after SRS/SRT. Patients and methods: from 1999 to 2005, 35/74 patients were treated with SRS, and 39/74 with SRT. Median age was 60 years. Treatment was delivered by a linear accelerator. Median single dose was 13 Gy (SRS) or 54 Gy (SRT). Patients were followed up ? 12 months after SRS/SRT. LC and toxicity were evaluated by clinical examinations and magnetic resonance imaging. 3-D TV shrinkage was evaluated with the planning system. QoL was assessed using the questionnaire Short Form-36. Results: Median follow-up was 50/36 months (SRS/SRT). Actuarial 5-year freedom from progression/overall survival was 88.1%/100% (SRS), and 87.5%/87.2% (SRT). TV shrinkage was 15.1%/40.7% ...

International Nuclear Information System (INIS)

Purpose: To develop an accurate, fast, and robust algorithm for registering portal and computed tomographic (CT) images for radiotherapy using a combination of sparse and dense field data that complement each other. Methods and Materials: Gradient Feature Weighted Minimax (GFW Minimax) method was developed to register multiple portal images to three-dimensional CT images. Its performance was compared with that of three others: Minimax, Mutual Information, and Gilhuijs' method. Phantom and prostate cancer patient images were used. Effects of registration errors on tumor control probability (TCP) and normal tissue complication probability (NTCP) were investigated as a relative measure. Results: Registration of four portals to CTs resulted in 30% lower error when compared with registration with two portals. Computation time increased by nearly 50%. GFW Minimax performed the best, followed by Gilhuijs' method, the Minimax method, and Mutual Information. Conclusions: ...

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Eight patients, one male and seven females, with no pre-existing hypothalamic-pituitary disease, who developed symptoms of hypopituitarism following cranial irradiation for nasopharyngeal carcinoma were studied 5 years or more after radiotherapy. All were GH deficient. Four of the patients with no GH response during insulin tolerance tests (ITT) showed increased GH in response to synthetic human growth hormone releasing factor (GRF-44). Four patients had impaired cortisol responses to ITT, and gradual but diminished cortisol responses to ovine corticotrophin releasing factor (CRF-41). There was no significant difference between mean peak increments in response to ITT and those in response to CRF-41. TSH responses to TRH were delayed in five and absent in two patients; four of these had low free T4 index. Prolactin was raised in all seven women and increased further in response to TRH. Two patients had impaired gonadotrophin responses to LHRH. None of the patients ...

Science.gov (United States)

Ionizing radiation is a standard treatment for various human solid tumors. However, several clinical studies showed that a significant proportion of patients undergoing radiotherapy for hepatocellular carcinoma (HCC) develop intrahepatic and extrahepatic metastasis. Understanding of radiation-induced cancer cell invasiveness and behavior is essential and of great important for developing suitable treatment strategies to contain cancer spread. Therefore, in this study we evaluated the effectiveness of using swept source optical coherence tomography (SS-OCT) to monitor the enhancement of HCC cell invasiveness by radiation. SS-OCT images were acquired and recorded to obtain three-dimensional data sets per four hours in 48 hours after irradiating HepG2 cells with 7.5 Gy. The cell migration behavior in three-dimensional tissue models was quantified from images of radiation-induced and sham-irradiated cells.

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In the treatment of prostatic cancer using a newly proposed intermittent multiportal therapy (DIMT), acute reactions, change in tumor marker levels, and complications more than 6 months after treatment were evaluated. From June 1989 to September 1990, 26 patients with prostatic cancer (stage A2, 3 patients; B, 9; C, 2; D, 10; recurrence, 2) were treated. Fifteen patients were followed up for more than one year, with a mean period of 11.6 months. The treatment schedule is 52.5 Gy in 16 fractions in 4 weeks for radical treatment, and 30.0 Gy in 8 fractions in 2 weeks for palliative treatment. The 360 degree rotation about the patient was divided into 16 fractions, and 2 opposing fractions were used in one day as parallel opposed portals to treat the target volume. The fractions were serially treated one per day, so that 8 treatment days produced a total dose of distribution similar to that for conventional conformational therapy. The size of the irradiation field ...

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Background and purpose: the recent RTOG guidelines for future clinical developments in gynecologic malignancies included the investigation of dose escalation in the paraaortic (PO) region which is, however, very difficult to target due to the presence of critical organs such as kidneys, liver, spinal cord, and digestive structures. The aim of this study was to investigate intensity-modulated radiotherapy's (IMRT) possibilities of either increasing, in a safe way, the dose to 50-60 Gy in case of macroscopic disease or decreasing the dose to organs at risk (OR) when treatment is given in an adjuvant setting. Material and methods: the dosimetric charts of 14 patients irradiated to the PO region at the department of radiation oncology, university hospital of Liege, Belgium, in 2000 were analyzed in order to compare six-field conformal external-beam radio-therapy (CEBR) and five-beam IMRT approaches. Both CEBR and IMRT ...

Science.gov (United States)

Caring for a child with a potentially fatal medical condition is a challenge for parents or caregivers. The ability to measure parental self-efficacy in pediatric palliative care may be an important component of targeting supportive services that address individual needs of families. Therefore, the goal was to develop a Pediatric Palliative Care Parental Self-Efficacy Measure (PCPEM). First, a list of questions were generated that asked parents their level of confidence in carrying out tasks involved in caring for a child with a potentially fatal medical condition in 6 palliative care domains: 1) medical discussion/decisions; 2) symptom management/medication; 3) daily activities; 4) feelings/concerns; 5) spirituality; and 6) end-of-life care. The PCPEM was narrowed to 58 questions after expert reviews. Then, 16 caregivers of children receiving palliative care services and 9 bereaved caregivers ...

UK PubMed Central (United Kingdom)

SummaryRadiotherapy is used commonly in the treatment of gynecologic malignancies. Many patients experience emotional distress prior to the initiation of radiotherapy, during...Full Text Available

UK PubMed Central (United Kingdom)

IntroductionRadiotherapy outcomes might be further improved by a greater understanding of the individual variations in normal tissue reactions that determine tolerance. Most published...Full Text Available

International Nuclear Information System (INIS)

Little clinical evidence has been provided to show the minimization of radiation resistance of tumors using high linear energy transfer radiation. We therefore investigated the radiobiological and molecular pathological aspects of carbon beam therapy. A total of 27 patients with squamous cell carcinoma (SCC) of the cervix were treated using a carbon beam and 50 control patients with SCC of the cervix using a photon beam. The expression of Ki-67, p53, and p27 proteins before radiotherapy and 5 and 15 days after therapy initiation were investigated using immunohistochemistry. Similar changes were observed in Ki-67 labeling index (LI) and p53 LI during carbon and photon beam therapies. However, for carbon beam therapy, the mean p27 LI significantly decreased from 25.2% before treatment to 18.6% on the 5th day after treatment initiation, followed by a significant increase to 36.1% on the 15th day. In contrast, for photon beam therapy, the p27 LI ...

British Library Electronic Table of Contents (United Kingdom)

Background The Norwood procedure consists of three palliative operations, performed in neonates with hypoplastic left heart syndrome. Especially the first stage (Norwood I) is associated with the highest mortality rates in paediatric cardiac surgery (up to 25%). During surgery, the aorta is reconstructed and a systemic-to-pulmonary shunt is applied. Originally the modified Blalock-Taussig shunt was used, but recently the right-ventricle-to-pulmonary-artery shunt is increasingly being employed. We reviewed the results of our operative strategy, where an individualised choice of shunt is made. Furthermore, attempts to reduce interstage mortality (between Norwood I and II) were assessed. Methods All neonates who underwent Norwood stage I palliation from August 2004 until November 2010 were in...

International Nuclear Information System (INIS)

Purpose/Objective: With the advent of computed tomography and magnetic resonance imaging, the three dimensional representation of the patient anatomy has become an invaluable resource for better diagnosis and delineation of the target volume and sensitive structures in radiation therapy. Although the therapeutic linear accelerator industry has made available highly sophisticated equipment, the aggressiveness in dose prescription and delivery has to be complimented by accurate dose computation methods. We have adopted a convolution/superposition algorithm for the calculation of absolute dose that fully accounts for the external shape and internal structure of the patient for photon treatment radiotherapy. In this paper, we will discuss the principles of the convolution algorithm and we will show how the computed dose compares to clinically relevant treatment techniques. Materials and Methods: A computer controlled data acquisition system and a ...

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MRI provides a non-invasive diagnostic tool complementing echocardiography on one hand, and showing advantages over echocardiography, on the other hand, especially after corrective procedures. The multiple different MRI sequences need to be adapted to examinations of children and patients with congenital heart disease (CHD), and can be used to detect morphologic changes, blood-flow in the heart and thoracic vessels and diastolic or systolic function of myocardium. Several factors determine the success of the examination of a complex congenital heart disease or a postoperative situs. Pediatric radiologists and radiologists experienced in congenital heart diseases have to work in close cooperation. Echocardiography should be performed before MRI. The results of prior examinations and the clinical history of the patients, including possible palliative or reconstructive operations, must be available before MRI to guide the planning of the ...

Energy Technology Data Exchange (ETDEWEB)

Lung cancer staging according to the TNM system is based on morphological assessment of the primary cancer, lymph nodes and metastases. All aspects of this important oncological classification are measurable with MRI. Pulmonary nodules can be detected at the clinically relevant size of 4-5 mm in diameter. The extent of mediastinal, hilar and supraclavicular lymph node affection can be assessed at the same time. The predominant metastatic spread to the adrenal glands and spine can be detected in coronal orientation during dedicated MRI of the lungs. Search focused whole body MRI completes the staging. Various additional MR imaging techniques provide further functional and clinically relevant information during a single examination. In the oncological context the most important techniques are imaging of perfusion and tumor motion. Functional MRI of the lungs complements the pure staging and improves surgical approaches and ...

International Nuclear Information System (INIS)

High-energy ionizing radiation is a prominent modality for the treatment of many cancers. The approaches to electron dose calculation can be categorized into semi-empirical models (e.g. Fermi-Eyges, convolution-superposition) and probabilistic methods (e.g. Monte Carlo). A third approach to dose calculation has only recently attracted attention in the medical physics community. This approach is based on the deterministic kinetic equations of radiative transfer. We derive a macroscopic partial differential equation model for electron transport in tissue. This model involves an angular closure in the phase space. It is exact for the free streaming and the isotropic regime. We solve it numerically by a newly developed HLLC scheme based on Berthon et al (2007 J. Sci. Comput. 31 347-89) that exactly preserves the key properties of the analytical solution on the discrete level. We discuss several test cases taken from the medical physics literature. A test case with an academic ...

International Nuclear Information System (INIS)

Monte Carlo simulation of beam modifiers such as physical wedges and compensating filters has been performed with a rectilinear voxel geometry module. A modified version of the EGS4/DOSXYZ code has been developed for this purpose. The new implementations have been validated against the BEAM Monte Carlo code using its standard component modules (CMs) in several geometrical conditions. No significant disagreements were found within the statistical errors of 0.5% for photons and 2% for electrons. The clinical applicability and flexibility of the new version of the code has been assessed through an extensive verification versus dosimetric data. Both Varian multi-leaf collimator (MLC) wedges and standard wedges have been simulated and compared against experiments for 6 MV photon beams and different field sizes. Good agreement was found between calculated and measured depth doses and lateral dose profiles along both wedged and unwedged directions for different depths and ...

International Nuclear Information System (INIS)

In radiotherapy treatment planning, convolution/superposition algorithms currently represent the best practical approach for accurate photon dose calculation in heterogeneous tissues. In this work, the implementation, accuracy and performance of the FFT convolution (FFTC) and multigrid superposition (MGS) algorithms are presented. The FFTC and MGS models use the same 'TERMA' calculation and are commissioned using the same parameters. Both models use the same spectra, incorporate the same off-axis softening and base incident lateral fluence on the same measurements. In addition, corrections are explicitly applied to the polyenergetic and parallel kernel approximations, and electron contamination is modelled. Spectra generated by Monte Carlo (MC) modelling of treatment heads are used. Calculations using the MC spectra were in excellent agreement with measurements for many linear accelerator types. To speed up the calculations, a number of calculation techniques were ...

Science.gov (United States)

A large proportion of patients may develop chronic pain following cancer treatments such as surgery, radiotherapy, or chemotherapy. These patients can experience significant levels of physical and psychological morbidity. Our aim was to investigate a cognitive-behavioral pain management program (PMP) for cancer patients with chronic treatment-related pain. Thirteen patients (1 man, 12 women; mean age 52 yrs) completed the study, 9 of whom had a history of breast cancer and had received extensive medical treatment, including surgery. A combination of physical and psychological techniques were adapted from previous work in chronic benign pain and implemented by two therapists. Interventions included education, relaxation, exercise training, and goal setting. A variety of outcomes were examined to assess general fitness, psychological distress, coping success, activities of daily living, and pain report. The median number of interventions by each therapist was 10 (4 ...

Science.gov (United States)

Studies begun during the first year of this project on biopsies from spontaneous tumors in dogs and from human patients undergoing radiotherapy treatment were continued. The results indicate that significant fractions of the spontaneous tumors in dogs and cervical carcinomas in patients undergoing radiotherapy have a DNA content higher than normal diploid cells. The higher DNA content in tumor cells permits distinguishing them from normal cells in the biopsy material with the aid of flow microfluorometric (FMF) instrumentation or multiangle light-scatter spectrometry.

British Library Electronic Table of Contents (United Kingdom)

PurposeTo conduct a retrospective analysis within a large university teaching hospital, comparing outcomes between patients receiving either radical surgery or radiotherapy as curative treatment for bladder cancer.Patients and MethodsBetween March 1996 and December 2000, 169 patients were treated radically for muscle-invasive bladder cancer. Data were collected from patient notes. Statistical analyses were performed using Kaplan-Meier methods and Cox proportional hazards regression analysis to compare radiotherapy and surgical outcome data.ResultsThere was no difference in overall, cause-specific, and distant recurrence-free survival at 5 years between the two groups, despite the radiotherapy group being older (median age, 75.3 years vs. 68.2 years). There were 31 local bladder recurrences...

International Nuclear Information System (INIS)

Objective: To evaluate the effect of metallic stent combined with stereotactic conformal radiotherapy (SCRT) for hilar cholangiocarcinoma. Methods: Fifty-four patients with hilar cholangiocarcinoma were analyzed, including 31 treated with stent plus stereotactic conformal radiotherapy (combined group) and 23 with metallic stent alone (control group). Results: The mean survival time of combined group was 11.1 #+-# 4.6 months, compared with 5.1 #+-# 2.8 months of the control group, giving a significant difference between the two groups (P<0.01). Conclusion: The combination of metallic stent and stereotactic conformal radiotherapy is more effective than metallic stent alone for unresectable hilar cholangiocarcinoma. (authors)

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The objective of this project was to implement a centralised data base of internal quality control in radiotherapy according to the criteria of the decree of A.f.s.s.a.p.s. (French agency of sanitary safety of health products on 27 july 2007, about the internal quality control of external radiotherapy facilities. The software on one year meets the objectives: compliance by comparison with A.f.s.s.a.p.s. criteria but particularly optimization of the centralisation and analysis of the internal quality controls. (N.C.)

UK PubMed Central (United Kingdom)

Adaptive radiation therapy for liver cancer has the potential to reduce normal tissue complications and enable dose escalation, allowing the potential for tumor control in this challenging site....Full Text Available

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The incidence of hepatocellular carcinoma (HCC) is increasing in developed countries and the general status of HCC patients is now by far better than a few years ago, allowing physicians to propose some different treatments of these patients. Among these treatments, intra-arterial injection of 131-iodine-labelled Lipiodol could be used in palliative, curative or adjuvant settings. After a brief summary of the modalities of this treatment, requiring the collaboration of Gastro-enterologists, Oncologists, Radiologists and Nuclear Medicine physicians, the different possibilities of therapeutic uses of this new approach are described and an outlook of these developments is proposed. (author)

International Nuclear Information System (INIS)

The aim of this retrospective study was to determine the safety and efficacy of chemoembolization (TACE) as palliative treatment for patients with unresectable intrahepatic cholangiocarcinoma (CCA) and to compare the results with those in the literature. Fifteen patients with histology-proven CCA (5 men, 10 women) had received palliative treatment with TACE over a 6-year period. The treatment protocol comprised repeated TACE at a minimum of 8-week intervals. TACE was performed with a mixture of 10 ml Lipiodol and 10 mg mitomycin C injected into the tumor-supplying vessels. Follow-up investigations after 8-10 weeks comprised contrast-enhanced multislice spiral CT and laboratory control. Statistical evaluation included survival analysis using the Kaplan-Meier method. During the investigation period 58 TACEs (3.9 #+-# 3.8; 1-15) were performed in 15 patients. Mean tumor size was 10.8 #+-# 4.6 cm (range, 2.0-18.0 cm). Unifocal tumor disease was ...

International Nuclear Information System (INIS)

Results of treatment of 30 children with Ewing's sarcoma irradiated in the First Radiotherapy Department, Cancer Center, Warsaw, in the period 1983-1992, are described. In 40% of patients NED survival from 1 till 10 years and in 70% the local control was obtained, and no serious radiations equelae were observed. (author).

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This report summarizes the activities and major accomplishments for the Idaho National Laboratory Advanced Radiotherapy Research Program for calendar year 2004. Topics covered include boron analysis in biological samples, computational dosimetry and treatment planning software development, medical neutron source development and characterization, and collaborative dosimetry studies at the RA-1 facility in Buenos Aires, Argentina.

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This report summarizes the activities and major accomplishments for the Idaho National Engineering and Environmental Laboratory (INEEL) Advanced Radiotherapy Research Program for calendar year 2002. Topics covered include computational dosimetry and treatment planning software development, medical neutron source development and characterization, and boron analytical chemistry.

International Nuclear Information System (INIS)

Present-day requirements for radiotherapy equipment are considered. The recently developed linacs of LUE-5, LUE-25, LUE-15MM models, as well as a newly designed unified series of medical linacs of LUER-5M, LUER-20M, LUER-40M models are described in brief. The main scientific and technical problems that were solved during their construction, namely, development of accelerating structures, a radiation head, dosimetry equipment, a programming unit, a magnetic mirror etc. are described.

Science.gov (United States)

PMID:10488815

KoreaScience (Korea)

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PMID:1354044

KoreaScience (Korea)

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International Nuclear Information System (INIS)

The evaluation of radiotherapy and surgery as exclusive local treatment in comparably selected subgroups of patients with Ewing's sarcoma on the basis of the CESS 86-data. In the German multicenter Ewing's sarcoma study CESS 86, treatment consisted for four 9-week-courses of VACA- or VAIA-chemotherapy plus local therapy. VACA (vincristine, actinomycin D, cyclophosphamide, adriamycin) was given in low-risk extremity tumors with a tumor volume below 100 cm"3. Highrisk patients with central lesions or a tumor volume >100 m"3 received VAIA (ifosfamide instead of cyclophosphamide). Local therapy started after one complete chemotherapy course in week 10. Based on an individual decision in each patient, local therapy was either radical surgery or resection plus postoperative irradiation with 45 Gy or definitive radiotherapy with 60 Gy. Because of poor results with radiotherapy in a preceeding study, it was intended to restrict ...

International Nuclear Information System (INIS)

Purpose: We present an update analysis of the multiinstitutional Ewing's sarcoma study CESS 86. Methods and Materials: From January 1986 through June 1991, 177 patients with localized Ewing's sarcoma of bone, aged 25 years or less, were recruited. Chemotherapy consisted of four 9-week courses of vincristine, actinomycin D, cyclophosphamide, and adriamycin (VACA) in low-risk tumors (extremity tumors =# 100 cm"3). Local therapy was an individual decision in each patient and was either radical surgery (amputation, wide resection) or resection plus postoperative irradiation with 45 Gy or definitive radiotherapy with 60 Gy (45 Gy plus boost). Irradiated patients were randomized concerning the type of fractionation in either conventional fractionation (once daily 1.8-2.0 Gy, break of chemotherapy) or hyperfractionated split-course irradiation simultaneously with the VACA/VAIA chemotherapy (twice daily 1.6 Gy, break of 12 days after 22.4 Gy and 44.8 Gy, total dose and ...

Science.gov (United States)

PMID:18640506

UK PubMed Central (United Kingdom)

This paper presents a new deformable model using both population and patient-specific statistics to segment the prostate from CT images. There are two novelties in the proposed method. First,...Full Text Available

UK PubMed Central (United Kingdom)

Currently several groups are actively researching the integration of a megavoltage teletherapy unit with magnetic resonance (MR) imaging for real-time image-guided radiotherapy. The use of a...Full Text Available

UK PubMed Central (United Kingdom)

PurposeRadiation-induced heart disease (RIHD) is a severe side effect of thoracic radiotherapy. This study examined the effects of PTX and α-tocopherol on...Full Text Available

UK PubMed Central (United Kingdom)

Adaptive radiation therapy (ART) is the incorporation of daily images in the radiotherapy treatment process so that the treatment plan can be evaluated and modified to maximize the amount of radiation...Full Text Available

International Nuclear Information System (INIS)

Background: The effective-dose method which was proposed by the ICRP (International Commission of Radiation Protection) for the estimation of risk to the general population from occupational or environmental, low-dose radiation exposure is not adequate for estimating the risk of cancer induction by radiotherapy of malignant or nonmalignant diseases. Methods:The risk of cancer induction by radiotherapy of benign diseases should be based on epidemiologic data directly derived from follow-up studies of patients who had been given radiotherapy for nonmalignant diseases in the past. Results: Risk factors were derived from epidemiologic studies of patients treated with irradiation for nonmalignant diseases to be used for selecting treatment options and optimizing treatment procedures. Conclusion: In most cases, cancer risks estimated by the effective-dose method may overestimate the true risks by one order of magnitude, yet in ...

UK PubMed Central (United Kingdom)

BackgroundTo compare the differences in dose-volume data among coplanar intensity modulated radiotherapy (IMRT), noncoplanar IMRT, and helical tomotherapy (HT) among patients with...Full Text Available

International Nuclear Information System (INIS)

Rectum reference dose points have a direct impact on the morbidity seen in gynecological intracavitaty radiotherapy. The aim of this study is to obtain less morbidity by marking rectum with radio opaque solution. Fourteen patients with gynecological cancer who underwent external radiotherapy received 15 Gray (Gy) intracavitary radiotherapy. During the internal radiotherapy planning, radio opaque solution has been administered into the rectum to observe it on lateral radiogram. Thus rectum reference dose point and five points were marked at sites nearest to the sources. Nucletron Planning system was used for obtaining three-dimensional planning. After therapy patients were followed at every three months. Median follow-up was 18 months. Most frequently observed morbidities were grade 1-2 rectitis and cystitis in six patients. As a result, more accurate rectum dose values and less factors causing dose ...

UK PubMed Central (United Kingdom)

Based on the assumption that an accelerated proliferation process prevails in tumour cell residues after surgery, the possibility that treatment acceleration would offer a therapeutic advantage in postoperative...Full Text Available

Energy Technology Data Exchange (ETDEWEB)

The key to the future for electric utilities will not be found in legislation or regulation. Title VII of the Energy Policy Act of 1992 will prove to be just as ineffectual in improving the industry's position as was the Public Utility Regulatory Policies Act of 1978. These legislative palliatives, which produced so much commotion and so many reams of heated commentary, are largely irrelevant to a successful future for electric utilities. The key will be found in economics, not in law, and the future will lie in completing Thomas A. Edison's century-old vision for the industry, half of which the industry has heretofore ignored. The industry must embrace the complete vision and evolve from electric utilities into [open quotes]end-use energy utilities.[close quotes

British Library Electronic Table of Contents (United Kingdom)

A 21-year-old woman developed midesophageal stricture two weeks after ingestion of aluminium phosphide (AlP) tablets. Aluminium phosphide is a lethal protoplasmic toxin and is also the most common cause of suicidal poisoning in northern India. Upper gastrointestinal endoscopy (UGIE) showed a tight esophageal stricture 29?cm from the incisors with a circumferential ulcer. Dilatation up to 17?mm was done using Savary-Gilliard dilators. She had repeated dilatations three times at nearly two-week intervals. In view of the resistant stricture, a silicone Polyflex stent was placed across the stricture and removed after 3?months; there was no recurrence of stricture even after three months of follow-up. Patients with recurrent esophageal stricture and those with fistula may benefit from silicone ...

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This report summarizes the major activities and accomplishments of the Idaho National Engineering and Environmental Laboratory (INEEL) Advanced Radiotherapy Research Program for calendar year 2001. Applications of supportive research and development, as well as technology deployment in the fields of chemistry, radiation physics and dosimetry, and neutron source design and demonstration are described. Contributions in the fields of physics and biophysics include development of advanced patient treatment planning software, feasibility studies of accelerator neutron source technology for Neutron Capture Therapy (NCT), and completion of major modifications to the research reactor at Washington State University to produce an epithermal-neutron beam for NCT research applications.

International Nuclear Information System (INIS)

A dose calculation algorithm for MLC based conformal radiotherapy is described in this paper. The algorithm is formulated by the coordinate of MLC leaves. Verification on the algorithm is made by comparing the dose distributions generated by this algorithm with that generated by a Differential Convolution Superposition algorithm for various regular and irregular fields. The results demonstrate that the present algorithm has suitable accuracy and high computational efficiency, thus it could be useful for the treatment planning process in MLC based conformal radiotherapy, where the workload for interactively or automatically designing the shapes of MLC is heavy. (authors)

International Nuclear Information System (INIS)

Purpose: To determine if involved field radiation (IF) is equivalent to standard whole bone radiation (SF) in local tumor control; to establish patterns of failure following treatment; and to determine response, event-free survival (EFS), and overall survival rates from multidisciplinary therapy in Ewing's sarcoma. Methods and Materials: Between 1983 and 1988, 184 children with Ewing's sarcoma were enrolled onto Pediatric Oncology Group 8346 (POG 8346). A total of 178 (97%) met eligibility criteria; 6 had pathology other than Ewing's sarcoma. Induction chemotherapy of cyclophosphamide/doxorubicin (adriamycin )(C/A) x 12 weeks was followed by local treatment either surgery or radiation therapy and C/A, dactinomycin, and vincristine for 50 weeks. Resection was advised for patients with small primary tumors if accomplished without functional loss. Forty patients were randomized to receive SF, whole bone radiation to 39.6 Gy plus a 16.2 Gy boost (total 55.8 Gy) or IF to 55.8 Gy, and the ...

UK PubMed Central (United Kingdom)

Study DesignThis is a retrospective study that was done according to clinical and radiological evaluation.PurposeWe analyzed the clinical and radiological...Full Text Available

UK PubMed Central (United Kingdom)

The Clinical Summary is a Web-based application for accessing the clinical database at the Massachusetts General Hospital. The application has been developed to give physicians in our health care community...Full Text Available

UK PubMed Central (United Kingdom)

PURPOSE The Wells rule is widely used for clinical assessment of patients with suspected deep vein thrombosis (DVT), especially in the secondary care setting. Recently a new clinical decision...Full Text Available

International Nuclear Information System (INIS)

Full text: A semiempirical algorithm for absorbed dose calculation at off-axis points in irregular beams was implemented. It is well known that semiempirical methods are very useful because of their easy implementation and its helpfulness in dose calculation in the clinic. These methods can be used as independent tools for dosimetric calculation in many applications of quality assurance. However, the applicability of such methods has some limitations, even in homogeneous media, specially at off axis points, near beam fringes or outside the beam. Only methods derived from tissue-air-ratio (TAR) or scatter-maximum-ratio (SMR) have been devised for those situations, many years ago. Despite there have been improvements for these manual methods, like the Sc-Sp ones, no attempt has been made to extend their usage at off axis points. In this work, a semiempirical formalism was introduced, based on the works of Venselaar et al. (1999) and Sanz et al. (2004), aimed to the ...

UK PubMed Central (United Kingdom)

A questionnaire on the development of specialist clinics was distributed to the members of the Association of British Neurologists and completed by 104 members (85 consultants). Half of the respondents...Full Text Available

UK PubMed Central (United Kingdom)

PURPOSE: To determine the risk factors and clinical signs of Curvularia keratitis and to evaluate the management and outcome of this corneal phaeohyphomycosis. METHODS: We reviewed clinical and laboratory...Full Text Available

UK PubMed Central (United Kingdom)

Although coagulase-negative staphylococci (C-NS) have been implicated in certain human infections, they are generally regarded as contaminants, and their clinical significance is questioned. To assess...Full Text Available

UK PubMed Central (United Kingdom)

Introduction: Generally agreed outcome criteria in psychosis are required to evaluate the effectiveness of new treatment strategies. The aim of this study is to explore clinical recovery...Full Text Available

UK PubMed Central (United Kingdom)

AIM: To evaluate the prevalence of upper gastrointestinal symptoms and their association with clinical and functional characteristics in elderly outpatients.METHODS: The study involved 3238 outpatients...Full Text Available

International Nuclear Information System (INIS)

Purpose: To evaluate the importance of surgical margins for local and systemic control of Ewing's sarcoma family tumors (ESFT). Methods and Materials: Between 1979 and 1999, 512 patients with ESFTs entered 4 different adjuvant and neoadjuvant studies performed at a single institution. Of these patients, 335 were treated with surgery alone (196) or surgery followed by radiotherapy at doses of 44.8 Gy (139). We compared their outcome with that of the 177 patients who were locally treated by radiotherapy at 60 Gy. Results: Local control (88.8% vs. 80.2%, p < 0.009) and 5-year disease-free survival (63.8% vs. 47.6%, p < 0.0007) were significantly better in patients treated with surgery and, among them, in those with adequate surgical margins (96.6% vs. 71,7%, p < 0.0008, and 69.6% vs. 46.3%, p < 0.0002). Nonetheless, better results were observed only in extremity tumors. Conclusions: Surgery is better than ...

International Nuclear Information System (INIS)

Purpose: Treatment results and the pattern of relapse were evaluated in the multimodal treatment of Ewing's sarcomas of the chest wall. Methods and Materials: In a retrospective analysis, 114 patients with non-metastatic Ewing's sarcoma of the chest wall were evaluated. They were treated in the CESS 81, CESS 86, or EICESS 92 studies between January 1981 and December 1993. The treatment consisted of polychemotherapy (VACA, VAIA, or EVAIA) and local therapy, either surgery alone (14 patients), radiotherapy alone (28 patients) or a combination of both (71 patients). The median follow-up was 46.6 months (range 5-170). A relapse analysis for all patients with local or combined relapses was performed. Results: Overall survival was 60% after 5 years, event-free survival was 50%. Thirty-seven patients had a systemic relapse (32.4%), 11 patients had a local relapse alone (9.6%), and 3 patients had a combined local and systemic relapse (2.6%). The risk to relapse locally ...

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The lymphographic agent Lipiodol (iodized oil) has been found to localize and remain in tumor vessels. Based on this finding, we attempted transcatheter internal radiotherapy by radioactive iodized oil (I-131 tagged Lipiodol) prepared by isotopic exchange reaction. Transcatheter internal radiotherapy (TCIR) was attempted in twelve patients with inoperable hepatoma by infusing a therapeutic dose of I-131 Lipiodol (7.6 approx. 28.3 mCi/2.0 approx. 5.0 ml) via the hepatic artery. Serial changes of serum alpha-fetoprotein (AFP) levels and in the size of tumor on computed tomography (CT) were estimated to evaluate the therapeutic effect. Serum AFP levels decreased in 9 patients with initial elevated levels of serum AFP, although they were again elevated in three of them within four weeks. More than 50 % decrease in tumor size was observed in 6 patients (50 %). There were no serious complications. This preliminary results suggest that TCIR with I-131 ...

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Science.gov (United States)

PMID:4721764

DEFF Research Database (Denmark)

Udgivelsesdato: 2009-Feb

KoreaScience (Korea)

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PMID:20091983

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The dosimetry for radiotherapy involving neutrons is very complicated, owing to the complexity of secondary radiation components, whose contributions to the total absorbed dose have to be discriminated, owing to the different radiobiological effects. In order to separate thermal neutrons and photons, LiF dosimeters are mostly utilized. containing different percentage of Li, like as TLD-700, TLD-100 and TLD-600, but many problems arise. In the response of TLD-700 exposed to neutron-gamma mixed fields with high neutron flux, the contribution of thermal neutrons to the Tl emission is high. Moreover. TLD-100 and TLD-600 may undergo radiation damage, and great care has to be taken in order to obtain reliable results. Other TLDs showing lower sensitivity to neutrons are proposed and experimented for such high-flux neutron fields. The faced problems and various proposed solutions are here described. (Author)

British Library Electronic Table of Contents (United Kingdom)

During the last few decades, accuracy in photon and electron radiotherapy has increased substantially. This is partly due to enhanced linear accelerator technology, providing more flexibility in field definition (e.g. the usage of computer-controlled dynamic multileaf collimators), which led to intensity modulated radiotherapy (IMRT). Important improvements have also been made in the treatment planning process, more specifically in the dose calculations. Originally, dose calculations relied heavily on analytic, semi-analytic and empirical algorithms. The more accurate convolution/superposition codes use pre-calculated Monte Carlo dose "kernels" partly accounting for tissue density heterogeneities. It is generally recognized that the Monte Carlo method is able to increase accuracy even furt...

International Nuclear Information System (INIS)

The behaviors of peripheral eosinophils during radiotherapy were examined in 200 cases of non-resected cervical cancer. Before irradiation, the mean absolute eosinophil count had been 170 +- 168/mm_3, and eosinophilia (more than 500/mm_3) had been observed in 11 cases (5.5%). Postirradiation eosinophilia occurred in 126 cases (63%). The mean period between institution of irradiation and the peak of the eosinophil count was 27.8 days. The mean highest eosinophil count was 691 +- 437/mm_3, and the mean bone marrow dose in this period was 906 rad. Comparisons of the eosinophil count according to the stage showed no significant differences. (Chiba, N.).

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The mortality in undrained abdominal abscesses is high with a mortality rate ranging between 45 and 100%. The outcome in abdominal abscesses, however, has improved due to advances in image guided percutaneous interventional techniques. The main indications for the catheter drainage include treatment or palliation of sepsis associated with an infected fluid collection, and alleviation of the symptoms that may be caused by fluid collections by virtue of their size, like pancreatic pseudocele or lymphocele. The single liver abscesses may be drained with ultrasound guidance only, whereas the multiple abscesses usually require computed tomography (CT) guidance and placement of multiple catheters. The pancreatic abscesses are generally drained routinely and urgently. Non-infected pancreatic pseudocysts may be simply observed unless they are symptomatic or cause problems such as pain or obstruction of the biliary or the gastrointestinal tract. Percutaneous routes that ...

International Nuclear Information System (INIS)

Rapid corrosion of PWR steam generator carbon steel support structures and consequential denting of steam generator tubes led to considerable investigation of the mechanism of corrosion and for palliatives. The basic mechanism is now fairly well understood. Chloride present in the boiler feedwater from condenser leakage is concentrated in the support plate crevice as a result of the superheat present. This leads to the formation of a low pH acid ferrous chloride environment either through the hydrolysis of a weak base chloride such as MgCl_2 or the combined action of a neutral chloride with an oxidizing agent. Rapid attack of the carbon steel ensues with the Fe_3O_4 corrosion product forming at the metal/oxide interface. This oxide has a volume approximately twice that of the steel consumed and thus eventually fills the crevice between the tube and the support plate. Oxide growth continues leading to compression of the Alloy 600 primary tube and to distortion and ...

UK PubMed Central (United Kingdom)

Multiple myeloma is a highly radiosensitive skeletal malignancy, but bone-seeking radionuclides have not yet found their place in disease management. We previously reported that the proteasome inhibitor...Full Text Available

UK PubMed Central (United Kingdom)

Hyperthermia (HT) is a strong adjuvant treatment with radiotherapy and chemotherapy because it causes tumor reoxygenation. However, the detailed molecular mechanisms of how HT enhances tumor oxygenation...Full Text Available

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Background and Purpose: In an earlier phase II study, irradiation together with razoxane was shown to improve local control in recurrent rectal cancer. Therefore, the Austrian Society of Radiooncology (OeGRO) initiated a randomized controlled trial in 1992 to compare this combined treatment versus radiation therapy alone. Patients and Methods: Between 1992 and 1999, 36 patients with localized recurrences of rectal cancer were randomized to receive radiotherapy without (group A) or with razoxane (group B). The prognostic variables of the two groups were similar except for a longer median latency period from initial surgery to local recurrence in group A. High-energy photons with daily fractions between 170 and 200 cGy were used. The median total radiation dose was 60 Gy in each group. The patients in group B received a median razoxane dose of 9.6 g (range, 5-12 g). Main outcome measures were local control, overall survival, and toxicity. Results: The combined ...

UK PubMed Central (United Kingdom)

The purpose of this study was to investigate if interfraction and intrafraction motion in free-breathing and gated lung IMRT can lead to systematic dose differences between 3DCT and 4DCT. Dosimetric...Full Text Available

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Electron beam therapy applied to a lymph node metastasis from a squamous cell carcinoma was followed by the development of histologically and immunologically typical bullous pemphigoid, the lesions being initially strictly confined to the irradiation area. This observation suggests that the bullous pemphigoid antigen may be altered or unmasked by electron beam radiotherapy, leading subsequently to the production of autoantibodies. The disease in this case effectively responded to the administration of tetracycline and niacinamide, a therapeutic regimen described recently.

International Nuclear Information System (INIS)

Purpose/Objective: The role of programmed cell death (apoptosis) as a cellular response to cancer therapy such as radiation or chemotherapy is the subject of much study, and manipulation of the apoptotic response in tumor cells may be valuable in the treatment of a variety of cancers. Both p53 dependent and independent apoptotic pathways have been identified; p53 is mutated in at least 50 % of human cancers and a majority of radiation resistant tumors contain p53 mutations. This study is designed to examine the induction of programmed cell death in a human colon carcinoma cell line that possesses two mutated p53 alleles. Ionizing radiation alone, or in combination with the chemotherapeutic drug 5-fluorouracil (5-FU), were used to elicit the apoptotic response. This study will focus on whether these treatments can induce a significant apoptotic response in cells that have mutated p53 alleles. Materials and Methods: HT-29 cells were assessed for clonogenic survival after being plated at ...

UK PubMed Central (United Kingdom)

This report describes a case of toxic myopathy in a two year old sheltie dog with clinical signs of profound weakness, myoglobinuria, and muscle enzyme elevations. The clinical signs were likely related...Full Text Available

UK PubMed Central (United Kingdom)

Objective. Cervical cancer patients who had an abandoned radical hysterectomy were evaluated for preoperative clinical predictors, complication rates, and outcomes. Study...Full Text Available

UK PubMed Central (United Kingdom)

Sex-related influences on pain and analgesia have become a topic of tremendous scientific and clinical interest, especially in the last 10 to 15 years. Members of our research group published...Full Text Available

UK PubMed Central (United Kingdom)

The relationship between malaria transmission intensity and clinical disease is important for predicting the outcome of control measures that reduce transmission. Comparisons of hospital data...Full Text Available

UK PubMed Central (United Kingdom)

AbstractQuantities and types of ceramides and their relationships to physical properties of the horn covering the claws of clinically normal cows and cows with subclinical laminitis were...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundPercutaneous endoscopic lumbar discectomy is a relatively new technique. Very few studies have reported the clinical outcome of percutaneous endoscopic discectomy in terms...Full Text Available

UK PubMed Central (United Kingdom)

Over the past 10 years, the original partnership of clinician and statistician for the running of clinical research projects, especially clinical trials, has come to be supplemented by the data manager...Full Text Available

UK PubMed Central (United Kingdom)

A double-blind, placebo-controlled clinical trial of a homeopathic treatment of neonatal calf diarrhoea was performed using 44 calves in 12 dairy herds. Calves with spontaneously derived diarrhoea were...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundPhysicians have difficulty keeping up with new evidence from medical research.MethodsWe developed the McMaster Premium...Full Text Available

UK PubMed Central (United Kingdom)

Policies and regulations in the current health care environment have impacted the manner in which patient data - especially protected health information (PHI) - are handled in the clinical and...Full Text Available

UK PubMed Central (United Kingdom)

PURPOSE We wanted to assess the impact of an electronic health record–based diabetes clinical decision support system on control of hemoglobin A_1c (glycated hemoglobin),...Full Text Available

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Membranous dysmenorrhea is an unusual clinical entity. It is characterized by the expulsion of huge fragments of endometrium during the menses, favored by hormonal abnormality or drug intake. This report describes a case with clinical, US, and MRI findings before the expulsion. Differential diagnoses are discussed. (orig.)

UK PubMed Central (United Kingdom)

This paper presents HEARTVIEW - a knowledge base (KB) that offers aid for clinical research in cardiology. This KB is an essential component of the medical workstation MW2000, now under development...Full Text Available

Science.gov (United States)

Glossitis among U.S. military working dogs in South Vietnam was characterized by variable redness and loss of papillae on the anterodorsal third of the tongue; salivation, drooling, and inappetence were the principal clinical signs. Symptomatic treatment ...

UK PubMed Central (United Kingdom)

IntroductionIntrarenal pseudoaneurysm is a rare, yet clinically significant, complication of percutaneous nephrolithotomy. A high index of clinical suspicion is necessary in order...Full Text Available

UK PubMed Central (United Kingdom)

The definitive clinical trial which demonstrated the beneficial effects of photocoagulation in treating diabetic retinopathy was reported in 1976 in the American Journal of Ophthalmology by the Diabetic...Full Text Available

UK PubMed Central (United Kingdom)

Coryneform isolates from clinical specimens frequently cannot be identified by either reference laboratories or research laboratories. Many of these organisms are skin flora that belong to a large number...Full Text Available

UK PubMed Central (United Kingdom)

In support of a new clinical trial designed to compare the effects of crushed fresh garlic and two types of garlic supplement tablets (enteric-coated dried fresh garlic and dried aged garlic...Full Text Available

Science.gov (United States)

Clinical-HINTS (Health Intelligence System) is a horizontally integrated decision support system (DSS) designed to meet the requirements for intelligent real-time clinical information management in critical care medical environments and to lay the foundation for the development of the next generation of intelligent medical instrumentation. The system presented was developed to refine and complement the information yielded by clinical laboratory investigations, thereby benefiting the management of the intensive care unit (ICU) patient. More specifically, Clinical-HINTS was developed to provide computer-based assistance with the acquisition, organisation and display, storage and retrieval, communication and generation of real-time patient-specific clinical information in an ICU. Clinical-HINTS is an object-oriented system developed in C+2 to run under Microsoft ...

UK PubMed Central (United Kingdom)

This article describes a new set of revised standards for the medical laboratory, which have been produced by Clinical Pathology Accreditation (UK) Ltd (CPA). The original standards have been in use...Full Text Available

UK PubMed Central (United Kingdom)

Background/AimsThe findings of several recent studies suggest that antinuclear antibodies (ANAs) are frequently detected in patients with acute hepatitis A (AHA). However, the clinical...Full Text Available

UK PubMed Central (United Kingdom)

ObjectiveDisc herniations at the L1-L2 and L2-L3 levels are different from those at lower levels of the lumbar spine with regard to clinical characteristics and surgical outcome....Full Text Available

UK PubMed Central (United Kingdom)

The prevalence of chlamydial infection of the urethra was studied in 172 consecutive male patients attending a sexually transmitted disease clinic in Teheran. Chlamydia trachomatis was isolated in 8.8%...Full Text Available

UK PubMed Central (United Kingdom)

A methodology and toolkit are described which enable the automated metadata-driven creation of datamarts from clinical data warehouses. The software uses schema-to-schema transformation driven by an...Full Text Available

UK PubMed Central (United Kingdom)

The level of total extracellular neuraminidase produced by 74 clinical isolates of group B streptococci isolated from diseased or asymptomatically colonized infants was assayed. Extracellular neuraminidase...Full Text Available

UK PubMed Central (United Kingdom)

The question of whether storage of red blood cells (RBCs) alters their capacity to deliver oxygen and affects patient outcomes remains in a state of clinical equipoise. Studies of the changes...Full Text Available

UK PubMed Central (United Kingdom)

ObjectiveCompare occlusal contacts calculated from 3D virtual models created from clinical records to contacts identified clinically using shimstock and transillumination.Full Text Available

UK PubMed Central (United Kingdom)

Recent health care policies and regulations have impacted the manner in which patient data – especially protected health information (PHI) – are handled in both the clinical...Full Text Available

UK PubMed Central (United Kingdom)

Incorporation of clinical decision support (CDS) capabilities is required to realize the greatest benefits from computerized provider order entry (CPOE) systems. Discussions at a conference on CDS in...Full Text Available

Science.gov (United States)

PMID:9226309

Science.gov (United States)

(January 1999) - PDF File (36K)

Energy Technology Data Exchange (ETDEWEB)

Negligent hazardous waste management has resulted in real threats to public health. The Federal Government has responded to the situation with laws and regulations aimed at the producers of hazardous waste, including clinical laboratories. The Resources Conservation and Recovery Act (RCRA) imposes controls on hazardous waste management through the Code of Federal Regulations (CFR). The Environmental Protection Agency (EPA) and the Department of Transportation (DOT) regulate these activities through 40 CFR and 49 CFR. Most clinical laboratories can operate satellite accumulation points and accumulate, store, transport, and dispose of waste in accordance with EPA and DOT regulations. Regulations pertaining to infectious waste, sure to affect many clinical laboratories, are being developed now by he EPA. The cradle to grave tracking system mandated by the Federal Government can be supplemented by state and local authorities ...

International Nuclear Information System (INIS)

The medical applications of radiation comprise three main fields namely: Diagnostic Radiology, Radiotherapy and Nuclear Medicine. With the new weighting factors of ICRP (IC91a) the effective dose due to medical applications can be established. I is common to separate the effective dose into the genetic part and the somatic part, SED. In dealing with gonad doses it is important to account for the age of the person at the time of exposure as this will influence the number of children still to be expected from that person. The resulting dose will then be called the genetically significant dose, GSD. In a similar fashion this age factor will be important in considering the chance of tumor induction. The age of patients differs considerably from the average age of the general population. This age difference has to be accounted for if a comparison is to be made with other sources of radiation. This justifies establishing a somatically significant dose, SSD. The reduction ...

Energy Technology Data Exchange (ETDEWEB)

Radiotherapy can be very significant as the treatment for ocular lesions, eyes need to be preserved as properly as possible on their functions and cosmetics. The application of conventional X ray therapy has been gradually abandoned as conventional X ray therapy ceased to be accepted as the general treatment for malignant tumors. Consequently the necessity of electron beam therapy has been rising even as the substituted method for conventional X ray therapy. The department of radiology of Gunma University was obliged to establish a new therapy for ocular lesions, and has been trying electron beam therapy since 1973. It is concluded that electron beam therapy is not at all inferior to conventional X ray therapy as reported above. Basic therapeutic methods for ocular lesions are the following: 1) For epidermoid carcinoma, 600 rads at a time, 3600 - 4200 rads in total is applied by 8 MeV electron twice a week method. 2) For malignant melanoma, 1000 rads at a time, ...

International Nuclear Information System (INIS)

Dose measurements were performed in several body regions of patients suffering from inflammatory degenerative diseases (humeral epicondylitis, humeroscapular periarthritis, gonarthrosis, axillary hidradenitis, rheumatoid arthritis, coxarthrosis, parotitis). The problem of the radiation induction of neoplasms is predominant concerning somatic as well as genetic risk, discussed by example of the most frequently occurring organ cancer. Compared to the rate of breast cancer in the highly developed industrial states (5,000 to 6,000 cancers/100,000 women) the 'radiation induction' calculated according to a mathematical model of ICRP 26 (1.25 cases of death for breast cancers/100,000 women following for example irradiation of epicondylitis) is behind several powers of ten and not demonstrable. The genetic radiation exposure is also low. Derived from the measurements it is wrong to give up reliable and approved indications of radiotherapy of non-malignant diseases because ...

Energy Technology Data Exchange (ETDEWEB)

This study examines some radiation accidents occurred in the past. This information has been systematically assessed to get global lessons. The experience feedback shows that the most of accidents happened in certain conditions. These conditions can be distributed in four categories: 1- perception and vigilance in occupation: accidental exposure happened by lack of vigilance in details and lack of vigilance and perception; 2- procedures: accidental exposure happened following a lack of procedures or control that were not enough complete, not enough documented or not completely implemented; 3- training and understanding: accidental exposures happened because the personnel was not enough qualified and educated, did not get the general training nor the the necessary specialized training; 4- liabilities: accidental exposures happened following lacks and ambiguity in the definition of functions of the personnel and in the hierarchy liabilities. In these precise cases the safety tasks have ...

Energy Technology Data Exchange (ETDEWEB)

From December 1981 to September 1986, 149 patients were treated at the Radiotherapy Department of the Hospital Clinico y Provincial of Barcelona by means of intracavity irradiation with 137 cesium high 1 sources and 2. To 112 of the total number of patients external radiotherapy to the whole of the pelvis using photons of 6 MeV was also administered. A total of 46 (30.7%) patients presented rectal complications. The rectitis observed was mild in 16 cases (10.7%), moderate in 15(10%) and severe in 15(10%). The 15 patients with severe rectitis had to be treated by unloading colostomy. In patients with severe complications, the maximum total rectal dose administered was between 5,855 and 9,490 cGy, and the maximum rectal dose administered via curietherapy was 1,055 to 7,320 cGy. Maximum total rectal dose administration greater than 4,000 cGy and maximum rectal dose administered via curietherapy greater than 5,800 cGy were statistically significant ...

International Nuclear Information System (INIS)

Computed tomography allows today to reconstruct three-dimensional (eD) images fram axial scans. The authors report their experience in cranio-facial pathology achived in two Departments of Radiology (University of Trieste, Italy and University of Standford, California). 3D images have been realized using two different softwares, one of which allows to reconstruct both soft tissue and bone structures. The application in maxillo-facial traumas, cranio-facial malformations and head tumours are disscussed. 3D images turned out to be very useful for the optimal visualization and for the spatial demostration of the lesion and have potential applications in cranio-facial surgery and radiotherapy.

International Nuclear Information System (INIS)

This text-book (electronic book - multi-media CD-ROM) constitutes a course-book - author's collection of lectures. It consists of 13 lectures in which the reader acquaints with the basis of radiobiology: Introduction to radiobiology; Physical fundamentals of radiobiology; Radiation of cells; Modification of radiation damage of cells; Reparation of radiation damage of cells; Radiation syndromes and their modification; Radiation injury; Radiation damage of tissues; Effect of radiation on embryo and fetus; Biological effects of incorporated radionuclides; Therapy of acute irradiation sickness; Delayed consequences of irradiation; Radiation oncology and radiotherapy. This course-book may be interesting for students, post-graduate students of chemistry, biology, physics, medicine as well as for teachers, scientific workers and physicians. (author)

Energy Technology Data Exchange (ETDEWEB)

It is possible to produce energetic beams of radioactive nuclei, as secondary beams, from the heavy-particle compound accelerator called BEVALAC. These beams can be focused into experimental areas without significant contamination using suitable magnetic filters and proper beam-optics. Properly selected high-energy beams of radioactive nuclei (those which defay by positron emission) can provide a truly unique opportunity to evaluate the effectiveness of these beams in localizing the Bragg peak on a tumor volume - necessary in heavy-particle therapy. Preliminary data are presented here to demonstrate the possible use of these beams in radiotherapy treatment-planning verification.

International Nuclear Information System (INIS)

Purpose: The occurrence of extraosseous Ewing's sarcoma (ES) in deep soft tissues has been well described, but cases in which this tumor occurs in a primary cutaneous or subcutaneous site have rarely been reported. The superficial variant may be less aggressive than are the more common bony and deep soft tissue counterparts with an apparently favorable outcome. A retrospective review of patients with cutaneous or subcutaneous ES was conducted to analyze outcome and patterns of failure. Methods and Materials: Between July 1985 and March 1997, 14 patients with cutaneous or subcutaneous ES were treated at St. Jude Children's Research Hospital. The median age at presentation was 16 years (range 7-21 years). Anatomic locations included trunk and pelvis (7), upper or lower extremity (4), and head and neck (3). The median size of the lesion was 3 cm (range, 1-12 cm). Thirteen had definitive surgical resections, and one had biopsy of the mass at the time of referral. They were enrolled on ...

International Nuclear Information System (INIS)

We report the case of a 22-year-old man with Ewing's sarcoma who attained a complete remission (CR) after combination radiotherapy and chemotherapy. Secondary acute lymphoblastic leukemia with multiple cytogenetic abnormalities involving chromosome 5 and 7 developed 16 years later. The patient underwent induction chemotherapy and entered a CR. Peripheral blood stem cell transplantation from a matched sibling was performed successfully and he is in complete remission of both ALL and Ewing's sarcoma. (Copyright (c) 1999 Elsevier Science B.V., Amsterdam. All rights reserved.)

International Nuclear Information System (INIS)

A fast and accurate segmentation of organs at risk, such as the healthy colon, would be of benefit for planning of radiotherapy, in particular in an adaptive scenario. For the treatment of pelvic tumours, a great challenge is the segmentation of the most adjacent and sensitive parts of the gastrointestinal tract, the sigmoid and descending colon. We propose a semi-automated method to segment these bowel parts using the fast marching (FM) method. Standard 3D computed tomography (CT) image data obtained from routine radiotherapy planning were used. Our pre-processing steps distinguish the intestine, muscles and air from connective tissue. The core part of our method separates the sigmoid and descending colon from the muscles and other segments of the intestine. This is done by utilizing the ability of the FM method to compute a specified minimal energy functional integrated along a path, and thereby extracting the colon centre line between ...

International Nuclear Information System (INIS)

Purpose: To evaluate the outcomes of patients with Ewing's sarcoma family of tumors (ESFT) treated with modern radiotherapy techniques with MRI along with optimal chemotherapy. Methods and Materials: The records of all 60 patients with ESFT who received radiation to the primary site between 1990 and 2004 were reviewed. All patients received chemotherapy, including vincristine, doxorubicin, cyclophosphamide, ifosfamide, and etoposide. Radiation was used as the sole modality for local control in 31 patients and was given either before (n = 3) or after surgical resection (n = 26) in the remainder. All patients had MRI and CT scan-based treatment planning, and 43% received intensity-modulated radiation therapy. Radiation doses ranged from 30 Gy to 60 Gy (median, 51 Gy), and 35% received hyperfractionated radiotherapy. Results: Median age was 16 years (range, 2-40 years). Because of selection bias for radiotherapy, the majority ...

International Nuclear Information System (INIS)

A human cholangiocarcinoma, Ch-1, serially transplanted to nude mice was used for experimental chemotherapy, radiotherapy, and conbination chemoradiotherapy. In the group of chemotherapy with single drug, Mitomycin C (MMC) revealed greater effectiveness than Adriamycin in terms of tumor regression, histological findings, and minor side effects. MMC and radiotherapy by Linac X-ray showed exponential linear dose response curve against tumor weight. Their effects were equivalent at doses of MMC 1 mg/kg and radiation 1,000 rads/mouse in the changes of tumor weight and of histological findings which were similar to each other. Combination chemoradiotherapy showed the synergistic action when the radiation (500 rads/mouse) was performed before MMC (0.5 mg/kg) administration, whereas only the additive effect was observed when the sequence was reversed. The cell kinetic analysis was performed by the impulse cytophotometry, "3H-thymidine uptake labeling ...

Energy Technology Data Exchange (ETDEWEB)

Ovarian function was evaluated in 11 women 16 to 43 years of age at treatment who received doxorubicin, cyclophosphamide, and high doses of methotrexate with or without radiotherapy in adjuvant therapy of soft tissue sarcoma. Five women (16-33 yr old) who received chemotherapy alone or combined with radiotherapy only at sites distant from the ovaries (chest wall, thigh, and leg) had minimal menstrual irregularities or temporary cessation of menses during therapy; cyclic menses returned promptly after therapy. Gonadotropin levels (expressed as means +/- SD (follicle-stimulating hormone (FSH), 10 +/- 5 mlU/ml; luteinizing hormone (LH), 10 +/- 4 mlU/ml) and 17 beta-estradiol (E2) levels (means +/- SD, 208 +/- 147 pg/ml) were normal. By contrast, 4 older women (ages 36-43 yr) who received similar treatment developed persistent amenorrhea with postmenopausal levels of gonadotropin (FSH, 108 +/- 29 mlU/ml; LH, 72 +/- 19 mlU/ml) and E2 (19 +/- 8 ...

Energy Technology Data Exchange (ETDEWEB)

Methods: Systemic irradiation of neuroaxis is an essential part in the management of medulloblastoma, stPNET and intracranial germ cell tumors. The introduction of quality assurance programs in radiooncology assures a precise radiotherapy of target volumes and is a prerequisite to improve survival. Results: Hyperfractionated radiotherapy has the potential of increasing dose to tumor more safely without increasing the risk for late adverse effects. Pilot studies revealed excellent tumor control in medulloblastoma with acceptable acute toxicity and a long-term survival of up to 96%. In medulloblastoma stereotactic radiation techniques reveal an acceptable toxicity and promising results in tumor control in recurrent disease or as primary treatment. They are now part of future treatment protocols in case of persisting residual tumor. Radiotherapy alone in pure germinoma is continuously yielding high cure rates. In secreting ...

International Nuclear Information System (INIS)

Total skin electron beam therapy (TSEB) was used in the treatment of 33 patients with lymphoma and 13 patients with leukemia involving extensive segments of the skin surface. Twenty-two of 23 had lesions as a primary manifestation of lymphoma (primary cutaneous lymphoma-PCL) and 11 developed cutaneous lesions following disseminated nodal lymphoma (secondary cutaneous lymphoma-SCL). A once weekly fractionation scheme was employed to irradiate the entire skin surface with 3.5 to 4 MeV electron beam from a 6 MeV linear accelerator. During each weekly session, 400 rad were delivered to the entire skin and a complete course consisted of 4-6 consecutive weekly sessions. The majority of patients have been previously treated elsewhere for various periods and all patients have been at risk for a median of 12 months, range from 12-117 months following TSEB. Striking predominance of the diffuse pattern (76%) was demonstrated in both the PCL and SCL. There was extracutaneous involvement in 63% ...

Science.gov (United States)

Eliminating anterior tooth contact is paramount when treating combination syndrome. It is possible to do so through the use of linear occlusion with a non-interceptive arrangement and the bilateral fulcrum of protrusive stability. The presence of mandibular anterior teeth often complicates this procedure. When establishing the horizontal plane of occlusion, clinical circumstances often necessitate modifications; nevertheless, certain principles must be incorporated into the design of the prostheses. Clinical circumstances may dictate altering the approach but these principles must be maintained to eliminate anterior hyperfunction. PMID:15055634

British Library Electronic Table of Contents (United Kingdom)

Interferons, a group of cytokines with antiangiogenic, direct antitumour and immunostimulating properties, have shown significant activity against osteosarcoma in vitro and in xenograft models. They have also been used in osteosarcoma clinical trials as a single adjuvant to surgery, with an apparent increase in relapse-free survival. In the ongoing EURAMOS 1 clinical trial, interferon a-2b is evaluated as an adjuvant treatment in osteosarcoma. This article reviews the rationale for the use of interferon in cancer with special reference to the treatment of osteosarcoma, including all published data of clinical efficacy in this disease. Pediatr Blood Cancer 2010;54:350-354. Copyright 2009 Wiley-Liss, Inc.

Science.gov (United States)

Clinical and hormonal indices of androgenic activity were compared in 118 males chronically intoxicated with alcohol. The population was divided into two groups with respect to their clinical and hormonal androgenic indices: 76 patients with (Group 1), and 46 patients without (Group 2) androgenic insufficiency. Distinct signs and syndromes of alcohol addiction were shown to correlate with the extent of cross-regulation impairment within hypothalamo-hypophyseo-gonadal system. This was particularly derived from comparison of clinical picture of chronic alcohol intoxication and hormone activity in the groups. Conventional therapy failed to restore the neuroendocrine indices that was apparently due to inhibition of cross-regulation links in the hypothalamo-hypophyseo-gonadal system at several stages of alcohol addiction. PMID:3223149

UK PubMed Central (United Kingdom)

BackgroundOxidative stress has been proposed as a mechanism linking the poor placental perfusion characteristic of preeclampsia with the clinical manifestations of...Full Text Available

Science.gov (United States)

Exponentially growing biological and bioinformatics data sets present a challenge and an opportunity for researchers to contribute to the understanding of the genetic basis of phenotypes. Due to breakthroughs in microarray technology, it is possible to simultaneously monitor the expressions of thousands of genes, and it is imperative that researchers have access to the clinical data to understand the genetics and proteomics of the diseased tissue. This technology could be a landmark in personalized medicine, which will provide storage for clinical and genetic data in electronic health records (EHRs). In this paper, we explore the computational and ethical challenges that emanate from the intersection of bioinformatics and healthcare informatics research. We describe the current situation of the EHR and its capabilities to store clinical and genetic data and then discuss the Genetic Information Nondiscrimination Act. ...

UK PubMed Central (United Kingdom)

Background:To encourage evidence-based practice, an Annals of Internal Medicine editorial called for a new professional on clinical teams: an informationist trained...Full Text Available

UK PubMed Central (United Kingdom)

The Johns Hopkins Hospital has initiated an ambitious program to apply modern technologies to the development of a new, comprehensive clinical information system. One component of this system is a...Full Text Available

UK PubMed Central (United Kingdom)

Hyaluronan (HA), a non-sulfated glycosaminoglycan, is widely used in the clinic for viscosurgery, viscosupplementation, and treatment of osteoarthritis. Four decades of chemical modification...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundTo identify the differential tuberculosis (TB) characteristics within the immigrant population with respect to natives in Spain.Methodology/Principal...Full Text Available

Science.gov (United States)

... their clothes set afire. One patient fell into a hot cupola furnace. Steam burns were observed for four patients. In the clinical ...

UK PubMed Central (United Kingdom)

The success of monoclonal antibodies in clinical practice is dependent on good design. Finding a suitable target is the most important part as other properties of the antibody can be altered by genetic...Full Text Available

UK PubMed Central (United Kingdom)

Purpose. To describe the characteristics of idiopathic macular holes (MH) on optical coherence tomography (OCT) and correlate OCT with clinical assessment. Design....Full Text Available

UK PubMed Central (United Kingdom)

Schizophrenia is a heterogeneous psychiatric disorder in which multiple neurotransmitter systems have been implicated. Increased and decreased dopamine transmission in the subcortical meso-limbic and...Full Text Available

UK PubMed Central (United Kingdom)

Necrotizing sialometaplasia, is a benign inflammatory lesion primarily involving the minor salivary glands of the hard palate. The lesion often presents itself as a deep-seated palatal ulcer with clinical...Full Text Available

UK PubMed Central (United Kingdom)

A case of intraocular coenurosis was clinically diagnosed and treated with praziquantel. The drug destroyed the coenurus, but vision was lost through toxic endophthalmitis and retinal detachment. There...Full Text Available

UK PubMed Central (United Kingdom)

PurposeClinical trials have commenced to evaluate the feasibility of targeting malignant gliomas with genetically engineered cytolytic T-cells (CTLs) delivered directly...Full Text Available

UK PubMed Central (United Kingdom)

A group of patients is described who developed the clinical features of foveomacular retinitis. No causative factors were isolated, and all patients strongly denied any type of sun gazing. It is possible...Full Text Available

UK PubMed Central (United Kingdom)

This Memorandum describes the following aspects of legionellosis: clinical presentations of legionella infection, general epidemiology (including nosocomial outbreaks and travel-associated legionnaires'...Full Text Available

UK PubMed Central (United Kingdom)

Cutaneous scarring can cause patients symptoms ranging from the psychological to physical pain. Although the process of normal scarring is well described the ultimate cause of pathological scarring...Full Text Available

UK PubMed Central (United Kingdom)

The importance of designating criteria for diagnosing dementia lies in its implications for clinical treatment, research, caregiving, and decision-making. Dementia diagnosis in Huntington's...Full Text Available

DEFF Research Database (Denmark)

Raltegravir is the first integrase inhibitor approved for treatment of HIV-infected patients harboring multiresistant viruses.

Science.gov (United States)

... POG Cook, BA A Case Control Study of Childhood 147 8552(85) Rhabdomyosarcoma (0) POG COOK, BA Phase II Study of 6-Mercaptopurine ...

Energy Technology Data Exchange (ETDEWEB)

This book discusses the procedures applied for the clinical nuclear medicine laboratory. The procedures are presented as proven guidelines. The chapters are included on quality assurance, radionuclide handling, and radiation safety.

UK PubMed Central (United Kingdom)

Breast cancer in the elderly has attracted considerable interest in recent years for three main reasons. Firstly, information concerning the profile (clinical and biological) of the disease in the geriatric...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundThe metagenomic analysis of microbial communities holds the potential to improve our understanding of the role of microbes in clinical conditions. Recent, dramatic improvements...Full Text Available