Abstract The authors provide a survey of how images are used in radiationtherapy to improve the precision of radiationtherapy plans, and delivery of radiation treatment. In contrast...Full Text Available
Purpose: To evaluate the effect of low-dose radiationtherapy and surgery on local control in patients with Ewing's Sarcoma. Materials and Methods: Between 1979 and 1995 24 patients (ages 4-47) with Ewing's sarcoma were treated with combined modality therapy that included multi agent chemotherapy, surgical resection, and radiationtherapy. Twelve patients had metastatic disease at the time of presentation (pleura = 3, lung = 5, bone 4). Tumor location was central in 16 and peripheral in 8. Multi agent chemotherapy consisted of vincristine/actinomycin D/cyclophosphamide/doxorubicin in 19. The same agents with the addition of ifosfamide and etoposide were given in 5. The extent of resection was considered to be radical in 14 and of the 16 patients who received preoperative chemotherapy, 5 were found to have a pathologic complete response. All patients with lung metastases at diagnosis ...
... radiation during clinical therapy and exposures due to radiation accidents or attacks, in which the doses are uncontrolled ... only be used off-label in victims of radiation accidents or attacks. The idea...
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 radiationtherapy. 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 ...
Forty-four patients with histologically proven Hodgkin's disease underwent initial treatment with extended-field radiationtherapy. Nineteen of these patients also received combination chemotherapy....Full Text Available
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 radiationtherapy 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 radiationtherapy. Radiationtherapy 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 ...
BackgroundTo compare two strategies of dynamic intensity modulated radiationtherapy (dIMRT) with 3-dimensional conformal radiationtherapy (3DCRT) in the setting of hypofractionated...Full Text Available
Adaptive radiationtherapy (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
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 radiationtherapy 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 ...
Radiationtherapy has shown definite technical improvement due to application of proton beam irradiation. Clinical results of proton beam therapy also suggested enlargement of indication ranges in radial treatment and decrease of post radiation damages of the treatment of cancers in deep-seated organs. Inprovement of result in cancer therapy could be expected by this treatment technique in the future.
BackgroundThe aim of this study was to compare and to validate different dose calculation algorithms for the use in radiationtherapy of small lung lesions and to optimize the treatment...Full Text Available
Purpose: Understanding the kinetics of tumor growth∕shrinkage represents a critical step in quantitative assessment of therapeutics and realization of adaptive radiationtherapy....Full Text Available
PurposeA dosimetric comparison between multiple static-field intensity-modulated radiationtherapy (IMRT), multi-arc intensity-modulated arc therapy (IMAT) and single-arc...Full Text Available
In many radiotherapy clinics, geometric uncertainties in the delivery of 3D conformal radiationtherapy and intensity modulated radiationtherapy of the prostate are reduced by aligning the...Full Text Available
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 ...
Some studies suggest that giving radiationtherapy after surgery for hilar cholangiocarcinoma improves the survival rate; however, many of these studies did not specify numbers of subjects or provide an impartial analysis. Thus, we evaluated the effectiveness of radiationtherapy as adjuvant treatment after surgery and attempted to establish appropriate adaptation standards. We reviewed the records of 69 patients who underwent surgery for hilar cholangiocarcinoma between June 1980 and April 1998. Thirty-nine patients were treated with surgery followed by radiationtherapy and 30 were treated with surgery alone. The clinicopathologic features that might have influenced prognosis were similar in the patients who received radiationtherapy and those who did not. Radiation as adjuvant ...
Background: EGFR (epidermal growth factor receptor) and VEGF (vascular endothelial growth factor) inhibitors confer clinical benefit in metastatic colorectal cancer when combined with chemotherapy. An emerging strategy to improve outcomes in rectal cancer is to integrate biologically active, targeted agents as triple therapy into chemoradiation protocols. Material and methods: cetuximab and bevacizumab have now been incorporated into phase I-II studies of preoperative chemoradiation therapy (CRT) for rectal cancer. The rationale of these combinations, early efficacy and toxicity data, and possible molecular predictors for tumor response are reviewed. Computerized bibliographic searches of Pubmed were supplemented with hand searches of reference lists and abstracts of ASCO and ASTRO meetings. Results: the combination of cetuximab and CRT can be safely applied without dose compromises of the respective treatment components. Disappointingly low ...
The patient positioning and repositioning control in radiationtherapy all along the treatment can be conducted using a variety of X-ray sources and imaging detector devices. The development of image guided radiationtherapy techniques leads to more frequent use of this imaging control. In this article we summarize the current methods for measuring the dose delivered by X-ray imaging devices used in radiationtherapy, as well as basic proposals to take account of these imaging doses for prescribing, recording and reporting radiationtherapy treatment. (authors)
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 ...
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 (EFS) and overall survival rates from multi-disciplinary therapy in Ewing's Sarcoma (ES). Materials and Methods: Between 1983 and 1988, 184 children with ES were enrolled onto POG 8346. 178 (97%) met eligibility criteria; 6 had non-ES pathology. Induction treatment of Cyclophosphamide/Adriamycin (C/A) x 12 weeks was followed by local treatment either surgery or radiationtherapy (XRT) and C/A, Dactinomycin and Vincristine for 50 weeks. Resection was advised for patients with small primary tumors if accomplished without functional loss. 40 patients were randomized to receive SF, whole bone XRT to 39.6 Gy plus a 16.2 Gy boost (total 55.8 Gy) or ...
The proton therapy gives an irradiation adapted to the shape and the depth of tumors ( eyes, head and neck) with a millimetric, even sub millimetric precision for the ophthalmological tumors. It is equally an excellent tool for the pediatrics tumors. For numerous treatments in France the proton therapy is associated to the photons treatments (x radiation). however, others physical treatments could modulate the medical offer, such thermal therapy or treatments by ultrasonic waves. (N.C.)
Albeit the considerable progress that has been made both in our understanding of the pathophysiology of acute renal failure (ARF) and in its treatment (continuous renal replacement therapies), the morbidity...Full Text Available
HIV-1 nonsubtype B variants account for the majority of HIV infections worldwide. Drug resistance in individuals who have never undergone antiretroviral therapy can lead to early failure and...Full Text Available
Radiationtherapy has had a significant and an expanded role in the management of cancer of the pancreas during the last decade. In particular, for locally advanced disease, radiationtherapy has improved the median survival of patients to 1 year. Intraoperative electron beam therapy has been applied to unresectable and resectable pancreatic cancer in an attempt to enhance local control of disease and to improve patient survival. This paper presents a survey of the role of radiationtherapy in treatment of cancer of the pancreas, provides information on the radiobiological aspects of this treatment modality and details the physical and dosimetric characteristics of intraoperative radiationtherapy with electrons. Presented are the design specifics of an applicator system, central axis beam data, ...
Radiationtherapy has had a significant and an expanded role in the management of cancer of the pancreas during the last decade. In particular, for locally advanced disease, radiationtherapy has improved the median survival of patients to 1 year. Intraoperative electron beam therapy has been applied to unresectable and resectable pancreatic cancer in an attempt to enhance local control of disease and to improve patient survival. This paper presents a survey of the role of radiationtherapy in treatment of cancer of the pancreas, provides information on the radiobiological aspects of this treatment modality and details the physical and dosimetric characteristics of intraoperative radiationtherapy with electrons. Presented are the design specifics of an applicator system, central axis beam data, ...
Gastrointestinal lymphomas are almost exclusively of a non Hodgkin's type. The Western form is characterized by a higher incidence of stomach location (50 %), a MALT type (mucosa associated lymphoid tissue) (40 %), a B-cell type (90 %), and a high grade (55 %). Chronic infection with Helicobacter pylori is an important risk factor. Mediterranean lymphomas form a particular clinical and pathological entity with diffuse involvement of the small bowel and are frequently being associated with a chronic malabsorption disorder. Eradication of Helicobacter pylori in early lymphomas, and the use of tetracyclines in early Mediterranean lymphomas, have been shown to induce durable remissions. For more advanced gastric lymphomas, treatment usually consists of anthracycline-based chemotherapy followed by involved field radiotherapy. Surgery is usually reserved for complications such as perforation or bleeding, or in some selected cases for salvage after failure of non-surgical ...
Several compact proton accelerator systems for use in proton therapy have recently been proposed. Of paramount importance to the development of such an accelerator system is the maximum kinetic energy...Full Text Available
Recent literature indicates that torsion of the left ventricle (LV) is a promising predictor for response to cardiac resynchronisation therapy (CRT). Among patients with severe heart failure, 45 to 75% of patients show rigid body rotation, where the base and apex rotate in the same direction, instead of normal, opposite rotation. The occurrence of this phenomenon seems to be a good indicator for response to CRT. From this review, it can be concluded that LV torsion might be a welcome addition to current selection criteria.
The role of radiationtherapy in local tumor control and decreased incidence of pulmonary metastasis is reported in 271 patients who were entered into the Intergroup Ewing's Sarcoma Study with more than one year follow-up and on whom all radiotherapy records were reviewed. The majority of the patients were irradiated to the primary tumor with doses of 4500 to 6500 rad in five to six weeks in combination with systemic administration of three drugs (vincristine, actinomycin-D and cyclophosphamide) or four drugs (vincristine, actinomycin-D, cyclophosphamide and adriamycin). One of the groups of patients was treated with three drugs and bilateral pulmonary irradiation (1500 rad, uncorrected dose, in two weeks). Preliminary analysis shows an overall local primary tumor control of 89%. Patients with lesions in the pelvis had a local failure rate of 17% (9 of 52) and in the humerus 23% (7 of 31). Factors affecting local ...
This paper is a progress report on the role of radiationtherapy (RT) in local tumor control and the decreased incidence of pulmonary metastasis in 251 patients entered in the Intergroup Ewing's Sarcoma Study. All were followed for more that 1 year, and their RT records were reviewed. Doses to the primary tumor in the range of 4,500--6,500 rad were administered over approximately 5 to 6 weeks in combination with 4 drugs, i.e., vincristine (VCR), dactinomycin (DAC), cyclophosphamide (CY), and adriamycin, or only the first 3. One group of patients received the 3 drugs and bilateral pulmonary irradiation (approximately 1,500 rad in 2 wk). Preliminary analysis showed a local primary tumor control of approximately 90%. Patients with lesions in the pelvis and humerus had local failure rates of 13% (7 of 54) and 21.4% (6 of 28), respectively. The treatment groups differed significantly in the incidence of pulmonary metastasis. ...
Only a small number of radiation accidents in the United States have been severe enough to result in multi-organ failure (MOF). Medical details of selected medical misadministration and criticality cases are reviewed, with an emphasis on pathophysiology. The four criticality cases are particularly relevant for analysis of MOF, since medical treatment was supportive and did not appreciably alter the clinical evolution of radiation injury. PMID:15975871
Conformal radiationtherapy represents a considerable and attractive challenge in oncology. Its aim is mainly to improve local control by increasing the dose with an acceptable rate of complications. This work overviews the world literature on this subject. The technical and theoretical requirements are highlighted. These requirements include a precise definition of the target volume by digital imaging (essentially CT scan), but also clear view of the target volume and the organs at risk, a specific collimation of the beam, 3-D dose calculations, optimization procedures, and a rigid immobilization of the patient with verification of his position. Moreover, the clinical applications of conformal radiationtherapy are reviewed and discussed. (authors). 80 refs., 1 tab.
Prostate cancer can be successfully treated using dynamic adaptive external beam radiation techniques along with interstitial brachytherapy to deliver curative therapies with low urinary, rectal and erectile function morbidity. Through the use of sophisticated, state-of-the art radiographic imaging for staging and treatment planning, a precise, individual design for treatment is accomplished. Symptom management and patient education are of paramount importance and are integrated throughout the treatment process.
HT-29 human colon tumor cells growing as spheroids have been evaluated as a model system for measuring the response of human colon tumor cell to antineoplastic agents. HT-29 cells have been capacity to form spheroids up to 1 mm or more in diameter when grown in spinner culture. The multicellular HT-29 spheroids develop hypoxic centers reflecting the cellular conditions found in human cancer treatment, i.e., nutritionally deficient hypoxic cells that are felt to be a significant source of both radiation and chemotherapy clinical treatment failures. Spheroids of increasing size were radiated and then dispersed into single cells for colony survival assay. Compared with irradiated single cell suspensions, the spheroid cells demonstrated a significant increase in radioresistance. Growing spheroids developed a complex radiation survival curve which was variable with respect to size of the spheroid. The drug ...
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 ...
Despite high local control rate in Ewing's sarcoma the exact indication of radiationtherapy is still controversial as well as the choice of the target volume and the optimal dose of radiation. The importance of the quality of radiotherapy has been stressed in recently published data and has shown a significant impact on long term local control with adequate radiationtherapy. The dramatic improvement of precision allowed by the conformal therapy and three dimensional dosimetry allow to expect a decrease of late effects expected for second malignancies. However, late sequelae and radio-induced osteosarcoma still remain the major side effects after radiotherapy. The authors discuss the results of the main trials on Ewing's sarcoma on the choice of dose and target volume. Surgery is still the preferred choice for small tumors if the foreseen outcome is identical. ...
Modern advances in the concept and the techniques of megavoltage radiationtherapy have revolutionized the treatment of medulloblastoma. Five-year survivals of 50 to 70 percent are achieved by craniospinalaxis...Full Text Available
Development of Portable Normobaric Hypoxia and Pulsed Magnetic Field Firmware System for Enhancement of Radio- and Non-specific Resistance in Workers of Environmentally Hazardous Industries
Previous research with individuals undergoing surgery or diagnostic procedures provided a conceptual framework for analysis of radiationtherapy, a common form of cancer treatment. The present...Full Text Available
Adaptive radiationtherapy 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
The invention refers a procedure of radiation dose control in irradiated tissues during electron-beam therapy. It aims at meeting the planned radiation dose for diseased tissues and taking care of the healthy ones. Therefore, the dose distribution required is determined before irradiation in consideration of such factors as energy-dependence of detector sensitivity, self-absorption within the tissue, and relative biological effectiveness. Furthermore, the expected intensity distribution of secondary quantum radiation excited in the irradiated tissue is calculated. A radiation detector for local resolution is used for registration. During irradiation the calculated intensity distribution is compared with the measured one. The invention is applicable in radiationtherapy with monoenergetic electron beams.
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, ...
Purpose: To assess the relationship between large intracranial vessel occlusive vasculopathy (vasculopathy) and radiationtherapy, and to clarify the clinical efficacy of magnetic resonance (MR) imaging in the diagnosis and screening of the vasculopathy. Methods and Materials: We retrospectively evaluated the medical records and serial MR images for 32 pediatric patients, in whom radiationtherapy had been given to fields including the circle of Willis and major cerebral arteries. All children had periodically undergone follow-up neurologic assessment and MR imaging examinations at Kanagawa Children's Medical Center for more than one year after radiationtherapy (range 1.3-14 years). Patients who had not remained free of tumor progression up to the time of final evaluation were excluded. Results: Vasculopathy developed in 6 of 32 patients 2-13 years after ...
The aim of this study was to evaluate the results of postoperative radiotherapy in a case of perihilar cholagiocarcinoma by analyzing overall survival rate, patterns of failure, prognostic factors for overall survival, and toxicity. Between January 1998 and March 2008, 38 patients with perihilar cholangiocarcinoma underwent a surgical resection and adjuvant radiotherapy. The median patient age was 59 years (range, 28 to 72 years), which included 23 men and 15 women. The extent of surgery was complete resection in 9 patients, microscopically positive margins in 25 patients, and a subtotal resection in 4 patients. The tumor bed and regional lymphatics initially received 45 Gy or 50 Gy, but was subsequently boosted to a total dose of 59.4 Gy or 60 Gy in incompletely resected patients. The median radiotherapy dose was 59.4 Gy. Concurrent chemotherapy was administered in 30 patients. The median follow-up period was 14 months (range, 6 to 45 months). The 3-year overall ...
PurposeWe conducted a comparative study of Clinical Target Volume (CTV) definition of pelvic lymph nodes by multiple GU radiation oncologists looking at the levels...Full Text Available
For intensity modulated radiation treatment (IMRT) dose reconstruction, multileaf collimator (MLC) log files have been shown applicable for deriving delivered fluence maps. However, MLC log files are...Full Text Available
Prostatic neoplasms are not uniformly distributed within the prostate volume. With recent developments in three-dimensional intensity-modulated and imageguided radiationtherapy, it is possible to treat...Full Text Available
Two patients who developed large intracranial vessel occlusion after standard radiationtherapy 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 radiationtherapy 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 radiationtherapy for an oligodendroglioma. Occlusion of a proximal vessel that had been included in the radiation port ...
Two patients who developed large intracranial vessel occlusion after standard radiationtherapy 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 radiationtherapy 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 radiationtherapy for an oligodendroglioma. Occlusion of a proximal vessel that had been included in the radiation port ...
Power devices such as MOSFETSs and IGBTs, include parasitic structures that can give rise to destructive failures such as breakdown and latch-up. To determine a suitable strategy for device radiation hardening, simulation software like MEDICI-2D can be used to model the effects of technological modifications and device parameters that are difficult to measure experimentally. (authors).
During the past 10 years, five infants with Kasabach-Merritt syndrome (K-M) receiving radiationtherapy were reported. We investigated whether radiationtherapy for K-M was useful and what the unfavorable factors of K-M were. During the past 10 years, we have treated five infants with K-M. The syndrome occurred at ages ranging from birth to 4 months. The incidence of female to male ratio was 3:2. Among 5 cases, the site of hemangioma was as follows; shoulder, anterior chest wall, lower abdominal wall, face and neck and inguinal site. All 5 cases received medication to control the coagulopathy including prednisone and blood transfusion at first. Because the platelet count and the bleeding tendency did not improve in any case, these cases received radiationtherapy. Total dose ranged from 5 to 10 Gy and fraction-size ranged from 0.5 to 1.75 Gy. Irradiation session ...
Two cases of primary Ewing's sarcoma of the rib are reported, in which radiationtherapy was quite effective. Case 1 was an 18-year-old female who had had an operation and radiationtherapy for Ewing's sarcoma of the left 7th rib. She was referred to our hospital after a recurrent tumor was found. Radiationtherapy (tumor dose 46.2 Gy) and chemotherapy were given. The tumor disappeared and there has been no relapse for 1 year and 3 months after the treatment. Case 2 was a 2-year-old-infant. Radiationtherapy (tumor dose 74 Gy) was given for primary Ewing's sarcoma of the left 6th rib. The tumor became small and was successfully removed at operation. There has been no relapse or distant metastasis for 8 months following the operation. We emphasize the importance of multidisciplinary treatment in case 1 and the usefulness ...
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 ...
Transplantation has emerged as the therapy of choice for many patients with end organ failure. One of the major goals is to tailor immunosuppressive therapy to the individual needs of every patient to balance the risk for rejection and over-immunosuppression. This will require diagnostic tools that can detect harmful processes in the allograft early, and that can be measured repeatedly. This review will consider recent advances in our understanding of the molecular nature of these processes and how this information is being utilized to design novel diagnostic assays to non-invasively monitor allografts. Highlighted is the need for large-scale prospective multi-centre studies to validate assays that show early promise in single centre studies.
The book is divided into two approximately equal parts. The first four chapters are relatively lengthy and cover the basic principles of radiation biology, carcinogenesis and therapy, along with a brief introduction to radiological physics to orient the reader without background in this specialized related discipline. The remainder consists of twenty-four relatively brief chapters, each covering the radiation biology of a specific organ, tissue, or systems tissues, with emphasis on the tumorigenic and tumoricidal action of ionizing radiations.
External radiation dose exceeded 5,000 rad in three cases, and intravaginal radiation dose was 5,000 rad in one case. Radiation damage including perforation was seen in the end of ileus in one case, in the sigmoid and rectum in two cases, and in the end of ileus, sigmoid and rectum in the last case. Satisfactory results were obtained by the removal of the ileocecum in the case of the damage in the end of the ileus. However, only colostomy was performed for the damage in the sigmoid and rectum.
Retrospective analyses were performed to evaluate the therapeutic efficacy of intra-oral cone (IOC) radiationtherapy for carcinoma of the oral tongue, especially about its faculty of local control and complications. Thirty-nine patients with squamous cell carcinoma of the oral tongue were treated with IOC radiationtherapy alone or in combination with external irradiation. IOC radiationtherapy was given not only for T1 and T2, but also for T3 tumors. Hypofractionation was used for IOC radiationtherapy. The 2 year local control rates, including surgical salvage, for T1, T2, T3 and T4 were 100%, 73.3%, 40% and 0%, respectively. The 5 year actuarial survival rates for Stage I, II, III and IV were 100%, 65.3%, 35.4% and 0%, respectively. The incidences of radiation complications, i.e. soft tissue ...
A long-term follow-up of a patient with beta thalassaemia with intra- and extraspinal extramedullary haematopoietic tissue compressing the spinal cord is presented. Extramedullary haematopoietic nodules are a rare cause of spinal cord compression and should be included in the differential diagnosis, especially in patients from Mediterranean countries. Treatment with radiationtherapy solely failed, giving rise to the need of surgical intervention. Surgical decompression of the spine and the removal of the culprit lesion compressing the spine were performed. Postinterventional radiationtherapy was applied to the spine. A relapse had to be treated again by surgical means combined with postinterventional radiationtherapy. A complete relief of the symptoms and control of the lesion could be obtained.
A wood/polymer composite was produced by impregnating Ramin wood with methyl methacrylate monomer and subsequently polymerizing it by gamma irradiation. To assess the improvement in compression strength of the wood caused by the polymer impregnation, a microbuckling compression failure mechanism was used to model the compression failure of the composite. Such a mechanism was found to predict a linear relationship between the compression strength and the percentage polymer impregnation (by weight). Uniaxial compression test results at 45({plus minus}5)% and 90({plus minus}5)% relative humidity levels, after being statistically analysed, showed that such a linear relationship was valid for up to 100% polymer impregnation. (author).
A wood/polymer composite was produced by impregnating Ramin wood with methyl methacrylate monomer and subsequently polymerizing it by gamma irradiation. To assess the improvement in compression strength of the wood caused by the polymer impregnation, a microbuckling compression failure mechanism was used to model the compression failure of the composite. Such a mechanism was found to predict a linear relationship between the compression strength and the percentage polymer impregnation (by weight). Uniaxial compression test results at 45(#+-#5)% and 90(#+-#5)% relative humidity levels, after being statistically analysed, showed that such a linear relationship was valid for up to 100% polymer impregnation. (author).
For over 50 years, electron beams have been an important modality for providing an accurate dose of radiation to superficial cancers and disease and for limiting the dose to underlying normal tissues and structures. This review looks at many of the important contributions of physics and dosimetry to the development and utilization of electron beam therapy, including electron treatment machines, dose specification and calibration, dose measurement, electron transport calculations, treatment and treatment-planning tools, and clinical utilization, including special procedures. Also, future changes in the practice of electron therapy resulting from challenges to its utilization and from potential future technology are discussed. (review)
Electron beam therapy has often been used for radiationtherapy of carcinomas of the buccal mucosa, though side effects, including stomatitis and dermatitis, are known to exist. We experimented using the additional back scatter and transit with the phantom under a lead plate within the irradiation field, in order to better focus the dose on the target volume moreover, we fabricated a mouthpiece fitted with a lead plate shaped to the target volume, and with respect to the influence of the mouthpiece on stomatitis and dermatitis, obtained good clinical results. (author).
Electron beam therapy has often been used for radiationtherapy of carcinomas of the buccal mucosa, though side effects, including stomatitis and dermatitis, are known to exist. We experimented using the additional back scatter and transit with the phantom under a lead plate within the irradiation field, in order to better focus the dose on the target volume moreover, we fabricated a mouthpiece fitted with a lead plate shaped to the target volume, and with respect to the influence of the mouthpiece on stomatitis and dermatitis, obtained good clinical results. (author).
The outcome was retrospectively examined and prognostic factors were discussed for arterial chemo-infusion therapy (ACT) through an implanted reservoir system and radiationtherapy (RT) in patients with unresectable intrahepatic cholangiocarcinoma (CCC). ACT plus RT were conducted to 25 patients (mean age 61.7 y, M/F 12/13, stage III-IVB) during 10 years from 1996 to 2005 with various regimens of cisplatin (CDDP), 5- fluorouracil (FU), epirubicin (FARM), mitomycin C (MMC) plus 39-50 Gy of radiation in a fractionated manner partly involving internal RT (2 cases, 15 Gy) and RT for metastatic bone (1, 25 Gy). The survival rates at 1, 2 and 3 years after ACT+RT were respectively 52.5, 43.7 and 28.1%; total efficacy (PR) was 36% (9/25) at 6 months; and significantly good prognostic factors were found to be female and absence of metastasis remote and/or lymphatic around artery. Authors concluded that ACT+RT ...
This document is the report of a task group of the RadiationTherapy Committee of the AAPM and has been prepared primarily to advise hospital physicists involved in external beam treatment of patients with pelvic malignancies who have high atomic number (Z) hip prostheses. The purpose of the report is to make the radiation oncology community aware of the problems arising from the presence of these devices in the radiation beam, to quantify the dose perturbations they cause, and, finally, to provide recommendations for treatment planning and delivery. Some of the data and recommendations are also applicable to patients having implanted high-Z prosthetic devices such as pins, humeral head replacements. The scientific understanding and methodology of clinical dosimetry for these situations is still incomplete. This report is intended to reflect the current state of scientific understanding and technical ...
The clinical results of electron beam therapy using intraoral cone in 8 cases of primary and recurrence carcinoma of tongue (T1 and smaller T2) were reported. The primary and recurrence cases were 5 and 3, respectively. In the 5 cases, a total dose of 10-30 Gy external radiationtherapy were combined prior to electron beam therapy. The total dose of electron beam therapy varied from 40 to 60 Gy. In all cases, tumor showed good response and disappeared clinically. Radiation stomatitis, pain of the tongue with masticatory disturbance due to tenderness were complicated in all cases. These complications gradually disappeared 2 to 6 months after treatment. However, loss of body weight and bone exposure were not recognized in any case. Intraoral-cone electron beam therapy is thought to be available and has less complications comparing interstitial ...
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.
Delayed cerebral necroses after irradiation are to be divided into hemispheric and midline lesions, as they differ from each other in several aspects. Apart from the symptoms, they are differing in the duration of latency, in the course and prognosis, and also with regard to morphology. Though there is no doubt that radiation tolerance of cerebral midline structures is relatively limited, on biological grounds, evidence of a difference between the tolerated doses could not be given from the existent inhomogeneous radiation data, with the help of the NSD-concept. Radiation planning for the region of the head, nevertheless, carefully should avoid in every case to involve the structures of the cerebral midline.
AbstractThe optimal definition of the size, shape and location of gross tumour volume is one of the most important steps in the planning of radiationtherapy, and necessitates a proper...Full Text Available
Microplanar beam radiationtherapy has been proposed to treat brain tumors by using a series of rapid exposures to an array of parallel x-ray beams, each beam having uniform microscopic thickness and...Full Text Available
... 46 DOUGLAS BOCCUZZI, MS, DABR: There are some electromagnetic fields in the room, not strong. You can ... 5 weeks or is she feeling any side effects? 00:43:33 SUSAN Y. KIM, MD: She ...
IntroductionIrradiation of normal, non-malignant bone during cancer therapy can lead to atrophy and increased risk of fracture at several skeletal sites, particularly...Full Text Available
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
Voxel-based prescriptions of deliberately non-uniform dose distributions based on molecular imaging, so-called dose painting or theragnostic radiationtherapy, require specification of a transformation...Full Text Available
Patients experiencing several cancers can be a challenge, as optimal treatment options for the different cancers might interfere with each other. In this case report, we present a woman diagnosed with...Full Text Available
Purpose:To investigate the clinical usage of dose verification of Helical Tomotherapy plans by using 2D-array ion chambers, and to develop an efficient way to validate the dose delivered...Full Text Available
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
- flushing Chemotherapy - what to ask your doctor Dry Mouth Oral mucositis Peripherally inserted central catheter Radiationtherapy - what to ask your doctor Safe drinking during...
Purpose: Reverse helical cone-beam computed tomography (CBCT) is a scanning configuration for potential applications in image-guided radiationtherapy in which an accurate anatomic image...Full Text Available
The results of 144 previously untreated cases of primary Ewing's sarcoma of bone are reported with a minimum follow-up of 5 years. This series was treated between 1972 and 1982 at Istituto Ortopedico Rizzoli with a combined therapy. The local control of the disease consisted of amputation (ten cases), resection followed by radiationtherapy (35-45 Gy) (48 cases) and radiationtherapy alone (40-60 Gy) (86 cases). Adjuvant chemotherapy, rigorously standardized, was performed according two different protocols: the first (85 cases treated in the period 1972-1978) consisted of vincristine (VCR) Adriamycin (doxorubicin) (ADM), and cyclophosphamide (EDX); the second (59 cases treated in the period 1979-1982) of VCR, ADM, EDX and dactinomycin (DACT). At a follow-up of 5 to 16 years (median, 9), 59 patients (41%) are continuously disease-free (CDF), 81 (56%) developed metastatic disease ...
Purpose: A retrospective analysis was undertaken to determine the indications for, the efficacy of, and the long-term complications of two courses of total skin electron beam therapy for mycosis fungoides. Methods and Materials: A retrospective analysis of 15 patients with the pathologic diagnosis of mycosis fungoides treated in the Department of Radiation Oncology at Stanford University Medical Center between 1968 and 1990 was performed. All patients received two courses of high-dose electron beam therapy to the skin. The mean dose for the total skin treatment for the first course was 32.6 Gy and 23.4 Gy for the second course of treatment. Results: Following the first course of total skin electron beam therapy, 11 of 15 had a complete response, with a mean duration of 11.6 months. All patients received adjuvant therapies between the first and second courses of high-dose total skin ...
This book examines the applications of Monte Carlo (MC) calculations in therapeutic nuclear medicine, from basic principles to computer implementations of software packages and their applications in radiation dosimetry and treatment planning. It is written for nuclear medicine physicists and physicians as well as radiation oncologists, and can serve as a supplementary text for medical imaging, radiation dosimetry and nuclear engineering graduate courses in science, medical and engineering faculties. With chapters is written by recognised authorities in that particular field, the book covers the entire range of MC applications in therapeutic medical and health physics, from its use in imaging prior to therapy to dose distribution modelling targeted radiotherapy. The contributions discuss the fundamental concepts of radiation dosimetry, radiobiological aspects of targeted radionuclide ...
Authors developed a C-arm type radiosurgery system of the linear accelerator suitable for stereotactic radiationtherapy and a software for arranging 3-dimensional therapy in the system. In this system, the gantry far conical irradiation of 4 MV (0.6-3 Gy/min) and 6 MV (0.9-4.5 Gy/min) X ray or electron beam for the therapy was connected to a newly designed C-arm and was made capable of rotating around either of the axes crossing vertically. With this system, it became unnecessary to move the bed table of the patient for getting suitable distribution of radiation dose. The local accuracy which was measured by the CCD videocamera on the gantry, was within 0.5 mm from the radiation center. The system made it possible to shorten the irradiation time and to improve the local accuracy of irradiating site. The clinical trial was begun from June, 1996. (K.H.)
It may result in acute radiation syndrome after body is exposed to ionizing radiation. The one of long-term effects of irradiation injury is leukemia. The bone marrow cells (BMC) transplantation including stem cells is the only effective therapy for acute radiation syndrome patients. Recently, with the advancement of stem cell research that the stem cells have multipotential and can convert each other, it may supply the new stem source for the irradiation injury patients. At the same time with the further research of radioprotective reagents, the hematopoietic stem cells proliferation after irradiation injury is promoted
Purpose: The results of therapy in 288 men with pathologic Stage C prostate cancer who underwent radical retropubic prostatectomy (RRP) were analyzed to determine the effects of adjuvant therapy. Methods and Materials: Twenty-seven of the 288 patients received preoperative neoadjuvant hormonal therapy (leuprolide acetate). Postoperatively, 60 patients received adjuvant radiotherapy (RT) to the prostate bed. Follow-up ranged from 3 to 83 months (median = 32 months). Freedom from failure (FFF) was defined as maintaining a serum PSA level of #<=# 0.3 ng/ml. Results: The FFF was 61% at 3 years and 45% at 5 years for the entire group. The FFF following RRP plus RT was 75% at 3 years and 57% at 5 years as compared to 56% at 3 years and 40% at 5 years for RRP without RT (p = 0.049). The FFF following RRP plus neoadjuvant hormonal therapy was 58% at 3 years and 40% at 5 years as compared ...
Background: Intestinal failure (IF) is the dependence upon parenteral nutrition to maintain minimal energy requirements for growth and development. It may occur secondary to a loss of bowel length, disorders of motility, or both. Short bowel syndrome (SBS) is a malabsorptive state resulting from surgical resection, congenital defect, or diseases associated with loss of absorptive surface area. A particularly vexing problem is associated with whole bowel and/or segmental intestinal dysmotility. Motility disorders within the context of SBS and IF may relate to rapid intestinal transit secondary to loss of intestinal length, dysmotility associated with loss or poor antegrade peristalsis, or gastroparesis. Therapy may be classified into medical (prokinetic and antidiarrheal agents) and surgica...
Purpose To evaluate disease failure patterns and overall survival (OS) of women with triple-negative (TN) breast cancer who underwent breast-conserving therapy (BCT) and to understand the relationship of TN tumors with other prognostic factors. Patients and Methods The Surveillance, Epidemiology, and End Results (SEER) registry identified 562 women diagnosed and/or treated with unilateral invasive breast cancer during 2003?2004 at three Emory hospitals. After medical record review, 193 eligible women, with all tumor types, received BCT. Primary endpoints (local, regional, and distant recurrences) and secondary endpoint (OS) were evaluated using chi-square tests and Cox proportional hazards models. Results Of the 193 women, 33 (17.1%) had TN tumors and 160 (82.9%) had non-TN tumors. Patient...
The surgical management of osteoradionecrosis of the temporal bone has met with limited success because of the difficulty in accurate assessment of the viability of nonnecrotic bone intraoperatively. Failure to resect all nonviable bone results in recurrence of a necrotic focus. With the use of hyperbaric oxygen therapy to stabilize marginal bone and oral tetracycline to label viable bone preoperatively, removal of all nonviable bone can be accomplished. Postoperatively, a second course of hyperbaric therapy enhances wound healing, thus assuring a successful outcome. This article details a successful systematic approach that was developed to resect a necrotic focus in the temporal bone of a 10-year-old boy who had undergone a full course of radiotherapy for treatment of a rhabdomyosarcoma.
Process control transmitters that incorporate digital signal processing could be used advantageously in nuclear power plants; however, because such transmitters are too sensitive to radiation, they are not used. The Electric Power Research Institute sponsored work at Sandia National Laboratories under EPRI contract RP2614-58 to determine why SMART transmitters fail when exposed to radiation and to design and demonstrate SMART transmitter circuits that could tolerate radiation. The term ''SMART'' denotes transmitters that contain digital logic. Tests showed that transmitter failure was caused by failure of the complementary metal oxide semiconductors (CMOS)-integrated circuits which are used extensively in commercial transmitters. Radiation-hardened replacements were not available for the radiation-sensitive CMOS circuits. A conceptual design ...
Purpose: The purpose of this study was to evaluate the efficacy and toxicity of replication-competent adenovirus-mediated double suicide gene therapy in an adjuvant setting with external beam radiationtherapy (EBRT) in an experimental prostate cancer model in preparation for a Phase I clinical study in humans. Methods: For efficacy studies, i.m. DU145 and intraprostatic LNCaP C4-2 tumors were established in immune-deficient mice. Tumors were injected with the lytic, replication-competent Ad5-CD/TKrep adenovirus containing a cytosine deaminase (CD)/herpes simplex virus thymidine kinase (HSV-1 TK) fusion gene. Two days later, mice were administered 1 week of 5-fluorocytosine + ganciclovir (GCV) prodrug therapy and fractionated doses of EBRT (trimodal therapy). Tumor control rate of trimodal therapy was compared to that of EBRT alone. For toxicology studies, ...
The use of absorbable polyglactin 910 mesh (Vicryl) is described in a case of Ewing's sarcoma of the pelvis. An operation was performed to hold the small bowel and colon out of the pelvis for a temporary period during which radical radiotherapy was delivered. The mesh allowed the temporary displacement of bowel and obviated bowel radiation morbidity. (author).
Patients with end stage renal failure (ESRD) require renal replacement therapy in the form of dialysis or renal transplantation. There is an increasing number of people receiving maintenance dialysis as patients with ESRD are increasing faster than the supply of transplantable organs. The mortality rate on dialysis is 4-6 times that of the general population and is substantially reduced by transplantation. For the past 8 years, dialysis research has focused on improving patient outcomes and quality of life on dialysis. This review examines recent advances in haemodialysis and peritoneal dialysis in a historical context and considers future research possibilities. PMID:19329705
From 1979 to 1986, 182 patients with biopsy proven diagnosis of Ewing's sarcoma of bone were observed. One hundred of the 182 patients (72 males, 28 females, median age 15.8 years) with localized disease and no previous treatment were treated with chemotherapy (VCR, ADM, CTX, D-ACT) for 15-18 months. Local treatment was radiotherapy (42 patients), surgery (31 patients), or a combination of both (27 pts). Radiation doses ranged from 45 to 64 Gy given with conventional fractionation. Median follow-up was 51.2 months (24-106). Overall and disease-free survival were, respectively, 58.7 and 42.6%. Resected patients tended to have a better local control (Surgery 93.6%, Surgery + Radiationtherapy 92.6%, Radiationtherapy 69.1%). Disease-free survival was significantly related to the volume of the primary tumor (bulky: 33.2%, not-bulky: 57.7%), to site (extremities 54.6%, central sites ...
Results are presented applying an enteral nutrition by means of probes with Cosilat in complex therapy of patients with radiotherapeutic late effects of the colon. This nutrition was prescribed with the intention to gave the colon a functional recovery and to guarantee optimal conditions for repair of radiation injuries. Good results were seen in 27 of 28 patients (96.7%), the situation of one patient (3.3%) continued without any change. Cosilat has a high nutritive value, good organoleptic qualities and is well digested without any complications. (author).
Forty-three patients with basal and squamous cell carcinomata arising on the pinna were treated radically using a 10 MeV electron beam. The technique and dosage are described and discussed. Primary cancer control with retention of the pinna was achieved in 34 patients. Salvage pinnectomy was performed in four patients for recurrence and one patient for radiation necrosis. Two patients with large primary tumours failed to resolve and died of their disease. The advantages for the patient of the policy of primary radical electron beam therapy are discussed.
The document represents a guide for the external decontamination of persons accidentally radio contaminated due to the use, production or transport of radioactive materials. The general conditions, from the medical point of view, to be kept in mind, in the event of accidental overexposures as decontamination treatment and the handling of samples are detailed throughout report. The external contamination without injury in skin or with wound its considered. The distribution of measures and responsibilities for the therapy of the irradiated patients with radioactive materials are enumerated. The preparations of decontaminate solutions are detailed in this work. Moreover, forms for the reception, physical evaluation of the patient and external contamination are presented. (author)
Background 2009 pandemic influenza A(H1N1) has led to a global increase in severe respiratory illness. Little is known about kidney outcomes and dialytic requirements in critically ill patients infected with pandemic H1N1. Study Design Prospective observational study. Setting & Participants 50 patients with pandemic H1N1 admitted to any of 7 intensive care units in Manitoba, Canada, were prospectively followed. Outcome & Measurements Outcomes were kidney injury and kidney failure defined using RIFLE (risk, injury, failure, loss, end-stage disease) criteria or need for dialysis therapy. Results The pandemic H1N1 group was composed of 50 critically ill patients with pandemic H1N1 with severe respiratory syndrome (47 confirmed cases, 3 probable). Kidney injury, kidney failure, a...
Twenty-four high-risk Ewing's sarcoma patients were treated on an intensive combined modality protocol including low-dose fractionated total body irradiaiton (TBI) and autologous bone marrow infusion (ABMI). Twenty patients (83%) achieved a complete clinical response to the primary and/or metastatic sites following induction therapy. The median disease-free interval was 18 months, and nine patients remain disease-free with a follow-up of 22 to 72 months. Local failure as a manifestation of initial relapse occurred in only three patients (15%), each having synchronous distant failure. Eight patients failed initially with only distant metastases, usually within 1-2 years following a complete clinical response. Two patterns of granulocyte recovery following consolidative therapy (including TBI and ABMI) were recognized. The time to platelet recovery was different for the groups with early and late ...
A thermoluminescence (TL) sheet and its spatial readout system for in vivo measurement of spatial dose distribution around sources has been newly developed for intracavitary high dose-rate radiationtherapy. The TL sheet (40 cm x 50 cm x 200 {mu}m), which is composed of teflon mixed with BaSO{sub 4} (Eu doped) powder, has a linear response with a very wide dynamic range from at least 0.002 cGy to 5000 cGy for {sup 60}Co sources. Phantom test of the TL sheet readout system demonstrated that absorbed dose with TL sheet and that with ionization chamber as standard dosimeter agreed well. For clinical application, TL sheet was attached on an applicator of intracavitary radiationtherapy for rectal cancer. After irradiation with high dose-rate {sup 60}Co sources, the in vivo dose distribution on the surface of the rectum was determined. The TL sheet was suggested to provide a convenient means of measuring the ...
We report a patient who developed occlusion of the intracranial major arteries induced by radiationtherapy for craniopharyngioma. The patient, a 9-year-old boy, presented with deterioration of vision, nausea and vomiting. He underwent a right ventriculo-peritoneal shunt operation, and the tumor was partially removed. Postoperatively, he received focal radiationtherapy with total of 60 Gy. Preoperative cerebral angiography, cerebral vessels had no sigh of occlusive lesion or stenosis. One year after irradiation, he started to have repeated cerebral ischemic attacks. But no regrowth of the tumor was detected on CT scans. Two years and 8 months after irradiation, he suddenly had right hemiparesis. Cerebral angiography revealed severe stenosis of the right anterior cerebral artery (precommunicating segment), middle cerebral artery (horizontal portion) and terminal portion of the right carotid artery. Left ...
We report a patient who developed occlusion of the intracranial major arteries induced by radiationtherapy for craniopharyngioma. The patient, a 9-year-old boy, presented with deterioration of vision, nausea and vomiting. He underwent a right ventriculo-peritoneal shunt operation, and the tumor was partially removed. Postoperatively, he received focal radiationtherapy with total of 60 Gy. Preoperative cerebral angiography, cerebral vessels had no sigh of occlusive lesion or stenosis. One year after irradiation, he started to have repeated cerebral ischemic attacks. But no regrowth of the tumor was detected on CT scans. Two years and 8 months after irradiation, he suddenly had right hemiparesis. Cerebral angiography revealed severe stenosis of the right anterior cerebral artery (precommunicating segment), middle cerebral artery (horizontal portion) and terminal portion of the right carotid artery. Left ...
The work scope of 'Biological Research for the Radiation Protection' had contained the research about ornithine decarboxylase and its controlling proteins, thioredoxin, peroxiredoxin, S-adenosymethionine decarboxylase, and glutamate decarboxylase 67KD effect on the cell death triggered ionizing radiation and H_2O_2(toxic agents). In this study, to elucidate the role of these proteins in the ionizing radiation (or H_2O_2)-induced apoptotic cell death, we utilized sensesed (or antisensed) cells, which overexpress (or down-regulate) RNAs associated with these proteins biosynthesis, and investigated the effects of these genes on the cytotoxicity caused by ionizing radiation and H_2O_2(or paraquat). We also investigated whether genisteine(or thiamine) may enhance the cytotoxic efficacy of tumor cells caused by ionizing radiation (may enhance the preventing effect ...
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.
Purpose: The aim of this study was to assess interinstitutional variations in planning for stereotactic body radiationtherapy (SBRT) for lung cancer before the start of the Japan Clinical Oncology Group (JCOG) 0403 trial.Methods and Materials: Eleven institutions created virtual plans for four cases of solitary lung cancer. The created plans should satisfy the target definitions and the dose constraints for the JCOG 0403 protocol.Results: FOCUS/XiO (CMS) was used in six institutions, Eclipse (Varian) in 3, Cadplan (Varian) in one, and Pinnacle3 (Philips/ADAC) in one. Dose calculation algorithms of Clarkson with effective path length correction and superposition were used in FOCUS/XiO; pencil beam convolution with Batho power law correction was used in Eclipse and Cadplan; and collapsed co...
Purpose: In this paper, we present an alternative to the originally proposed technique for the delivery of spatially fractionated radiationtherapy (GRID) using multi-leaf collimator (MLC) shaped fields. We employ the MLC to deliver various pattern GRID treatments to large solid tumors and dosimetrically characterize the GRID fields. Methods and materials: The GRID fields were created with different open to blocked area ratios and with variable separation between the openings using a MLC. GRID designs were introduced into the Pinnacle3 treatment planning system, and the dose was calculated in a water phantom. Ionization chamber and film measurements using both Kodak EDR2 and Gafchromic EBT film were performed in a SolidWater phantom to determine the relative output of each GRID design as w...
Many mechanical parts are subjected to stresses and strains that may eventually lead to their failure. In order to prevent the costly delays associated with equipment down-time, many parts have to be tested for weaknesses and defects when machinery is constructed or dismantled for maintenance. These procedures are known as Non-Destructive Testing (NDT) methods. Five types of non-destructive testing methods routinely used are radiographic testing, ultrasonic testing, magnetic particle inspection, liquid penetrant testing and eddy current testing. Out of these five techniques industrial radiography plays an important role in non-destructive testing to reveal interior defects in materials. In radiography almost two-thirds of the radiation reaching the film is scattered radiation which does not form the image of defects. Scattered radiation generated inside and outside a material has a very large effect on ...
Epiphyseal plates of growing bones are sensitive to ionizing radiation and this poses problems for the paediatric radiotherapist. In this case report we describe a child in whom electron beam therapy to the groin delivered only low dose radiation to the proximal hip epiphyses - 130 cGy fractionated over 5 weeks - but who suffered late maldevelopment. We explore the success of various radiotherapy techniques in minimizing the dose to the hip epiphyses in four other children. The appropriate positioning of the limb, the choice of treatment modality and, where possible, individual shielding blocks are considered and their effect on the dose to the hip estimated. Absorbed doses of radiation delivered to the midpoint of the proximal femoral epiphyses have been retrospectively determined. (author).
A 38 year old male dentist developed an oligodendroglioma of the left medial temporal lobe and parasellar region 12 years after radiotherapy with 6600 rads for acromegaly. The 30 cases of radiation-induced gliomas reported in the English literature are reviewed and analysed. The criteria for defining radiation-induced tumours of the central nervous system are proposed as follows: the tumour has a long quiescent ''latency period'', a location in the previously irradiated field, a verified histological difference from a primary condition, and does not arise from a primary condition associated with a genetic syndrome such as neurofibromatosis or tuberous sclerosis. The reported case fulfilled these criteria but appears to be the only reported radiation-induced oligodendroglioma.
Oral mucositis associated with head and neck radiotherapy can substantially hinder completion of cancer therapy. Alleviation of this often severe stomatitis can provide enhanced patient comfort and facilitate appropriate care. A double-blind format was used in a pilot project to measure, against a control rinse, the effectiveness of an oral rinse consisting of hydrocortisone, nystatin, tetracycline, and diphenhydramine in controlling radiation-related mucositis. A combination of clinical evaluation and patient responses to a questionnaire was used to judge the results of the topical medications. Patients using the experimental medication developed less mucositis than did patients in the control group.
The long-term survival of certain patients after treatment with radiation or chemotherapeutic agents has allowed the realization that agents that effectively control cancer in the human subject may also possess an oncogenic potential, resulting in secondary malignancies in a significant proportion of surviving patients. A quantitative assessment of the oncogenic effects of these agents at a cellular level is important, as is information on conditions and agents that may effectively alter the development of the neoplastic state. Cell culture systems where the neoplastic transformation of cells can be scored after exposure to carcinogens offer powerful tools for evaluating the oncogenic potential of radiation and chemotherapeutic agents.
A set of eight questions was put to advanced nuclear medicine physicians-in-training participating in a continuing assessment exercise in practical therapeutic nuclear oncology. Using the particular example of {sup 131}I-MIBG treatment of neuroblastoma in children, the questions were directed to the rationale of therapy and the contribution of other forms of treatment to toxic effects. The best answer to the questions are reproduced together with an introduction by the examiner, Dr. H. Turner. tabs.
The reconstruction of coronal and Sagittal Image of Brain C. T. is helpful to diagnosis of Brain. Three Dimensional Reconstruction software package allows to display three dimensional Image clerived from a series of Horizontal, Sagittal and Coronal Brain C. T. images. It useful in determine approach of operation, to define portals of deep radiationtherapy.
PurposeUsing a retrospective analysis of treatment plans submitted from multiple institutions accruing patients to the RTOG #0236 non-small cell SBRT protocol, this...Full Text Available
... or she will start intensive rehabilitation. This includes physical therapy and occupational therapy. Physical and occupational therapies aim at strengthening the remaining ...
Background: The outcome of acute myocardial infarction (AMI) complicated with cardiogenic shock is poor. The aim of this study was to analyse, whether upfront abciximab administration could improve the outcomes of cardiogenic shock. Methods: This multicentre open trial randomized 80 patients with AMI complicated by cardiogenic shock expected to undergo primary PCI into group A (routine upfront-pre-procedural-abciximab bolus followed by 12-h abciximab infusion) and group B (standard therapy). The study primary objective was 30-day combined outcome (death/reinfarction/stroke/new severe renal failure). Results: PCI was technically successful in 90% (A) versus 87.5% (B) patients. Abciximab was used in 100% (A) versus 35% (B). The primary endpoint occurred in 17 group A patients (42.5%) and 11 ...
In 1981, the German Society of Pediatric Oncology initiated a multi-institutional study for the treatment of Ewing's sarcoma. The protocol (Cooperative Ewing's Sarcoma Study, CESS 81) consisted of four courses of a four-drug-regimen (VACA), each course taking nine weeks. Local therapy (radical surgery or resection plus irradiation or radiotherapy alone) was performed after the second course. The results of CESS 81 can be summarized as follows: VACA-chemotherapy is effective in controlling systemic disease. Initial tumor mass and response to initial chemotherapy are of major prognostic value for local control and survival. Permanent local control is a problem, especially in irradiated patients. The high local failure rate in irradiated patients in CESS 81 could be attributable to the following reasons: Late start of local therapy (after 18 weeks of chemotherapy), uneven distribution of prognostic parameters: Large tumors ...
Transcatheter coil embolization for coronary artery to left ventricular fistula was successfully performed in a neonate. At 30 weeks' gestation, fetal echocardiography showed a hypoplastic right ventricle with intact ventricular septum, absent pulmonary valve, tricuspid atresia, and marked distension of the right coronary artery. After birth, the neonate had congestive heart failure and the electrocardiogram showed myocardial ischemic changes in the left ventricular area. Aortography showed a dilated right coronary artery arising from the ascending aorta and draining into the left ventricle. Transcatheter coil embolization was carried out on the 9th day after birth. Since the procedure, no myocardial ischemic changes have been detected. Transcatheter coil embolization is a useful therapy for coronary artery fistula associated with myocardial ischemia. PMID:15564713
Paraquat is a nonselective contact herbicide of great toxicological importance, being associated with high mortality rates, mainly due to respiratory failure. We report the case of a 22-year-old male admitted to the emergency room with a sore throat, dysphagia, hemoptysis, and retrosternal pain after the ingestion of 50 mL of a paraquat solution, four days prior to admission. Chest CT scans revealed pulmonary opacities, pneumomediastinum, pneumothorax, and subcutaneous emphysema. The patient was submitted to two cycles of immunosuppressive therapy with cyclophosphamide, methylprednisolone, and dexamethasone. The pulmonary gas exchange parameters gradually improved, and the patient was discharged four weeks later. The clinical and tomographic follow-up evaluations performed at four months after discharge showed that there had been further clinical improvement. We also present a brief review of the literature, as well as a discussion of the ...
Paraquat is a nonselective contact herbicide of great toxicological importance, being associated with high mortality rates, mainly due to respiratory failure. We report the case of a 22-year-old male admitted to the emergency room with a sore throat, dysphagia, hemoptysis, and retrosternal pain after the ingestion of 50 mL of a paraquat solution, four days prior to admission. Chest CT scans revealed pulmonary opacities, pneumomediastinum, pneumothorax, and subcutaneous emphysema. The patient was submitted to two cycles of immunosuppressive therapy with cyclophosphamide, methylprednisolone, and dexamethasone. The pulmonary gas exchange parameters gradually improved, and the patient was discharged four weeks later. The clinical and tomographic follow-up evaluations performed at four months after discharge showed that there had been further clinical improvement. We also present a brief review of the literature, as well as a discussion of the ...
The authors have evaluated bone mineral content in the vertebral spongiosa by means of Computed Tomography. The method proposed by Genant and Cann [17, 18] has been applied to examine 164 healthy volunteers and 108 patients. Both healthy males and females showed a progressive bone mineral loss increasing with age; the bone mineral loss was most severe in females during the 4th and 5th decade of life. Pathology included patients with osteoporotic fractures (vertebral and femural neck), patients with partial gastrectomy, renal failure, primary hyperparathyroidism, Cushing syndrome, corticosteroid therapy. Bone mineral values were significantly lower in most pathologic groups. Computed Tomography proves thus to be a valuable method to assess bone mineral content and to identify patients at risk for fractures.
In this study, a miniature fiber-optic radiation detector has been developed using a water-equivalent organic scintillator for electron beam therapy dosimetry. Usually, two kinds of light signals such as fluorescent and Cherenkov lights are generated in a fiber-optic radiation detector when a high-energy electron beam is irradiated. The fluorescent light signal is produced in the scintillator and is transmitted through a plastic optical fiber to a remote light-measuring device such as a PMT or a photodiode. The Cherenkov light could be also produced in the plastic optical fiber itself and be detected by a light-measuring device. Therefore, it could cause problems or limit the accuracy of the detection of a fluorescent light signal that is proportional to dose. The objectives of this study are to measure, characterize and eliminate Cherenkov light generated in a plastic optical fiber used as a component of a fiber-optic ...
Megavoltage photon intensity-modulated radiationtherapy (IMRT) is typically used in the treatment of prostate cancer at our institution. Approximately 1% to 2% of patients with prostate cancer have hip prostheses. The presence of the prosthesis usually complicates the planning process because of dose perturbation around the prosthesis, radiation attenuation through the prosthesis, and the introduction of computed tomography artifacts in the planning volume. In addition, hip prostheses are typically made of materials of high atomic number, which add uncertainty to the dosimetry of the prostate and critical organs in the planning volume. When the prosthesis is bilateral, treatment planning is further complicated because only a limited number of beam angles can be used to avoid the prostheses. In this case study, we will report the observed advantages of using noncoplanar beams in the delivery of IMRT to a prostate cancer ...
Total 125 patients with primary and metastatic Ewing's sarcoma were treated in various ways between 1963 to 1977. Patients were divided into 3 groups according to the treatment methods. Group 1 was nonprotocol patients with or without chemotherapy. Total 58 patients were entered. Group 1 was divided into 2 subgroups. 33 patients were treated locally without chemotherapy and 25 patients were treated with local therapy and nonprotocol chemotherapy. Group 2 was treated with local therapy and plus T-2 regimen multiagent chemotherapy. 29 patients were entered. Group 3 was treated with local therapy and T-6 regimen multiagent chemotherapy. 38 patients were entered. Local treatments for primary tumor were surgery and/or radiationtherapy. Radiation dose ranged between 2,000 and 8,000 rad. Patients with pulmonary metastases received bilateral pulmonary RT. Local ...
Oncospheres produced by a nonirradiated worm and oncospheres produced by a worm that had been subjected to high gamma radiation (successive generations of cysticercoids were irradiated with 15,000 r until a cumulative dose of 120,000 r was obtained) were compared. Radiation had no effect on the sizes of the embryos, the shell, and the median hooks. Radiation may have resulted in certain large, hookless embryos that did not occur in the normal worm. Two anomalies, reduced hook number and failure of growth, were more frequent in the normal than in the irradiated worm. This result, although surprising, can be explained by the high selection pressure operating under the experimental conditions. (auth)
In this paper the measurements of radon-222 concentration in the air of Kowary Radon Inhalatorium in the vicinity of Jelenia Gora, Lower Silesia, Poland, performed by Radiation Protection and Radiobiology Department of National Institute of Hygiene in Warsaw, have been presented. For the measurements the integration method with the application of charcoal canisters have been used. The radon concentration was found within the very broad ranges from about 4 to 420 kBq m"-"3 depending of the season of the year. Basing on the radon concentration measurements during the inhalation therapy session and taking into account the equilibrium factor of 0.8 the doses to the bronchi of the patients in range from 1.2 to about 204 mSv (0.12-20.4 rem) have been assessed. The majority of patients (ca. 76%) received the doses between 115 and 204 mSv. (author)
The technology for performance testing and improvement of materials which are durable at space environment is a military related technology and veiled and securely regulated in advanced countries such as US and Russia. This core technology cannot be easily transferred to other country too. Therefore, this technology is the most fundamental and necessary research area for the successful establishment of space environment system. Since the task for evaluating the effects of space materials and components by space radiation plays important role in satellite lifetime extension and running failure percentage decrease, it is necessary to establish simulated space radiation facility and systematic testing procedure. This report has dealt with the status of the technology to enable the simulation of space environment effects, including the effect of space radiation on space materials. This information such as ...
Purpose: In this paper, we present an alternative to the originally proposed technique for the delivery of spatially fractionated radiationtherapy (GRID) using multi-leaf collimator (MLC) shaped fields. We employ the MLC to deliver various pattern GRID treatments to large solid tumors and dosimetrically characterize the GRID fields. Methods and materials: The GRID fields were created with different open to blocked area ratios and with variable separation between the openings using a MLC. GRID designs were introduced into the Pinnacle"3 treatment planning system, and the dose was calculated in a water phantom. Ionization chamber and film measurements using both Kodak EDR2 and Gafchromic EBT film were performed in a SolidWater phantom to determine the relative output of each GRID design as well as its spatial dosimetric characteristics. Results: Agreement within 5.0% was observed between the Pinnacle"3 predicted dose distributions and the ...
In the context of radiation protection for both workers and the population in general, natural sources of radiation, and in particular radon gas and its short-life decay products assume great importance. In particular, workers in thermal spas can easily be exposed to a level of radon radiation and its decay products comparable to those in uranium mines, though often these workers are unaware of the danger. The main source of radon in thermal baths is the thermal water itself, coming as it often does from deep springs, and this can produce high radon concentrations which are left in those areas in which therapy is carried out. Another factor which cannot be overlooked is the radioactive content of thermal mud, often matured for long periods by contact with thermal water. Thermal cures, though varying slightly from site to site, consist principally of mud cures, hydro-therapy and ...
Endothelial dysfunction and increased platelet aggregation may be involved in the pathogenesis of normal tissue radiation toxicity. This study assessed clopidogrel, an inhibitor of ADP-induced platelet aggregation, as a modulator of intestinal radiation injury (radiation enteropathy). Rat small intestine was exposed to 21 Gy X-radiation. Clopidogrel (20 mg/kg/day) or vehicle was administered from 2 days before to 10 days after irradiation. Structural radiation injury, neutrophil infiltration, smooth muscle cell proliferation, collagen content, and TGF-beta1 expression were assessed 2 weeks (early phase) and 26 weeks (delayed phase) after irradiation, using quantitative histology and immunohistochemistry, morphometry, and real-time fluorogenic probe RT-PCR. Irradiated intestine exhibited significant histopathologic injury, reduced mucosal surface area, vascular sclerosis, intestinal ...
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 ...
RADIANT{trademark} is manufactured by United States Surgical Corporation, Vascular Therapies Division, (formerly Progressive Angioplasty Systems). The system comprises a liquid {beta}-radiation source, a shielded isolation/transfer device (ISAT), modified over-the-wire or rapid exchange delivery balloons, and accessory kits. The liquid {beta}-source is Rhenium-188 in the form of sodium perrhenate (NaReO{sub 4}), Rhenium-188 is primarily a {beta}-emitter with a physical half-life of 17.0 hours. The maximum energy of the {beta}-particles is 2.1 MeV. The source is produced daily in the nuclear pharmacy hot lab by eluting a Tungsten-188/Rhenium-188 generator manufactured by Oak Ridge National Laboratory (ORNL). Using anion exchange columns and Millipore filters the effluent is concentrated to approximately 100 mCi/ml, calibrated, and loaded into the (ISAT) which is subsequently transported to the cardiac catheterization laboratory. The delivery ...
Objective The aim of this study was to analyze the clinical results of our adaptive radiationtherapy scheme of a two-step intensity-modulated radiotherapy (IMRT) method for nasopharyngeal cancer (NPC) at Kinki University Hospital. Methods Between 2000 and 2007, 35 patients with Stage I-IVB NPC treated by IMRT were included. For all patients, treatment-planning computed tomography was done twice before and during IMRT to a total dose of 60-70 Gy/28-35 fractions (median 68 Gy). Chemotherapy (cisplatin 80 mg/m2/3 weeks x 1-3 courses) was given concurrently with IMRT for 31 patients. Results The 3- and 5-year overall survival rates for the 31 patients treated with concurrent chemotherapy were 88% and 83%, respectively. The 3- and 5-year loco-regional control rates for the 31 patients were 93%...
Purpose: Extrahepatic cholangiocarcinoma is a rare malignancy. Despite radical resection, survival remains poor, with high rates of local and distant failure. To clarify the role of radiotherapy with chemotherapy, we performed a retrospective analysis of resected patients who had undergone chemoradiotherapy. Methods and Materials: A total of 45 patients (13 with proximal and 32 with distal disease) underwent resection plus radiotherapy (median dose, 50.4 Gy). All but 1 patient received concurrent fluoropyrimidine-based chemotherapy. The median follow-up was 30 months for all patients and 40 months for survivors. Results: Of the 45 patients, 33 underwent adjuvant radiotherapy, and 12 were treated neoadjuvantly. The 5-year actuarial overall survival, disease-free survival, metastasis-free survival, and locoregional control rates were 33%, 37%, 42%, and 78%, respectively. The median survival was 34 months. No patient died perioperatively. Patient age #<=#60 years ...
From 1981 up to February 1985, a total of 93 protocol patients entered the study CESS 81. The protocol recommended an initial 18-week period of polychemotherapy (VACA) followed by local therapy and two additional cycles of chemotherapy. Local therapy consisted either of radical surgery or of incomplete resection plus postoperative irradiation with 36 Gy or of radiotherapy alone (46 and 60 Gy). Centrally located lesions were always irradiated with 60 Gy. This article summarizes the data after 5 years. Data of 93 patients were analysed in October 1986 after a median follow-up of 37 months. The projected 5-year survival is 50%. The relapse rate was 42%, distant relapses occurred in 19%, local (plus distant) relapses in 23%. Most of the relapses occurred during the first 3 years of observation. Failure rate was high in patients undergoing irradiation alone (44%). Initial tumour mass (> 100 ml) and histopathologic response to ...
Advances in the diagnosis of Ewing's sarcoma of the rib were considered and retrospective analysis of the treatment of 32 patients (76% of them were children at the age of 10-15 y.o.) in the clinic of children oncology was performed. It was shown that the diagnosis of Ewing's sarcoma of the rib in children ought to be combined taking into account the course, morphology and radiation examination techniques. Most optimum treatment consisted of combined therapy (cyclic polychemotherapy, lesion focus irradiation at the summary focus dose of 57 Gy, surgery with subsequent polychemotherapy for not less than 1.5 years
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.
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.
We present the case of a 12-year-old girl who presented with a pathological fracture through a benign-appearing osteolytic lesion that was presumed to represent fibrous dysplasia. The fracture healed, and over the next 2.5 years there was further refracturing and healing with progressive osteolysis. A biopsy was performed and revealed Ewing's sarcoma. The disease was locally controlled by neoadjuvant chemotherapy and radiationtherapy. The patient is disease free with excellent function 6 years following the discovery of the lesion. We illustrate and discuss the sequence of events. (orig.)
Two patients are described in whom sunburn and electron beam radiodermatitis, respectively, were critical determinants in localizing the initial presentation of drug eruptions. In the first instance, a severe sunburn of the back and thighs was followed 7 months later by the appearance of a toxic epidermal necrolysis drug reaction to trimethoprim-sulfamethoxazole in the exact sites of the previous bullous sunburn reaction. In the second patient, a radiodermatitis of the left upper arm due to electron beam therapy for metastatic breast cancer was followed 7 weeks later by a codeine drug reaction confined to the area of the radiodermatitis. In both instances, oral rechallenge with the offending drug reproduced the eruption.
The radiation properties of the #alpha# emitter "2"1"1At are in favor of its application malignant tumor therapy. As a basis for further investigations the biokinetics of At"-, At x H_2O, At I_2"-, and [At(thio)_2]"+ were determined after i.v. injection into healthy and tumor-bearing mice. The estimation of the ion mobility of the carrier-free compounds allowed the use of uniquely characterized initial compounds. The organ distribution of all species examined was similar to the distribution of astatide. Accumulation was found in the thyroid and other inner organs. (author).
We encountered a case of Ewing's sarcoma. The patient was a 19 year-old girl, who visited a local physician because of pain in the left scapular region, and was referred to us. Roentgenograms of her left scapula revealed an irregular moth-eaten shadow which was suspected to be a malignant bone tumor. The histological diagnosis of Ewing's sarcoma was comfirmed by needle biopsy. The initial stage of treatment consisted of radiationtherapy (6000 rads) and chemotherapy (VAC and ADR). At the end of the initial stage, the symptoms were improved, the size of the local lesion was reduced on the roentgenogram and there was no evidence of distant metastases. (author).
Purpose : To detect differentially expressed genes in the patients with uterine cervical cancer during the radiationtherapy. Materials and Methods : In patients with biopsy proven uterine cervical cancer, we took a tumor tissue just before radiationtherapy and at 40 minutes after external irradiation of 1.8 Gy. Total RNAs isolated from non-irradiated and irradiated tumor tissue samples were analyzed using the differential-display reverse transcription-polymerase chain reaction (DDRT-PCR). Complementary DNA (cDNA) fragments corresponding to differentially expressed messenger RNAs(mRNAs) were eluted, and cloned. The differential expression of the corresponding mRNAs was confirmed by reverse northern blot. Differentially expressed cDNA bands were sequenced. Nucleotide sequence data were analyzed in the Gene Bank and EMBL databases via the BLAST network server to identify homologies to known genes or cDNA ...
Background and purpose: In order to investigate the feasibility, toxicity and antitumor efficacy of hyperfractionated radiationtherapy, 37 adult patients with incompletely resected supratentorial low-grade glioma were entered into a phase II study. Materials and methods: The radiationtherapy dose was 55 Gy in 50 fractions in 25 treatment days over 5 weeks to the tumor plus a 2-cm margin, with an additional 17.6 Gy given in 16 fractions in 8 treatment days over 1.5 weeks to the tumor plus a 1-cm margin, using 1.1 Gy b.i.d. fractionation with a 6 h interfraction interval. The total tumor dose was 72.6 Gy in 66 fractions in 33 treatment days over 6.5 weeks. Results: The median survival time (MST) for all 37 patients has not yet been attained, while 5- and 7-year survival rates were 75% and 69%, respectively. The median time to tumor progression (MTP) has also not yet been attained, while 5- and 7-year ...
Changes in the phosphate metabolism of the transplanted SCCVII (squamous cell carcinoma VII) tumor were studied before and after irradiation using in vivo [sup 31]P-magnetic resonance spectroscopy (MRS). Phosphocreatine (PCr), [gamma]-, [alpha]-, [beta]-ATP, inorganic phosphate (Pi), phosphomonoester (PME), and phosphodiester (PDE) were detected in [sup 31]P-MR spectra of tumor tissues. The curve fitting method was employed for calculating each peak of [sup 31]P-MR spectra (PCr, [beta]-ATP, Pi, PME, PDE). The values of PCr, PCr/Pi, [beta]-ATP/Pi and pH decreased in proportion to the growth of tumor, whereas that of Pi, PME and PDE increased. But the changes of [beta]-ATP were minimal in degree. Based on the fact that the ratio of PCr/Pi highly correlated with tumor volume and showed the most remarkable change among various parameters, it might be the useful index for the tumor growth. Because the phospholipid metabolite PME was detected in the earlier stage of tumor growth, PME might ...
The purpose of the current study was to evaluate the difference in prognostic factors between stage IB and II uterine cervical carcinoma patients treated with postoperative radiationtherapy. Between May 1988 and May 1998, a total of 94 patients including 47 patients with stage IB and 47 patients with stage II uterine cervical carcinoma were treated with postoperative radiationtherapy at Tokyo Metropolitan Komagome Hospital. All patients were treated with 10 MV X-rays using an anterior-posterior parallel opposed field which covered the whole pelvis. Fractionation was 2 Gy per day, five fractions per week, to a total dose of 50 Gy. The 5-year overall survival rates of stage IB and II were 89.4% and 79.3%, respectively. In multivariate analysis for all patients, lymph node status, histology, and surgical margin status were recognized as prognostic factors. Limited to stage IB patients, lymph node status ...
Purpose. We report a case of Ewing's sarcoma in the right distal femur in a 6-year-old male to demonstrate how dynamic contrast-enhanced magnetic resonance imaging (DEMRI) findings predicted histopathology. Materials and methods. DEMRI was performed at presentation and during and after completion of chemotherapy and radiationtherapy. Histopathologic studies were done at presentation, at 77 weeks (20 weeks after a pathological fracture), and from the en bloc resection at 104 weeks. Results. DEMRI predicted the early tumor response, absence of tumor recurrence, presence of necrosis and lack of fracture healing, confirmed by histopathology. Conclusion. DEMRI is a clinically useful tool in managing Ewing's sarcoma. (orig.)
Endothelial dysfunction is involved in radiation responses in many normal tissues, including intestine. Endothelium-directed interventions ameliorate intestinal radiation injury (radiation enteropathy) in animal models, and anecdotal reports also suggest a beneficial effect of heparin. This study assessed low molecular weight heparin as an intestinal radiation response modifier. Rats underwent localized small bowel irradiation. Groups of rats were treated with saline, nadroparin (3 mg/kg/d), or a non-anticoagulant heparin (SR80258, 3 mg/kg/d), from 3 days before to 2 weeks after irradiation. The intestinal radiation response was assessed 2 weeks and 6 weeks after irradiation using quantitative histology; morphometry, and cellular and molecular end-points. Compared to vehicle-treated controls, nadroparin significantly exacerbated structural radiation injury, ...
Polymers are required to use in radiation environments as insulation materials. However, they often suffer from tracking failure. There is an increasing demand to evaluate radiation effects on dielectric performance. This paper presents a recurrence plot (RP) approach to analyse surface discharge sequences of gamma-ray irradiated polymer materials based on tracking test. Studying the non-linear characteristics of discharge sequences can assist in understanding the underlying mechanism of the discharge process. Discharge sequences of the test are extended to m-dimensional phase space by using the phase space reconstructed method. As test samples, polybutylene terephthalate (PBT) and polybutylene naphthalate (PBN) were irradiated to 100 kGy and then up to 1 MGy with a dosage rate of 10 kGy h{sup -1} by using a {sup 60}Co gamma source. The tracking tests were carried out according to the test method described in IEC60112. It ...
Samples of fat coal-E, its roof sandstone-A and blind coal-W from two coal mines in Hebei Province of China were brought to the laboratory to study the features of infrared thermal images and radiation temperature in the course of uni-axial load and uni-axial cycle load. To check the results of infrared remote sensing detection, two other methods, acoustic emission detection and electrical resistance detection were also used. The AGA-782 thermalvision detected change of the temperature field of the samples` surfaces. The study showed that: (1) coal rocks and sandstone in the course of loading have three types of infrared thermal image features and three types of infrared radiation temperature features; (2) infrared detection is comparable with acoustic emission detection and electrical resistance detection. Generally, the infrared forewarning of coal rocks` failure comes later than that of acoustic and electrical ...
In this updated second edition, the order of contents of the textbook has been reorganized. It has been divided into main parts: Basic Science and Clinical Nuclear Medicine. Basic Science, Part I, encompasses basic physics, radiation protection, interaction of radiation with matter and radiation detection, imaging, nuclear pharmacy, and radiation biology. Part II, Clinical Nuclear Medicine, covers the central nervous system, bone, gastroenterology (liver/spleen), cardiovascular system, pulmonary system, genitourinary system, thyroid and endocrine systems, gallium studies, radioassay, hematology, and therapy. The total number of pages of the current edition is increased to 250 from the 213 of the first edition but there are fewer questions because those in the basic science area have been carefully selected to 60 of the original 98 questions. Compared with the previous edition, there ...
As a series of estimations of population doses and of risk estimates from medical exposures in Japan, the malignancy significant dose (MSD) and the fatal malignant risk from beam therapy were estimated based on a nationwide survey of radiotherapeutic treatments, using a malignancy significant factor and a weighting factor determined from the data on the cancer mortality among the atomic bomb survivors in Nagasaki. The effective dose was defined as a sum of the product of the weighting factor and the organ or tissue doses with respect to the malignant diseases. The organ or tissue doses were determined with ionization chambers placed at the positions of their center in a MixDp-phantom simulated lung tissues by a block of cork, using a telecobalt unit, a conventional X-ray unit and a medical linear accelerator. The organ or tissue doses were categorized into three dose components; namely 1) dose from useful beams; 2) scattered radiation dose from ...
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 +/- 15 mlU/ml; luteinizing hormone (LH), 10 +/- 4 mlU/ml) and 17 ..beta..-estradiol (E/sub 2/) levels (means +/- SD, 208 +/- 147 pg/ml) were normal. By contrast, 4 older women (ages 36-43 yr) who received similar treatment developd persistent amenorrhea with postmenopausal levels of gonadotropin (FSH, 109 +/- 29 mlU/ml; LH, 72 +/- ...
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) ...
A 72-year-old man was exposed to the sarin gas attack in a Tokyo subway on March 20 th, 1995. After exposure, he noticed eye discomfort, chest tightness, headache and weakness of the lower limbs and oropharyngeal muscles. Despite these symptoms, he visited a hot spring on the same day with his family. On March 25 th, his muscle weakness progressed, and a low grade fever appeared. His muscle weakness disappeared 8 days after exposure to sarin, but respiratory failure rapidly developed, necessitating artificial ventilation within four day after hospitalization on March 28th. Chemotherapy with erythromycin, imipenem/cilastatin, and steroid pulse therapy was begu. PCR and culture of sputum collected by bronchofiberscopy were positive for Legionella pneumophila, serogroup I. His respiratory state improved, but subsequent infection with Pseudomonous aeruginosa. Enterobacter cloacae, and Candida tropicalis/glabrata caused his death 71 days after ...
Severe damage to the pelvic viscera is a complication of irradiation therapy that, unfortunately, cannot always be avoided. Resulting rectal and rectocolonic strictures, rectovaginal fistulas, and shortening and stenosis of the vagina present very difficult problems that frequently require a colostomy for relief and may permanently impair sexual function. The authors present a new approach to correction of these unfortunate lesions based on the use of proximal nonirradiated colon which serves as a vascular pedicle graft to correct the defect without a complicated and massive resection. Twenty-two such operations have been done with 19 satisfactory to excellent results and two total failures (one death from small bowel complications). All patterns and combinations of irradiation injury have been found amenable to this technique of repair. These have included both web and linear strictures with and without fistulas. In half of the patients, it ...
Experience in the diagnosis and treatment of infertility has led to an increased understanding of the prominent role male factors play in many couples' inability to conceive. While many forms of male factor infertility are amenable to treatment, for some patients there is no corrective therapy available. For this reason, a great deal of attention has been focused on developing technologies for semen processing and sperm utilization in cases of decreased semen quality. One area of research is the development of more sophisticated methods of assessing sperm function, as well as methods of sperm preparation. Progress is also being made in the application of technologies such as intrauterine insemination and in vitro fertilization in the treatment of male factor infertility. Such developments have improved prospects for fertility among patients suffering from decreased semen quality, as well as those suffering from such disorders as ejaculatory ...
The requirements to design nuclear power plants for the effects of an instantaneous double-ended guillotine break (DEGB) of the reactor coolant piping have led to excessive design costs, interference with normal plant operation and maintenance, and unnecessary radiation exposure of plant maintenance personnel. This report describes an aspect of the NRC/Lawrence Livermore National laboratory-sponsored research program aimed at investigating whether the probability of DEGB in Reactor Coolant Loop Piping of nuclear power plants is acceptably small such that the requirements to design for the DEGB effects (e.g., provision of pipe whip restraints) may be removed. This study estimates the probability of indirect DEGB in Reactor Coolant piping as a consequence of seismic-induced structural failures within the containment of the GE supplied boiling water reactor at the Brunswick nuclear power plant. The median probability of indirect DEGB was estimated ...
This paper shows the efficacy of computed radiography for major airway in pediatrics. For this purpose, we examined 40 children (range 2 weeks to 14 years; mean 2.3 years) using Fuji Computed Radiography (FCR) and radiation dose using pediatric phantom under FCR and conventional film and screen system. In comparison study with FCR and conventional film and screen system, FCR images are superior to conventional system in all cases. Scorings were done for the quality of the image of the pharynx, the trachea, and both main bronchi. In phantom study to check radiation dose, radiation dose could be reduced 1/6 of the value using high speed film and screen and 1/15 of the value using conventional speed film and screen. FCR also showed clear airway images in all cases but technical failure to evaluate the clinical lesion. These results suggest that FCR is the adequate imaging modality to evaluate the major ...
Portal verification images were generated from the photon contamination in electron beams produced by a linear accelerator during treatment of patients receiving high-energy electron radiationtherapy (8-14 MeV). An experimental storage phosphor system was used to record the images and display them on laser-printed film. Images were obtained from four or more treatment fractions from 21 cases of head and neck cancer. Precision in field placement was estimated by determining the position of a selected anatomic landmark relative to the center of the field for each series of images. The average standard deviation in the field-position measurements was 3.8 mm. Several procedural problems were also detected and corrected after review of the verification images. The results indicate that the emphasis placed on monitoring and control of field-positioning error in high-energy electron treatments should be similar to the emphasis placed on this aspect ...
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 useful approach which is also applicable ...
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 useful approach which is also applicable to ...
Between 1970 and 1981, 348 patients underwent definitive irradiation. Of these patients 6 (1.7 per cent) sustained severe rectal injury as manifest by major rectal bleeding, rectal stricture, rectal mucosal slough and rectal ulceration. Severe rectal injury was observed in 0 of 13 patients (0 per cent) treated with 125iodine, 3 of 329 (1 per cent) treated with 6,400 to 6,800 rad external irradiation, 2 of 39 (5 per cent) treated with 7,000 to 7,300 rad external irradiation, and 1 of 7 (14 per cent) treated with 198gold and external irradiation. The impact of radiation dose, radiationtherapy technique and surgical trauma was assessed. Rectal injury was managed by supportive measures in 2 patients and by diverting colostomy in 3 with benefit. One patient underwent abdominoperineal resection. A small bowel fistula and an intra-abdominal abscess developed, and the patient died.
Experiments were carried out on mice and the subjects irradiated for cancer therapy to evaluate the protective efficacy of a Chinese medicinal herb-compound (CMHC). The lethality and the degree of leucopenia caused by radiation in mice medicated with CMHC were significantly less in comparison with control mice (p less than 0.01 and p less than 0.001, respectively). CMHC significantly improved the WBC and the thrombocytes in irradiated workers (p less than 0.01 and p less than 0.001, respectively). The WBC count of 40 patients under radiotherapy while treated with CMHC recovered from 3450 +/- 77/c.mm to 5425 +/- 264/c.mm (p less than 0.001); whereas, in the control group, without any medication, the WBC count dropped significantly (p less than 0.001). Our results revealed the applicabilities of CMHC in protection against radiation damage in spaceflight and in other fields.
In August 1982, a 44-year-old man was diagnosed as having rectal cancer, histologically diagnosed as well differentiated adenocarcinoma, and abdominoperineal resection and colostomy were performed. Postoperatively, he received chemotherapy with mitomycin C up to a total dose of 100 mg. In September 1986, lung metastasis occurred and he was treated with a combination chemotherapy consisting of cisplatin, pirarubicin and 5-fluorouracil. In the following year, radiation treatment (total: 6900 rad) was given for a recurrent pelvic lesion. Peripheral blood on April 30, 1988, showed anemia, thrombocytopenia and appearance of myeloblasts, and a diagnosis of acute myelogenous leukemia (FAB: M1) was made. Combination chemotherapy (including aclarubicin, vincristine, behenoyl ara-C, daunorubicin, 6-mercaptopurine, cytarabine, etoposide and prednisolone) failed to induce remission and the patient died in June 1988. This case was thought to be one of secondary leukemia ...
The proton beam has an advantage of the sharp dose falloff in dose distribution called Bragg peak while conventional radiationtherapy modalities such as photons exhibit considerable amount of exit dose. To take advantage of this property it is important to know the exact location of the distal dose falloff. An error can cause overdose to the normal tissue or underdose to the tumor volume. The only way of finding out the dose distribution in-situ in particle therapy is to measure the gammas produced by nuclear reactions with tissue materials. Two kinds of gammas can be used: one is prompt gamma and the other is coincident gamma from the positron-emission isotopes. We chose to detect prompt gammas, and developed a prompt gamma scanning system (PGS). The proton beams of the proton therapy facility at National Cancer Center were used. The gamma distribution was compared to the dose distribution measured by ...
Thirty-seven patients with primary nonresectable intrahepatic cholangiocarcinoma (57% with prior treatment and/or metastasis) were prospectively treated with external radiation, chemotherapy, and "1"3"1I labelled anti-CEA. Therapy began in all trials with whole liver irradiation (21.0 Gy, 3.0 Gy/Fx, 4 days/week, 10 MV photons) with alternate treatment day chemotherapy (Adriamycin, 15 mg + 5-FU, 500 mg). One month after external beam therapy, chemotherapy was given (Adriamycin, 15 mg + 5-FU, 500 mg) followed the next day by the first administration of "1"3"1I anti-CEA. The treatment schedule used was 20 mCi day 0; 10 mCi day 5 as an outpatient. This schedule was derived from tumor dose estimates which indicated that 20 mCi (8-10 mCi/mg IgG) was sufficient to achieve tumor saturation with a tumor effective half-life of 3 to 5 days, depending upon the species of animal from which the antibody was obtained. The median tumor ...
Background: Determinants of warfarin use and anticoagulation levels in atrial fibrillation (AF) patients have not been clarified thoroughly. Methods and Results: A total of 6,324 patients with non-valvular AF and congestive heart failure, hypertension, age, diabetes, prior stroke (CHADS(2)) score ?1 were used to investigate determinants of warfarin use, and 6,932 patients with AF receiving warfarin were used to investigate determinants of international normalized ratio (INR) of prothrombin time. Target INR levels for non-valvular AF patients were 1.6-2.6 for patients aged ?70 years and 2-3 for patients aged transient ischemic attack (TIA), and had higher CHADS(2) scores than those not receiving warfarin. Determinants of warfarin use were age (?60 years), AF type (persistent and permanent), and comorbidities (congestive heart failure, diabetes mellitus, and prior stroke or TIA). Use of antiplatelet drugs was a negative determinant of warfarin ...
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 diagnosed in eight patients, and multifocal ...
In the report the results of the estimations of radiological risk of various stages of decommissioning of nuclear submarines are presented. At occurrence on nuclear submarine the heavy failure, relating to the class hypotetical volume of acting of radionuclides in atmosphere can reach 1.6E(15) Bq. Results of estimations probable doses on an axis of a trace of a radioactive loop show, that at distribution of radionuclides during atmospheric carry to 'agreed' settlement (500-1000 m) the maximum doses on its territory can make: about 6.0E(-3) Sv (for the whole body); 3.0E(-3) Gy for the leather (basal layer); 6.3E(-2) Gy for the lungs (acute exposure) and up to 1.8 Gy for the thyroid gland. Hypotetical failure for the estimation of the greatest possible radioecological consequences for hydrobiocenosis is considering, connected with single discharge of liquid radioactive waste (LRW) in water area. At navigating failure of the ...
Commercial focused ion beam (FIB) systems are commonly used to image integrated circuits (ICS) after device processing, especially in failure analysis applications. FIB systems are also often employed to repair faults in metal lines for otherwise functioning ICS, and are being evaluated for applications in film deposition and nanofabrication. A problem that is often seen in FIB imaging and repair is that ICS can be damaged during the exposure process. This can result in degraded response or out-right circuit failure. Because FIB processes typically require the surface of an IC to be exposed to an intense beam of 30--50 keV Ga{sup +} ions, both charging and secondary radiation damage are potential concerns. In previous studies, both types of effects have been suggested as possible causes of device degradation, depending on the type of device examined and/or the bias conditions. Understanding the causes of this damage is ...
Industrial radiography accounts for approximately half of all the reported accidents for the nuclear related industry, in both developed and developing countries. This Safety Report is the result of a review made of a large selection of accidents in industrial radiography reported by regulatory authorities, professional associations and scientific journals. A small, representative selection of 43 accident descriptions has been used to illustrate the primary causes of radiography accidents, and a set of measures provided to prevent the recurrence of such accidents or to mitigate the consequences of those that do occur. These accident descriptions were categorized by primary causes as follows: inadequate regulatory control; failure to follow operational procedures; inadequate training; inadequate maintenance; human error; equipment malfunction or defect; design flaws; and wilful violation. The information in this Safety report is intended for use by those regulatory ...
Shadow effect was used for investigating damage of uranium dioxide monocrystal. The dependence of shadow minimum parameters on fluence of "2"2Ne ions with 172 MeV energy was followed when detecting fission fragments. Ion dose responsible for sufficient microdamage of lattice structure, included into the classification of heavy ion damage effect on monocrystals was determined. The problem of radiation intensity effect on the character of occurred damages was studied. It was established that macroscopic sample failure, caused by generation of considerable mechanical stresses in monocrystal under beam effect could be observed along with microdamages of lattice structure at ion flux density >10"1"2 cm"-"2Xs"-"1.
Fatty acid esters such as Lipiodol or Ethiodol are known to selectively localize in vascular hepatocellular carcinomas (HCC), following intraarterial hepatic administration. Lipiodol was labeled with radioactive /sup 131/I and administered in 47 patients with HCC for both imaging and therapy. The short term preliminary results suggest radiolabeled Lipiodol is effective in eliminating ascites, shrinking the tumor by a high internal radiation dose, and in improving symptomatology of these tumors. In the future, /sup 90/Y, which is a stronger pure beta-emitter (maximum beta energy of 2.27 MeV, a half life of 64 h, and a maximum penetration or beta range of 11mm), than /sup 131/I will be used for more effective treatment of HCC.
The aim of this study was to evaluate the differences in accuracy of dose calculation between 3 commonly used algorithms, the Pencil Beam algorithm (PB), the Anisotropic Analytical Algorithm (AAA), and the Collapsed Cone Convolution Superposition (CCCS) for intensity-modulated radiationtherapy (IMRT). The 2D dose distributions obtained with the 3 algorithms were compared on each CT slice pixel by pixel, using the MATLAB code (The MathWorks, Natick, MA) and the agreement was assessed with the gamma function. The effect of the differences on dose-volume histograms (DVHs), tumor control, and normal tissue complication probability (TCP and NTCP) were also evaluated, and its significance was quantified by using a nonparametric test. In general PB generates regions of over-dosage both in the l...
Thyroid cancer is the most frequently diagnosed endocrine cancer and causes more deaths than all other endocrine cancers combined. Research findings support the concept that a subpopulation of thyroid cancer cells displays properties characteristic of stem cells. These putative cancer-forming entities drive tumorigenesis as a result of their dual ability to undergo self-renewal and to differentiate into various types of cancer cells; they also mediate metastasis and are resistant to the effects of chemotherapy and radiationtherapy. This Review discusses the cellular origin of thyroid cancer and the properties of the thyroid cancer stem cell niche. The article critically evaluates the methods used to identify molecular markers expressed by thyroid-cancer-initiating cells and outlines prosp...
Boron neutron capture therapy (BNCT) trials for human glioma (glioblastoma multiform) were initiated September 1994 at the Brookhaven National Laboratory (BNL). Patients are given p-boronophenylalanine-fructose (BPA-F) intravenously as the boron carrier followed by exposure to the epithermal-neutron beam at the Brookhaven Medical Research Reactor (BMRR). The initial phase of the study is to determine safety and toxicity of the drug and irradiation procedure. The epithermal-neutron beam was developed in a joint effort by BNL and Idaho National Engineering Laboratory (INEL) researchers. For the human trials, treatment planning and radiation dose estimation is performed using the BNCT-Rtpe and the rtt-MC computer codes developed by the INEL BNCT program. This paper discusses our initial experience using these treatment planning codes for human subjects. The basic principles of BNCT have been previously documented.
Between 1964 and 1977, 94 patients with Ewing's sarcoma of bone were treated at the National Cancer Institute. They received 5000 rad to the whole bone and progressively more aggressive chemotherapy protocols. The patients were divided according to site of primary lesion into central, proximal and distal lesions, with 19%, 33% and 57%, respectively, alive and well. The local control rate is high (93%), with good functional results in the distal lesions, and no changes are needed in radiationtherapy dose or volume. Control is not as satisfactory for central and proximal lesions and efforts need to be made to increase control at these sites. We are at present attempting to define more accurately the extent of soft tissue disease, increasing the dose to 6000 rad for central lesions, and using a more aggressive chemotherapy program, in the hope of increasing the local control in these more aggressive tumors.
To evaluate the usefulness of radiationtherapy alternative to surgery for clinical N0-N1 non-small cell lung cancer (NSCLC). From 1976 through 1989, 116 patients with NSCLC without mediastinal involvement were treated with definitive radiationtherapy alone at Gunma University Hospital. All patients were treated with once-daily standard fractionation using 10 MV X-rays. The total dose ranged from 60 Gy to 80 Gy. The actuarial 2- and 5-year survival rates of the entire group were 43% and 20%, respectively with a median survival time of 19 months. The survival of 76 patients with stage T2 tumors was significantly better than that of 28 patients with T3 tumors (mean survival time 21 versus 15.5 months; p<0.05). Sixty-two patients with tumors less than 5 cm in diameter had a 2-year progression rate of 20%, in comparison with 39% of 54 patients with tumors greater than 5 cm. The difference of survivals ...
This introductory paper surveys potential sources of electric magnetic, and electro-magnetic fields. Various cases are discussed to exemplify the total frequency range: nuclear magnetic resonance tomography, high-voltage transmission lines, transformer stations, effect lighting balls, military transmitters, transmitter towers of the Postal Services and other operators, mobile radiotelephone equipment, large broadcasting transmitters, radar radiation, high-frequency heat therapy. There is evidence suggesting that electric, magnetic and electro-magnetic fields may possibly represent a certain nuisance or health hazard even at field strength occuring in equipment used for every-day-life purposes, with an emphasis on their possible actions and effects in children and adolescents. The author discusses, in conclusion, the aerial equipment ordinance issued by Lower Saxony. (Uhe).
The purpose of this study was to compare 2 adaptive radiotherapy strategies with helical tomotherapy. A patient having mesothelioma with mediastinal nodes was treated using helical tomotherapy with pretreatment megavoltage CT (MVCT) imaging. Gross tumor volumes (GTVs) were outlined on every MVCT study. Two alternatives for adapting the treatment were investigated: (1) keeping the prescribed dose to the targets while reducing the dose to the OARs and (2) escalating the target dose while maintaining the original level of healthy tissue sparing. Intensity modulated radiotherapy (step-and-shoot IMRT) and 3D conformal radiotherapy (3DCRT) plans for the patient were generated and compared. The primary lesion and nodal mass regressed by 16.2% and 32.5%, respectively. Adapted GTVs and reduced plan...
Adaptive radiationtherapy 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...
We have developed a flexible radioactive polyurethane patch incorporating {beta}-emitting radionuclide (166Ho) to treat malignant skin lesions. We covered the tumor surface (n=133) with the radioactive patch for 33.58 {+-} 5.33 minutes. Radiation dose delivered was 35 Gy for Bowen's disease (n=78), Kaposi sarcoma (n=25), actinic keratosis (n=5), and 50 Gy for BCC (n=17) and squamous carcinoma (n=8). Complete response was observed in 91.7% after the first therapeutic trial, 96.2% after 2nd and 97.7% after 4th trial with excellent cosmetic outcome for 31.15{+-}13.88 months of follow-up. Radioactive patch therapy is effective for superficial skin cancers that are impractical for surgery.
The interest for medicinal plants has raised again in the last decades, after overcoming a declination period caused by the advances in the researches and development of the synthetic drugs industries. This growing interest has been stimulated mainly by searching cheap and accessible alternative therapies. However, in order to have natural products based treatment in an efficient and safety way, it is necessary to guarantee the plant authenticity, finding adulterations and to assure a low level of microbiological contaminations to avoid damages to consumer's health. The decontamination method should be chosen for eliminating or reduce the microorganisms level without loss of the plant active constituents that would destroy its therapeutic action. At the present work, the possibility of using #gamma# and X electromagnetic radiations to sterilize a Brazilian medicinal plant (Maytenus aquifolium Martius, Celastraceae), which shows anti-ulcer ...
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 ...
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 ...
Beams may be viewed as directed and focussed flow of energy and information, carried by particles and electromagnetic radiation fields (ie, photons). Often, they interact with each other (eg, in high energy colliders) or with other forms of matter (eg, in fixed targets, sychrotron radiation, neutron scattering, laser chemistry/physics, medical therapy, etc.). The whole art and science of beams revolve around the fundamental quest for, and ultimate implementation of, mechanisms of production, storage, control and observation of beams -- always directed towards studies of the basic structures and processes of the natural world and various practical applications. Tremendous progress has been made in all aspects of beam physics and technology in the last decades -- nonlinear dynamics, superconducting magnets and rf cavities, beam instrumentation and control, novel concepts and collider praradigms, to name a few. We illustrate ...
Accurate dose calculation in radiation treatment planning is most important for successful treatment. Since human body is composed of various materials and not an ideal shape, it is not easy to calculate the accurate effective dose in the patients. Many methods have been proposed to solve inhomogeneity and surface contour problems. Monte Carlo simulations are regarded as the most accurate method, but it is not appropriate for routine planning because it takes so much time. Pencil beam kernel based convolution/superposition methods were also proposed to correct those effects. Nowadays, many commercial treatment planning systems have adopted this algorithm as a dose calculation engine. The purpose of this study is to verify the accuracy of the dose calculated from pencil beam kernel based treatment planning system comparing to Monte Carlo simulations and measurements especially in inhomogeneous region. Home-made inhomogeneous phantom, Helax-TMS ver. 6.0 and Monte ...
Purpose: The aim of this study was to assess interinstitutional variations in planning for stereotactic body radiationtherapy (SBRT) for lung cancer before the start of the Japan Clinical Oncology Group (JCOG) 0403 trial. Methods and Materials: Eleven institutions created virtual plans for four cases of solitary lung cancer. The created plans should satisfy the target definitions and the dose constraints for the JCOG 0403 protocol. Results: FOCUS/XiO (CMS) was used in six institutions, Eclipse (Varian) in 3, Cadplan (Varian) in one, and Pinnacle3 (Philips/ADAC) in one. Dose calculation algorithms of Clarkson with effective path length correction and superposition were used in FOCUS/XiO; pencil beam convolution with Batho power law correction was used in Eclipse and Cadplan; and collapsed cone convolution superposition was used in Pinnacle3. For the target volumes, the overall coefficient of variation was 16.6%, and the interinstitutional ...
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 investigations were planned to ...
Hepatocellular carcinoma (HCC) is the most common primary liver cancer and has very limited therapeutic options. Recently, it has been found that hyaluronic acid (HA) shows selective binding to CD44 receptors expressed in most cancer histotypes. Since the trend in cancer treatment is the use of targeted radionuclide therapy, the aim of this research was to label HA with rhenium-188 and to evaluate its potential use as a hepatocarcinoma therapeutic radiopharmaceutical. Methods: {sup 188}Re-HA was prepared by a direct labelling method to produce a ReO(O-COO){sub 2}-type coordination complex. {sup 188}Re-HA protein binding and its stability in saline, phosphate buffer, human serum and cysteine solutions were determined. Biokinetic and dosimetric data were estimated in healthy mice (n=60) using the Medical Internal Radiation Dose methodology and mouse model beta-absorbed fractions. To evaluate liver toxicity, alanine aminotranferase (AST) and ...
Objective To determine whether a centralised telephone intervention reduces the incidence of death or admission for worsening heart failure in outpatients with chronic heart failure.Design...Full Text Available
Heart failure affects nearly 6 million Americans, with a half-million new cases emerging each year. Whereas up to 50% of heart failure patients die of arrhythmia, the diverse mechanisms underlying...Full Text Available
Failure of a dam is something we hope never happens. But if a failure occurs, it`s important to study the circumstances in order to expand our knowledge base, and then apply what we learn to other structures.
BackgroundTransarterial chemoembolization (TACE) therapy is an effective locoregional treatment in hepatocellular cancer (HCC) patients. For early modification of therapy, markers...Full Text Available
The importance of intact host defense mechanisms for successful antimicrobial therapy was investigated in an animal model. Recovery from lobar pneumococcal pneumonia as a result of penicillin therapy...Full Text Available
Radionuclide bone metastases therapy is a major achievement of nuclear medicine. Development of less radiotoxic and more effective radiopharmaceuticals is therefore a challenge for radiopharmacists and industry. This paper reviews the application of rhenium-188 HEDP as a reactor- or generator-produced nuclide for bone metastases therapy. (author)
Heart failure has been singled out as an emerging epidemic, which could be the result of increased incidence and/or increased survival leading to increased prevalence. Knowledge of the responsibility...Full Text Available
BackgroundProvision of consumer information and patient education are considered an essential part of chronic disease management programmes developed for patients with heart failure....Full Text Available
Ultimate compressive strength and failure modes were studied using 24- ... to 81 % of the average ultimate compressive strength (UCS). Figure 1 (a) is the failure ...
Congestive heart failure (CHF) is a leading cause of morbidity and mortality. CHF is marked by atrial and ventricular enlargement and reduced cardiac contractility, as well as an association...Full Text Available
Diagnostic accuracy of the currently available serum markers of cardiac injury, such as myoglobin, creatine kinase and its myocardial isoform, are altered in patients with renal failure. It is shown...Full Text Available
The Steam Generator (SG) serves as an interface between primary and secondary cycle in Pressurized Heavy Water Reactor (PHWR). Failure of steam generator tubes result in leaking of active heavy water in the secondary closed loop. In Tarapur Atomic Power Station-3 and 4 (TAPS- 3 and 4), Scintillator detectors are provided to detect on line heavy water leakages in SG and moderator heat exchangers by monitoring Nitrogen-16 (16N) and Oxygen-19 (19O) activities. Efficacy of detection of these activities at designed detector position on SG blow down line in presence of background radiation field is analysed theoretically. The count rate of 19O and 16N estimated at the detector position inside Reactor Building (RB) shows that detectors only respond to very high leak rates due to presence of high ambient radiation level even though sensitivity is appreciably good. For detector position in RB in the accessible areas and out side the ...
The current therapy for extrinsic and intrinsic asthma, together with that of ‘wheezing bronchitis’, is presented, with special attention to bronchodilators and adrenocorticosteroids....Full Text Available
The eye is an easily accessible, highly compartmentalised and immune-privileged organ that offers unique advantages as a gene therapy target. Significant advancements have been made in understanding...Full Text Available
PurposeTo determine the dosimetric impact of inter-fraction anatomical movements in prostate cancer patients receiving proton therapy.Full Text Available
1 Recommendations for correct therapy with digoxin from twenty-five sources are reviewed. 2 Some recommendations may be unsuitable for use with high bioavailability...Full Text Available
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 ...
Power system components, especially components failure, can significantly affect the reliability of a power system. Data about failure rate in electrical products were obtained from products life testing and analyzed in order to predict reliability. The distribution curve fitting method was used to estimate failure probability. Ten relays of different life times have been used to illustrate the validity of this analytical technique. 3 refs., 3 tabs.
A survey was conducted of experience with steam generator tubes at nuclear power stations during 1976. Failures were reported at 25 out of 68 water-cooled reactors. The causes of these failures and the repair and inspection procedures designed to cope with them are summarized. Examination of the data indicates that corrosion was the major cause of steam generator tube failures. Improvements are needed in steam generator design, condenser integrity and secondary water chemistry control. (author).
This report documents the investigation regarding the failure of CPVC piping that was used to connect a solar hot water system to standard plumbing in a home. Details of the failure are described along with numerous pictures and diagrams. A potential failure mechanism is described and recommendations are outlined to prevent such a failure.
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, ...
The Steam Generator (SG) serves as an interface between primary and secondary cycle in Pressurized Heavy Water Reactor (PHWR). Failure of steam generator tubes result in leaking of active heavy water in the secondary closed loop. In Tarapur Atomic Power Station-3 and 4 (TAPS- 3 and 4), Scintillator detectors are provided to detect on line heavy water leakages in SG and moderator heat exchangers by monitoring Nitrogen-16 ("1"6N) and Oxygen-19 ("1"90) activities. Efficacy of detection of these activities at designed detector position on SG blow down line in presence of background radiation field is analysed theoretically. The count rate of "1"9O and "1"6N estimated at the detector position inside Reactor Building (RB) shows that detectors only respond to very high leak rates due to presence of high background even though sensitivity is appreciably good. For detector position out side the RB containment, the travel time for the feed water becomes ...
This paper deals with the calculations of 3D nuclear heat generation profile in the charcoal filter and subsequently the commencement time of Primary Containment Cleanup (PCC) system of 540MWe Pressurized Heavy Water Reactor (PHWR). Fuel failure is predicted due to overheating of the fuel under loss of Coolant Accident (LOCA) without Emergency Core Cooling System (LOCA without ECCS). Subsequently fission product gasses along with water vapours are released to Reactor Building (RB) atmosphere. Plate-out and water trapping mechanism stabilizes the concentration of significant fission products i.e. radioiodines in about 4 hours before being circulated through charcoal filters of Containment Cleanup system. After cleaning up the RB atmosphere, it is discharged to outside atmosphere through stack. The isotopes of radioiodine emit beta and gamma radiations. Gamma radiations are partly stopped within the charcoal and heat is ...
Extensive investigations and detailed analysis of the failure reason of 9DVN002ZV fan in Daya Bay Nuclear Power Station showed that the fan destroy was caused by the failure of non-drive end bear. The direct cause of this bearing' failure was its improper assembly caused by improper maintenance procedure, and the root cause was too small internal radial clearance after mounting. The factor affecting bearing internal radial clearance, the relationship between clearance and operating life time and fan failure process were discussed. (authors)
The failure took place on a welded elbow pipe which exhibited a catastrophic transverse rupture. The failure was located on the welding HAZ region, parallel to the welding path. Branching cracks were detected at the edge of the rupture area. Deposits of corrosion products were also spotted. The optical microscope analysis showed the presence of transgranular failures which were related to the stress corrosion cracking (SCC) and were predominantly caused by the welding residual stress. The significant difference in hardness between the welded area and the pipe confirmed the findings. Moreover, the failure was also caused by the low Mo content in the stainless steel pipe which was detected by means of spark emission spectrometer. (orig.)
Dose calculations for radiation arc therapy are traditionally performed by approximating continuous delivery arcs with multiple static beams. For 3D conformal arc treatments, the shape and weight variation per degree is usually small enough to allow arcs to be approximated by static beams separated by 5"0-10"0. But with intensity-modulated arc therapy (IMAT), the variation in shape and dose per degree can be large enough to require a finer angular spacing. With the increase in the number of beams, a deterministic dose calculation method, such as collapsed-cone convolution/superposition, will require proportionally longer computational times, which may not be practical clinically. We propose to use a homegrown Monte Carlo kernel-superposition technique (MCKS) to compute doses for rotational delivery. The IMAT plans were generated with 36 static beams, which were subsequently interpolated into finer angular intervals for dose ...
In radiationtherapy with hadron beams, conformal irradiation to a tumour can be achieved by using the properties of incident ions such as the high dose concentration around the Bragg peak. For the effective utilization of such properties, it is necessary to evaluate the volume irradiated with hadron beams and the deposited dose distribution in a patient's body. Several methods have been proposed for this purpose, one of which uses the positron emitters generated through fragmentation reactions between incident ions and target nuclei. In the previous paper, we showed that the maximum likelihood estimation (MLE) method could be applicable to the estimation of beam end-point from the measured positron emitting activity distribution for mono-energetic beam irradiations. In a practical treatment, a spread-out Bragg peak (SOBP) beam is used to achieve a uniform biological dose distribution in the whole target volume. Therefore, in the ...
The serum levels of ferritin in 394 patients, including 339 patients with various malignant tumors and 23 with various non-malignant diseases, and 32 healthy subjects were determined. The normal levels of ferritin were 82.7 +- 42.3 ng/ml for males and 42.0 +- 36.9 ng/ml for females. The positive ratio of serum ferritin level was 28% in patients with malignant tumors and 22% in patients with non-malignant diseases. The usefulness of serum ferritin assay in screening for malignant tumors appeared to be limited. High serum levels of ferritin were found in patients with malignant lymphoma (positive ratio: 42%), pulmonary cancer (38%) and esophageal cancer (37%). According to the histological types, epidermoid cancer appeared to produce a higher serum level of ferritin than adenocarcinoma in patients with pulmonary cancer. It was interesting that malignant lymphoma had a high serum level of ferritin in spite of its low serum level of CEA. Carcinoma of the digestive tracts except for ...
Stereotactic radiosurgery (SRS) precisely delivers high-dose radiation to a small target (usually less than 3-4 cm in diameter), in a single session with steep dose-fall, employing various radiation methods. SRS provides good tumor control for small brain metastases from various primary cancers, with minimal untoward effects on surrounding normal brain. This excellent tumor control prevents neurological death and maintains good activity of daily life. Although surgery with whole-brain radiationtherapy (WBRT) remains an important option for patients with a solitary brain metastasis, SRS with or without WBRT should be considered in patients with a limited number of small tumors and a good prognosis. Many reports, as well as both retrospective and prospective reviews, have shown WBRT before or after SRS to improve local control and reduce new distant lesion emergence. However, upfront WBRT does not ...
Radiation-induced enteritis is a well-recognized sequel of therapeutic irradiation. Therefore we examined the radioprotective properties of Punica granatum peel extract (PPE) on the oxidative damage in the ileum. Rats were exposed to a single whole-body X-ray irradiation of 800 cGy. Irradiated rats were pretreated orally with saline or PPE (50 mg/kg/day) for 10 days before irradiation and the following 10 days, while control rats received saline or PPE but no irradiation. Then plasma and ileum samples were obtained. Irradiation caused a decrease in glutathione and total antioxidant capacity, which was accompanied by increases in malondialdehyde levels, myeloperoxidase activity, collagen content of the tissue with a concomitant increase 8-hydroxy-2'-deoxyguanosine (an index of oxidative DNA damage). Similarly, pro-inflammatory cytokines (TNF-?, IL-1? and IL-6) and lactate dehydrogenase were elevated in irradiated groups as compared to control. PPE treatment reversed ...
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 radiationtherapy 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, ...
Nuclear steam generator tubes have become flawed in ways that challenge conventional eddy current probes. In response to the shortcomings of conventional probes, array probes have been developed to improve measurement capabilities. However, the commercially available array probes have exhibited several weaknesses that offset the advantages and limit the applications in steam generator inspections. A primary weakness is the relatively high rate of probe failure coupled with the high unit cost for each probe. This can be costly for a utility in the time lost for probe replacement and increased radiation exposure in addition to the probe costs. Other weaknesses which make array probes undesirable for routine use are: poor mechanical and electrical characteristics; difficulty in operation and calibration; and incomplete coverage of the tube circumference. Several prototype array probes have been built to address the weaknesses of the commercially ...
Subject of this study is the question of whether cone beam CT (CBCT) images with reduced projection data are suitable for use in adaptive radiationtherapy (ART) treatment planning. For this purpose image quality and dose calculation accuracy depending on imaging modality were analysed. In this context, two CBCT-methods will be indicated having reduced projection data sets: Scans acquired with 200^o rotation angle in order to accelerate the CBCT process (half scan), or scans with an asymmetric cone beam and detector offset, used to enlarge the field-of-view (half fan). Methods: For three different CBCT-modes (On-Board-Imaging, Varian Medical Systems), two of them based on reduced projection data, and a conventional multidetector CT system, the main image quality parameters were studied. Tr...
The aim of this study was to evaluate the differences in accuracy of dose calculation between 3 commonly used algorithms, the Pencil Beam algorithm (PB), the Anisotropic Analytical Algorithm (AAA), and the Collapsed Cone Convolution Superposition (CCCS) for intensity-modulated radiationtherapy (IMRT). The 2D dose distributions obtained with the 3 algorithms were compared on each CT slice pixel by pixel, using the MATLAB code (The MathWorks, Natick, MA) and the agreement was assessed with the ? function. The effect of the differences on dose-volume histograms (DVHs), tumor control, and normal tissue complication probability (TCP and NTCP) were also evaluated, and its significance was quantified by using a nonparametric test. In general PB generates regions of over-dosage both in the lung and in the tumor area. These differences are not always in DVH of the lung, although the Wilcoxon test indicated significant differences in 2 of 4 patients. ...
A book has been written to introduce the physical aspects of the radiotherapy electron beam by presenting a summary of the developments in this field. The first chapter is a brief introduction to the technology of medical accelerators with emphasis on the electron beam production facilities. Chapter 2 describes the interaction processes at the atomic level once the electron beam enters the medium. Chapter 3 is concerned with the various properties of the electron beam purely from the clinical point of view. The electron beam algorithms and models for distribution calculations are covered in Chapter 4 with inclusion of age diffusion and multiple scattering approaches. The factors affecting the beam distribution in a patient, with inhomogeneities, surface irregularities, backscattering etc. are discussed in Chapter 5. The last two chapters are devoted to electron beam dosimetry including various dosimetric methods, specification and measurement of beam energy, ...
Forty cases of Ewing's sarcoma of various sites had attended the Department of Radiotherapy at the Wanless Hospital and the Miraj Medical Centre, attached to the Government Medical College, Miraj, Maharashtra, from January, 1970 through December, 1979. There were 28 male patients and 12 female patients in the series with a male to female ratio of 2.3:1. The youngest patient in the series was a female of 6 years of age with the tumour in the scapula and the oldest patient was a 32-year-old male with a lesion in the metacarpal bone. Sixty per cent of the cases were seen in the second decade. The average age of the patients was 13.5 years. The bones of the lower extremities were most commonly involved with the highest number (35 per cent) of the cases occurring in the femur. Involvement of the bones of the right side of the body was almost equal to that of the left side. Swelling over the site of the lesion and pain over the swelling were the most common complaints noted in all the cases. ...
The purpose of this study was to determine the optimal technique for delivering postoperative radiotherapy for vulvar cancer and other tumors requiring treatment of the inguinal nodes. This project compared tumor coverage and normal tissue sparing for the 5 main radiotherapy techniques that are used to treat vulvar cancer. The intensity-modulated radiationtherapy (IMRT) plan was undesirable because it resulted in an excessive dose to portions of the central pelvic structures. The photon thunderbird with skin match was unacceptable because it underdosed a portion of the groin region. The electron thunderbird was ideal for thin patients but was not applicable for most patients because of excessive dose to the skin and subcutaneous tissues. The photon through-and-through and the photon thunderbird with deep match were acceptable in most situations. In thin patients, where the depth of the inguinal vessels is less than 3 cm, the electron ...
The aim of this study was to evaluate the radioprotective effect of turmeric extract (40 mg/kg body weight) and vitamin E (#alpha# - tocopherol acetate, 400 IU/kg body weight) supplementation on lipid peroxidation, reduced glutathione and antioxidant defense enzymes in various organs like liver, kidney and salivary glands at 24 h in adult Swiss mice. "1"3"1Iodine exposure significantly increased lipid peroxidation in kidney and salivary glands in comparison to control animals. Pre supplementation with turmeric extract for 15 days showed significant lowering of lipid peroxidation in kidney. On the other hand vitamin E pre supplementation showed marked reduction in lipid peroxidation in salivary glands. Reduced glutathione levels decreased significantly in liver after radiation exposure. However, pre supplementation with turmeric extract and vitamin E did not improve glutathione levels in liver. In conclusion we have observed differential radioprotective effect of ...
A method has been developed for calibration of CT-numbers to volumetric electron density distributions using tissue substitutes of known elemental composition and experimentally determined electron density. This information have been used in a dose calculation method based on photon and electron interaction processes. The method utilizes a convolution integral between the photon fluence matrix and dose distribution kernels. Inhomogeneous media are accounted for using the theorems of Fano and O'Connor for scaling dose distribution kernels in proportion to electron density. For clinical application of a calculated dose plan, a method for prediction of accelerator output have been developed. The methods gives the number of monitor units that has to be given to obtain a certain absorbed dose to a point inside an irregular, inhomogeneous object. The method for verification of dose distributions outlined in this study makes it possible to exclude the treatment related variance contributions, ...
As yet, the role of Computed Tomography (CT) as a routine imaging technique in the staging and follow-up of thoracic Hodgkin's disease has not been assessed. The authors reported the results obtained in 120 patients affected with thoracic Hodgkin's disease, staged and followed by means af chest X-rays and CT. CT better identified intrathoracic involvement of mediastinal nodes, of lung parenchyma, of pleura, and of pericarcial and chest walls in 54/120 patients (45%), with staging modifications in 18 (15%) of them only. Treatment was changed only in 12 patients (19%) where radiationtherapy had been planned. The clinical value of the additional information yielded by CT was especially evident in the follow-up: CT allowed the correct evaluation of persistent/ recurrent disease in 51/117 patients (43.5%), a figure high enough to suggest the use of CT in the routive follow-up of patients affected with thoracic Hodgkin's disease.
In portal images with high energy X-ray (10 MV), it is sometimes difficult to verify the irradiation field because of the low contrast. Especially, in the abdominal and pelvic region, the deterioration of portal image quality is remarkable. To solve this problem, we took portal images using computed radiography (FCR). Also, we develop a technique in which a copper plate (3 mm) and lead foil (0.3 mm) are closely set in the front and rear of the photostimulable phosphor plate (imaging plate), for increased energy absorption. As a result, image quality was very high and we confirmed image improvement using observer performance experiments. We made a special cassette which can closely set metallic plates to imaging plate and load FCR-7000 directly. Therefore, image process becomes simple, and suitable for routine work. In computed radiography, image processing (tone scale modification and edge enhancement) is possible, and is advantageous portal imaging. When PACS is introduced to the ...
In portal images with high energy X-ray (10 MV), it is sometimes difficult to verify the irradiation field because of the low contrast. Especially, in the abdominal and pelvic region, the deterioration of portal image quality is remarkable. To solve this problem, we took portal images using computed radiography (FCR). Also, we develop a technique in which a copper plate (3 mm) and lead foil (0.3 mm) are closely set in the front and rear of the photostimulable phosphor plate (imaging plate), for increased energy absorption. As a result, image quality was very high and we confirmed image improvement using observer performance experiments. We made a special cassette which can closely set metallic plates to imaging plate and load FCR-7000 directly. Therefore, image process becomes simple, and suitable for routine work. In computed radiography, image processing (tone scale modification and edge enhancement) is possible, and is advantageous portal imaging. When PACS is introduced to the ...
Primary malignant lymphoma of the brain is a disease of unknown etiology, which is increasing in incidence and has an unfavorable prognosis. Despite the lack of specific changes on CT or MRI in most cases, these procedures may typically facilitate the diagnosis: A focal-enhancing mass with subependymal spread on CT or MRI and hyperattenuation on nonenhanced CT are the most reliable features in the diagnosis of primary malignant lymphoma of the brain. Peritumoral edema and mass effect are usually not prominent features. On unenhanced CT scans they usually appear homogeneously isodense to mildly hyperdense relative to the gray matter. On MRI these tumors are slightly hypointense on T1-weighted images and slightly hpyerintense on PD- and T2-weighted images relative to the gray matter. On CT and MRI enhancement is usually homogeneous. Contrast-enhanced MRI, with its multiplanar capability, lack of bone-induced artifacts, and high-contrast resolution, is likely to reveal subependymal spread ...
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 investigations were ...
S>Hydrogen-induced delayed failure in an alpha-beta titanium alloy (4Al-- 4Mn) was sensitive to microstructure. A quenched structure was less susceptible to delayed failure than aged or annealed structures. The tendency for delayed failure was magnified in all structures by an increase in hydrogen content or an increase in strength level. Hydrogen-induced delayed failure occurred by a process of crack initiation and controlled crack growth. Delayed failures resulting from creep were also encountered. Plastic strain resulting from creep tended to retard crack initiation. Changes occurring in material under static load prior to formation of cracks were reversible, as long as no appreciable plastic strain occurred, indicating stress-induced diffusion of hydrogen. Hydrogen-induced delayed failure disappeared at both high and low ...
Abstract Background: Premature ovarian failure is diagnosed with a picture of amenorrhea, elevated follicle-stimulating hormone (FSH), and age under 40 years. Twenty percent (20%) of patients with premature ovarian failure have a concomitant autoimmune disease. Cases of premature ovarian failure associated with Sj?gren syndrome have been reported in the literature. Patient and method: We report a case of a 42-year-old white woman with Sj?gren syndrome and premature ovarian failure who underwent a reversal of her premature ovarian failure and restoration of normal menses using an elimination diet protocol. The patient was diagnosed with her rheumatological condition in 2005 and started on disease-modifying antirheumatoid drugs, which were taken intermittently due to a concern over medicatio...
Breaker failure relaying has been generally achieved through the use of a current monitoring relay to determine whether current continues to flow into a fault after a breaker has been instructed to interrupt the circuit. If current continues to flow after a predefined period of time, the circuit breaker is considered to have failed. Steps must then be taken to trip the next set of upstream breakers in the power system to remove the faulted circuit and prevent system damage. However, with industrial power systems, this may be the utility`s breakers on the feeding transmission line. Regardless, breaker failure schemes must be designed to isolate both the faulted circuit and the failed circuit breaker. This paper discusses a new and innovative method of protecting a circuit breaker from the failure described above, plus other failures that go unprotected with conventional schemes, this providing total ...
Radio-biologists have pointed out a novel radiobiological phenomenon observed in many tumor and normal cell lines: hyper-radiosensitivity to very low-dose (H.R.S.) followed by induced radioresistance (I.R.R.) after a threshold dose of 0.1-0.3 Gy that depends on the cell line. Radioresistance at high dose (i.e. higher than 0.5 Gy) and metastatic potential of tumor cells are likely major factors of failure in radiotherapy. A careful review of literature suggests that: 1) radiotherapy does not increase the metastatic potential of tumor cells; 2) radioresistance at high dose and metastatic potential are not related. However, inside a given tumor cell line, highly metastatic clones may elicit more cells showing H.R.S; or are more radiosensitive at high dose than poorly metastatic ones. Recent data obtained from molecular techniques (comet and immunofluorescence assays) applied to single cells irradiated at very low radiation doses (1-100 mGy) ...
A 450 MeV Synchrotron Radiation Source, Indus-1 is being constructed at Centre for Advanced Technology at Indore in central India. This paper narrates our experience in construction and alignment of synchrotron machines which was first of its kind for most of us. Careful design, planning and execution of the work yielded modest results so that alignment accuracies between 0.1 to 0.3 mm could be achieved (in booster synchrotron) and, which have proved to be adequate up till now. The building of the SRS complex was constructed such that machine rings have their foundations isolated from rest of the building. A number of 100 x 150 mm size steel plates were embedded in the concrete of floor and walls to serve as base for reference surveying marks which were established later. The pre-injector and booster ring are enclosed in a radiation shielding zone with separate ventilation system. Dipoles, quadrupoles and a few sextupoles were fiducialised ...
A number of procedures in diagnostic radiology and cardiology make use of long exposures to x-rays from fluoroscopy units. Although numerous studies have been performed to measure or calculate skin dose from these procedures, there have only been a handful of studies to determine the dose to the other organs. This thesis was focused on devising a method to calculate the absorbed dose to underlying tissues and organs. The work was performed in several stages. First, a commercial convolution/superposition-based treatment planning system used in radiation oncology was modified and complemented to make it usable with the low energies of x-rays used in diagnostic radiology. This required generation of energy deposition kernels in the kilovoltage energy range. The kernels were generated using the EGS4 Monte Carlo system of codes and added to the treatment planning system. The treatment planning system was then evaluated for its accuracy of calculations at low energies ...
Nitroaromatic radiosensitizers become metabolically bound preferentially to hypoxic cells and at least 10/sup 9/ adducts/cell can be tolerated as non-toxic. EMT-6 tumor cells have been incubated in hypoxia in the presence of /sup 3/H-Misonidazole and /sup 125/I-Azomycin Riboside for various times and the amount of /sup 3/H or /sup 125/I bound/cell was determined. Cells were stored as monolayers at 25"0C for up to 96 hr to accumulate radioactive decays and transferred at various times to 37"0C for colony-forming assays. No radiation inactivation was measured in cells which had incorporated at least 10/sup 6/ /sup 3/H or 10/sup 5/ /sup 125/I atoms. Previous studies had shown that -- 1% of MISO adducts to EMT-6 cells was associated with cellular DNA. These data indicate that the radiation-induced damage produced by these quantities of bound /sup 3/H or /sup 125/I causes little or not cell inactivation. The results of current studies to measure the ...
We irradiated proton beams on the ears of rabbits and the Harding-Passey mouse melanoma and observed their morphological change. We used 52 MeV proton beams from the INS-FM cyclotron. We adjusted the energy of the proton beams to be at the plateau part of the Bragg curve, at the half-way point of the Bragg peak, and at the Bragg peak. The amount of radiation was 5000rad in each case. The Harding-Passey mouse melanoma was transplanted into the subcutan of a three week old mouse. In this experiment, we used tumors, the diameter of which grew up to 1.5-2cm in 2-3 weeks after the transplantation. Using the jroscope, we observed both lightly and severely damaged cells. Using proton irradiation with the Bragg peak located at depth of 1mm in the rabbit's ears, we studied the change in the tissue. Irradiated epidermis fell off and was eroded because of radiation damage, but the rear surface of the rabbit's ears was only slightly ...
Background and purpose: A diagnosis of malignancy and its treatment is a very stressful time for patients and their families. This study was conducted to determine the impact of more intensive written information on patients' anxiety levels. The secondary aim was to determine the impact of this information on patients' satisfaction levels. Materials and methods: This prospective randomized trial consisted of patients with a pathological diagnosis of cancer having radical radiotherapy (RT). Patients were randomized to receive the more intensive information (including written information and a telephone call from the research nurse) or not to receive the more intensive information at the time of their initial consultation with the radiation oncologist. Study questionnaires measuring anxiety (STAI form) were completed prior to their first consultation (baseline) at the time of simulation (pre-RT) and at the completion of radiotherapy. A second questionnaire assessing ...
Chronic heart failure (HF) is a cardiovascular disease of cardinal importance because of several factors: a) an increasing occurrence due to the aging of the population, primary and secondary prevention...Full Text Available
We describe a 59-year-old patient who developed acute renal failure because of rhabdomyolysis after extensive red fire ant bites. This case illustrates a serious systemic reaction that may occur from...Full Text Available
Refractory ascites can occur in patients with various conditions. Although several procedures based on the reinfusion of ascitic fluid have been reported after the failure of bed rest, salt and water...Full Text Available
Forty-six patients with end-stage renal failure were subjected to iliac crest biopsy before the initiation of a dialysis programme and regardless of the presence of skeletal symptoms....Full Text Available
BackgroundThe rhizomes of Cynodon dactylon are used for the treatment of heart failure in folk medicine. In the present study, we investigated the effects of hydroalcoholic...Full Text Available
Angiotensin II has adverse actions in heart failure including vasoconstriction, aldosterone secretion, and activation of the sympathetic nervous system. Valsartan, a potent specific angiotensin II type 1 receptor blocker, may produce beneficial effects in heart failure. The purpose of this study was to evaluate the steady-state pharmacokinetics of valsartan 40, 80, and 160 mg each given every 12 h for 7 days in heart failure patients. Eighteen patients with chronic stable heart failure and left ventricular ejection fractions power model, showed that doubling the dose increased the AUC and Cmax 1.8 times. The pharmacokinetics of valsartan are predictable in heart failure patients within the dose range of 40-160 mg BID. Age did not appear to have influenced the valsartan clearance in heart failure patients. The pharmacokinetic values were higher in heart ...
A mechanistic understanding of fracture in human bone is critical to predicting fracture risk associated with age and disease. Despite extensive work, a mechanistic framework for describing how the underlying microstructure affects the failure mode in bone is lacking.
BackgroundAlthough dilated cardiomyopathy (DCM) is a leading cause of heart failure (HF), the mechanism underlying DCM is not well understood. Previously, it has been demonstrated...Full Text Available
Background:The cardiac sodium–calcium exchanger (NCX1) is a key sarcolemmal protein for the maintenance of calcium homeostasis in the heart. Since heart failure...Full Text Available
Premature menopause, ovarian failure younger than 40 years of age, is relatively rare but may preclude childbearing for some women who delay attempts at fertility. We present five kindreds in which...Full Text Available
AimsTo determine the effect of exercise training on clinical events and health-related quality of life (HRQoL) of patients with systolic heart failure.Methods...Full Text Available
ObjectiveThe aim of this study was to ascertain whether all cervical cancer patients who received adjuvant concurrent chemoradiation (CCRT) for high risk of treatment failure after...Full Text Available
There is limited information about the true incidence of acute renal failure (ARF). Most studies could not quantify disease frequency in the general population as they are hospital-based and...Full Text Available
The side effects of cancer therapy on normal tissues limit the success of therapy. Generation of reactive oxygen species (ROS) has been implicated for numerous chemotherapeutic agents including doxorubicin...Full Text Available
BackgroundIt remains unclear if certain antiretroviral medications, particularly abacavir, compromise response to hepatitis C virus (HCV) therapy. Such data can inform...Full Text Available
BackgroundAdolescents have been identified as a high-risk group for poor adherence to and defaulting from combination antiretroviral therapy (cART) care. However, data on outcomes...Full Text Available
A simple device is described which is used to determine treatment distance and beam direction in electron therapy employing one collimation. A technique for the production of irregular field templates and localization films is given.
ObjectivesTo investigate the effect of group cognitive behavioural therapy (CBT) for fatigue self-management, compared with groups receiving fatigue information alone, on fatigue...Full Text Available
BackgroundTo assess the relationship between improved regional and global myocardial function in patients with ischemic cardiomyopathy in response to β-blocker therapy or...Full Text Available
Current adherence assessments typically detect missed doses long after they occur. Real-time, wireless monitoring strategies for antiretroviral therapy may provide novel opportunities to proactively...Full Text Available
Epidermal growth factor receptor (EGFR) related therapies – mainly tyrosine kinase inhibitors (TKIs) such as erlotinib and gefitinib, but also monoclonal antibodies targeting EGFR, for example,...Full Text Available
BackgroundThe lack of adequate randomized clinical trials (RCT) has hindered identification of new therapies that are safe and effective for patients with primary focal segmental...Full Text Available
Photodynamic therapy (PDT) is an established endoscopic technique for ablating Barrett’s esophagus with high-grade dysplasia or early-stage intraepithelial neoplasia. The most common clinically...Full Text Available
BackgroundArtemisinin-based combination therapy, currently considered the therapy of choice for uncomplicated Plasmodium falciparum malaria in endemic countries,...Full Text Available
The effect of Photofrin-based photodynamic therapy (PDT) and adjuvant treatment with serum vitamin D3-binding protein-derived macrophage-activating factor (DBPMAF) was examined using a mouse SCCVII...Full Text Available
BackgroundHerpes simplex virus (HSV) suppressive therapy reduces genital and plasma HIV-1 RNA over periods up to three months but the longer-term effect is unknown.Full Text Available
Somatic cell nuclear transfer or therapeutic cloning has provided great hope for stem cell-based therapies. However therapeutic cloning has been experiencing both ethical and technical difficulties....Full Text Available
ObjectiveTo evaluate the effect of different concomitant disease modifying antirheumatic drugs (DMARDs) on the persistence with antitumour necrosis factor (anti-TNF) therapies in...Full Text Available
Suppressed IL-12 production and maladaptive immune activation, both of which are ameliorated by successful highly active antiretroviral therapy (HAART), are thought to play important roles in the immunopathogenesis...Full Text Available
Purpose:The risks and benefits of continuing bisphosphonate therapy beyond 5 years in patients with primary osteoporosis have not been well established.Methods:We...Full Text Available
The heterogeneity of metastatic breast cancer mandates the need to select therapies taking into account tumor and patient characteristics. Chemotherapy is indicated in the palliative setting especially...Full Text Available
Multiple disease-specific systematic reviews on the effectiveness of physical therapy intervention for shoulder dysfunction have been inconclusive. To date, there have been two systematic reviews that...Full Text Available
IntroductionThe optimal dialysis dose for the treatment of acute kidney injury (AKI) is controversial. We sought to evaluate the relationship between renal replacement therapy (RRT)...Full Text Available
... and at that point she had already failed physical therapy, which someone else had prescribed, and so ... MRI, we may try a brief course of physical therapy to see if they feel better, but ...
ObjectiveTo report the efficacy and safety of combined photodynamic therapy (PDT) and intravitreal bevacizumab (IVB) injection in the treatment of idiopathic polypoidal choroidal...Full Text Available
Premature circuit clotting is a major problem in daily practice of continuous renal replacement therapy (CRRT), increasing blood loss, workload, and costs. Early clotting is related to bioincompatibility,...Full Text Available
This study was an evaluation of the performance of self-applied, blue light, light-emitting diode therapy in the treatment of mild-to-moderate inflammatory acne on the face, concerning: 1) time to improvement...Full Text Available
This joint statement was developed by the CMA and the Canadian Pharmaceutical Association, a national association of pharmacists, and includes the goal of drug therapy, strategies for collaboration...Full Text Available
BackgroundPostnatal glucocorticoid therapy in premature infants diminishes chronic lung disease, but it also increases the risk of hypertension in adulthood. Since glucocorticoid...Full Text Available
Adjuvant therapy aims to prevent outgrowth of residual disease but can induce serious side effects. Weighing conflicting treatment effects and communicating this information with patients is not elementary....Full Text Available
The reliability of an electrical power system is influenced by the operation of circuit-breaker (CB). A good indicator of circuit-breaker condition is its switching time. Based on it some of the critical circuit-breaker irregularities can be detected and removed before they develop to a failure. In this paper, the evaluation of time measurements (timings) in case of different failures will be carried out for two circuit-breaker solutions, i.e. with spring and hydraulic drive. Moreover, the relationships between switching time and failure type/location will be derived. Thereby, the influence of failure trend will also be taken into account. (author)
Presented are the results of the investigation of the kinetics and micromechanism of the failure in impact bending of oriented-crystallized specimens having the eutectic composition Ni_3Al-Ni_3Nb and of the bimetal composed of 45 steel + M3 copper. The failure kinetics was studied by high-speed filming, whereas the fractures were studied by electron fractography. The particularities of the failure of the laminar-type composite materials were found. Analyzed was the effect of the kinetic factors and the mechanism of failure upon its energy consumption.
... with the additional US funds supporting Islamic ... the FATA and NWFP, keeping Pakistan's government and ... Without these madrassas, the TTP is left ...
Aluminum electrolytic capacitors, with 1043 failures, are a good example. Also, categorization by size and voltage reveals such frequencies of occurrence as ...
... which extend beyond the upper airway. These include attention deficit hyperactivity disorder, learning disorders, failure to thrive, and enuresis. Tonsillectomies ...
Stability concerns of the Par Pond Dam, an embankment structure in the Savannah River Site complex, resulted in a comprehensive evaluation of the state of its integrity. Specifically, excessive seepage through the embankment, slope failure due to an earthquake event as well as liquefaction potential of the embankment and the foundation are addressed and the potential of failure is evaluated. Lastly, remedial benefits of the addition of a berm structure are also assessed.
Heart failure goes beyond mechanical dysfunction and involves an interplay of multiple pathophysiologic mechanisms, including inflammation, tissue remodeling, neurohormonal and endocrine signaling, and interactions with the renal and nervous systems. This article highlights some novel biomarkers that may aid in diagnosis, treatment, and prognosis of acute heart failure, specifically focusing on ST2, endoglin, galectin-3, cystatin C, neutrophil gelatinase?associated lipocalin, midregional pro-adrenomedullin, chromogranin A, adiponectin, resistin, and leptin and their emerging clinical roles.
AimsThe prevalence and importance of liver function test (LFT) abnormalities in a large contemporary cohort of heart failure patients have not been systematically evaluated.Full Text Available
A case study is presented about the failure of a stainless steel blade reinforcing band in a steam turbine. The inspection results and analysis of samples of material are discussed. Being pitting corrosion and cracks the main defects found, a study of chemical composition and heat treatment state of the steel is made and findings are related to type of failure. (orig.)
1 The decreased binding of drugs and dyes to plasma proteins from male and female rats with acute renal failure has been investigated using equilibrium dialysis at 37 degrees C. 2 Acute renal failure...Full Text Available
An electron accelerator unit is described for electron beam therapy, comprising: a source of an electron beam; means for finally directing at least a portion of the beam to a therapy site, the directing means being mechanically independent of, and electrically isolated from, the source, and having a target area; and means for aligning the source with the directing means, the aligning means comprising means for projecting at least one beam of light from the source toward the target area.
An electron accelerator unit is described for electron beam therapy, comprising: a source of an electron beam; means for finally directing at least a portion of the beam to a therapy site, the directing means being mechanically independent of, and electrically isolated from, the source, and having a target area; and means for aligning the source with the directing means, the aligning means comprising means for projecting at least one beam of light from the source toward the target area.
The Monte Carlo transport codes LAHET and MCNP were used to calculate energy fluence spectra at three neutron therapy facilities. The results compare very favourably with measured data. Kerma spectra and the ratio of ICRU muscle tissue kerma to A-150 kerma, along the carbon to oxygen kerma ratio, were determined. Absorbed dose rate calculations are in reasonable agreement with measured values. Use of these codes to study modifications to existing therapy beams is briefly discussed. (author).
The anesthetic agents methohexital (Brevital), Innovar, and ketamine (Ketaject) were examined for their effect on seizure duration following electroconvulsive stimulation in a rat model of electroconvulsive therapy (ECT). Compared to unanesthetized control animals, methohexital anesthesia shortened seizure duration by 42%, ketamine anesthesia tended to increase seizure duration, and Innovar anesthesia had no effect on duration of seizures. PMID:7349626
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 radiationtherapy. 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 ...
With the advent of intensity-modulated radiationtherapy (IMRT), the inclusion of heterogeneity corrections is further complicated by the conformal delivery of many small beams forming steep dose gradients. Radiation treatment planning has evolved to take into account even small changes in tissue density so that the dose to tumor can be further optimized. However, different treatment planning systems incorporate different heterogeneity correction algorithms, and it is unclear whether any of these algorithms are superior to others in terms of accurately predicting delivered radiation doses relative to measurement in a clinical setting. The purpose of this study was to determine the accuracy of heterogeneity dose calculations from two widely used IMRT treatment planning systems (Pinnacle and Corvus) against measurement. These two systems handle heterogeneity dose corrections by means of a collapsed-cone ...
Most of previous study for creep rupture of RPV lower head under severe accident condition, have been focused on global failure of RPV lower head. In contract, the local failure of the RPV nozzle region has not been studied in detail. The existence and features of nozzle failure in LAVA-ICI specimen of KAERI and LHF-4 specimen of Sandia National Lab., are observed. It is confirmed that the nozzle failure of LHF-4 specimen is due to the hoop stress in the RPV. The tensile tests in various temperatures and the creep rupture tests in various temperatures and stresses, are accomplished. The finite element analysis for LAVA-ICI experiment was confirmed, and the stress and deformation analysis results are used in LAVA-ICI experiment. 17 refs., 34 figs., 3 tabs. (Author)
In the field of Living Probabilistic Safety Assessment (LPSA) the reliability data updating is an important factor. In risk analysis equipment failure data is needed to estimate the frequencies of events contributing to risk posed by a facility. Five years data of emergency diesel generator (EDG) of Daya Bay Nuclear Power Plant (NPP) has been studied in this paper. The data updating process has been done by using two methods, i.e., the classical method and Bayesian method. The aim of using these methods is to calculate the operational failure rate (@l) and demand failure probability (p). The results show that the operational failure rate is 1.7E-3 per hour and the demand failure probability is 2.4E-2 demand per day for Daya Bay NPP. By comparing the results obtain from classical and Bayesi...
AbstractBackground: So far, infliximab (IFX) therapy for the treatment of Crohn's disease (CD) has generally been guided by clinical symptoms. Data on treatment response as ascertained by endoscopy in IFX therapy are scarce. The aims of this study were to measure the endoscopic response rate during IFX induction and maintenance therapy in luminal CD, and also evaluate the role of endoscopy in monitoring IFX therapy. Methods: Data obtained from 71 patients with active luminal CD and treated with IFX were analyzed retrospectively. The endoscopy findings were scored according to mucosal activity as: 0 (remission), 1-2 (mild), 3-4 (moderate), and 5-6 (severe). A positive endoscopic response was determined by a decrease in score of at least two points and mucosal healing was assigned a score of...
Microelectronic failure analysis (FA) has been an integral part of the development of state-of-the-art integrated circuits. FA of MicroElectroMechanical Systems (MEMS) is moving from its infancy stage to assume an important role in the successful design, fabrication, performance and reliability analysis for this new technology. In previous work, the authors focused on the application of several techniques developed for integrated circuit analysis to an earlier version of a surface micromachined microengine fabricated at Sandia. Recently, they have identified important new failure modes in binary counters that incorporate a newer design of the microengine, using a subset of integrated circuit failure analysis techniques including optical microscopy, focused ion beam (FIB) techniques, atomic force microscopy (AFM), and scanning electron microscopy (SEM). The primary failure mode they have identified is ...
Full text: Radiotherapy treatment planning (RTP) relies heavily on medical imaging. Until recently, the most important planning tool was the treatment simulator. The kilovoltage radiographic capabilities in a treatment simulator enabled the boundaries of treatment fields to be visualized with respect to bony anatomic landmarks. Perhaps the most important advance in treatment planning in recent years is the ability to visualize the passage of the beams with respect to a more accurate geometrical representation of the tumor and other soft tissue structures. This 'virtual simulation' uses a computer-based representation of a patient to determine the extent of the disease and the location of radiation sensitive normal tissue. Computer tomographic (CT) imaging produces a high-resolution three-dimensional representation of anatomy that can be correlated with other image sets such as magnetic resonance images (MRI) of function. Positron emission tomographic (PET) imaging ...
This probabilistic analysis of WIPP TRUDOCK crane failure is based on two sources of failure data. The source for operator errors is the report by Swain and Guttman, NUREG/CR-1278-F, August 1983. The source for crane cable hook breaks was initially made by WIPP/WID-96- 2196, Rev. O by using relatively old (1970s) U.S. Navy data (NUREG-0612). However, a helpful analysis by R.K. Deremer of PLG guided the authors to values that were more realistic and more conservative, with the recommendation that the crane cable/hook failure rate should be 2.5 x 10-6 per demand. This value was adopted and used. Based on these choices a mean failure rate of 9.70 x 10-3(1/yr) was calculated. However, a mean rate by itself does not reveal the level of confidence to be associated with this number. Guidance to making confidence calculations came from the report by Swain and Guttman, who stated that ...
The case of spontaneous radiation of channeled ultrarelativistic particles is considered when the dipolarity condition is not satisfied. The change of the particle longitudinal velocity affecting the maximum radiation frequency is included. The angular and frequency characteristics of the radiation for superhigh energies are studied for the first time. It is shown that there is an optimum energy at which the radiation density is maximum. The influence of the angle at which electrons enter a crystal and of the beam divergence on the radiation is investigated. The problem of quasichanneled particle radiation and also the radiation in axis-plane transitions are considered. (author).
Purpose: To identify results and prognostic factors on long-term survival and local control following treatment of localized Ewing's sarcoma. Patients and Methods: Between 1979 and 2004, a total of 60 children and young adults with Ewing's sarcoma were treated. Patients with distant metastases at presentation (n = 6) and recurrent cases (n = 2) were excluded from this analysis. Patients were exclusively treated within ongoing national and international protocols CESS-81, CESS-86, EICESS-92, EURO-EWING-99. All patients received local irradiation with a total dose of 45-60 Gy; in addition, 41 (79%) of the patients had local surgical procedures, 27 (52%) of them with clear margins. Results: Overall survival rates at 5 and 10 years were 56% and 45%, respectively. Patients #<=# 14 years at diagnosis had overall survival rates of 66% and 61% at 5 and 10 years compared to older patients with corresponding survival rates of 47% and 31%, respectively (p = 0.05). Patients with tumors of lower ...
Several recent improved methods for the EGFM are introduced in order to avoid artificial holes seen in the synthetic acceleration spectrum. Furthermore evaluation of input ground motions at Wolsung NPP are performed by varying the source parameters that may control the high-frequency wave radiation and the deviation of the synthetic motions are revealed. The PSHA case studies for four NPP sites (Wolsung, Kori, Uljin, Younggwang) are performed. In the analysis, site-specific attenuation equations developed for Korean NPP sites are employed, and the seismic hazards for the target sites are evaluated in the case where the four kind of seismic source models are considered. Moreover, the PSHA for Wolsung and Younggwang are conducted by using the site-specific attenuation equation with the index of response spectra and the uniform hazard spectra are evaluated for the two sites. The supporting tool for seismic response analysis and the evaluation tool for evaluating ...
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 definitive ...
An add-on multileaf collimator for electrons (eMLC) has been developed that provides computer-controlled beam collimation and isocentric dose delivery. The design parameters result from the design study by Gauer et al (2006 Phys. Med. Biol. 51 5987-6003) and were configured such that a compact and light-weight eMLC with motorized leaves can be industrially manufactured and stably mounted on a conventional linear accelerator. In the present study, the efficiency of an initial computer-controlled prototype was examined according to the design goals and the performance of energy- and intensity-modulated treatment techniques. This study concentrates on the attachment and gantry stability as well as the dosimetric characteristics of central-axis and off-axis dose, field size dependence, collimator scatter, field abutment, radiation leakage and the setting of the accelerator jaws. To provide isocentric irradiation, the eMLC can be placed either 16 or 28 cm above the ...
Systematics of neutron capture radiative width were studied in the target element range from Th to Cm. Reduced radiative widths were analyzed with a simple radiative width formula based on E1 transition. Average radiative width is presented with the standard deviation of 15%. (author)
For a given linac design, the dosimetric characteristics of a photon beam are determined uniquely by the energy and radial distributions of the electron beam striking the x-ray target. However, in the usual commissioning of a beam from measured data, a large number of variables can be independently tuned, making it difficult to derive a unique and self-consistent beam model. For example, the measured dosimetric penumbra in water may be attributed in various proportions to the lateral secondary electron range, the focal spot size and the transmission through the tips of a non-divergent collimator; the head-scatter component in the tails of the transverse profiles may not be easy to resolve from phantom scatter and head leakage; and the head-scatter tails corresponding to a certain extra-focal source model may not agree self-consistently with in-air output factors measured on the central axis. To reduce the number of adjustable variables in beam modelling, we replace the focal and ...
Full text: Production: This radio iodine produced by three methods: 1) Wet method: The irradiated tellurium is dissolved in an oxidizing mixture which also converts iodine in to iodide. This is a chemical method and iodine that it produced with this method has low purity and efficiency. 2). Dry Method: The irradiated tellurium is dissolved in furnace (750 deg. C) with sublimation method and iodine absorbed in sodium solution . In this case we have more than 99.5 % purity and 80 % efficiency. We are using this type in Iran. 3) Fission fragment method: In this case the iodine separated from fission fragment directly and we have high purity (career free) and specific activity of iodine. Application: Iodine is a versatile tracer element. It is used to determine thyroid cancer metastases, and size, shape and activity of the thyroid gland. Critical organ of iodine is thyroid gland. One of the common diagnostic procedures for determining thyroid function therefore, is to measure the ...
High quality "3"1P MR spectra (signal to noise ratio (S/N) approximately 18, 15 min acquisition for each spectrum) were consistently obtained with surface coils over a period of 6-week RT. Both transient and steady state alterations in metabolites in response to RT were found in this case. The transient changes occurred during the first 3 hr immediately after the 3rd fractionated RT, these changes include the transient elevation of the PCr resonance, a decrease in PDE and an increase in intracellular pH. The monitoring showed that the metabolites approached steady state approximately 2 hr after the fractionated radiation intervention, suggesting that in vivo MRS can be useful for studying the dynamics of tumor response to RT such as repair of potential lethal damage, growth delay, and reoxygenation etc. The steady-state MR spectra showed the net response to each intervention and can clinically be useful for predicting and measuring the result of the fractionated ...
Purpose: To evaluate the results of radiotherapy in cholangiocarcinoma patients managed with various combinations of chemotherapy and surgical resection with selective liver transplantation. Methods and Materials: From January 1990 to December 1995, 61 patients with histologically confirmed biliary duct adenocarcinoma were seen in the Radiation Oncology Department of the University of Pittsburgh. Median follow-up was 22 months (1 to 91 months). The extent of surgery was complete resection in 23 patients (including 17 with orthotopic liver transplant), partial resection in 4, and biopsy in 34. All patients had radiotherapy; median dose was 49.5 Gy. Thirty patients received chemotherapy: 5-fluorouracil (5-FU)-leucovorin with interferon alpha (IFN#alpha#) in 27, and taxol in 3. Results: The median survival was 20 months (95% CI 15-25 months). The 5-year actuarial survival was 23.8 #+-# 6.8%. The only significant variable in multivariate analysis was achieving a ...
The Anisotropic Analytical Algorithm (AAA) is a new pencil beam convolution/superposition algorithm proposed by Varian for photon dose calculations. The configuration of AAA depends on linear accelerator design and specifications. The purpose of this study was to investigate the accuracy of AAA for an Elekta SL25 linear accelerator for small fields and intensity modulated radiationtherapy (IMRT) treatments in inhomogeneous media. The accuracy of AAA was evaluated in two studies. First, AAA was compared both with Monte Carlo (MC) and the measurements in an inhomogeneous phantom simulating lung equivalent tissues and bone ribs. The algorithm was tested under lateral electronic disequilibrium conditions, using small fields (2x2 cm"2). Good agreement was generally achieved for depth dose and profiles, with deviations generally below 3% in lung inhomogeneities and below 5% at interfaces. However, the effects of attenuation and scattering close to ...
Purpose: The aim of this study was to create, perfect and test a hyperthermia balloon catheter for local treatment of cholangiocarcinoma. The device should induce hyperthermia in tumor tissue by acting locally in the bile duct lumen in contact with the tumor-infiltrated duct wall. In addition, it should exert tissue compression to cause an appreciable reduction in tumor microvasculature flow, thus improving thermal performance. Methods: According to the design specifications, the working temperature range should allow the device to be used for hyperthermia therapy either in combination with radiation and/or chemotherapy(radio/chemo-sensitizing effect at 42-45 deg. C) or alone (induction of coagulation necrosis above 65 deg. C). The balloon serves as an anchoring system during treatment and as a functional element to induce tissue compression. In vitro mechanical evaluation of the pressure/volume relationship, with the balloon inside rigid ...
From 1977 through 1984, 293 previously untreated patients with biopsy proven carcinoma of the uterine cervix were treated by whole pelvis irradiation and high intensity 60Co remote afterloading (RAL) intrauterine tandem techniques in Haiti. The treatment results were analyzed retrospectively to evaluate the therapeutic results and prognostic factors of a strict protocol involving 40 Gy to the whole pelvis (2 Gy/day, 5 days/week). In addition, on the 5th day of the 3rd week, the first outpatient 60Co remote afterloading intracavitary insertion, delivering 7.5 Gy to point A with each insertion, repeated 3 times by a week separation for a total of 4 times. The total TDF for external beam plus RAL was 158 and 175 for early and late effects respectively. One hundred-four patients were evaluable after 1 year or more follow-up, with a median of 26.5 months. No evidence of disease (NED) by Stage at 1 year was: Stage I of 100% (3/3), Stage II of 82% (9/11), Stage III of 80% (47/59), and Stage ...
The OASIS Registry started annual collection of longitudinal data on patients on home parenteral nutrition (HPN) in 1984. This report describes outcome profiles on 1594 HPN patients in seven disease categories. Analysis showed clinical outcome was principally a reflection of the underlying diagnosis. Patients with Crohn's disease, ischemic bowel disease, motility disorders, radiation enteritis, and congenital bowel dysfunction all had a fairly long-term clinical outcome, whereas those with active cancer and acquired immunodeficiency syndrome (AIDS) had a short-term outcome. The long-term group had a 3-year survival rate of 65 to 80%, they averaged 2.6 complications requiring hospitalization per year, and 49% experienced complete rehabilitation. The short-term group had a mean survival of 6 months; they averaged 4.6 complications per year and about 15% experienced complete rehabilitation. The registry data also indicated HPN was used for 19,700 patients in 1987 with ...
The convolution/superposition algorithm for computing dose from photon beams in radiationtherapy planning requires knowledge of the energy spectrum. The algorithm can compute the dose for a polyenergetic beam as the weighted sum of the individual dose contributions from monoenergetic beams. In this study we exploit interface effects apparent in the dose distributions to discriminate among spectra of high energy photon beams. We have studied the sensitivity of the depth dose distribution to the energy components using a hypothetical beam for various field sizes and depths in water and water-lung-water media. Six theoretical spectra were simulated. We compared depth dose data from these spectra using three quantitative measures which are inherently free of normalization ambiguities: for homogeneous water, the ratio D_2_0/D_1_0 and a logarithmic derivative in the buildup region LD_b_u_i_l_d_-_u_p and for inhomogeneous lung/water, the lung ...
The effects of extended source-to-surface distance (SSD) on the electron beam dose profiles were evaluated for various electron beam energies - 6, 9, 12, 15 and 20 MeV - and the accuracy of various output correction methods was analysed on a Mitsubishi linear accelerator using a radiation field analyser (RFA). The dose fall-off region of the central axis depth-dose curves was nearly independent for SSDs up to 120 cm where as in the build-up region, a marginal reduction of surface dose was observed, particularly for lower energies and for smaller field sizes. Effective SSDs and virtual source distances were evaluated for field sizes ranging from 5x5 to 15x15 cm"2 for various energies. Curve fitting was done with the measured outputs with various equations and coefficients were evaluated. The accuracy of the derived output correction factors by effective SSD, virtual source distance and curve-fit methods was assessed by evaluating correlation coefficients between the ...
The number of multislice CT (MSCT) scans performed in polytraumatized children has increased rapidly. There is growing concern regarding the radiation dose in MSCT and its long-term consequences, especially in children. To determine the effective dose to polytraumatized children who undergo whole-body MSCT. A total of 51 traumatized children aged 0-16 years underwent a polytrauma protocol CT scan between November 2004 and August 2006 at our institution. The effective dose was calculated retrospectively by a computer program (CT-Expo 1.5, Hannover, Germany). The mean effective dose was 20.8 mSv (range 8.6-48.9 mSv, SD{+-}7.9 mSv). There was no statistically significant difference in the effective dose between male and female patients. Whole-body MSCT is a superior diagnostic tool in polytraumatized children with 20.8 mSv per patient being a justified mean effective dose. In a potentially life-threatening situation whole-body MSCT provides the clinicians with ...
Cervix cancer is the most common female cancer in Korea. In spite of their relatively local invasive tendency, still 44% of patient will develop recurrent cancer This result suggests that more aggressive local treatment may increase the cure rate but increased complication risk also cannot be avoidable. Various institutions proposed different treatment regimen, but recommended dose were about 4500 cGy for whole pelvis and 8000 cGy at point A, even though they agreed that those doses may not be satisfactory for control of bulky disease. 96 cases of invasive cervical cancer, treated with postoperative or primary radiationtherapy were analyzed to determine the complication rate and prognostic factor in our treatment regimen which is 500-1000 cGy higher than other institution. Mean follow up duration was 21 months. Symptomatic patients including mild but persistent abdominal discomfort was 46%, but only 1 patient (1%) had operative treatment ...
A new leaf-sequencing approach has been developed that is designed to reduce the number of required beam segments for step-and-shoot intensity modulated radiationtherapy (IMRT). This approach to leaf sequencing is called continuous-intensity-map-optimization (CIMO). Using a simulated annealing algorithm, CIMO seeks to minimize differences between the optimized and sequenced intensity maps. Two distinguishing features of the CIMO algorithm are (1) CIMO does not require that each optimized intensity map be clustered into discrete levels and (2) CIMO is not rule-based but rather simultaneously optimizes both the aperture shapes and weights. To test the CIMO algorithm, ten IMRT patient cases were selected (four head-and-neck, two pancreas, two prostate, one brain, and one pelvis). For each case, the optimized intensity maps were extracted from the Pinnacle"3 treatment planning system. The CIMO algorithm was applied, and the optimized aperture ...
Background and purpose: We evaluate the feasibility of concomitant and adjuvant docetaxel combined with three-dimensional conformal radiotherapy (3D-CRT) and androgen deprivation in high-risk prostate carcinomas. Methods: Fifty men with high-risk localized prostate cancer (16), locally advanced (28) or very high-risk prostate cancer (6) were included. Seventy Gy were delivered on prostate and seminal vesicles in 35 fractions, concurrently with weekly docetaxel (20 mg/m"2). Three weeks after the completion of 3D-CRT, docetaxel was given for 3 cycles (60 mg/m"2), every 3 weeks. Patients had to receive LHRH agonist during 3 years. Results: The intent to treat analysis shows that four patients out of 15 stopped prematurely the chemotherapy due to grade 3-4 acute toxicity. In the per protocol analysis, 46 patients completed a full-dose chemoradiation regimen representing 413 cycles: five patients experienced a grade 3 toxicity, and 15 patients experienced a grade 2 toxicity. With a median ...
Plutonium isotopes (239Pu and 238Pu, and 241Am) with a total activity of 269 kBq were accidentally deposited in a puncture wound of the right index finger of a nuclear worker at the Mayak Production Association. Tissues surrounding the wound site contaminated with radionuclides were excised 4.5 h after the injury. Residual contamination within the wound amounted to 0.05% of the initial contamination. The 10-d therapy with CaNa3-diethylene triamine pentaacetate acid (CaNa3-DTPA) was performed in parallel with in vivo measurements of the wound site and daily urine bioassays. The wound intake of radionuclides was consistent with two forms of radioactive materials detected within the wound site, i.e., soluble compounds and a large fragment, which was completely removed by excision. On day 9 after the injury, the clearance rate from the wound site was 1.8 times higher than the rate predicted by the National Council on Radiation Protection and ...
Polyethylene gas piping is expected to be in service for times on the order of 50 years depending on service conditions. Therefore research research on piping materials and pipes has two principal objectives: (a) developing methods for predicting when a pipe will fail and (b) improving the material for piping. The prediction of long time failure hinges on the development of short time test methods which relate to long time failure. The improvement in the behavior of current materials also hinges on the use of test methods of short duration relative to the anticipated life time of the pipe in service. One of the primary criterion for an acceptable test method is that it produces the same type of failure as is observed after long time failure in service. It has been found that P.E. pipe material fails in a brittle mode after long periods of time. The failure mode is called brittle ...
The TS-1 and TS-2 TREAT transient experiments subjected a low burnup (2 MWd/kg) and a medium burnup (58 MWd/kg), respectively, FFTF irradiated fuel pin to unprotected 5 cents/s overpower transient conditions. The fuel pin failure response was similar in the two tests, which demonstrated a large margin to failure (P/P_0 > 3) and a favorable upper level failure location. Thus, for these transient conditions, burnup effects on transient performance appeared to be minimal in the range tested. Pin disruption in the medium burnup TS-2 test was more severe due to the higher fission gas pressurization, but failure occurred at only a 5% lower power level than for the low burnup TS-1 fuel pin. Both tests exhibited axial extrusion of molten fuel to the region above the fuel column several seconds before pin failure, demonstrating a potentially beneficial inherent safety mechanism to delay ...
Airborne pollutants can cause failures in switching and computing equipment. This paper focuses on a subset of such pollutants - airborne fine particles (<2.5 [mu]m diameter). It begins by examining the extent to which different improvements in heating, ventilating and air conditioning (HVAC) systems reduce indoor concentrations of fine particles. For each modification, the consequent reduction in soiling rate is derived. The concomitant increase in operating costs is also calculated. These costs are then compared with the costs of failures in telephone switching offices, leading to estimates of failure rate reductions that would make improvements cost-effective. Finally, the reduction in failures required to offset the costs of the improvements are compared with documented differences in failure rates between unimproved and improved environments. This study suggests that, in ...
This paper presents a method for the optimal design of high voltage transmission lines taking into consideration shielding and backflashover failure rates. The minimization of suitably defined performance indices, which relate the failures caused by lightning in a transmission line to both line insulation level and tower footing resistance, is aimed. Optimum values for both line insulation level and tower footing resistance are calculated. The method is applied on several operating Hellenic transmission lines of 150 and 400kV, respectively, carefully selected among others, due to their high failure rates during lightning thunderstorms. Special attention has been paid on open loop lines, where a possible failure could bring the system out of service causing significant problems. The obtained design parameters, which reduce the failure rates caused by lightning, are compared with the ...
This study describes the formulations to optimize the time interval of inspections and/or replacements of equipment/parts taking into account the probability density functions (PDF) for failure rates and parameters of failure distribution functions (FDF) and evaluates the optimized results of these time intervals using our formulations by comparing with those using only representative values of failure rates and the parameters of FDF instead of using these PDFs. The PDFs are obtained with Bayesian method and the representative values are obtained with likelihood estimation method. However, any significant difference is not observed between both optimized results within our preliminary calculations. (author)
Oak Ridge National Laboratory (ORNL) has for over ten years provided materials testing and failure analysis services to various coal conversion and utilization facilities in the United States. ORNL was involved in these types of activities at all four of the major coal liquefaction pilot plants. This paper presents a summary of activities at Wilsonville over the past two and one-half years. Some details of these activities are discussed below. Failure analysis of elastomers, stainless steels, and alloys is discussed. 6 refs., 9 figs., 13 tabs.
The wind industry has experienced premature turbine component failures during the past years. With the increase in turbine size, these failures, especially those found in the major drivetrain components, i.e. main shaft, gearbox, and generator, have become extremely costly. Given that the gearbox is the most costly component in the drivetrain to fix, the National Renewable Energy Laboratory (NREL) initiated the Gearbox Reliability Collaborative (GRC) to determine the causes for premature gearbox failures and subsequently, recommend improvements to gearbox design, manufacture, and operational practices. The GRC has two identical test gearboxes, which are planned for a dynamometer and a field test, respectively.
There has been a steady increase in the number of revision total knee arthroplasties being performed in the United States. Hinge knee prostheses are used predominantly in complex primary or revision arthroplasties, often as salvage procedures. Significant improvement of the articulation between the rotating hinge mechanism and tibial component has decreased the stresses that contributed to earlier failures in previous generation designs. Two cases of fracture of the tibial metal post in the rotating hinge of a revision total knee arthroplasty were evaluated and treated at our institution within a 1-month period. We present our experience with this construct failure and subsequent patient management.
A fuel plate examination was conducted in the hot cell and canal to determine the possible failure modes for three plates leaking fission products. The plates were irradiated in the Extended Life Aluminide Fuel (ELAF) program in support of university research reactor goals to increase the limits presently allowed. The examination indicated pitting corrosion to be the failure mode. Other failure modes such as: (a) nonbonded swelling, (b) excessive fuel swelling, and (c) overheating of the plates were not observed.
of the Intelligent Control System (ICS) for reusable rocket engines. .... the incoming measurements with corresponding estimates, a sensor failure can be ...
Several randomized studies have been completed in prostate cancer that show a benefit to immediate postoperative treatment in patients undergoing prostatectomy. In one of the studies, there was even...Full Text Available
Mangroves are disappearing rapidly worldwide despite their well documented biodiversity and the ecosystem services they provide. Failure to link ecological processes and their societal benefits has...Full Text Available
The location of defective LMFBR fuel pins by the determination of gas tag isotopic ratios is discussed. The application of this method to the FFTF Reactor briefly described.
The coolant activity analysis to obtain the information about the fuel failure has been studied long before. And several codes have been developed to estimate the number of fuel failures through evaluating volatile and inert fission products release in coolant from the defective fuel. These codes use a fission product diffusion model coupled with a mass balance in the gap and coolant. But each code has a different model to assess fuel failure. In order to develop the model to estimate the number of fuel failures we analysis well-known code's models such as CHIRON, CADE, IODYNE, and CAAP and compare accuracy through Korean PWR activity data
Corrosion failures in circuits of foreign NPPs are considered. According to American statistics there are more corrosion failures in two-circuit NPPs than in NPPs with one circuit. Steam generators mostly suffer from ''corrosion denting''. Lately pitting corrosion becomes a potentially serious problem. Steam generator vertical tubes are mainly subjected to this corrosion type. Attention is drawn to intercrystalline corrosion. The causes of corrosion are described. The problem of optimization of structural materials is discussed to reduce corrosion failures as well as other methods of decreasing corrosion failures. Organization of nondestructive testing, increased requirements to water and steam purity are of great importance.
A general purpose Emergency Generator Set (EGS) is considered for a methodological study and related reliability behavior is analyzed. In particular in a procedure of reliability and availability analysis of a EGS, dependent failure events need a complex mathematical model as state-space model to be a accurately evaluated. Furthermore these dependent failure events are one of the most important reliability characteristic of EGS. This paper suggests a procedure for reliability calculations in presence of dependent failure based on the evaluation of a equivalent failure rate that can be fitted to a network reduction method by simple mathematical calculations. The simplified models analyzed show a good accuracy for a wide range of variation of main reliability characteristics of EGS and utility. The advantages obtained are very useful on reliability evaluation because the possibility of use of network ...
... position must not be penalized in their NCO Evaluation Report (NCOER). ... failure to perform MOS-, SQI-, or ASI-related duties after counseling. ...
The most frequent ultimate cause of death is myocardial arrest. In many cases this is due to myocardial hypoxia, generally arising from failure of the coronary macro- and microcirculation to deliver...Full Text Available
Innovative therapy may appear to coincide with medical experimentation, raising ethical and legal issues, for instance on informed consent and institutional review. Medical treatments may be classified,...Full Text Available
Background and ObjectivePulsed dye laser (PDL) treatment of cutaneous vascular lesions is associated with variable and unpredictable efficacy. Thus, alternative treatment...Full Text Available
Objectives: Acupuncture has served as a major complementary and alternative therapy that supplements conventional medicine and is the subject of growing public interest. This study was conducted to estimate the usage rate of acupuncture as a supplemental treatment in acute ischaemic stroke patients and to identify factors associated with the choice to use this therapy. Methods: Using the registry of stroke patients admitted to an academic medical centre in Korea, the use of acupuncture therapy was recorded and analysed, along with the patients' socio-demographic characteristics, hospital access variables, risk factors for ischaemic stroke and clinical characteristics. The data were analysed using descriptive statistics, chi-square tests and multiple logistic regression analyses. Results: O...
Mycosis fungoides (MF) in deep-seated lymph nodes, spleen or liver appears to be associated with a lack of response of the disease to topical external therapy. Fourteen patients with mycosis fungoides...Full Text Available
Summary: The increasing emergence of antimicrobial-resistant organisms, especially methicillin-resistant Staphylococcus aureus (MRSA), has resulted in the increased...Full Text Available
Structured abstractObjectiveAlthough most reviews of Pseudomonas aeruginosa therapeutics focus on antibiotics currently in use or...Full Text Available
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
Penile rehabilitation therapy following radical prostatectomy is a much debated topic. Erectile dysfunction is still a significant contributor to postoperative morbidity following radical prostatectomy, despite meticulous nerve-sparing technique. Secondary smooth muscle changes in the penis have been identified as the underlying causes of penile atrophy, veno-occlusive dysfunction, and fibrosis. Initial observations that intracavernous injection therapies used on a regular basis postoperatively resulted in improvements in the return of spontaneous erectile function led to the development of penile rehabilitation protocols. Chronic dosing of PDE-V inhibitors is now commonly used by urologists after radical prostatectomy. Despite the current enthusiasm of penile rehabilitation therapy, current scientific evidence with clinical trials is still limited. PMID:19255627
PurposeTo identify the extent of persistence (period of time of continuous therapy with the drug prescribed) of glaucoma patients treated with prostaglandins (latanoprost, bimatoprost,...Full Text Available
BackgroundStump and phantom pains are debilitating sequelae of amputations that are often resistant to treatment. The efficacy of pharmacologic therapies, including...Full Text Available
BackgroundLymphangioleiomyomatosis (LAM) is a rare lung disease characterised by progressive airflow obstruction. No effective medical treatment is available but therapy with sirolimus...Full Text Available
SYNOPSISPreterm infants are at risk for both iron deficiency and iron overload. The role of iron in multiple organ functions suggests that iron supplementation is essential for...Full Text Available
Hyperglycemia frequently occurs with acute medical illness, especially among patients with cardiovascular disease, and has been linked to increased morbidity and mortality in critically ill patients....Full Text Available
Invasive fungal infections can be devastating, particularly in immunocompromised patients, and difficult to treat with systemic drugs. Furthermore, systemic administration of those medications...Full Text Available
An elderly man receiving chlorambucil for chronic lymphatic leukaemia developed focal fits. The onset and frequency were dose related. There was no evidence of metabolic disturbance or of meningeal...Full Text Available
The potential of radiolabelled phenylpiperazines as agents for the detection and therapy of tumours of neural crest origin was evaluated by in vitro pharmacological studies with human neuroblastoma...Full Text Available
BackgroundTo investigate the effects of intravenous lignocaine infusions (IV lignocaine) in fibromyalgia.MethodsProspective study...Full Text Available
SynopsisAttention-deficit / hyperactivity disorder (ADHD) is a valid and impairing psychological disorder that persists into adulthood in a majority of cases and is associated...Full Text Available
BackgroundAlthough advances in rehydration therapy have made cholera a treatable disease with low case-fatality in settings with appropriate medical care, cholera continues...Full Text Available
... mammography or on ultrasound but not found on physical examination, we consider them non-palpable or not ... lot of this. We send every patient for physical therapy, no matter what type of reconstruction we ...
Antimony toxicity occurs either due to occupational exposure or during therapy. Occupational exposure may cause respiratory irritation, pneumoconiosis, antimony spots on the skin and gastrointestinal...Full Text Available
BackgroundAdequate pain assessment is critical for evaluating the efficacy of analgesic treatment in clinical practice and during the development of new therapies. Yet the currently...Full Text Available
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 germ cell tumors cisplatin containing ...
Objective: To develop a computerized method of internal dose estimation on radiation protection. Methods: Based on MIRD mathematic model of the organs and by means of the programming language of MS Visual Basic 6.0, a computer program of dose estimation in internal radiation was developed for radiation protection. Results: The computerized method of dose estimation for internal radiation was completed. Conclusions: This computerized method is very convenient for internal radiation dose estimation of several aspects. It can also be used in radiation accident. (authors)
Gel dosimetry is a new dosimetry method applied in radiationtherapy. Gel dosimeters consist of a radiation sensitive gel, which can integrate absorbed doses from several radiation sources or beams. The dose to the gel can be evaluated by magnetic resonance imaging (MRI), a procedure that is the focus of the present thesis. A robust tool for the evaluation of the nonuniformity in MRI has been developed, the Deviation Image method. Unlike previously presented methods, the Deviation Image method includes all nonuniformity variations across a phantom surface and is insensitive to stochastic noise. Methods for the estimation of stochastic noise were analyzed in terms of sensitivity to nonuniformities. A method that averages the stochastic noise level over five regions over the phantom surface, and a method that assesses the stochastic noise level from the background, were found to be the methods of choice. ...
Purpose/Objective: At present, treatment verification between portal and reference images is performed based on manually-identified features by radiation oncologist, which is both time-consuming and potentially error-prone. There is a demand for the computerized verification procedure in clinical application. The purpose of this study is to develop a computerized portal verification scheme for pelvic treatment fields. Materials/Methods: The automated verification system involves image acquisition, image feature extraction, feature matching between reference and portal images and quantitative evaluation of patient setup. Electronic portal images with a matrix size of 256 x 256 and 12 bit gray levels were acquired using a liquid matrix electronic portal imaging device. Simulation images were acquired by digitizing simulation films using a TV camera into images with 256 x 256 matrix and 8 bit gray levels. Initially a Canny edge detector is applied to identify the ...
German translation of the publication 'The evaluation of risks from radiation' published in 1965 by the International Commission on Radiological Protection. In a survey, genetic and somatic risks from radiation are presented and explained. (HP).
This book gives an overview of the entire field of radiation protection with the subject areas radioactivity, X-rays, UV radiation, laser beams and high-frequency electromagnetic fields. It deals graphically with the most important physical notions, the incidence, origin, properties and biological effects of types of radiation, administrative and practical protection measures and the code of rules governing them. Apart from fundamentals of radiation protection the emphasis on the following: natural radiation exposure, radiation exposure to radon, disaster relief plans in the environment of nuclear plant, the precautionary radiation protection system evolved after Chernobyl, radiation exposure through UV radiation devices, radio, RF communication, radar, microwave ovens and high-voltage transmission ...
The failure of receivers has been one of the main operating problems at the White Cliffs solar thermal power plant. This Technical Note reports the results of an initial investigation that identifies the cause as having been their thermal fatiguing of the tube walls. The fatigue appears to be caused by unstable heat transfer at vapor qualities below the point where critical heat flux is generally exceeded. Methods for avoiding this problem are tested.
Failure of multiple components due to a common cause represents one of the most important issues in evaluation of system reliability or unavailability. The frequency of such events has relatively low expectancy, when compared to random failures, which affect individual components. However, in many cases the consequence is a direct loss of safety system or mitigative safety function. For this reason, the modeling of a common cause failure (CCF) and its presentation in fault tree structure is of the uttermost importance in probabilistic safety analyses (PSA). Amongst the different techniques available to reduce the impact of common cause failures, the most important operations related technique, is that of staggered testing. In the TAPP 3,4 Level-1 PSA it was found that the contribution of Common Cause Failures to the Core Damage Frequency (CDF) was significant. The Common Cause ...
The purpose of the Microelectronic Evaluation Laboratory at Sandia is to develop a program for evaluating CMOS LSI (complementary metal oxide silicon - large scale integrated) technology devices which are being used for the first time in a weapon system. These evaluations are based on accelerated aging studies and electrical tests to determine the reliability and life of the devices. In accelerated aging, specific, controlled stresses are applied to the device to accelerate time-to-failure. Data are used tin mathematical models to estimate life in acutal use. The stresses used for this technology are temperature and voltage. The devices are stored at temperatures with or without voltage applied (steady-state or cyclical) and periodically tested until at least 50% failures are encountered. Since most current technologies use epoxy-die-attachment, aging temperatures must be under 200/sup 0/C. This delays device failure, and a ...
This paper investigates the calculation of availability for parallel transmission lines (two or more) in the same tower or on the same right of way. As in many studies, the development of mathematical models is an important step. The models are justified using historical data and known characteristics of power system elements. A statistical method was used to generalize the failure rate and repair rate from real operating data. Application of the new model (which combines common-mode, simultaneous independent, and dependent outages) is discussed.
This report contains the results of a survey of reactor coolant pump shaft seal reliability. The survey sample is representatively large (approx. = 27% of total US commercial plant population) and includes the three industry seal suppliers (Bingham-Williamette, Byron Jackson, and Westinghouse). Operationally incurred/induced problems and seal redesign parameters are identified. Failure hypotheses in the form of fault trees have been developed to describe the failure mechanisms. Recommendations are made for seal reliability improvement.
The paper presents results of studies on the effect of heat treatment on strength and pattern of 40Kh steel impact failure. Loading levels corresponding to macroscopic spalling microdamage initiation in the material are determined for three initial states. Metallographic study on the spalling failure pattern for 40Kh steel in different initial states and data on microhardness measurement are presented.
Probabilistic assessment methods can be used to identify specific plant vulnerabilities. Application of such methods can also facilitate selection among system design alternatives available for safety enhancements. The quality of assessment results is however strongly dependent on realistic and accurate input data for modelling of system component behaviour and failure modes during conditions to be assessed. Use of conservative input data may not lead to results providing guidance on safety upgrades. Adequate input data for probabilistic assessments seems to be lacking for at least failure modes of some electrical components when exposed to a fire. This report presents an attempt to improve the situation with respect to such input data. In order to take advantage of information in existing documentation of fire incident occurrences some of the lessons learned from the fire at Browns Ferry Nuclear Power Plant on March 22, 1975 are discussed in ...
A historical overview of corrosion problems found in power plant condensers and mitigation procedures is presented. The paper is organized according to alloy type and failure mode. Alloys considered are copper-base alloys, stainless steels and titanium. Failure modes discussed include erosion-corrosion, sulfide attack, environmentally assisted cracking, galvanic corrosion, steam condensate corrosion, pitting corrosion, and dealloying. Mitigation procedures discussed include cathodic protection, ferrous ion injection, as well as tube cleaning and layup practices.
BackgroundHamstring injuries are the most common injury in Australian Rules football. It was the aims to investigate whether a sports chiropractic manual therapy intervention protocol...Full Text Available
A previously healthy young man experienced several episodes of syncope while being treated with tenofovir, emtricitabine and nevirapine initiated during primary HIV-1 infection. Symptoms disappeared after discontinuation of antiretroviral therapy and we suggest that syncope may be a side effect to one of the three antiretroviral drugs that has not been described previously.
A tiered communications architecture for managing network traffic in a distributed system. Communication between client or control computers and a plurality of hardware devices is administered by agent and monitor devices whose activities are coordinated to reduce the number of open channels or sockets. The communications architecture also improves the transparency and scalability of the distributed system by reducing network mapping dependence. The architecture is desirably implemented in a proton beam therapy system to provide flexible security policies which improve patent safety and facilitate system maintenance and development.
OBJECTIVE: To present recent evidence on the use of ovarian hormone therapy (OHT) for osteoporosis and outline safe and effective regimens. OPTIONS: Estrogen alone, estrogen and progestins, progestins...Full Text Available
In the 21st century, eighty years after William Baer presented his groundbreaking work treating bone and soft tissue infections with live maggots, thousands of therapists around the globe have rediscovered...Full Text Available
Cell therapy is a promising novel option for treatment of cardiovascular disease. Because the role of bone marrow-derived circulating progenitor cells (BM-CPCs) after cell therapy is less clear, we...Full Text Available
A case is presented in which the diagnosis of acute myelomonocytic leukemia was made 16 months after the start of irradation and chemotherapy for Ewing's sarcoma. The association of these two diseases is rare. The etiologic role of therapy in the development of leukemia is speculative in this case. However, there is need for surveillance for secondary neoplasms of all types so that the benefits of therapy may be properly weighed against the risks.
On February 9, 1995 ComEd experienced a pipe type cable failure on 138kV line 13717. Line 1737 is a bulk power transmission cable circuit connecting The Fisk and Crawford generating stations located within city limits. The line is approximately 4.5 miles long and was originally installed in 1975. This line is forced cooled, has 2,500 KCMIL copper conductors with 505 mils of paper insulation in an 8 inch pritec coated steel pipe. The splices are constructed with Voltalit castings. The failure occurred approximately 3,500 feet from Crawford Station. It was easy to locate the failure since the cable joint casing was breached resulting in the loss of approximately 2,600--2,700 gallons of dielectric fluid. Upon field examination B Phase was determined to have failed. The failure occurred 12 inches inside the casing in an area where it was impossible to install a long connector or add an additional short ...
Reliability has an impact on wind energy project costs and benefits. Both life test data and field failure data can be used for reliability analysis. In wind energy industry, wind farm operators have greater interest in recording wind turbine operating data. However, field failure data may be tainted or incomplete, and therefore it needs a more general mathematical model and algorithms to solve the model. The aim of this paper is to provide a solution to this problem. A three-parameter Weibull failure rate function is discussed for wind turbines and the parameters are estimated by maximum likelihood and least squares. Two populations of German and Danish wind turbines are analyzed. The traditional Weibull failure rate function is also employed for comparison. Analysis shows that the three-parameter Weibull function can obtain more accuracy on reliability growth of wind turbines. This work will be ...
A 25m wind turbine blade was tested to failure when subjected to a flapwise load. With the test setup, it was possible to test the blade to failure at three diffe-rent locations. The objective of these tests is to learn about how a wind turbine blade fails when exposed to a large flapwise load and how failures propagate. The report shows also results from ultra sonic scan of the surface of the blade and it is seen to be very useful for the detection of defects, especially in the layer between the skin laminate and the load carrying main spar. Acoustic emission was successfully used as sensor for the detection of damages in the blade during the test. The report contains measurements of the total deflection of the blade, the local deflection of the skin and the load carrying main spar and also measurement of strain all as a function of the applied load and up to failure of the blade. The 'post ...
A modified boundary element approach was used to analyze the response of offshore piles subjected to external soil movements. The computer model employed to solve the pile-soil problem was able to model pile head and tip loading, and loading caused by lateral movement of soil. A nonlinear pile-soil interface element with the ability to represent a hardening or softening plastic response prior to reaching an ultimate state was incorporated. With the program, 4 failure modes can be determined: flow of the soil slide past an intact stationary pile; rotation of the pile with the soil at failure along the full pile length; translation of the pile with the sliding soil, resulting in failure of the supporting soil; and the long-pile mode, in which the maximum bending moment in the pile reaches the yield moment of the pile before complete development of the other 3 modes. Theoretical solutions for a realistic hypothetical offshore ...
As part of the Nondestructive Evaluation Reliability Program sponsored by the US Nuclear Regulatory Commission, the Pacific Northwest Laboratory is developing a method that uses risk-based approaches to establish in-service inspection plans for nuclear power plant components. This method uses probabilistic risk assessment (PRA) results and Failure Modes and Effects Analysis (FEMA) techniques to identify and prioritize the most risk-important systems and components for inspection. The Surry Nuclear Power Station Unit 1 was selected for pilot applications of this method. The specific systems addressed in this report are the reactor pressure vessel, the reactor coolant, the low-pressure injection, and the auxiliary feedwater. The results provide a risk-based ranking of components within these systems and relate the target risk to target failure probability values for individual components. These results will be used to guide the development of ...
Sprengel deformity is a congential malformation with usually unilateral elevation and medial rotation of the scapula. An omovertebral bone is generally present. Associated skeletal malformations are frequently present. Though functional impairment is mild, the cosmetic and psycho-social impairment can be considerable. The prognosis of early surgical therapy is good. The presented case also justifies surgical correction in the older child. (orig.) [German] Die Sprengel-Deformitaet ist eine angeborene Fehlbildung mit meist einseitiger Elevation und Medialrotation der Skapula. Meist ist ein Os omovertebrale vorhanden. Assoziierte skelettale Fehlbildungen sind haeufig. Obgleich funktionell wenig einschraenkend, ist die kosmetische und psycho-soziale Beeintraechtigung oft erheblich. Die Prognose der fruehen operativen Therapie ist gut. Der vorliegende Fall ermutigt zur operativen Therapie auch im hoeheren Kindesalter. (orig.)
Until recently no active treatment for advanced or metastatic gastrointestinal stroma tumors (GIST) was available. The tyrosine kinase inhibitor imatinib has revolutionized the treatment of this disease and the median overall survival now reaches 5 years. The standard dose of imatinib is 400 mg per day. Locally advanced GIST should be treated with systemic therapy prior to surgical resection. Imatinib was recently licensed for adjuvant therapy following complete surgical removal of GIST in patients with a significant risk of recurrence. (orig.) [German] Bis vor einigen Jahren existierte keine wirksame systemische Therapie fuer fortgeschrittene oder metastasierte gastrointestinale Stromatumoren (GIST). Der Tyrosinkinaseinhibitor Imatinib hat die Behandlung dieser Tumoren revolutioniert, die mediane Ueberlebenszeit liegt heute bei etwa 5 Jahren. Die Standarddosierung von Imatinib betraegt initial 400 mg/Tag. Lokal ...
Subject to the provisions of the Radiation Protection Act, the Authority, on the advice of ...(f) in collaboration with the Radiation Protection Board, conduct an ionising radiation monitoring programme and ...or document kept under the control of the Radiation Protection Board.
Described and discussed in this paper are radiation processes and their advantages over the conventional techniques. Radiation sterilization of medical products, food irradiation, wood plastic composites, and radiation treatment of sewage and waste waters are presented. The Philippine experience in using these technologies, its problems and barriers are also given. (ELC).
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This chapter is concerned with standards and guidances for limiting radiation exposures. It is divided into three sections, each of which has several parts. Section 1: Ionizing Radiation -- Standards and Guidances Applicable to the Public: Part A, Radiation Protection Standards; Part B, Environmental Radiation Standards; Part C, Exempt Levels of Radioactivity; Part D, Protective Action Guides for Accidents. Section 2: Ionizing Radiation -- Standards Applicable to the Workplace. Section 3: Medical and Other Standards.
On the basis of legally provided area dose measurements and time records of fluoroscopic examinations during the operation, radiation doses to medical personnel and patients are evaluated. Adequate radiation protection measures and a careful behaviour in the operating room keep the radiation exposure to the personnel below the maximum permissible exposure. Taking into account the continuous personnel radiation monitoring and medical supervision, radiation hazards in the operating room can be considered low.
For the step-and-shoot intensity-modulated radiationtherapy (IMRT) technique, the combination of high dose rate, multiple beam segments and low dose per segment can lead to significant differences between the planned dose and the dose delivered to the patient. In this technique, a dose delivery inaccuracy known as the 'overshoot' effect is caused by the dose servo control system. This typically occurs in the first and last beam segments and causes an over- and underdose, respectively. Some dose positional error in the segment sequence is also possible there. Commercial ionization chambers (RK-type) and radiographic Kodak films were used for the measurements. The reported results were obtained using the Pinnacle{sup 3}-V6.2 treatment planning system and a Varian Clinac 21 EX linear accelerator equipped with a 120-leaf Millennium MLC. The dose inaccuracy measurements were based on the comparison of the dose and profiles for ...
The current state and need for radiation protection training in Finland have been surveyed by the Radiation and Nuclear Safety Authority STUK. The survey sought to determine whether the current requirements for radiation protection training had been met, and to promote radiation protection training. Details of the scope and quality of present radiation protection training were requested from all educational institutes and organizations providing radiation protection training. The survey covered both basic and further training, special training of radiation safety officers, and supplementary training. The questionnaire was sent to 77 educational organization units, 66 per cent of which responded. Radiation workers and radiation safety officers were asked about radiation protection ...
The study presented in this thesis is a contribution about the analysis of failures modes of electrolytic capacitors and thyristors. The studied components are main elements of the protection system of the superconductive magnets of the LHC. The study of the ageing of the electrolytic capacitors has shown that their reliability is strongly related to their technological characteristic. Evolution of their principal indicator of ageing (ESR) can be modeled according to different laws chosen according to their running mode. It appears that the prediction of failure of these components other than that due to wear can be only statistical taking into account the many causes of failure involving various modes of failure. In order to be able to evaluate influence of the ageing of the electrolytic capacitors on a system, simple models taking into account this parameters as well as the effective temperature of ...
A series of six transient tests was performed on FFTF irradiated fuel pins to demonstrate their transient performance capability. The tests were performed in the TREAT reactor using sodium loops and instrumented test trains. The TEMECH computer code was used to design overpower transients which would simulate FFTF fuel pin thermal conditions during slow and fast unprotected transients. Some tests were run to substantial overpower levels but terminated prior to fuel pin failure, while other tests were intentionally extended to fuel failure to establish failure thresholds and characteristics. Post-test examination data provided significant cladding strain and fuel melting information used for performance code calibration and validation. These data showed that cladding damage caused by fuel melting is related to the steady state condition of the fuel.
The fatigue life variability of the #alpha#+#beta# titanium alloy, Ti-6Al-2Sn-4Zr-6Mo increased with decreasing stress level. The variability in life was found to be due to segregation of lives due to two failure mechanisms. A bimodal cumulative distribution model was shown to accurately describe the combined failure modes. The nominal failure processes for the two regimes were similar, with crack nucleation occurring in equiaxed #alpha#p particles, irrespective of life or stress level. However the variability in life was not controlled by the size of the crack-nucleating #alpha#p, but rather by the ability of the material to distribute deformation and avoid early crack nucleation.
The performance of steam generator tubes in water-cooled nuclear power reactors has been reviewed for 1979. Tube failures occurred at 38 of the 93 reactors surveyed. Causes of these failures and procedures designed to deal with them are described. The defect rate was twice that in 1978 but still lower than the two previous years. Methods being employed to detect defects include increasing use of multifrequency eddy-current testing and a trend to full-length inspection of all tubes. To reduce the incidence of tube failures by corrosion, plant operators are turning to full-flow condensate demineralization and more leak-resistant condenser tubes. (author).
Carbon steel is frequently used to construct concentrated sulphuric acid storage tanks. This paper discussed the corrosion performance of carbon steel tanks and outlined the underlying mechanisms responsible for major corrosion modes. Analyses of hydrogen grooving and dilute acid corrosion failure mechanisms were presented. Recent corrosion-induced leak failures were also discussed. The use of anodic protection and organic coatings as a corrosion control measure was also evaluated. The results of laboratory studies that were conducted to understand corrosion-induced failures showed that carbon steel electrodes exhibited transpassive corrosion at relatively high anodic potentials, while stainless steel electrodes exhibited transpassive corrosion at anodic potentials less than 1 V. It was concluded that corrosion-induced leaks can be prevented by using anodic protection and baked phenolic coating technologies. 23 refs., 9 ...
Design rules for robustness require insensitivity to local failure and the prevention of progressive collapse. This is often verified by applying the load case ''removal of a limited part of the structure''. This paper will evaluate typical structural systems for large-span timber roof structures against these requirements, comparing the results against typical reasons for damages and failures. Applying the finding that most failures of timber structures are not caused by random occurrences or local defects, but by global (repetitive) defects (e.g. from systematic mistakes), it is shown that the objective of load transfer-often mentioned as preferable-should be critically analysed for such structures. Based on these findings, proposals for structural systems and details towards a robust de...
The aim of the risk assessment consists of a comparative security evaluation for the SNR-300 and the PWR Biblis B. The failure analysis focusses on the reactor core; in addition, possible fission product release from the spent fuel pits is examined. By reliability analyses, the frequency of events leading to incidents is determined together with the probability of core destruction. In the accident analysis, the kind and frequency of failure of the activity barriers, i.e., primary system (reactorvessel) and inner and outer containment are investigated for the various incident sequences. The radionuclide release into the environment is classified into five different release categories. Besides internal failures, external causes (especially earthquakes and plane crashes) are considered under the aspect of their risk contribution. (RF).
This paper presents a probabilistic approach for structural robustness assessment for a timber structure built a few years ago. The robustness analysis is based on a structural reliability based framework for robustness and a simplified mechanical system modelling of a timber truss system. A complex timber structure with a large number of failure modes is modelled with only a few dominant failure modes. First, a component based robustness analysis is performed based on the reliability indices of the remaining elements after the removal of selected critical elements. The robustness is expressed and evaluated by a robustness index. Next, the robustness is assessed using system reliability indices where the probabilistic failure model is modelled by a series system of parallel systems.
Reference failures, and their increase in affectively negative conditions (known as affective reactivity of speech), are more frequently observed in schizophrenia patients than in normal controls, but no information is available comparing schizophrenia with depression, ie, a mental disorder closely linked to the concept of affective reactivity. To address this gap in the literature, the present study compared 24 schizophrenia inpatients, 21 unipolar depression inpatients and 21 normal controls. Two 10-minute conversational speech samples (1 on negative and 1 on positive memories) were collected from each patient. The transcripts of the audiotaped interviews were analyzed blindly for frequencies of 6 types of referential failures, employing the Communication Disturbances Index, adapted for ...
Premature Failure of a Riata Defibrillator Lead. A 63-year-old woman with a St. Jude Medical Riata 1570 right ventricular lead complained of intermittent hiccups 2 months after implant. Interrogation revealed elevated pacing threshold and diaphragmatic stimulation. Pacing and shock lead impedances remained stable. No inappropriate sensing was noted. Fluoroscopic examination of the lead revealed a thin radio-opaque wire seen between the 2 defibrillator coils away from the main body of the lead. After extraction, a tear in the insulation of the lead was noted allowing the inner wire to protrude. This case illustrates a novel mechanism of insulation failure without inappropriate sensing or impedance change.-(J Cardiovasc Electrophysiol, Vol. 22, pp. 1070-1072, September 2011)
In general, macroscopic material failure is a manifestation of irreversible changes at the microscopic level. Many tissues, which may appear to be macroscopically homogeneous, are, at a fundamental microscopic level, a composite material. For example, cornea is composed of a hyaluronic acid matrix in which layers of collagen fibers are overlaid in a crossing pattern. The points where the collagen fibers intersect are potential nucleation sites for microscopic defects, which under the action of tensile stress, nucleate, grow and coalesce to form macroscopic failure planes, or spall planes. Using a model based on microstructural evolution, this paper examines the failure process during photoablation. Specifically, the paper describes a physically motivated, micromechanical model based on the nucleation and growth of spherical voids. This model is then used to simulate photoablation of cornea. Potential for using this model to ...
Twenty-two out of 31 patients with chronic renal failure and secondary hyperparathyroidism who underwent parathyroidectomy before operation underwent non-invasive image diagnosis of parathyroid glands by computed tomography (CT), scintigraphy with /sup 201/TlCl and /sup 99m/TcO/sup 4 +/, and/or ultrasonography. CT visualized 39 of 45 parathyroid glands (86.7%), weighing more than 500 mg. Scintigraphy with a subtraction method using a computer performed the diagnosis in 19 of 27 glands (70.4%). Ultrasonography detected 21 of 27 glands (77.8%). Image diagnosis was also useful in the postoperative follow-up study. The non-invasive image diagnosis of parathyroid glands in patients with chronic renal failure is thus valuable for 1) definite diagnosis of secondary hyperparathyroidism, 2) localization, and 3) diagnosis for effectiveness of conservative treatment.
The reliability analysis of the Fast Flux Test Facility reactor shutdown system was reevaluated. Failure information based on five years of plant operating experience was used to verify original reliability numbers or to establish new ones. Also, system modifications made subsequent to performance of the original analysis were incorporated into the reevaluation. Reliability calculations and sensitivity analyses were performed using a commercially available spreadsheet on a personal computer. The spreadsheet was configured so that future failures could be tracked and compared with expected failures. A number of recommendations resulted from the reevaluation including both increased and decreased surveillance intervals. All recommendations were based on meeting or exceeding existing reliability goals. Considerable cost savings will be incurred upon implementation of the recommendations.
The reliability analysis of the Fast Flux Test Facility reactor shutdown system was reevaluated. Failure information based on five years of plant operating experience was used to verify original reliability numbers or to establish new ones. Also, system modifications made subsequent to performance of the original analysis were incorporated into the reevaluation. Reliability calculations and sensitivity analyses were performed using a commercially available spreadsheet on a personal computer. The spreadsheet was configured so that future failures could be tracked and compared with expected failures. A number of recommendations resulted from the reevaluation including both increased and decreased surveillance intervals. All recommendations were based on meeting or exceeding existing reliability goals. Considerable cost savings will be incurred upon implementation of the recommendations.
Analyses were performed of the safety-related performance of the reactor protection system (RPS) at U.S. Westinghouse and General Electric commercial reactors during the period 1984 through 1995. RPS operational data from these reactors were collected from the Nuclear Plant Reliability Data System (NPRDS) and Licensee Event Reports (LER). The common-cause failure (CCF) modeling in the fault trees developed for these studies and the analysis and use of common-cause failure data were sophisticated, state-of-the-art efforts. The overall CCF effort helped to test and expand the limits of the U.S. Nuclear Regulatory Commission's CCF methodology.
BackgroundAlthough self-expandable metal stent (SEMS) insertion is widely used for relief of malignant colorectal obstructions, the immediate technical and clinical failure rates of SEMSs and the associated risk factors remain largely unknown. ObjectiveTo identify rates and factors predictive of technical and clinical failure of SEMSs when their use is attempted for the decompression of malignant colorectal obstruction. DesignRetrospective chart review. SettingA tertiary-care academic medical center in South Korea. PatientsThis study involved a total of 412 patients with malignant colorectal obstruction in whom SEMS insertion was attempted. InterventionPlacement of colonic SEMSs. Main Outcome MeasurementsTechnical success and immediate and long-term clinical success rates. ResultsTechnical...