... 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 ...
BackgroundCardiovascular magnetic resonance (CMR) allows volumetric carotid plaque measurement that has advantage over 2-dimensional ultrasound (US) intima-media thickness (IMT)...Full Text Available
High-intensity contact ultrasound (HICU) under MRI guidance may provide minimally invasive treatment of endocavitary digestive tumors in the esophagus, colon or rectum. In this study, a miniature receive-only coil was integrated into an endoscopic ultrasound applicator to offer high-resolution MRI guidance of thermotherapy. A cylindrical plastic support with an incorporated single element flat transducer (9.45 MHz, water cooling tip) was made and equipped with a rectangular RF loop coil surrounding the active element. The integrated coil provided significantly higher sensitivity than a four-element extracorporeal phased array coil, and the standard deviation of the MR thermometry (SDT) improved up to a factor of 7 at 10 mm depth in tissue. High-resolution morphological images (T1w-TFE and IR-T1w-TSE with a voxel size of 0.25 x 0.25 x 3 mm3) and accurate thermometry data (the PRFS method with a voxel size of 0.5 x 0.5 x 5 mm3, 2.2 s/image, 0.3 ...
This paper presents a new approach to improve the in silico modeling of ultrasound transducer arrays. While current simulation tools accurately predict the theoretical element...Full Text Available
As an alternative to surgery, endovascular therapy with stent grafts has become the second main treatment option for infrarenal abdominal aortic aneurysms. Unlike surgery, endovascular treatment with stent grafts is also applicable in patients unfit for open repair. Despite current improvements in endovascular repair devices, significant anatomic barriers still exclude this technique for a large number of patients. Computed tomography, magnetic resonance imaging, and ultrasound are essential for diagnostics, preintervention planning, and postintervention follow-up of abdominal aneurysms treated with stent grafts. This review covers etiology, pathology, and diagnostic aspects. Materials and methods for endovascular treatment of abdominal aortic aneurysms are presented in detail, and clinical results and complications are discussed. (orig.) [German] Die endovaskulaere Therapie des infrarenalen Bauchaortenaneurysmas hat sich ...
The effect of ultrasound waves, airflow and combined ultrasound with the airflow on the thermal instability suppression of a hollow needle-to-plate electrical discharge was studied experimentally. To evaluate the thermal instability suppression we used the V-A characteristics of the discharge in stationary air, with ultrasound applied in stationary air, and finally when the airflow was supplied into the discharge through the needle without and with ultrasound application. To illustrate the effect of ultrasound, airflow and combined ultrasound with airflow on the discharge thermal instability suppression we also studied the discharge ozone production. We found that in stationary air the application of ultrasound only slightly suppresses thermal instability. A substantial increase of ozone generation was not detected. Application of the ...
To assess the efficacy and resulting complications of tetracycline sclerotherapy in renal, hepatic, ovarian, and perivesical cysts. We retrospectively reviewed 23 cases of benign cysts (16 renal, 4 hepatic, 2 ovarian, and 1 perivesical) in 22 patients in whom the condition was diagnosed or confirmed by either ultrasound, CT, or cytology, and who underwent percutaneous tetracycline sclerotherapy. Using a 21-gauge Chiba needle, the target cyst was punctured under ultrasound guidance. Prior to the injection of 1500 mg of tetracycline diluted in 5 ml of normal saline, almost all the cystic content was aspirated, and at the end of the procedure the tetracycline was left in the cyst. During a period of between 3 and 22 months, 18 of the 23 cases were followed up. In six of the 18 cases followed up, the cysts either decreased in size by 10%, or collapsed completely. In seven cases a collapse of over 50% was noted, and in the remaining five the cyst ...
Of 1850 patients with cholelithiasis diagnosed in the past 17 years, 1116 female and 734 male, 598 patients (32.3%) presented with one or more of three major symptoms, i.e., abdominal pain, fever and jaundice, whereas the remainder (67.7%) had none of these symptoms. The proportion of the asymptomatic patients was similar in all age groups, being around 70%. Only 20 per cent of 680 asymptomatic patients, followed for 10 to 17 years (median 13.3 years), developed biliary symptoms. Older patients over 70 years of age had a higher rate of change to the symptomatic group, as compared with younger patients under 70, 29.5% vs. 19.3%, respectively. During this period, carcinoma of the gallbladder developed in one of the asymptomatic patients (0.1%). Oral dissolution therapy was successful in only 4.2 per cent of attempted cases and associated with a recurrence rate of as high as 20%. We conclude that asymptomatic gallstone patients should only be followed up by ...
The authors report a case of a cephalopagus conjoined twin that was diagnosed at 29 weeks of gestation despite the mother having had two ultrasounds done previously. The fetus had one head and face,...Full Text Available
We investigate a method for gene delivery to vascular smooth muscle cells using ultrasound triggered delivery of plasmid DNA from electrostatically coupled cationic microbubbles. Microbubbles...Full Text Available
Although ultrasound arrays were exploited in photoacoustic imaging to improve imaging speed, ultrasound-array-based optical-resolution photoacoustic microscopy (OR-PAM) has never been achieved...Full Text Available
A bladder neck obstruction was suspected after ultrasound investigation at 16 weeks' gestation. Evaluation of protein content in the amniotic fluid, fetal ascites, and fluid from the overdistended bladder...Full Text Available
Previous ultrasound elasticity imaging experiments supported a generally accepted concept that the hardness of deep venous thrombi increases with thrombus aging. Results also showed that this...Full Text Available
Although previous intravascular ultrasound (IVUS) radiofrequency-based analysis data showed acceptable reproducibility for plaque composition, measurements are not easily obtained, particularly that...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 ...
Sep 19, 2011 ... (The whispering voice, on the other hand, was the latest in ultrasound directed audio technology from the firm Audio Spotlight.) The NASA ...
ObjectiveAngiography remains a critical component for diagnostic imaging and therapeutic intervention in peripheral arterial disease (PAD). The goal of this study...Full Text Available
Ultrasound examinations for foetal brain abnormalities have been a part of the routine antenatal screening programme in the UK for many years. In utero brain magnetic resonance imaging (MRI) is now being used increasingly successfully to clarify abnormal ultrasound findings, often resulting in a change of diagnosis or treatment plan. Interpretation requires an understanding of foetal brain development, malformations and acquired diseases. In this paper we will outline the technique of foetal MRI, relevant aspects of brain development and provide illustrated examples of foetal brain pathology.
Background/AimsAlthough endoscopic ultrasound guided fine needle aspiration (EUS-FNA) has been introduced and its use has been increasing in Korea, there have not been many reports...Full Text Available
Abstract The authors provide a survey of how images are used in radiation therapy to improve the precision of radiation therapy plans, and delivery of radiation treatment. In contrast...Full Text Available
The aim of the paper is to review the role of interventional radiology in the management of hemodialysis vascular access and complications in renal transplantation. The evaluation of patients with hemodialysis vascular access is complex. It includes the radiology/ultrasound (US) evaluation of the peripheral veins of the upper extremities with venous mapping and the evaluation of the central vein prior to the access placement and radiological detection and treatment of the stenosis and thrombosis in misfunctional dialysis fistulas. Preoperative screening enables the identification of a suitable vessel to create a hemodynamically-sound dialysis fistula. Clinical and radiological detection of the hemodynamically significant stenosis or occlusion demands fistulography and endovascular treatment. Endovascular prophylactic dilatation of stenosis greater than 50% with associated clinical abnormalities such as flow-rate reduction is warranted to prolong access patency. The ...
Purpose Skilled placement of peripherally inserted central catheters (PICC) has a profound impact on patient well-being and costs of care. The use of ultrasound-guided methods and prescribed training for cannulation skills are evidence-based practice recommendations. The purpose of this study was to compare two methods of PICC instruction on the acquisition of applied skills. Methods Residents were randomly assigned to one of two groups (N?=?16/16) of this blind-rater study and were trained to perform ultrasound-guided PICC cannulation using either simulation or apprenticeship methods. All residents were assessed placing a PICC in applied clinical patient care. Results Residents who completed simulation training had significantly better transfer of skills to applied clinical practice than ...
The growth of silver chloride nanoparticles on ancient textile was achieved by sequential dipping steps in alternating bath of potassium chloride and silver nitrate under ultrasound irradiation. The effect of ultrasound irradiation and sequential dipping steps in growth of the AgCl nanoparticles has been studied. These systems depicted a decrease in the particles size accompanying a decrease in the sequential dipping steps. The samples were characterized with powder X-ray diffraction (XRD) and scanning electron microscopy. XRD analyses indicated that the prepared AgCl nanoparticles on fiber were crystalline. The textile samples containing AgCl nanoparticles were tested for their antibacterial efficacy against Escherichia coli and were found to possess significant antibacterial activity.
Objectives To investigate the feasibility and reproducibility of measurements of nasal bone length using a three-dimensional (3D) ultrasound in the first trimester. Methods In a prospective study, 118 consecutive pregnant women attending for Down syndrome screening at 11-13 + 6 weeks were recruited. They had successful fetal nasal bone measurement by two-dimensional (2D) ultrasound by four operators. Three-dimensional volumes were recorded in the mid-sagittal plane of fetal profile by the fifth operator and examined using multiplanar techniques. Another independent investigator randomly compared his measurements with one of the four operators. Results In the subsequent 3D examination, the nasal bone length could be examined in 94 cases (79.7%). The mean difference between the 2D and 3D mea...
A prospective comparative study with pathology was performed to assess the clinical value of Computed Tomography (CT) and endoscopic ultrasound (EUS) for nodal staging in lung cancer. A total of 329 nodal stations were dissected or sampled and 755 lymph nodes were examined at histology. On a pre-station basis, CT had greater sensitivity (74%) than EUS (56%), but EUS was more specific (83% versus 93%). The accuracy rates of the two techniques were similar. In conclusion, endoscopic ultrasound should be part of a routine preoperative diagnostic approach to non-small-cell lung cancer., because of its high specificity. Results can be improved when EUS and CT are combined., which suggests that these imaging modalities should be used together in selected patients for the noninvasive staging of non-small-cell lung cancer to identify local lymphatic spread.
To evaluate the current situation and implementation of embolization of uterine leiomyomas into the treatment concept in women with symptomatic uterine leiomyomas in Germany. A questionnaire addressing the clinical background of uterine myomas, recommended treatment concepts, preclinical evaluation, technical approach and complications was sent to 164 departments of gynecology and radiology in Germany. 33 radiological departments and 19 gynecological departments submitted a completed questionnaire. Only 7 departments of radiology reported to have own experience with embolization of uterine leiomyomas, while only 2 departments of gynecology considered embolization as an alternative treatment option in patients with symptomatic leiomyomas. 18/33 radiological departments offer this treatment option but get no patient referrals. Agreement was found concerning the indications for treatment, preclinical evaluation by ultrasound and MRI, preferable location of treatable ...
Femur fractures typically affect elderly patients with multiple co-morbidities. Pain control can be difficult, requiring intensive nursing and physician care as elderly patients may manifest cardiovascular...Full Text Available
The goal of ultrasonic molecular imaging is the detection of targeted contrast agents bound to receptors on endothelial cells. We propose imaging methods that can distinguish adherent microbubbles...Full Text Available
A novel method for non-destructive intramuscular fat (IMF) estimation via spectral ultrasound backscatter analysis of signals obtained from pig carcasses early post mortem is described. A commercial hand-held ultrasound device (center frequency: 2.7MHz) was modified to focus the sound beam to the longissimus muscle at the 2nd/3rd last rib. Time-resolved ultrasound backscatter signals of loin muscle were recorded 45minp.m. on 82 pig carcass sides. Backfat width (d"B"F=18.9+/-3.8mm) and muscle attenuation (@a"m"u"s"c"l"e=.77+/-.15dBMHz^-^1cm^-^1) were assessed from the measured pulse echo data. Other propagation properties of skin, backfat and muscle tissue obtained in a previous investigation were incorporated into the signal pre-processing to minimize parameter estimation artifacts. Spectr...
Advances in neuroscience have resulted in the development of new diagnostic and therapeutic agents for potential use in the central nervous system (CNS). However, the ability to deliver the...Full Text Available
BackgroundThe aim of the present article was to evaluate whether angiogenic parameters as assessed by transvaginal color Doppler ultrasound (TVCD) may predict those prognostic factors...Full Text Available
OBJECTIVES: To define a method for measurement of the cross sectional area and volume of the quadriceps femoris muscle using magnetic resonance imaging (MRI) in conjunction with stereology, and to compare...Full Text Available
A 30-year-old man with acquired immune deficiency syndrome (AIDS) and Kaposi's sarcoma had a palpable thyroid mass and cervical lymphadenopathy. Nuclear medicine and ultrasound scans revealed multiple thyroid nodules. Results of biopsy showed Kaposi's sarcoma metastatic to the thyroid.
Percutaneous coronary intervention can be associated with distal embolization of thrombotic material causing myocardial necrosis and infarction.We discuss the role of intravascular imaging to...Full Text Available
Endovascular surgery is a new multidisciplinary field that applies the recently innovated techniques of angioscopy, intraluminal ultrasound, balloon angioplasty, laser, mechanical atherectomy, and stents....Full Text Available
Background:During transurethral resection surgery (TUR), accidental stimulation of the obturator nerve can cause violent adductor contraction, leading to serious intraoperative...Full Text Available
BackgroundLifestyle, genetics and environmental factors are established determinants of bone density. We aimed to describe the bone characteristics of competitive top-ranked Nigerian...Full Text Available
An 11-year-old mare presented 36 hours after foaling with a ruptured bladder. Uroperitoneum was diagnosed on ultrasound and from the creatinine concentration of the peritoneal fluid. Bladder endoscopy...Full Text Available
To study the utility of ultrasound and computed tomography (CT) in case of suspected appendicitis. To determine the diagnostic yield in terms of different clinical contexts and patient characteristics. to assess the costs and benefits of introducing these techniques and propose a protocol for their use. Negative appendectomies, complications and length of hospital stay in a group of 152 patients with suspected appendicitis who underwent ultrasound and CT were compared with those of 180 patients who underwent appendectomy during the same time period, but had not been selected for the first group: these patients costs for each group were calculated. In the first group, the diagnostic value of the clinical signs was also evaluated. The reliability of the clinical signs was limited, while the results with ultrasound and CT were excellent. The incidence of negative appendectomy was 9.6% in the study group and 12.2% in the ...
The incidence of hilar cholangiocarcinoma is very rare worldwide. Radical resection is the only prognostic factor for long survival in patients with hilar cholangiocarcinoma. Postoperative radiation therapy can improve local control and survival rates for patients with palliative resection, but it remains controversial in patients with radical resection. Biliary drainage can effectively release bile duct obstruction for the majority of patients with locally advanced disease, and may even prolong survival when combined with radiation therapy. Radiation therapy includes extrernal beam therapy alone, external beam therapy with intraluminal brachytheapy and new radiation technique, such as three dimentional conformal therapy and intensity modulated radiation therapy. The propective randomized clinical study is needed for further investigation in ...
BackgroundTransarterial chemoembolization (TACE) therapy is an effective locoregional treatment in hepatocellular cancer (HCC) patients. For early modification of therapy, markers...Full Text Available
Forty-four patients with histologically proven Hodgkin's disease underwent initial treatment with extended-field radiation therapy. Nineteen of these patients also received combination chemotherapy....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)
OBJECTIVE: To evaluate the interobserver agreement of ultrasonographic assessment of finger and toe joints in patients with rheumatoid arthritis (RA) by 2 investigators with different medical backgrounds. METHODS: Ultrasonography and clinical examination were performed on 150 small joints of 30 patients with active RA. A General Electric LOGIQ 500 ultrasound unit with a 7-13-MHz linear array transducer was used. In each patient, 5 preselected small joints (second and third metacarpophalangeal, second proximal interphalangeal, first and second metatarsophalangeal) were examined independently on the same day by 2 ultrasound investigators (an experienced musculoskeletal radiologist and a rheumatologist with limited ultrasound training). Joint effusion, synovial thickening, bone erosions, and power Doppler signal were evaluated in accordance with an introduced 4-grade semiquantitative scoring system, on which the investigators ...
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
... 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...
The purpose of this project was to design, build, and characterize the performance of a volume breast ultrasound (VBUS) scanner that images the pendant breast. VBUS scanner design includes a: 1) clinical ultrasound scanner and transducer; 2) scanning table with a hole for the pendant breast; 3) rotational gantry; 4) probe mounting assembly; 5) compressionless breast stabilization device; 6) acquisition, control, reconstruction, and display software. Performance assessment characterized a variety of parameters including: spatial resolution, uniformity, and distortion using high and low contrast test objects in both horizontal and vertical scanning modes. The VBUS scanner modules have been constructed and initial performance evaluated. Approximately 300 scans are acquired over 360 degrees in 18 seconds. Reconstruction requires 25 ms per slice. Test object images depicted hyper- and hypo-echoic masses and demonstrated good resolution, soft tissue ...
In principle four different methods (ultrasound, microwaves, {gamma}-radiation and x-rays) are available for the non-destructive testing of refractories. Three of these methods, i.e. ultrasound, microwaves and {gamma}-radiation, are in use by different producers of AZS materials to carry out the quality control of their products. This paper will compare the three methods on the basis of the physical properties, present the existing devices, and show the advantages as well as the limits of the different methods. {gamma}-radiography, the oldest method in use, has one main disadvantage, which is the requirement of protection against radioactive radiation. Furthermore, while cracks and cavities can be detected with this method, structural changes can not be monitored. Therefore, the ultrasonic method was developed that allows to detect variations of porosity and grain size as well as cracks and voids when the ultrasonic parameters are tuned as well ...
In this work, the antibacterial effect of fluoroquinolones (FQs) upon Escherichia coli (E.coli) was measured with and without application of 40kHz ultrasound (US) stimulation. The research results demonstrated that simultaneous application of 40kHz US apparently enhanced the antibacterial effectiveness of FQs. That is, the synergistic effect was observed and the bacterial viability was reduced when FQs and US were combined. In addition, various influencing factors, such as FQs drug concentration, US irradiation time and solution temperature, on the inhibition of E.coli were also investigated. The antibacterial activity was enhanced apparently with increasing of FQs drug concentration, US irradiation time and solution temperature. Furthermore, we discussed preliminarily the mechanism of US ...
Background: Mechanisms underlying the association between myocardial bridge (MB)-stenting and in-stent restenosis (ISR) are still unclear. Objective: To assess the impact of MB on ISR using intravascular ultrasound (IVUS). Methods: In the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial, 100 left anterior descending artery (LAD) culprit lesions (79 treated with paclitaxel-eluting stents [PES] and 21 treated with bare metal stents) were imaged with serial IVUS immediately postprocedure and at 13 months. Results: At baseline the LAD stent extended into the MB segment beyond the culprit lesion in seven patients (MB-stent group). In the remaining 93 patients the LAD stent was implanted only in the culprit lesion without extending into t...
17 patients with chronic aortic dissection were examined by MRI. In 12 patients, comparison between gradient echo sequences and SE sequences was possible. Gradient echo sequences, unlike SE sequences, permitted evaluation of flow in the true and false lumen, reliable differentiation between thrombus and flowing blood and clear delination of the intimal flap. An additional comparison between transoesophageal ultrasound and MRT in 15 patients showed significant advantages in favour of MRI. In three patients MRI was able to detect more proximal origins of the dissection. Moreover, MRI allowed evaluation of the major aortic branches and their relation to the dissection; this was not possible with ultrasound. MRI plays an important role in the follow-up of chronic aortic dissections. (orig.).
Background This study aimed to evaluate the feasibility, safety, and follow-up results of endoscopic papilletomy (ESP) with pancreatic and biliary duct stent placement for ampullary tumors. The therapeutic approach to benign ampullary tumors remains unsettled. The ESP procedure is a curative treatment option for benign papillary tumors, but ESP raises concerns about a relatively high risk for procedure-related complications such as pancreatitis. A pancreatic stent may protect against complications. Methods Between September 2000 and June 2008, 36 patients with ampullary tumors confined to the mucosa and no intraductal tumor growth underwent ESP. The preprocedural diagnostic tools included endoscopic ultrasound, transpapillary intraductal ultrasound, and endoscopic retrograde cholangiopancr...
Calcaneus quantitative ultrasound (QUS) assessment is a safe and reliable method for evaluating skeletal status. Until now, considerable data have been accumulated on the distribution of QUS in Caucasian populations, whereas such data are still insufficient in Asian populations, especially in Chinese mainland. The present study aimed to obtain the distribution characteristic of calcaneus QUS in healthy Chinese women, and to further investigate the distribution of low bone mass by QUS stiffness index (SI). This study included 2,498 healthy Chinese females aged 10-87 yr. The QUS exhibited a characteristic mild rise and then fall pattern with increasing age. Age, body height, and weight were significant influencing factors on SI, especially age and weight. The prevalence of osteoporosis detec...
Radiation therapy 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.
BackgroundTo compare two strategies of dynamic intensity modulated radiation therapy (dIMRT) with 3-dimensional conformal radiation therapy (3DCRT) in the setting of hypofractionated...Full Text Available
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, ...
Ultrasound tomography is an attractive imaging method for the detection of breast cancer. The complex anatomy of the breast with its different spatial scales and material property contrasts make accurate reconstructions very challenging. This paper proposes a hybrid approach whereby Travel-of-Flight and Diffraction Tomography are combined together to achieve high-resolution and high-accuracy sound-speed reconstructions. The method is validated with several numerical phantoms.
This case report presents the prenatal diagnosis of conjoined twins at 7 weeks and 6 days’ gestation according to the last menstrual period and 6 weeks and 4 days’ gestation according...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 aim of this study was to compare and to validate different dose calculation algorithms for the use in radiation therapy of small lung lesions and to optimize the treatment...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
Adaptive radiation therapy (ART) is the incorporation of daily images in the radiotherapy treatment process so that the treatment plan can be evaluated and modified to maximize the amount of radiation...Full Text Available
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
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
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: Understanding the kinetics of tumor growth∕shrinkage represents a critical step in quantitative assessment of therapeutics and realization of adaptive radiation therapy....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
Some studies suggest that giving radiation therapy 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 radiation therapy 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 radiation therapy and 30 were treated with surgery alone. The clinicopathologic features that might have influenced prognosis were similar in the patients who received radiation therapy and those who did not. Radiation as adjuvant therapy did not have a beneficial effect on overall survival (P=0.554, log-rank test); however, it ...
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 ...
PurposeA dosimetric comparison between multiple static-field intensity-modulated radiation therapy (IMRT), multi-arc intensity-modulated arc therapy (IMAT) and single-arc...Full Text Available
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
In many radiotherapy clinics, geometric uncertainties in the delivery of 3D conformal radiation therapy and intensity modulated radiation therapy of the prostate are reduced by aligning the...Full Text Available
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.)
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
For the evaluation of diseases of salivary origin, ultrasound and/or sialography is recommended instead of MRI. In cases of salivary tumor, ultrasound may be helpful in delineating superficial tumors. For small tumors no further imaging is needed. When dealing with a large tumor or a tumor in the deep lobe of the parotid gland, MRI is the preferred imaging method. Not only does MRI provide a large variety of soft tissue signal differences, but also the multiplanar facilities are helpful in delineating the extent of the tumor, whether located in the submandibular, sublingual, or parotid gland. Skull base invasion is often well seen by MRI. Subtle changes may be missed and in those cases CT is recommended to exclude or prove destruction of the skull base. For the evaluation of patients presenting with a recurrent pleomorphic adenoma, MRI is recommended in all patients. MRI delineates the extent and number of recurrent tumors better than palpation ...
Intramuscular hermorrhage was induced by injecting autologous blood into the paraspinal muscle of 8 rabbits. In order to evaluate the time-dependent changes of hemorrhage observed on MRI, the animals were imaged at different stages of blood resolution at 0.02 tesla (T), and control examined with ultrasound using a 7.5 MHz linear transducer. Six inversion recovery sequences (TR=1 000 ms. TE=30 ms, and TI=18, 48, 148, 201, 302, and 398 ms) were used for the invivo calculation of T1 relaxation times. IR 1 000 (398)/30 imaging was performed before and after the Gd-DOTA administration. The hemorrhage was evident on MR images throughout the study, especially on the T2 weighted (SE 1 000/100) images. MRI showed the healing lesion longer than ultrasound. The T1 relaxation time increased during the time of resolution. Lesions on days 4 to 7 enhanced in intensity after the injection of Gd-DOTA. (orig.).
For good image quality using ultrasound inverse scattering, one alternately solves the well-posed forward scattering equation for an estimated total field and the ill-posed inverse scattering equation for the desired object property function. In estimating the total field, error or noise contaminates the coefficients of both matrix and data of the inverse scattering equation. Previous work on ill-posed inverse ultrasonic scattering commonly used Tikhonov regularization, which considers error only in the data. The solution so obtained is not precise enough to reconstruct the quantitative internal structure of a large or high-contrast object. This paper adopts the truncated total least squares method, simultaneously considering error and noise on both sides of the inverse scattering equation, and compares it with the classical Tikhonov regularization. We show that it can substantially improve reconstruction fit and image quality when the inverse scattering equation ...
A 1.5-year-old male Belgian Malinosis Military Working Dog presented with a 1-month history of intermittent hematuria. Diagnostic ultrasound and contrast radiography demonstrated large blood clots in the urinary bladder and a filling defect in the right renal pelvis. At surgery, clotted blood was present in the right ureter and bladder. Following right nephrectomy, the dog returned to training. One month later, elevations in urea nitrogen and creatinine were noted. Hematuria recurred at 3 months and the dog was found dead in its kennel. Necropsy showed a blood-filled left renal pelvis and ureter. PMID:1454185
The patient positioning and repositioning control in radiation therapy all along the treatment can be conducted using a variety of X-ray sources and imaging detector devices. The development of image guided radiation therapy 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 radiation therapy, as well as basic proposals to take account of these imaging doses for prescribing, recording and reporting radiation therapy treatment. (authors)
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...
Objective: To compare the enhancement pattern of hilar cholangiocarcinoma on contrast-enhanced ultrasound (CEUS) with that on contrast-enhanced computed tomography (CECT). Methods: Thirty-two consecutive patients with pathologically proven hilar cholangiocarcinomas were evaluated by both low mechanical index CEUS and CECT. The enhancement feature of the tumor, portal vein infiltration, and lesion conspicuity on them was investigated. Results: In the arterial phase, the numbers of the lesions showing hyperenhancement, isoenhancement, and hypoenhancement, were 14 (43.8%), 14 (43.8%), and 4 (12.6%), on CEUS, and 12 (37.5%), 9 (28.1%), and 11 (34.4%), on CECT (P = 0.162). In portal phase, the numbers of the lesions showing hypoenhancement, isoenhancement, and hyperenhancement were 30 (93.8%), 1 (3.1%), and 1 (3.1%), on CEUS, and 23 (71.9%), 8 (25.0%), and 1 (3.1%), on CECT (P = 0.046). The detection rates for portal vein infiltration were 84.2% (16/19) for baseline ...
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 electron beam ...
Little clinical evidence has been provided to show the minimization of radiation resistance of tumors using high linear energy transfer radiation. We therefore investigated the radiobiological and molecular pathological aspects of carbon beam therapy. A total of 27 patients with squamous cell carcinoma (SCC) of the cervix were treated using a carbon beam and 50 control patients with SCC of the cervix using a photon beam. The expression of Ki-67, p53, and p27 proteins before radiotherapy and 5 and 15 days after therapy initiation were investigated using immunohistochemistry. Similar changes were observed in Ki-67 labeling index (LI) and p53 LI during carbon and photon beam therapies. However, for carbon beam therapy, the mean p27 LI significantly decreased from 25.2% before treatment to 18.6% on the 5th day after treatment initiation, followed by a significant increase to 36.1% on the 15th day. In ...
Radiation therapy 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, radiation therapy 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 radiation therapy 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 radiation therapy with electrons. Presented are the design specifics of an applicator system, central axis beam data, applicator parameters, dose distribution data, shielding, treatment planning and means ...
Radiation therapy 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, radiation therapy 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 radiation therapy 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 radiation therapy with electrons. Presented are the design specifics of an applicator system, central axis beam data, applicator parameters, dose distribution data, shielding, treatment planning and means ...
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 radiation therapy 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 radiation therapy 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).
Conformal radiation therapy 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 radiation therapy 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.
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
Despite high local control rate in Ewing's sarcoma the exact indication of radiation therapy 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 radiation therapy. 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. (authors). 28 refs.
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
Modern advances in the concept and the techniques of megavoltage radiation therapy have revolutionized the treatment of medulloblastoma. Five-year survivals of 50 to 70 percent are achieved by craniospinalaxis...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
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
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
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 radiation therapy 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 irradiation therapy ...
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 radiation therapy (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, immune-competent male mice ...
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
Previous research with individuals undergoing surgery or diagnostic procedures provided a conceptual framework for analysis of radiation therapy, a common form of cancer treatment. The present...Full Text Available
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
Adaptive radiation therapy for liver cancer has the potential to reduce normal tissue complications and enable dose escalation, allowing the potential for tumor control in this challenging site....Full Text Available
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
The objective of this study was to determine the usefulness of parathyroid scintigraphy in histological estimation for secondary hyperparathyroidism (2HPT) using Tc-99m sestamibi or Tc-99m tetrofosmin. Tc-99m sestamibi (MIBI) and Tc-99m tetrofosmin (Tetro) parathyroid imaging following double-phase study, magnetic resonance imaging (MRI), and ultrasound were performed on 14 patients with 2HPT. All patients underwent parathyroidectomy. The uptake of two tracers in parathyroid areas was compared with the histopathologic findings. Forty-nine parathyroid glands were surgically explored and histologically proven to be hyperplastic. Of these, 42 were diagnosed with nodular type (N-type) hyperplasia, and 7 with diffuse type (D-type) hyperplasia. MIBI and Tetro parathyroid imagings detected 34 and 35 parathyroid glands, respectively. The sensitivity of MIBI was determined to be 76.2% (32/42) for N-type, and 28.6% (2/7) for D-type. The sensitivity of Tetro was determined to ...
AIM: The purpose of the study was to evaluate the percutaneous use of the new nitinol SMARTeR stents in patients with biliary obstruction. MATERIALS AND METHODS: Four stents were placed in three patients percutaneously under ultrasound and fluoroscopic guidance. RESULTS: The deployment of the stents was successful in all three patients. All stents maintained their patency and position after short-term follow-up. CONCLUSION: The nitinol SMARTeR stent is useful in the management of patients with biliary obstruction although accurate placement across the ampulla was found to be technically more difficult than with the Wallstent. Larger, long-term follow-up studies are required to evaluate the long-term patency of these new devices.
In previous work, on cooling from 300 K to 10 K the elastic moduli for both #alpha#- and #delta#-Pu dropped 30%. This large change may reflect effects of 5f-electron localization. In this work, the elastic moduli at ambient temperature of several Pu-Ga alloys were measured using resonant ultrasound spectroscopy (RUS). The strong temperature dependence of the bulk and shear modulus and the temperature independence of Poisson's ratio was confirmed and the upper temperature limit for #alpha#-Pu was extended to 360 K. Measurements of the time dependence of the shear moduli of Pu and Pu-2.36 at.% Ga were determined with high precision as a function of time and temperature. Using a model for time dependence of point defects, we determined the exponential time constant at ambient temperature for such variations. The low temperature results are consistent with Fluss .
Abstract Suspension of solids in stirred reactor is widely used for catalytic reactions, dissolution, etc. Quality of solid suspension is an important parameter required for the reliable design, optimum performance, and scale up of the system. Quality of suspension depends on local characteristics of solid velocity and hold up profiles. The present work was focused on investigating quality of solid suspension using ultrasound velocity profiler (UVP) measurements and CFD simulations. The slip velocity measurements carried out with UVP were used to evaluate different drag correlations used in CFD simulations. Results discussed in this work would be useful for extending the applications of CFD models for simulating large stirred slurry reactors.
This paper is concerned with the real time automatic discriminating of flaws from two categories; i. cracks (planar defect) and ii. Non-cracks (volumetric defect such as cluster porosity and slag) using pulse-echo ultrasound. The raw ultrasonic flaws signal were collected from a computerized robotic plane scanning system over the whole of each reflector as the primary source of data. The signal is then filtered and the analysis in both time and frequency domain were executed to obtain the selected feature. The real time feature analysis techniques measured the number of peaks, maximum index, pulse duration, rise time and fall time. The obtained features could be used to distinguish between quantitatively classified flaws by using various tools in artificial intelligence such as neural networks. The proposed algorithm and complete system were implemented in a computer software developed using Microsoft Visual BASIC 6.0 (author)
Opinion statement Because a minority of patients with D-transposition of the great arteries are diagnosed in utero by ultrasound, most present after delivery with cyanosis. In the absence of apparent lung disease, cyanotic neonates suspected of having a cardiac lesion should be immediately transferred to an intensive care unit at a pediatric tertiary care center for monitoring, resuscitation, and to define the cardiac anatomy and physiology. A prostaglandin E-1 infusion is usually initiated to maintain ductal patency and promote intra-cardiac mixing. In the past, balloon atrial septostomy (BAS) was routinely performed to enlarge the atrial septal defect and improve intra-cardiac mixing while the infants awaited surgery. Recent literature has reported an increase risk of stroke in neonates ...
We present two cases of fetal neck masses that were initially diagnosed by ultrasound and further evaluated with prenatal MRI. MRI findings aided in further delineating the neck masses, increasing confidence in the final diagnosis (cervical teratoma and cystic hygroma). With the fetal airway typically filled with fluid that is of high signal on T2-weighted sequences, MRI images in three planes could identify whether the fetal larynx and trachea were partially or completely compressed by the neck tumor. This information was particularly useful in determining if a controlled delivery such as ex utero intrapartum treatment (EXIT) was necessary and aided the surgeons in planning their approach to establishing airway control in the delivery room. (orig.)
Objective To report the clinical response to image-guided percutaneous cryotherapy (IPC) for the palliative management of localized metastases in patients with gynecologic malignancies. Methods Institutional review board approval and patient consent were obtained. Gynecologic oncology patients were identified from our institution's cryotherapy database from August 2003 to August 2007. Cryotherapy was performed with 2.4?mm diameter probes (Endocare, Irvine, CA) with ultrasound or computerized tomography (CT) guidance under conscious sedation and local anesthesia. Follow-up was conducted by imaging studies and clinical encounters, using Response Evaluation Criteria in Solid Tumors (RECIST criteria). Results Twenty-eight ablation sessions were performed for 41 metastatic foci in 15 patients w...
Abstract In this brief report, we have described the fine-needle aspiration cytology (FNAC) of a hepatosplenic T-cell lymphoma (HSTCL) in a 60-year-old female patient. The patient complained of fever and heaviness of left upper abdomen. Ultrasound-guided FNAC of the spleen showed immature lymphoid cells, and a diagnosis of primary non-Hodgkin lymphoma of spleen was offered. Subsequently, the patient underwent splenectomy and wedge biopsy of liver that confirmed the cytological diagnosis. The lymphoma cells were positive for CD3 immunostain. Primary hepatosplenic T-cell lymphoma is a rare entity and may often pose diagnostic problems on FNAC. Diagn. Cytopathol. 2010. 2010 Wiley-Liss, Inc.
Fetal MRI examines non-invasively the unborn fetus. Ultrafast MRI sequences effectively suppress fetal motion. Multiple case reports and studies have shown that fetal MRI is particularly helpful in the evaluation of the central nervous system. The high contrast-to-noise ratio, the high spatial resolution, the multiplanar capabilities, the large field of view and the simultaneous visualisation of fetal and maternal structures have proven to be advantageous. Fetal MRI is particularly helpful in the evaluation of the normal and pathological development of the brain. Despite the fact that no side effects have been reported or are to be expected, the use of MRI during pregnancy is still limited to the second and third trimester of pregnancy. Magnetic resonance imaging contrast media are not to be used as it passes the placenta. Ultrasound remains the primary screening modality for fetal pathology; fetal MRI can serve as an adjunct or second-line imaging modality. ...
Two cases of focal nodular hyperplasia (FNH), in which ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MR) studies detected an atypical hemorrhagic pattern associated with an intrahepatic arterio venous malformation (AVM) around the growths, are presented. In both cases, histology demonstrated a very early regenerative stage and necrotic-hemorrhagic areas within the lesions. In these cases, the analysis of radiological findings, surgical specimens and histology seemed to confirm the pathogenetic hypothesis suggested by Wanless: in normal liver parenchyma, a ``blood steal`` phenomenon due to congenital or acquired intrahepatic AVM could cause ischemic damage, appearing as a hemorrhagic necrotic area, the extent of which depends on the degree of residual portal supply. (orig.)
Background: Superficial inferior epigastric artery (SIEA) flap has a great advantage over other flaps of the area, that is, readily non-existent donor-site problems. The main reason why the SIEA flap has never been extensively used in breast reconstruction is the small diameter and variable anatomy of its donor artery. This study presents a possibility of enlarging the SIEA diameter using the delay-phenomenon mechanism. Methods: A prospective clinical study of 26 patients was undertaken. Prior to surgery, ultrasound examinations were performed, measuring the diameter of SIEA and the velocity of blood flow in SIEA. The ipsilateral deep inferior epigastric artery (DIEA) was then ligated in all patients who had a measurable SIEA preoperatively. Two weeks later, measurements were repeated. The...
Objective To demonstrate clinical features of a patient subgroup presenting with polycystic ovary syndrome (PCOS) without polycystic ovary morphology. Design Retrospective study. Setting Hospital-based IVF center. Patient(s) In the present study, 876 PCOS patients were selected from women who visited the Reproductive Medicine Center at Shandong Provincial Hospital, Shandong University, between September 2004 and October 2006. Women with PCOS were divided into two groups based on ultrasound image: group A, PCOS patients with classic polycystic ovary (n = 800); group B, PCOS patients without polycystic ovary morphology (n = 76). The following available data were analyzed in the large cohort of women: body height, weight, waistline, hip circumference, hirsutism scores, family history, serum s...
The techniques in order to measure the depth of defect in weldment and structure accurately have been developed. Many researches have made efforts to develop the methods for the accurate depth sizing of defect. TOFD is known as the most accurate method of various methods for measuring depth sizing. However, there is a possibility to miss defects because of the limitation of beam coverage for the ultrasound incident angle. In this study, the results for detectability and depth sizing using phased array ultrasonic technique for thick body were compared with those of conventional TOFD technique. It was experimentally confirmed that the phased array ultrasonic TOFD technique gives good detectability and accurate depth measurement for the various types of defects. The phased array ultrasonic TOFD technique developed in this study will contribute to increase the inspection reliability in thick component such as the pressure vessel of power generation industry
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.
During the past 10 years, five infants with Kasabach-Merritt syndrome (K-M) receiving radiation therapy were reported. We investigated whether radiation therapy 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 radiation therapy. Total dose ranged from 5 to 10 Gy and fraction-size ranged from 0.5 to 1.75 Gy. Irradiation session was 2 or 3 times per week. In 5 cases, 4 cases showed cure of ...
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
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.
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
Purpose: To assess the relationship between large intracranial vessel occlusive vasculopathy (vasculopathy) and radiation therapy, 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 radiation therapy 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 radiation therapy (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 radiation therapy. Three of them presented with ...
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
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.
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.
The outcome was retrospectively examined and prognostic factors were discussed for arterial chemo-infusion therapy (ACT) through an implanted reservoir system and radiation therapy (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 was a meaningful treatment for highly ...
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 ...
Two cases of primary Ewing's sarcoma of the rib are reported, in which radiation therapy was quite effective. Case 1 was an 18-year-old female who had had an operation and radiation therapy for Ewing's sarcoma of the left 7th rib. She was referred to our hospital after a recurrent tumor was found. Radiation therapy (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. Radiation therapy (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 of preoperative radiotherapy in case 2. (author).
Purpose: For planning the therapeutic strategies and estimating the prognosis in esophageal cancer, N-staging is very important. To date, MRI still is of minor importance as imaging modality of the mediastinum despite promising developments in the past, like ECG-gating or 'averaging' sequences, e.g. LOTA (Long-term averaging), which facilitate mediastinal and thoracic MR-imaging. In a prospective approach, the value of MRI based N-staging was examined with respect to LOTA-sequences. Material and Methods: Within from weeks prior to esophagectomy, standardized MRI of the esophagus was performed in 15 patients (10 squamous-cell-carcinomas and 5 adenocarcinomas) using a 1.5 T whole body scanner. Imaging quality was classified based on depiction of aortic wall or tracheal wall layers. Criteria for malignant infiltration were a diameter of more than 15 mm or a round appearance of a lymph node together with GD-DTPA enhancement. All data were blinded and separately read by two radiologists. ...
The aim of this work is to investigate the acoustic wave generation by pulsed and periodically modulated ion beams in different solid materials depending on the beam parameters and to demonstrate the possibility to apply an intensity modulated focused ion beam (FIB) for acoustic emission and for nondestructive investigation of the internal structure of materials on a microscopic scale. The combination of a FIB and an ultrasound microscope in one device can provide the opportunity of nondestructive investigation, production and modification of micro- and nanostructures simultaneously. This work consists of the two main experimental parts. In the first part the process of elastic wave generation during the irradiation of metallic samples by a pulsed beam of energetic ions was investigated in an energy range from 1.5 to 10 MeV and pulse durations of 0.5-5 #mu#s, applying ions with different masses, e.g. oxygen, silicon and gold, in charge states from 1"+ to 4"+. The ...
Purpose To investigate the sensitivity and accuracy of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for restaging the mediastinum after induction chemotherapy in patients with non-small-cell lung cancer (NSCLC). Patients and Methods One hundred twenty-four consecutive patients with tissue-proven stage IIIA-N2 disease who were treated with induction chemotherapy and who had undergone mediastinal restaging by EBUS-TBNA were reviewed. On the basis of computed tomography, 58 patients were classified as having stable disease and 66 were judged to have had a partial response. All patients subsequently underwent thoracotomy with attempted curative resection and a lymph node dissection regardless of EBUS-TBNA findings. Results Persistent nodal metastases were detected by using EBUS-TBNA in 89 patients (72%). Of the 35 patients in whom no metastases were assessed by EBUS-TBNA, 28 were found to have residual stage IIIA-N2 disease at ...
Carpal tunnel syndrome (CTS) is a common disorder, for which various conservative treatment options are available. The objective of this study is to determine the efficacy of the various conservative treatment options for relieving the symptoms of CTS. Computer-aided searches of MEDLINE (1/1966 to 3/2000), EMBASE (1/1988 to 2/2000) and the Cochrane Controlled Trials Register (2000, issue 1) were conducted, together with reference checking. Included were randomised controlled trials evaluating the efficacy of conservative treatment options in a study population of CTS patients, with a full report published in English, German, French or Dutch. Two reviewers independently selected the studies. Fourteen randomised controlled trials were included in the review. Assessment of methodological quality and data-extraction was independently performed by two reviewers. A rating system, based on the number of studies and their methodological quality and findings, was used to determine the strength ...
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 to 60% at 3 years ...
Retrospective analyses were performed to evaluate the therapeutic efficacy of intra-oral cone (IOC) radiation therapy 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 radiation therapy alone or in combination with external irradiation. IOC radiation therapy was given not only for T1 and T2, but also for T3 tumors. Hypofractionation was used for IOC radiation therapy. 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 ulceration and osteoradionecrosis, were 42.9% and 2.9%, respectively. It is suggested that relatively high ...
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 radiation therapy (35-45 Gy) (48 cases) and radiation therapy 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 and/or local recurrence, and four (3%) had a ...
Objective A number of effective treatments for bulimia nervosa have been developed, but they are infrequently used, in part due to problems with dissemination. The goal of this study was to examine the cost effectiveness of telemedicine delivery of cognitive behavioral therapy for bulimia nervosa. Method A randomized controlled trial of face-to-face versus telemedicine cognitive behavioral therapy for bulimia nervosa. One hundred twenty eight women with DSM-IV bulimia nervosa or eating disorder, not otherwise specified subsyndromal variants of bulimia nervosa were randomized to 20 sessions of treatment over 16 weeks. A cost effectiveness analysis from a societal perspective was conducted. Results The total cost per recovered (abstinent) subject was $9324.68 for face-to-face CBT, and $7300....
Two patients who developed large intracranial vessel occlusion after standard radiation therapy for brain tumor are described. This form of vascular occlusion is usually seen in patients who have previously been treated by radiotherapy for intracranial tumor who then develop a relatively acute change in neurologic status. Histology of the lesion mimics accelerated focal arteriosclerosis. The clinical and radiographic manifestations of one case were highly atypical. The vasculopathy became evident shortly after termination of radiation therapy for a fourth ventricular ependymoma, and the angiographic picture stimulated a diffuse arteritis. The second patient was more typical, with clinical symptoms developing 12 years after radiation therapy for an oligodendroglioma. Occlusion of a proximal vessel that had been included in the radiation port was demonstrated radiographically and confirmed by pathologic examination. The ...
Two patients who developed large intracranial vessel occlusion after standard radiation therapy for brain tumor are described. This form of vascular occlusion is usually seen in patients who have previously been treated by radiotherapy for intracranial tumor who then develop a relatively acute change in neurologic status. Histology of the lesion mimics accelerated focal arteriosclerosis. The clinical and radiographic manifestations of one case were highly atypical. The vasculopathy became evident shortly after termination of radiation therapy for a fourth ventricular ependymoma, and the angiographic picture stimulated a diffuse arteritis. The second patient was more typical, with clinical symptoms developing 12 years after radiation therapy for an oligodendroglioma. Occlusion of a proximal vessel that had been included in the radiation port was demonstrated radiographically and confirmed by pathologic examination. The ...
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 radiation therapy with monoenergetic electron beams.
Portal localization images for high-energy electron beam therapy are necessary to confirm the treatment field by comparing them with a simulation image obtained before treatment or portal verification images after treatment. In this study, portal localization images were acquired using the computed radiography (CR) system and bremsstrahlung X-rays generated in the electron beam irradiations. All images obtained with phantom and the irradiations of in the electron energy of 8, 10, 12 and 15 MeV were feasible for clinical use. The CR system used in this study included general diagnostic imaging cassette and storage phosphor plate, but none of other special devices. The system can usually supply portal localization images, which maintains the quality assurance of high-energy electron beam therapy. (author)
The aim of this review is to evaluate the role of inflammatory spine disease in patients with chronic back pain. The contribution of imaging modalities for the diagnostic evaluation of back pain is discussed. A systematic literature search based on the classification of seronegative spondyloarthropathies and rheumatoid arthritis was performed. The results of this search and the experiences in a large collective of rheumatological patients are analyzed. The prevalence of rheumatoid arthritis (1-2%) is comparable to that of spondyloarthropathies (1.9%). The etiology of these entities is not fully elucidated. Magnetic resonance imaging is increasingly used for early detection and surveillance of therapy with TNF-#alpha# antagonists. Bone marrow edema, which is only detectable with MRI, represents an early sign of inflammation. Therapy with TNF-#alpha# antagonists is based on clinical and laboratory criteria, and signs of inflammation in MRI. MRI ...
Therapeutic decisions are quite clear-cut for asymptomatic gallstone disease and acute cholecystitis. However, the appropriate therapeutic course for older patients with chronic cholecystitis may be less obvious. Watchful waiting may be reasonable for patients with mild and infrequent symptoms. For healthy patients, cholecystectomy is recommended if symptoms are becoming more frequent and severe. Laparoscopy may reduce the complication rate and be safely performed even in those with underlying medical illness. Oral dissolution therapy can be attempted for qualifying symptomatic patients who are at poor surgical risk or who refuse surgery. Shock wave lithotripsy and contact dissolution therapy show some promise but are currently experimental. PMID:8339941
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 radiation therapy 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 radiation therapy was applied to the spine. A relapse had to be treated again by surgical means combined with postinterventional radiation therapy. A complete relief of the symptoms and control of the lesion could be obtained.
The philosophy pervading the treatment approach to Ewing's sarcoma was to have therapy encompass all foci of disease, including sites of occult or potential involvement in addition to obvious clinical manifestations. The experience with integrated methods of treatment in 66 consecutive patients at the National Cancer Institute is reviewed. A median survival of 18 months (44 percent 2 year survival rate) for patients with recognizable metastases on admission bears impressive witness to the value of adjuvant therapy in Ewing's sarcoma. Even more encouraging, an uncorrected 5 year survival rate of 53 percent (42 percent continuously free of disease) for patients given ''pyrophylactic'', adjuvant therapy indicates the potential for permanent control of disease in a significant fraction of cases with clinically localized primary tumors. (U.S.).
This study investigated dose to bone tissue in electron beam therapy. Measurements were made using films and thermoluminescent dosimeters in a polystyrene phantom containing bone inhomogeneity for 15-MeV, 12-MeV, and 9-MeV electron beams. An increase in dose of approximately 18%, 12%, and 11%, for the three electron energies respectively, relative to the dose in polystyrene, was found for bone material having an electron density (relative to water) of 1.73. Measurements were also made using films for 15- and 9-Mev electrons in a phantom with a mandibular bone and teeth. A dose enhancement in bone of approximately 10% and 7%, respectively, for the two energies was found in the phantom where the electron density of bone was about 1.60. These results suggest that injury to bone is possible in those clinical situations where high doses of electrons are used for therapy.
This study investigated dose to bone tissue in electron beam therapy. Measurements were made using films and thermoluminescent dosimeters in a polystyrene phantom containing bone inhomogeneity for 15-MeV, 12-MeV, and 9-MeV electron beams. An increase in dose of approximately 18%, 12%, and 11%, for the three electron energies respectively, relative to the dose in polystyrene, was found for bone material having an electron density (relative to water) of 1.73. Measurements were also made using films for 15- and 9-Mev electrons in a phantom with a mandibular bone and teeth. A dose enhancement in bone of approximately 10% and 7%, respectively, for the two energies was found in the phantom where the electron density of bone was about 1.60. These results suggest that injury to bone is possible in those clinical situations where high doses of electrons are used for therapy.
In everyday radiotherapy we must carry out the determination of absorbed dose measurement according to JARP's protocol. We explained an outline of JARP's 1974 and 1986 protocol in electron beam therapy, and mentioned it about the matter that should examined. To use it easily in clinic, a simplified procedure based on precisely to JARP's 1986 protocol is practical, the character of this procedure settles briefly the determination of mean incident energy of electron beams and get ready to table of ionization to absorbed dose conversion factor for various ionization chamber. Also, this procedure almost not influence on the accuracy of determination. We described systematically practical procedure for requisite absorbed dose calculation in a patient in electron beam therapy. (author).
Primary percutaneous coronary intervention (PPCI) is superior to thrombolysis (TL) as reperfusion therapy in ST-elevation myocardial infarction (STEMI). TL is a rapidly available, but semi-effective therapy (effective reperfusion in 50% of patients only), whereas PPCI is a potentially delayed, but highly effective therapy (effective reperfusion in >90%). Since TL loses its efficacy beyond 2?3?h after symptom onset, it is a significant reperfusion alternative to PPCI in early presenters only. The individual decision to treat an early presenter with PPCI or TL requires the evaluation of the time delay between potential start of TL or PPCI, the PCI-related delay (PRD). PRD is greatest, if TL is given in the prehospital setting. Until now, prehospital TL as the most rapidly available reperfusi...
In this study we investigated cultural, familial, and individual beliefs that influenced international students? perceptions of therapy and help-seeking behaviors. Included were changes in perception or behavior before and after the students came to the US, and factors that influenced help-seeking behaviors. Six international students from East Asian countries where English is a foreign language, including Taiwan, Mainland China, Japan, and South Korea, were interviewed. We used semi-structured interviews and participant observations for collecting data. The findings indicated changes after students came to the US. Further discussions focus on encouraging and discouraging factors relative to seeing therapists, and culturally sensitive interventions for family therapy clinicians.
Records of 154 patients with Ewing's sarcoma treated at the National Cancer Institute were reviewed to assess the incidence and risk of developing isolated central nervous system (CNS) Ewing's sarcoma. Sixty-two of the 154 patients had received CNS irradiation and intrathecal (i.t.) methotrexate as part of their initial therapy to prevent the occurrence of isolated CNS Ewing's sarcoma. The risk of developing isolate CNS Ewing's sarcoma was greatest within the first two years after diagnosis and was approximately 10%. The overall risk of CNS recurrence in the group of patients receiving DNS treatment was similar to the group receiving no therapy directed to the CNS. The occurrence of isolated CNS involvement was not prevented by the use of CNS irradiation and i.t. methotrexate. Because of a lack of efficacy to the CNS irradiation regimen, current treatment regimens do not include therapy directed to CNS.
A nonviral vector for highly efficient site-specific integration would be desirable for many applications in transgenesis, including gene therapy. In this study we directly compared the genomic integration...Full Text Available
Atypical hemolytic uremic syndrome (aHUS) is a heterogeneous disease that is caused by defective complement regulation in over 50% of cases. Mutations have been identified in genes encoding both complement...Full Text Available
AbstractThe optimal definition of the size, shape and location of gross tumour volume is one of the most important steps in the planning of radiation therapy, and necessitates a proper...Full Text Available
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
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
AbstractThere is an urgent need for innovative therapies against ovarian cancer, one of the leading causes of death from gynecological cancers in the United States. Immunotherapy employing...Full Text Available
Background: Patients with a typical depression are more likely to respond to monoamine oxidase inhibitors than to tricyclic antidepressants. They are frequently offered psychotherapy...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
Two large, prospective, randomized, controlled trials have shown a beneficial effect of intensive insulin therapy (IIT) on the kidney function of critically ill patients. The data from these trials...Full Text Available
Most breast cancers are multicentric in origin. They drain into two primary lymphatic depots—the axilla and internal mammary chain of nodes. The incidence of metastasis to the internal mammary...Full Text Available
Recent reports confirm that, due to the presence of long-lived, latently infected cell populations, eradication of human immunodeficiency virus type 1 (HIV-1) from infected patients by using antiretroviral...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
The difficulties created by the lack of generally accepted views on classification, diagnostic criteria and natural history of the cutaneous lymphomata are discussed. Only the lymphomata which remain...Full Text Available
After lifestyle and behavioral measures to control overactive bladder, the mainstay of pharmacological treatment is the use of antimuscarinic therapy. Overactive bladder predominantly affects older...Full Text Available
PurposeTo date there remains no effective therapy for metastatic melanoma and at the molecular level disease progression remains poorly understood. Recent work by...Full Text Available
Monogenic autoinflammatory diseases encompass a distinct and growing clinical entity of multisystem inflammatory diseases with known genetic defects in the innate immune system. The diseases...Full Text Available
Shoulder pain is a common orthopedic condition seen by physical therapists, with many potential contributing factors and proposed treatments. Although manual physical therapy interventions for the cervicothoracic...Full Text Available
Human antibodies targeting prostate cancer cell surface epitopes may be useful for imaging and therapy. The objective of this study was to evaluate the tumor targeting of an internalizing human...Full Text Available
Total thyroidectomy involving the adjacent structures of the trachea can cause tracheal damage such as early tracheal necrosis. The authors describe the first case of anterior tracheal necrosis following...Full Text Available
Chronic pain patients who show aberrant drug-related behavior often are discontinued from treatment when they are noncompliant with their use of opioids for pain. The purpose of this study was...Full Text Available
Microplanar beam radiation therapy 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
Oxidative stress contributes to the pathophysiology of exposure to heavy metals/metalloid. Beneficial renal effects of some medications, such as chelation therapy depend at least partially on the ability...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 ...
Patients with Alport syndrome progressively lose renal function as a result of defective type IV collagen in their glomerular basement membrane. In mice lacking the α3 chain of type IV collagen...Full Text Available
BackgroundDiscovery of biomarkers that are correlated with therapy response and thus with survival is an important goal of medical research on severe diseases, e.g. cancer. Frequently,...Full Text Available
Lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) are highly prevalent in older men. Medical therapy is the first-line treatment for LUTS associated with BPH. Mainstays...Full Text Available
Although major inroads into making antiretroviral therapy available in resource-poor countries have been made, there is an urgent need for an effective vaccine administered shortly after birth, which...Full Text Available
Recurrent or primary carcinoma of the breast en cuirasse, which may involve the skin of the entire thorax and abdomen, cannot be controlled by means of surgery or conventional local irradiation. The...Full Text Available
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
The etiology of major depression remains unknown, but dysfunction of serotonergic signaling has long been implicated in the pathophysiology of this disorder. p11 is an S100 family member recently...Full Text Available
BackgroundIn β-thalassemia, profound anemia and severe hemosiderosis cause functional and physiological abnormalities in various organ systems. In recent years, there have...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
Incidence of esophageal cancer (EC) is rising more rapidly in the Western world than that of any other cancer. Despite advances in therapy, more than 50% of patients have incurable disease at the time...Full Text Available
BackgroundThe aim of this double-blind randomized study is to test the efficacy of a radio electric stimulator device using an auricular reflex therapy protocol for stress-related...Full Text Available
BackgroundThis study aimed to assess whether endoscopic implantation of an injectable esophageal prosthesis, the Gatekeeper Reflux Repair System (GK), is a safe and effective therapy...Full Text Available
Erectile dysfunction following radical prostatectomy remains a frequent problem despite the development of nerve-sparing techniques. This erectile dysfunction is believed to be neurogenic, enhanced by hypoxia-induced structural changes which result in additional veno-occlusive dysfunction. Recently, daily use of intracavernous vasoactive substances and oral use of PDE5-inhibitors have been clinically studied for treatment of postprostatectomy erectile dysfunction. Since these studies showed benefits of "penile rehabilitation therapy," these effects have been studied in a preclinical setting. We reviewed experimental literature on erectile tissue preserving and neuroregenerative treatment strategies, and found that preservation of the erectile tissue by the use of intracavernous nitric oxide donors or vasoactive substances, oral PDE5-inhibitors, and hyperbaric oxygen therapy improved erectile function by antifibrotic effects and preservation of ...
Idiopathic frozen shoulder is a common medical diagnosis for patients seeking physical therapy. Radiographic and surgical evidence exists that describes the coracohumeral ligament (CHL) as a major contributor...Full Text Available
1 Measuring total plasma levels of disopyramide (DP) and the main metabolite mono-N-dealkyldisopyramide (MND) in patients on maintenance therapy with DP has shown concentrations of MND comparable with...Full Text Available
Eight patients who had received megavoltage therapy for Cushings' disease 5-12 years previously have been reviewed. The long term response to this therapy was assessed with respect to efficacy of treatment in inducing continued remission and disturbance of hypothalamic-pituitary function. One patient showed clear evidence of relapse of Cushings' disease. One patient had unequivocal hypopituitarism. Basal levels of growth hormone (GH), TSH, LH, and FSH were not statistically different from controls, but provocative testing revealed significant abnormalities of response of cortisol/ACTH, GH, prolactin and LH. Six out of eight patients had absent diurnal cortisol variation and five patients had elevated serum prolactin levels. Thus, in this group of patients normal pituitary-adrenal function has not been satisfactorily restored. It is clear that significant disturbances of hypothalamic-pituitary function follow megavoltage ...
Eight patients who had received megavoltage therapy for Cushings' disease 5-12 years previously have been reviewed. The long term response to this therapy was assessed with respect to efficacy of treatment in inducing continued remission and disturbance of hypothalamic-pituitary function. One patient showed clear evidence of relapse of Cushings' disease. One patient had unequivocal hypopituitarism. Basal levels of growth hormone (GH), TSH, LH, and FSH were not statistically different from controls, but provocative testing revealed significant abnormalities of response of cortisol/ACTH, GH, prolactin and LH. Six out of eight patients had absent diurnal cortisol variation and five patients had elevated serum prolactin levels. Thus, in this group of patients normal pituitary-adrenal function has not been satisfactorily restored. It is clear that significant disturbances of hypothalamic-pituitary function follow megavoltage ...
The ability to achieve tumor selective expression of therapeutic genes is an area that needs improvement for cancer gene therapy to be successful. One approach to address this is through the...Full Text Available
BackgroundThe aim of the study was to compare the prevalence and types of HIV-related oral lesions between children and adult Tanzanian patients on HAART with those not on HAART...Full Text Available
BackgroundReplication capacity (RC) of specific HIV isolates is occasionally blamed for unexpected treatment responses. However, the role of viral RC in response to antiretroviral...Full Text Available
Cognitive rehabilitation is an effective intervention for addressing cognitive impairments in patients with schizophrenia. Previous research has shown that the early application of Cognitive...Full Text Available
Voxel-based prescriptions of deliberately non-uniform dose distributions based on molecular imaging, so-called dose painting or theragnostic radiation therapy, require specification of a transformation...Full Text Available
Since the beam width on the helical tomotherapy machine produced by TomoTherapy, Inc. is typically a few centimeters in the longitudinal direction (into the bore), the optimizer must choose...Full Text Available
BackgroundStem cell characteristics are an important feature of human cancer cells and play a major role in the therapy resistance of tumours. Strategies to target cancer stem cells...Full Text Available
BackgroundRetinitis pigmentosa (RP) is characterized by progressive night blindness, visual field loss, altered vascular permeability and loss of central vision. Currently there...Full Text Available
The long-term goal of nuclear transfer or alternative reprogramming approaches is to create patient-specific donor cells for transplantation therapy, avoiding immunorejection, a major complication in...Full Text Available
Neurodegenerative and infectious disorders including Alzheimer’s and Parkinson’s diseases, amyotrophic lateral sclerosis, and stroke are rapidly increasing as population’s...Full Text Available
The 37/67-kd laminin receptor, LAMR, is a multifunctional protein that associates with the 40S ribosomal subunit and also localizes to the cell membrane to interact with the extracellular matrix. LAMR...Full Text Available
BackgroundThe precise mechanisms involved in the initiation and progression of rheumatoid arthritis (RA) are not known. Early stages of RA often have non-specific symptoms, delaying...Full Text Available
BackgroundIntrafractional motion results in local over- and under-dosage in particle therapy with a scanned beam. Scanned beam delivery offers the possibility to compensate target...Full Text Available
1 An in vitro technique is described for measuring the uptake of 86Rb by human erythrocytes. 2 Fifteen patients were treated with digoxin for atrial fibrillation and other fast arrhythmias. 3 86Rb uptake...Full Text Available
In 1871, the observation of yellowish nodules in the enlarged spleen of a cow was considered to be the first reported case of bovine leukemia. The etiological agent of this lymphoproliferative disease,...Full Text Available
BackgroundThe proteomics approach termed proteome pattern analysis has been shown previously to have potential in the detection and classification of breast cancer. Here we aimed...Full Text Available
Tea ranks second only to water as a major component of fluid intake worldwide and has been considered a health-promoting beverage since ancient times. For the past two decades, we and others...Full Text Available
Patients with haemarthros of the knee were examined by MRI and arthroscopy to identify the bleeding source and to determine surgical or conservative therapy. A prospective study was performed on 120 patients who underwent MRI and arthroscopy, point lesions and bleeding sources were documented separately on a standardised form. Arthroscopy demonstrated a ruptured anterior cruciate ligament in 86%, meniscal tears in 55%, disruption of collateral ligaments in 17%, osteochondral lesions in 5% and tears of capsule or plicae in 13%. Disruption of cruciate ligaments caused haemorrhage in all but three cases. In contrast, only meniscal tears located very adjacent to the meniscal basement had bled. Those types of osteochondral lesions caused haemorrhage characterised on MRI by destruction of the subchondral plate and overlying cartilage. Severe lesions of the knee were diagnosed by MRI in 71% to 100%, slight lesions in 13% to 40% of the cases. Single, combined and bland ...
35 patients with ankle sprain were examined by MRI and stress radiographs. 13 were operated afterwards, 22 patients underwent a functional conservative therapy and were examined by MRI and stress radiographs and second time after three months. MRI reports were correct in 12 of 13 operated cases. After conservative therapy we did not find any disrupted ankle ligament. MRI showed intact ligaments thickened by scar. (orig./MG) [Deutsch] 35 Patienten mit klinischem Verdacht auf Aussenbandruptur wurden mit der MRT untersucht. 13 Patienten wurden operiert, 22 konzervativ therapiert. Letztere wurden nach drei Monaten erneut mit MRT und gehaltenen Aufnahmen untersucht. Die MRT-Befunde stimmten in 12 von 13 Faellen mit den operativ erhobenen Befunden ueberein. Nach dreimonatiger konzervativer Therapie waren alle 22 Sprunggelenke stabil. Die rupturierten Baender stellten sich verdickt und durchgaengig dar. (orig./MG)
In this paper we report a case with primarily unspecific arthralgia after surgical therapy of hallux valgus deformity and consecutive reflex sympathetic dystrophy in which MR led to the diagnosis of Lyme disease. (orig.)
Despite the demonstrated clinical efficacy of CD20 monoclonal antibody (mAb) for lymphoma therapy, the in vivo mechanisms of tumor depletion remain controversial and variable. To identify the molecular...Full Text Available
Sixty glaucomatous eyes of 60 patients treated with laser trabeculoplasty as primary therapy were reviewed retrospectively. There were 42 eyes with capsular glaucoma and 18 with simple glaucoma. The...Full Text Available
Penile rehabilitation has been an area of intense study and debate over the last decade. Interest in this topic was stimulated by the observation that erectile dysfunction remained a significant problem after radical prostatectomy despite meticulous nerve-sparing technique. Smooth muscle alterations and fibrotic changes in the penis were identified as the underlying causes of penile atrophy, veno-occlusive dysfunction, and Peyronie's-like changes that were observed after surgery. 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 oral type V phosphodiesterase inhibitors is now commonly used by urologists after radical prostatectomy despite a lack of convincing evidence from randomized, placebo-controlled clinical trials. Use of local therapies to ...
BackgroundHuman immunodeficiency virus type 1 (HIV-1) infection frequently causes neurologic disease, which is the result of viral replication and activation of macrophages and microglia...Full Text Available
A Legionella-like organism (strain 1087-AZ-H) was isolated from a pleural-fluid specimen from a renal transplant patient undergoing immunosuppressive therapy. Growth characteristics and gas-liquid chromatography...Full Text Available
Path analysis was used to determine the interrelationships between postpartum administration of gonadotrophin releasing hormone and cloprostenol and the occurrence of reproductive disease and reproductive...Full Text Available
Bolus infusion of insulin along with a meal is a standard procedure with continuous subcutaneous insulin infusion. Modern insulin pumps allow applying this bolus in four different ways: infusion of...Full Text Available
The development of azole resistance in Candida albicans is most problematic in patients with AIDS who receive long courses of drug for therapy or prevention of oral candidiasis. Recently,...Full Text Available
It is possible to slow down the progression of Alzheimer's disease with pharmacological treatment. When this treatment is given to people with types of dementia that affect the frontal and temporal lobes (Frontotemporal Dementia) the results are discouraging. It is observed that the patients show pronounced restlessness and mania. In this article we describe a nonpharmacological psychosocial approach, music therapy, and how it is possible to work with this method when constitutional, regulative, dialogical, and integrative aspects are included. The focus is on therapeutic singing where well-known songs are applied in order to build up structure and stability and/or as means of arousal regulation. Songs with personal meaning make it possible to acknowledge the person's emotions, breaking the social isolation, and meeting the music therapy participant's psychosocial needs. The clinical approach is an integration of a relational music ...
Immunotherapy has shown promise in a number of tumor types, but its exact role in sarcoma remains to be defined. Advanced bone and soft tissue sarcomas are challenging diseases to treat with an unmet...Full Text Available
ContextResponse Evaluation Criteria in Solid Tumors [RECIST (unidimensional)], World Health Organization [WHO (bi-dimensional)] and European Association for Study...Full Text Available
Neuropilin-1 (NRP1) acts as a co-receptor for class 3 semaphorins and vascular endothelial growth factor and is an attractive angiogenesis target for cancer therapy. In addition to the transmembrane...Full Text Available
The identification of host cell factors for virus replication holds great promise for the development of new anti-viral therapies. Recently, high-throughput screening methods have emerged as...Full Text Available
Human blinding disorders are often initiated by hereditary mutations that insult rod and/or cone photoreceptors and cause subsequent cellular death. Generally, the disease phenotype can be predicted...Full Text Available
BackgroundRecessive mutations in guanylate cyclase-1 (Gucy2d) are associated with severe, early onset Leber congenital amaurosis-1(LCA1). Gucy2d...Full Text Available
Background:Stem cells can differentiate into multiple cell types, and therefore can be used for cellular therapies, including tissue repair. However, the participation of stem cells...Full Text Available
BackgroundSeveral diseases, many of which nowadays pandemic, consist of multifactorial pathologies. Paradigmatic examples come from the immune response to pathogens, in which cases...Full Text Available
BackgroundIn patients with Stage 5 Chronic Kidney Disease who require renal replacement therapy a major decision concerns modality choice. However, many patients defer the decision...Full Text Available
BackgroundHerbs and other dietary supplements are among the most commonly used complementary medical therapies. However, clinicians generally have limited knowledge, confidence and...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
Inhaled corticosteroids (ICS) are often prescribed as first-line therapy for patients with asthma Despite their efficacy and improved safety profile compared with oral corticosteroids, the potential...Full Text Available
SummaryEpigenetic drugs have been shown to enhance gene expression and drug sensitivity in ovarian cancer cell lines and animal models. Based on promising pre-clinical studies,...Full Text Available
Colistin is increasingly used as last-line therapy against Gram-negative pathogens. The pharmacokinetic (PK)/pharmacodynamic (PD) index that best correlates with the efficacy of colistin remains undefined....Full Text Available
BackgroundAn artemisinin-based combination therapy, artesunate (AS) plus sulphadoxine-pyrimethamine (SP), was compared to SP monotherapy to provide evidence of further treatment...Full Text Available
BackgroundDespite numerous treatments available for deteriorated cutaneous wound healing such as a diabetic foot, there is still the need for more effective therapy. Adipose-derived...Full Text Available
Glioblastoma, the most common malignant brain tumor, is among the most lethal and difficult cancers to treat. Although epidermal growth factor receptor (EGFR) mutations are frequent in glioblastoma,...Full Text Available
Background:Continuous renal replacement therapy is used to manage fluid and solute imbalances in critically ill patients but may affect the clearance of concurrently administered...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
Authors developed a C-arm type radiosurgery system of the linear accelerator suitable for stereotactic radiation therapy 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.)
Recent preclinical and clinical data suggest that TP53 status and TP53 mutations may be important in determining tumour aggressiveness and therapy response. In this study we investigate the feasibility...Full Text Available
Lung cancer is the leading cause of cancer deaths worldwide. Standard chemotherapy has been shown to improve quality of life and has a modest influence on overall survival. This modest improvement in...Full Text Available
The results of clinical trials conducted in Europe and North America have been incorporated into treatment strategies for breast cancer in Japan. Despite the use of similar treatment regimens, why has...Full Text Available
Prostatic neoplasms are not uniformly distributed within the prostate volume. With recent developments in three-dimensional intensity-modulated and imageguided radiation therapy, it is possible to treat...Full Text Available
BackgroundLoss to follow-up (LTF) challenges the reporting of antiretroviral treatment (ART) programmes, since it encompasses patients alive but lost to programme and deaths misclassified...Full Text Available
PurposeA major obstacle in glioblastoma (GBM) therapy is the restrictive nature of the blood-brain barrier (BBB). Convection-enhanced delivery (CED) is a novel method...Full Text Available
Clinical applications of genetic therapies, including delivery of short, interfering RNAs (siRNAs) for RNA interference (RNAi), are limited due to the difficulty of delivering nucleic acids...Full Text Available
BackgroundPolyethyleneimine (PEI), which can interact with negatively charged DNA through electrostatic interaction to form nanocomplexes, has been widely attempted to use as a gene...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
Compact dielectric wall (DWA) accelerator technology is being developed at the Lawrence Livermore National Laboratory. The DWA accelerator uses fast switched high voltage transmission lines to generate pulsed electric fields on the inside of a high gradient insulating (HGI) acceleration tube. Its high electric field gradients are achieved by the use of alternating insulators and conductors and short pulse times. The DWA concept can be applied to accelerate charge particle beams with any charge to mass ratio and energy. Based on the DWA system, a novel compact proton therapy accelerator is being developed. This proton therapy system will produce individual pulses that can be varied in intensity, energy and spot width. The system will be capable of being sited in a conventional linac vault and provide intensity modulated rotational therapy. The status of the developmental new technologies that make the compact system possible ...
Objective: To further delineate the clinicopathological and radiological features of solid pseudopapillary tumor (SPT) of the pancreas and summarize the surgical therapy strategy for this tumor. Methods:...Full Text Available
Background & AimsData are conflicting on the benefit of selective serotonin reuptake inhibitors (SSRIs) for patients with irritable bowel syndrome (IBS);...Full Text Available
We presented data showing that the CART-19 cells expressing the 4-1BB signaling domain can have unprecedented and massive in-vivo expansion, traffic to tumor sites, persist long term in vivo, and induce...Full Text Available
Carotid artery stenosis is a major risk factor for stroke, and treatments for this condition to decrease the risk of stroke include medical therapy, carotid endarterectomy (CEA), and, more recently,...Full Text Available
BackgroundInadequate platelet inhibition despite aspirin and clopidogrel therapy during and after a percutaneous coronary intervention is associated with an impaired clinical outcome....Full Text Available
Stem cell therapies for neurodegenerative disorders require accurate delivery of the transplanted cells to the sites of damage. Numerous studies have established that fluid injections to the hippocampus...Full Text Available
The diagnostic accuracy of computed tomography (CT) in several patterns of thoracic and abdominal fatty masses, has been examined. In selected cases our findings overlap the features of the recent literature. The possibility of surgical therapy in peculiar cases of adipose deposits, commonly esteemed benign, is considered.
Low bone mineral density (BMD) is prevalent in human immunodeficiency virus (HIV)–infected subjects. Initiation of antiretroviral therapy is associated with a 2%–6% decrease...Full Text Available
- flushing Chemotherapy - what to ask your doctor Dry Mouth Oral mucositis Peripherally inserted central catheter Radiation therapy - what to ask your doctor Safe drinking during...
Nitric oxide (NO)-based therapies effectively inhibit neointimal hyperplasia in animal models of arterial injury and bypass grafting, but are not available clinically. We created a simple, effective,...Full Text Available
Antiplatelet resistance has been proposed as a possible mechanism to explain recurrent cardiovascular events in patients who have coronary artery disease and who are undergoing dual antiplatelet therapy....Full Text Available
The two categories of anti-albumin antibodies (AAA), namely precipitins (AA-P) and agglutinins (AA-Aggl), were investigated in 260 patients with morphologically diagnosed chronic liver diseases (CLD)....Full Text Available
Oncolytic viruses (OVs) represent a relatively novel anti-cancer modality. Like other new cancer treatments, effective OV therapy will likely require combination with conventional treatments. In order...Full Text Available
Background/AimTobacco use reduces the effect of non-surgical periodontal therapy. Host-modulation with low-dose doxycycline (LDD) might favour repair and promote...Full Text Available
Recombinant adenoviruses have been widely used for various applications, including protein expression and gene therapy. We herein report a new and simple cloning approach to an efficient and robust...Full Text Available
Purpose: Reverse helical cone-beam computed tomography (CBCT) is a scanning configuration for potential applications in image-guided radiation therapy in which an accurate anatomic image...Full Text Available
Purpose: Patients with mycosis fungoides [cutaneous T-cell lymphoma (CTCL)] may benefit from adjuvant therapy after completing total skin electron beam therapy (TSEBT). We report the results for (T1(T2)) CTCL patients treated with adjuvant oral psoralen plus ultraviolet light (PUVA) with respect to overall survival (OS), disease-free survival (DFS), salvage of recurrence, and toxicity. Methods and Materials: Between 1974 and 1993, TSEBT was administered to a total of 213 patients with CTCL. Records were reviewed retrospectively, and a total of 114 patients were identified as having T1 or T2 disease. Radiotherapy was provided via a 6-MeV linac to a total of 36 Gy, 1 Gy/day, 4 days/week, for 9 weeks. Beginning in 1988, patients were offered adjuvant PUVA within 2 months of completing TSEBT. This was started at 0.5-2 J/m"2, 1-2 treatments/week, with a taper over 3-6 months. Therapy then continued once per month. There were 39 ...
The radiotherapy is the prime treatment for the cavum cancer. It is also useful to treat the tumor recurrences, in this case the reirradiation stays the only efficient therapy option to give a correct local control. The reirradiation, exclusive or in association with other therapies can contribute to the local control of cavum cancer recurrences with a survival rate at five years of 36 to 58%. (N.C.)
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).
Of the radionuclides with physical properties most suited for use with monoclonal antibody for tumor imaging or therapy, few are more available or desirable than Pb-203, 212 and Bi-212. Yet no clinical studies have as yet been possible solely due to the lability in vivo of known complexes. We now report that bismuth complexes of the ligands p-SCN-Bz-DOTA and p-SCN-Bz-trans-cyclohexylDTPA are effective at protecting Bi-206 from release when linked to immunoproteins. Practicable, efficient ligand syntheses will be reported. Initial studies reveal that antibody is labeled efficiently with radiolead DOTA complexes. Preliminary studies indicate stability in vivo.
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.
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 long and resource intensive process of drug discovery and development is confronted with the basic challenge of providing effective and safe therapies at reasonably low costs. The better the mechanism of a disease is known, the higher the probability to find an appropriate therapy. Also, the better and earlier a disease can be diagnosed and characterized, the higher the chance to be able to interfere in this process with a chemical entity. This reasoning sets the framework for the use of imaging in drug discovery. We discuss the relevance of magnetic resonance imaging and spectroscopy to derive anatomical, functional, metabolic and target-related information in the context of pharmacological research in vivo. (author)
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)
Comparison of dosimetry measured in a noncylindrical Rando-Alderson phantom by two-field, four-field, and six-field total-skin electron-beam therapy (TSEBT) techniques with our dual-field rotational (DFR) technique reveals a superior dosimetry for the latter. Our technique of dual-field rotational DFR-TSEBT is described in detail, and its advantages and indications for the primary management of cutaneous T-cell lymphoma (CTCL) and Kaposi's sarcoma (KS) are discussed.
Carcinoma en cuirasse of the breast, which invades the skin via lymphatics and may encase the entire thorax and abdomen, is poorly controlled by surgery, chemotherapy, or conventional irradiation. Palliation of patients with breast carcinoma en cuirasse is a difficult clinical problem which must be effectively managed over extended periods due to the indolent nature of this disease. The management of three cases is reported, and the new technique of rotational subtotal skin electron-beam therapy (SSEBT) is presented. (author).
In this paper, we put forward a systematic method to analyze, control and evaluate the safety issues of medical robotics. We created a safety model that consists of three axes to analyze safety factors. Software and hardware are the two material axes. The third axis is the policy that controls all phases of design, production, testing and application of the robot system. The policy was defined as hazard identification and safety insurance control (HISIC) that includes seven principles: definitions and requirements, hazard identification, safety insurance control, safety critical limits, monitoring and control, verification and validation, system log and documentation. HISIC was implemented in the development of a robot for urological applications that was known as URObot. The URObot is a universal robot with different modules adaptable for 3D ultrasound image-guided interstitial laser coagulation, radiation seed implantation, laser resection, and electrical ...
The solid-pseudopapillary tumor (SPT) of the pancreas is a rare type of exocrine pancreatic neoplasm. SPT predominantly affects young women and female children, and is usually discovered incidentally. This tumor is generally benign with a low incidence of malignancy. A 13-year-old girl was admitted to the hospital with a few weeks' history of mild abdominal pain and jaundice. On physical examination, there was no palpable mass. The laboratory tests showed increased SR, CRP, high bilirubin, amylase and lipase serum levels. Ultrasound imaging revealed a solid lesion in the region of the pancreatic head. On MRI, precise tumor localization in the head of the pancreas with pancreatic duct dilatation and compression of the common bile duct were visualized. Pancreaticoduodenectomy and cholecystectomy was performed with good clinical outcome. Microscopic and immunohistochemical studies indicated that tumor cells were typical of SPT without any signs of malignancy. After ...
The mortality in undrained abdominal abscesses is high with a mortality rate ranging between 45 and 100%. The outcome in abdominal abscesses, however, has improved due to advances in image guided percutaneous interventional techniques. The main indications for the catheter drainage include treatment or palliation of sepsis associated with an infected fluid collection, and alleviation of the symptoms that may be caused by fluid collections by virtue of their size, like pancreatic pseudocele or lymphocele. The single liver abscesses may be drained with ultrasound guidance only, whereas the multiple abscesses usually require computed tomography (CT) guidance and placement of multiple catheters. The pancreatic abscesses are generally drained routinely and urgently. Non-infected pancreatic pseudocysts may be simply observed unless they are symptomatic or cause problems such as pain or obstruction of the biliary or the gastrointestinal tract. Percutaneous routes that ...
Fiber delivered laser pulses emulsify thrombus by mechanical stresses that include a combination of pressure, tension and shear stress. Laser radiation is delivered to the locality of a thrombus and the radiation is absorbed by blood, blood dot, or other present materials. The combination of a leading pressure wave and subsequent vapor bubble cause efficient, emulsification of thrombus. Operating the laser in a low average power mode alleviates potential thermal complications. The laser is operated in a high repetition rate mode to take advantage of ultrasound frequency effects of thrombus dissolution as well as to decrease the total procedure time. Specific parameter ranges for operation are described. The device includes optical fibers surrounding a lumen intended for flow of a cooling agent. The fibers may be arranged concentrically around the lumen to deliver radiation and heat over as large an area as possible. An alternative design approach incorporates the ...
SommarioScopo Valutare limpatto clinico negli anni dellecografia intraoperatoria (IOUS) nella identificazione delle metastasi epatiche rispetto alle altre metodiche di imaging. Materiali e metodi risultati delle ecografie intraoperatorie effettuate per lidentificazione delle metastasi epatiche in un periodo compreso tra gli anni 2000 e 2006 sono stati retrospettivamente revisionati e comparati con le metodiche di imaging preoperatorio: Ecografia (US), Tomografia Computerizzata (TC) e/o Risonanza Magnetica (RM). Tutti i casi sono stati patologicamente provati. Sono stati calcolati per anno i casi discordanti in termini di presenza/assenza di lesione focale epatica. Il confronto statistico e stato effettuato con il test di McNemar. Un valore del p<0,05 e stato considerato statisticamente sig...
The diagnostic imaging findings in hepatic amoebiasis and the capabilities of percutaneous drainage have already been described but some debate is open on both diagnosis and treatment. It is reported the experience with the ultrasound (US) and Computed Tomography (CT) studies of the hepatic amoebic abscess and its management. [Italian] I reperti con diagnostica per immagini nell'amebiasi epatica e le possibilita' del drenaggio percutaneo sono stati gia' illustrati; esistono tuttavia controversie sul piano sia diagnostico che terapeutico. Obiettivo di questo lavoro e' quello di riportare l'esperienza personale nella diagnostica con ecografia e tomografia computerizzata (TC) e nel trattamento degli ascessi amebici del fegato.
Materials and methods: 12 patients with 22 coronary bypass grafts underwent intraoperative flow quantification using the transit time ultrasound method. These values were compared to postoperative MR phase shift measurements. Flow measurements were performed preoperatively in 28 coronary arteries of 20 patients. For flow measurement, we used a velocity-encoded k-space segmented gradient echo sequence with a temporal resolution of 110 or 125 ms, respectively. 6-8 pase shift images could be acquired during one cardiac cycle. Results: There was a significant correlation between intraoperative and flow measurements using velocity-encoded MR imaging (r=0.76, p<0.0001, t-test). Flow volumes determined by MR imaging were systematically larger than those determined by the transit time ultrasound method. Mean flow in coronary arteries was reduced in severely stenosed vessels (>70%) compared to normal vessels. Intra- and interobserver ...
Purpose: To evaluate the effect of low-dose radiation therapy 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 radiation therapy. 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 received whole-lung irradiation to 1400 ...
Clinical studies have proved the effectiveness of local ablading methods in pations with non-resectable liver metastases of a colorectal carcinoma. RF ablation and LITT are a potentially curative therapy option and an alternative to systemic chemotherapy; the latter is carried out primarily for reducing tumour size with the goal of secondary resectability. The number of R0-sesectable metastases can be enhanced by a combined therapy of surgery and local ablading methods, e.g. by preoperative, intraoperative or postoperative ablasion of further non-resectable tumours during surgery. Systemic chemotherapy combined with surgery as an adjuvant method is not recommended unless in cases of non-abladable tumour recidivation. Currently, systemic chemotherapy is used as a neo-adjuvant therapy for tumour size reduction with the goal of secondary resectability or, in case of inoperability, local ablation. (orig.) [German] Abladierende ...
Purpose: Evaluation of the diagnostic efficacy and cost-benefit of contrast enhanced CT (CT) and MRI pre- and post-SPIO-particles in focal hepatic disease with consideration of therapeutic outcome. Results: In 34/52 (65.4%) of the cases the correct diagnosis was primarily stated by CT (sensitivity [se.] 85.2%, specificity [sp.] 44.0%). In additional 10/52 of the cases unenhanced MRI (se. 91.4%, sp. 75.0%) enabled correct diagnoses, and in another 6 cases the diagnosis was established only by SPIO-MRI (se. 100%, sp. 86.7%). Considering the possible therapeutic recommendation arising from each modality, CT would have induced needless therapy costs of 191,042 DM, unenhanced MRI of 171,035 DM, and SPIO-MRI of 7,311 DM. In comparison to the real therapy costs of 221,873 DM, this would have corresponded to an unnecessary increase of therapy costs of 86.1%, 77.1%, and 3.3%, respectively. In two cases (91 hemangioma, 1 regenerative ...
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 + Radiation therapy 92.6%, Radiation therapy 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 16.6%, other sites 40.9%), and to local treatment (Radiation ...
Brain glucose metabolism was evaluated in four patients with acquired immunodeficiency syndrome (AIDS) dementia complex using ["1"8F]fluorodeoxyglucose (FDG) and positron emission tomography (PET) scans at the beginning of therapy with 3'-azido-2',3'-dideoxythymidine (AZT, zidovudine), and later in the course of therapy. In two patients, baseline, large focal cortical abnormalities of glucose utilization were reversed during the course of therapy. In the other two patients, the initial PET study did not reveal pronounced focal alterations, while the post-treatment scans showed markedly increased cortical glucose metabolism. The improved cortical glucose utilization was accompanied in all patients by immunologic and neurologic improvement. PET-FDG studies can detect cortical metabolic abnormalities associated with AIDS dementia complex, and may be used to monitor the metabolic improvement in response to AZT treatment.
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 radiation therapy. 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 radiation therapy 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 dose distribution around {sup 60}Co ...
We report a patient who developed occlusion of the intracranial major arteries induced by radiation therapy 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 radiation therapy 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 carotid angiography showed complete ...
We report a patient who developed occlusion of the intracranial major arteries induced by radiation therapy 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 radiation therapy 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 carotid angiography showed complete ...
Between 1984 and 1988, seven women with breast cancer were treated with intraoperative electron beam therapy (IOEBT). All patients were Caucasian. Patient age ranged from 37 to 62 (median 53) years. Histopathology was infiltrating duct carcinoma (6/7) or medullary carcinoma (1/7). Four tumors were staged T1 N0 MO, one T1 N1 MO, one T2 N1 MO, and one lesion was recurrent. At the time of primary lumpectomy or axillary node dissection, a dose of 10 or 15 Gy IOEBT was administered to the tumor bed with 6 or 9 MeV electrons through the lumpectomy wound. All patients received 45 or 50 Gy over five to six weeks with 6 MV photons to the breast and, in four patients, to the regional nodes. Three patients received adjuvant chemotherapy and tamoxifen. No post-operative complications were observed. All patients are alive as of August, 1989, with no evidence of recurrent disease. Excellent cosmesis is the rule. Clinical and technical aspects of treatment are presented along ...
The present work was carried out to illuminate the relation between high cholesterol diet and incidence of prostate caner. Also, in this study, the effect of DHEA, selenium or oxygen therapy were tested in order to show to what extent they are valid to ameliorate the deleterious effects of prostate cancer. The obtained results revealed that prostate cancer caused a significant (p<0.01) elevation of TAP, PAP, PSA, total cholesterol, triglyceride, HDL-cholesterol and LDL-cholesterol and prostate COX-2, whereas, testosterone, free testosterone, DHEA-S, FT_4 and FT_3 were decreased significantly as compared with the corresponding levels in control rats in both normal and high cholesterol diet. Supplementation of DHEA, selenium or oxygen therapy ameliorated all variables recorded herein but, their values did not revert to normal. Any how, the results of this investigation showed that the above mentioned antioxidants possess potential benefits in ...
In the treatment of prostatic cancer using a newly proposed intermittent multiportal therapy (DIMT), acute reactions, change in tumor marker levels, and complications more than 6 months after treatment were evaluated. From June 1989 to September 1990, 26 patients with prostatic cancer (stage A2, 3 patients; B, 9; C, 2; D, 10; recurrence, 2) were treated. Fifteen patients were followed up for more than one year, with a mean period of 11.6 months. The treatment schedule is 52.5 Gy in 16 fractions in 4 weeks for radical treatment, and 30.0 Gy in 8 fractions in 2 weeks for palliative treatment. The 360 degree rotation about the patient was divided into 16 fractions, and 2 opposing fractions were used in one day as parallel opposed portals to treat the target volume. The fractions were serially treated one per day, so that 8 treatment days produced a total dose of distribution similar to that for conventional conformational therapy. The size of the ...
Background: Recent series describing the clinical presentation, response to therapy, and long-term outcome of Zollinger-Ellison syndrome are limited. Aims: To assess the clinical characteristics and long-term outcome of patients with Zollinger-Ellison syndrome. Methods: Over a 20-year period, patients with Zollinger-Ellison syndrome were enrolled in a prospective trial evaluating the efficacy of lansoprazole. Following dose stabilization, patients were followed on a 6-monthly basis with interval history, physical examination, endoscopy with gastric biopsies, gastric acid analysis and laboratory studies. Results: 72 patients (mean age 54+/-12 years, % male 58%, % Caucasian 69%) were prospectively enrolled. The clinical presentation was stereotypical for Zollinger-Ellison syndrome. Symptoms ...
We present our initial experience with a new biodegradable (BD) esophageal stent in two patients, one for a therapy-resistant benign esophageal stricture, and the other as a temporary measure during curative radiotherapy for oesophageal carcinoma. The BD stents need to be loaded into a conventional pull-back delivery system but are then placed in a standard fashion. Pre-dilatation should be avoided to reduce the risk of migration, however if migration occurs the stents can be left to dissolve in the stomach. The stents are radiolucent but easily identified on CT with minimal artefact and thus might even aid with radiotherapy planning. BD stents offer an exciting new strategy for therapy-resistant benign strictures as well as a supportive measure for oesophageal cancer undergoing non-surgical treatment. (orig.)
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 therapy and the various components and steps required for ...
Patients with acute myocardial infarction (AMI) and diabetes mellitus, as well as patients admitted with elevated blood glucose without known diabetes, have impaired outcome. Therefore intensive glucose-lowering therapy with insulin (IGL) has been proposed in diabetic or hyperglycaemic patients and has been shown to improve survival and reduce incidence of adverse events. The current manuscript provides an overview of randomised controlled trials investigating the effect of IGL. Furthermore, systematic glucose?insulin?potassium infusion (GIK) has been studied to improve outcome after AMI. In spite of positive findings in some early studies, GIK did not show any beneficial effects in recent clinical trials and thus this concept has been abandoned. While IGL targeted to achieve normoglycaemi...
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)
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 main goal of local drug delivery is to increase the concentration of a specific therapeutic agent in a target tissue with minimal nontarget distribution. Compared to systemic therapy, local drug delivery provides a high level of therapeutic efficacy with minimal systemic effects. The current primary imaging modality for drug delivery has been x-ray angiography, but it has major limitations including anatomical ambiguity and inability to visualize the targeted tissues. Due to these inherent problems, MR guidance has been explored as an alternative imaging modality for guiding and monitoring of drug therapy. Recently, interventional MR (XMR) systems have been implemented that have both dual x-ray and MRI capabilities in a single suite and allow for real-time interventional procedures to ...
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.
BACKGROUND: Epinephrine injection is the most common endoscopic therapy for peptic ulcer bleeding. Controversy exists concerning the optimal dose of proton pump inhibitors (PPI) for patients with bleeding peptic ulcers after successful endoscopic therapy. The objective of this study was to determine the optimal dose of PPI after successful endoscopic epinephrine injection in patients with bleeding peptic ulcers. METHODS: A total of 200 peptic ulcer patients with active bleeding or nonbleeding visible vessels (NBVV) who had obtained initial hemostasis with endoscopic injection of epinephrine were randomized to receive omeprazole 40 mg infusion every 6 h, omeprazole 40 mg infusion every 12 h or cimetidine (CIM) 400 mg infusion every 12 h. Outcomes were checked at 14 days after enrollment. RE...
This study emphasizes the need for a systematic and in-depth connection between the progress in quantum theory of energetic ion collisions and applications to hadron therapy. Scattering theory for fast ion beams has reached its stage of development where accurate and robustly applicable methodologies can advantageously be exported to applied fields such as space research, fusion energy program, medicine, etc. In particular, distorted wave collision theories at high energies readily provide total, partial and fully differential cross sections for inelastic collisions of ionic projectiles with any target system. By numerous and thorough testings, such theoretical cross sections were found to exhibit excellent agreement with experimental data on atomic targets. Adequate extensions of these me...
Abstract Tumor necrosis factor (TNF)- is a pro-inflammatory cytokine associated with psoriasis pathogenesis. Anti-TNF- therapies are effective in psoriasis. A significant weight gain has been reported in patients treated with anti-TNF- agents. The aim of the present study was to evaluate the body composition changes in psoriatic patients receiving anti-TNF- therapies according with disease phenotype. Forty patients affected with psoriasis were followed up for 24 weeks and divided into two groups: psoriasis vulgaris (PsO) and psoriatic arthritis (PsA). Anthropometric, blood biochemical, body composition parameters, resting metabolic rate, and disease activity indexes were measured at baseline and at week 24. After 24 weeks of anti-TNF- administration, the disease activity indexes and concen...
Effect of different factors on survival of patients with Ewing sarcoma (20 people), primary bone reticulosarcoma (43) and myeloma (10) of pelvic bones, has been studied. Independently of the method of treatment, the rate of 3-year survival from reticulosarcoma start constituted (31.5+-7.1)%, Ewing sarcoma - (33.0+-10.8)%, myeloma - (36.0+-15.9)%. Index of 5-year survival in case of reticulosarcoma constituted (20.9+-6.4)%, Ewing sarcoma - (23.6+-11.0)%, myeloma - (36.0+-15.9)%. Improvement of delayed results after prophylactic therapy courses is pointed out. Degree of pelvic bone affection is of a very important prognostic value.
The treatment of chronic pain conditions continue to present a challenge to the medical field. Physical therapy treatment needs to approach the management of chronic pain differently than the approach used to resolve acute pain. Patients with chronic pain often have many factors that have perpetuated the pain condition. These factors, as well as pain itself, influence their ability to reactivate and perform functional daily activities. Physical therapists can begin to address some of the factors, including fear and deconditioning, by building confidence and body awareness in a self-care model including a slow graduated reactivation program. There is evidence that patients with chronic pain conditions have altered motor control that may be influencing reoccurrences and possible flares of pa...
Purpose. To compare erectile function (EF) recovery of patients treated by early penile rehabilitation therapy (PRT) with sildenafil and with control group. Method. Forty men treated by bilateral nerve sparing radical prostatectomy (NSRP) and with a normal pre-operative EF were enrolled. Fourteen days after surgery, they were randomised to a flexible-dose sildenafil group and to a control group. The International Index of Erectile Function (IIEF) questionnaire was completed before surgery and at 3, 6, 12 and 24 weeks after NSRP. Results. In the group treated, the mean IIEF score before surgery was 26.2 and 14.1, 16.2, 22.5 and 25.2 at 3, 6, 12 and 24 weeks after NSRP, respectively. In the control group, the respective scores were 26.5 and 12.4, 15.8, 15.3 and 17.4. There was a significant ...
Introduction: Restrictions in prescribing broad spectrum antimicrobials have been part of a strategy to reduce Clostridium difficile cases in the UK in recent years. However, there has been little work on assessing the safety of alternative antimicrobial agents. Methods: We performed an uncontrolled prospective observational survey over a 1-year period to determine the effectiveness and safety of a new antimicrobial stewardship programme in a district hospital in the UK. Results: In total, 227 Gram-negative bacteraemias (203 episodes) occurred in the study period. Guidelines were adequate in 194 of 203 (95%) episodes and 163 episodes (80.2%) received adequate therapy. Patients in the inadequate therapy group had >2-fold increased likelihood of death [odds ratio (OR) = 2.63, 95% confidence ...
Asthma, affecting as many as 400 million individuals worldwide, is one of the most prevalent chronic health condition in the United States. With an increasing number of patients with asthma and the frequent inability of conventional lifestyle modification and therapy to effectively control the problem, nutritional and dietary therapies are being sought. This study was undertaken to investigate the efficacy of the purple passion fruit peel (PFP) extract, a novel mixture of bioflavonoids, on asthma symptoms. Patients with asthma were studied in a 4-week randomized, placebo-controlled, double-blind trial with oral administration of PFP extract (150 mg/d) or placebo pills. The effects of PFP extract were evaluated by assessing the clinical symptoms of asthma and spirometry tests. Most clinical...
Allogeneic stem-cell transplantation (SCT) is potentially curative therapy in AML by providing both dose-intensive chemo-radiotherapy and induction of graft-versus-leukemia (GvL) effect. Historically, more emphasis was given to the intensity of conditioning. Over the last decade the pendulum turned more towards induction of GvL as the primary goal. A plethora of non-myeloablative (NMA) and reduced-intensity conditioning regimens (RIC) were introduced trying to reduce transplant-related toxicities and allow SCT in elderly and medically infirm patients. In addition, reduced-toxicity myeloablative regimens (RTC) based on fludarabine and myeloablative alkylating-agent doses were designed to allow safer administration of dose-intensive therapy. Conditioning dose-intensity is highly correlated w...
Abstract Background. Complementary and alternative medicine (CAM) use is common among breast cancer patients. Several CAM therapies may have negative side effects or interact with conventional therapies. We studied biologically based CAM use with and without vitamins/minerals in relation to patient and tumor characteristics as well as treatment in an ongoing prospective cohort of 855 primary breast cancer patients. Methods. Patients from two hospitals in southern Sweden were included. Pre-operative and follow-up questionnaires containing questions on food intake, lifestyle, and concomitant medications, including natural remedies, were completed up to five years postoperatively. Clinical information was obtained from clinical records and tumor characteristics from pathology reports. Results...
Antibodies directed against markers on cancer cells are gaining in importance for the purpose of targeting diagnostic and therapeutic agents. In the past, this approach has had very limited success principally because the classical methods for producing antibodies from blood serum of animals immunized with cancer cells or extracts were unsatisfactory. The situation has changed dramatically since 1975 following the design of procedures for 'immortalizing' antibody-producing cells (lymphocytes) by fusing them with cultured myeloma cells to form hybridomas which continuously secrete antibodies. Since these hybridomas produce antibodies coded for by a single antibody-producing cell, the antibodies are called monoclonal. Building on these advances in biomedical research, it is now possible to reproducibly manufacture monoclonal antibodies on a scale suitable for use in cancer detection and therapy.
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 radiation therapy (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...
One of the research challenges in oncology is to develop new biochemical methods for noninvasive tumor therapy evaluation to determine whether the chemotherapeutics is effective. Vascular endothelial growth factor (VEGF) was labeled with radioiodine and evaluated in vitro as well as in vivo, using A2058, a melanoma cell line overexpressing VEGFR-1 and -2. Saturation binding analysis with [{sup 125}I]-VEGF resulted in a K {sub d} of 0.1 nM. Internalization assays indicate the preserved ligand induced internalization and metabolization of the tracer. Biodistribution studies with [{sup 123}I]-VEGF in wild type and A2058 tumor-bearing athymic mice showed low background activity and a tumor to reference tissue ratio of maximum 6.12. These results suggest that [{sup 123}I]-VEGF is a potentially suitable tracer for tumor therapy evaluation.
The author discusses the pervasive difficulty psychotherapists seem to have in discussing patient morality, relating it to the fear of imposing (and feeling) shame and guilt. A way of nonjudgmentally discussing moral values with patients is presented, which places emphasis not on moral abrogations, but rather on the "virtues" of altruism, responsibility, justice, egalitarianism, and honesty. Drawing on empirical studies of prosocial behavior, the author gives a rationale for how these virtues may, whether the therapist is conscious of it or not, be inherently promoted through the group therapy process. Ways are suggested by which the therapist can help the group deal with thorny moral issues and confront the morally confused patient without causing shame. PMID:8473062
Discovery of better biomarkers for diagnosis, prognosis, and therapy-response prediction is the most critical task of a scientific quest aimed at developing newly designed, tailor-made therapies for patients with cancer. Consequently, a proteome wide analysis, in addition to genomic studies, is an absolute requirement for a complete functional understanding of tumor biology. Ultra-sensitive, high-performance Fourier transform ion cyclotron resonance (FTICR) mass spectrometry (MS) currently holds an important role in fulfilling the demands of biomarker discovery. In this review, we describe the applicability of FTICR MS for breast cancer proteomics, particularly for the analysis of complex protein mixtures obtained from a limited number of cells typically available from clinical specimens.
Context. Cardiovascular medication overdoses can be difficult to treat. Various treatment modalities are currently recommended. Objective. To describe patient outcomes and adverse events of high-dose insulin therapy in consecutive overdose patients in cardiogenic shock after implementation of a high-dose insulin protocol (1-10 U/kg/h, while avoiding or tapering off vasopressors). Methods. This is an observational consecutive case series of patients identified from a registry. Data were collected by retrospective chart review of patients treated by our toxicology service with this protocol from February 2007 until March 2010. Results. Twelve patients were treated with high-dose insulin. The mean age was 36.5 years (SD 11.7). Seven patients had pre-existing vasopressor therapy, and all were ...
"Pillar pain" is a relatively frequent complication after surgical release of the median nerve at the wrist. Its etiology still remains unknown although several studies highlight a neurogenic inflammation as a possible cause. Pillar pain treatment usually includes rest, bracing and physiotherapy, although a significant number of patients still complain of painful symptoms two or even three years after surgery. The aim of this study was to investigate the efficacy of low-energy, flux density-focused extracorporeal shock wave therapy (ESWT) in the treatment of pillar pain. We treated 40 consecutive patients with ESWT who had pillar pain for at least six months after carpal tunnel release surgery, and to our knowledge, this is the first study that describes the use of ESWT for treating this c...
Purpose: In this paper, we present an alternative to the originally proposed technique for the delivery of spatially fractionated radiation therapy (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...
This document is the report of a task group of the Radiation Therapy 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 methodology in clinical dosimetry for radiation oncology patients ...
Abstract Background Atopic dermatitis (AD) affects health and quality of life and it has great impact on both health-care costs and costs to the society. Objectives The objective of this study was to develop a model to analyse the cost-effectiveness of a barrier-strengthening moisturizing cream as maintenance therapy compared with no treatment after initial treatment with betamethasone valerate in adult patients with AD in Sweden. A further aim was to apply a similar health-economic analysis for Denmark, Norway and Finland. Methods A Markov simulation model was developed including data from three sources: (i) efficacy data from a randomized controlled trial including patients with moderate AD treated with either a moisturizing cream or no treatment, (ii) resource utilization and quality of...
Summary Objectives To describe the pattern of incident illness in children after initiation of antiretroviral therapy (ART) in a large public health sector programme in Lusaka, Zambia. Methods Systematic chart review to retrospectively extract data from medical records of children (i.e. <15 years) initiating ART in the Lusaka, Zambia public sector. Incident conditions were listed separately and then grouped according to broad categories. Predictors for incident diagnoses were determined using univariate and multivariable analysis. Results Between May 2004 and June 2006, 1705 HIV-infected children initiated ART. Of these, 1235 (72%) had their medical records reviewed. Median age at ART initiation was 77 months and 554 (45%) were females. Eight hundred and forty-one (68%) children had an inc...
Summary Background- Treatments that achieve sustainable steroid-free clinical remission in Crohn-s disease are needed; however, long-term steroid-sparing efficacy data are limited. Aim- To evaluate steroid-sparing efficacy and the impact of steroid discontinuation on adverse events during treatment of Crohn's disease with adalimumab in the phase III randomised, double-blind 1-year CHARM trial and for an additional 2-years in its open-label extension ADHERE. Methods- Steroid-free remission and response and steroid-sparing (-50% steroid dose reduction) remission rates were evaluated over 3-years in patients who were taking corticosteroids at CHARM baseline. Results- Of 778 patients randomised in CHARM (including those who did not achieve clinical response to open-label induction therapy), 31...
Glioblastoma multiforme is the most aggressive form of human brain tumor, which has no effective cure. Previously, we have demonstrated that overexpression of the C-terminal fragment of the human telomerase reverse transcriptase (hTERTC27) inhibits the growth and tumorigenicity of human cervical cancer HeLa cells. In this study, the therapeutic effect and molecular mechanisms of hTERTC27-mediated cancer gene therapy were further explored in vivo in established human glioblastoma xenografts in nude mice. We showed that intratumoral injection of adeno-associated virus carrying hTERTC27 (rAAV-hTERTC27) is highly effective in reducing the growth of the subcutaneously transplanted glioblastoma tumors. Histological analyses showed that rAAV-hTERTC27 treatment leads to profound necrosis, apoptosi...
A non-resonant RF cavity loaded with amorphous alloy cores has been designed and tested. The cavity has a re-entrant structure loaded with 8 amorphous alloy toroidal core and its characteristic impedance is designed as 450 Omega . The RF power is fed by 1 kW solid state amplifier using a step-up transformer with 1:9 impedance ratio. In the high power test, an accelerating gap voltage of more than 900 V was measured with input power of 1 kW in the frequency range of 1 to 10 MHz. The voltage standing wave ratio (VSWR) was less than 2.0. The results prove that the cavity may be used successfully within a compact proton synchrotron for a cancer therapy facility. (3 refs).
The clinical manifestation of wounds of the heart is determined by the mode, site and size of the injury as well as the structure of the pericardial and myocardial lesion. Diagnosis can be confirmed by ECG and echocardiography. Only 20% of the patients with penetrating wounds of the heart live for more than 30 minutes. Pericardio-centesis should be used only to gain time for a safe sternotomy, cardiac decompression and suture of the wound of the heart. An aggressive surgical approach is mandatory. Cardiopulmonary bypass is necessary only to correct of concomitant lesions. PMID:1983618
Success in improving treatment outcomes in childhood cancer has been achieved almost exclusively through multicenter and multidisciplinary clinical and applied research over several decades. While biologically rational as well as empirical approaches have led to combination chemotherapy and multimodality approaches to therapy, which have given rise to evidence-based practice standards, similar scientific rigor has not always been as evidently applied to modalities utilized to assess initial disease burden and, more important, response to investigational approaches to therapy. As the empirical approach to therapeutic advances has likely maximized its benefit, future progress will require translation of biologic discovery most notably from the areas of genomics and proteomics. Hence, attempts to improve efficacy of therapy will require a parallel effort to minimize collateral damage of future therapeutic approaches, and such ...
Lymphomatous processes involving the skin can be managed effectively by total skin electron beam irradiation. A technique using weekly doses (400 rad for each of 6 successive weeks) has been employed...Full Text Available
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).
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.
Chronic HTLV-I (human T cell lymphotropic virus type I) infection may cause adult T cell leukemia/lymphoma (ATL), a disease with dismal long-term prognosis. The HTLV-I transactivator, Tax, initiates...Full Text Available
Telavancin is a bactericidal lipoglycopeptide with a multifunctional mechanism of action. We conducted a randomized, double blind, active-control phase II trial. Patients ≥18 years of age with...Full Text Available
The synthesis of novel b-functionalized derivatives of the clinically used photosensitizer Temoporfin has been achieved by nucleophilic addition reactions to a corresponding diketo chlorin. The b-substituted dihydroxychlorin products exhibit a strong absorption in the red spectral region, a high singlet oxygen quantum yield, and were found to be highly effective in in vitro assays against HT-29 tumor cells.
The paper is concerned with the results of a morphological study following chemoradiotherapy in 25 patients with Ewing's sarcoma and 14 patients with reticulum cell carcoma. The signs of therapeutic pathomophosis were observed in the first 3 days, and substitution of the connective tissue for a necrotized tumor started by the 3rd-4th week after the initiation of therapy. In some cases tumor growth and recurrences at the site of a treated tumor were observed.
BackgroundHIV infection causes a qualitative and quantitative loss of CD4+ T cell immunity. The institution of anti-retroviral therapy (ART) restores CD4+ T...Full Text Available
The evaluation of radiotherapy and surgery as exclusive local treatment in comparably selected subgroups of patients with Ewing's sarcoma on the basis of the CESS 86-data. In the German multicenter Ewing's sarcoma study CESS 86, treatment consisted for four 9-week-courses of VACA- or VAIA-chemotherapy plus local therapy. VACA (vincristine, actinomycin D, cyclophosphamide, adriamycin) was given in low-risk extremity tumors with a tumor volume below 100 cm"3. Highrisk patients with central lesions or a tumor volume >100 m"3 received VAIA (ifosfamide instead of cyclophosphamide). Local therapy started after one complete chemotherapy course in week 10. Based on an individual decision in each patient, local therapy was either radical surgery or resection plus postoperative irradiation with 45 Gy or definitive radiotherapy with 60 Gy. Because of poor results with radiotherapy in a preceeding study, it was intended to restrict ...
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.
Resistance exercise has been widely reported to have positive rehabilitation effects for patients with neuromuscular and orthopaedic conditions. This paper presents an optimal design of magneto-rheological fluid dampers for variable resistance exercise devices. Adaptive controls for regulating the resistive force or torque of the device as well as the joint motion are presented. The device provides both isometric and isokinetic strength training for various human joints.
Two patients receiving maintenance dialysis therapy developed osteonecrosis, the first in the humeral head and the second in the talus. Both patients lacked known risk factors for developing osteonecrosis. A possible pathogenic role of secondary hyperparathyroidism in this disorder is suggested. Rheumatologists evaluating patients receiving maintenance dialysis with rheumatic manifestations should be aware of this potential complication. PMID:2185360
Caffeine and related xanthines were identified as potent stimulators for the bacterial cellulose production in A. xylinum. These compounds are present in several plants whose infusions are useful as culture-medium supplements for this acetobacterium. The proposed target for these native purine-like inhibitory substances is the novel diguanyl nucleotide phosphodiesterase(s) that participates in the bacterial cellulogenic complex.
Distribution of Lipiodol within hepatic tumor was evaluated using serial computed tomography. Imagistic Lipiodol transition into the tumor via hepatic artery was slower than that of water soluble contrast medium, spreading to central part first and turn to peripheral part of the tumor. This method was thought to be useful to clarify Lipiodol distribution in hepatic tumor and to decide the method or necessity of additional trans-arterial therapy. (author).
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 radiation therapy.
AbstractThe gag p6 region of HIV-1 has various nonsubstitutionary mutations, including insertions, duplications, deletions, and premature stop codons. Studies have linked gag p6 mutations...Full Text Available
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 granulocyte recovery. Patients with late recovery ...
A discussion is presented of the 750-KeV chopper experience with both proton and negative ion beams and the ability of these systems to tailor the Linac beam to the diverse requirements of its users; normal accelerator injection, neutron therapy beam, and electron cooling experiments. This flexibility plus a cleaner beam pulse, improved thyratron operation, and mechanical modularity are the results of recent improvements. Additional benefits have been increased reliability and ease of service to the 750-KeV chopper. 3 refs.
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.
... and pathogen transmission. Because the ultimate object of stem cell research is cell-based clinical therapy, hES cells should ... 4%) Supported by grants (SC12021 and SC11012) from Stem Cell Research...
Using an adenoviral system as a delivery mediator of therapeutic gene, we investigated the therapeutic effects of the use of combined MDR1 shRNA and human NIS (hNIS)...Full Text Available
Parathyroid hormone (PTH) is used clinically in osteoporotic patients to increase bone mass by enhancing bone formation. PTH therapy is not uniformly effective at all skeletal sites and “lifestyle”...Full Text Available
Increasing frequency of skin cancer, mycosis fungoides, Kaposi sarcoma etc, it need to treatment dose planning for total skin electron beam (TSEB) therapy. Appropriate treatment planning for TSEB therapy is needed to give homogeneous dose distribution throughout the entire skin surface. The energy of 6 MeV electron from the 18 MeV medical linear accelerator was adapted for superficial total skin electron beam therapy. The energy of the electron beam was reduced to 4.2 MeV by a 0.5cmx90cmx180cm acryl screen placed in a feet front of the patient. Six dual field beam was adapted for total skin irradiation to encompass the entire body surface from head to toe simultaneously. The patients were treated behind the acryl screen plate acted as a beam scatterer and contained a parallel-plate shallow ion chamber for dosimetry and beam monitoring. During treatment, the patient was placed in six different positions due to be homogeneous ...
Purpose: In this paper, we present an alternative to the originally proposed technique for the delivery of spatially fractionated radiation therapy (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 measurements for the ...
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
PurposeRTOG protocol 95-17 was a phase I/II trial to evaluate multi-catheter brachytherapy as the sole method of adjuvant breast radiotherapy for stage I/II breast...Full Text Available
A prospective pilot trial was performed in 20 patients randomised to receive either {sup 131}I-Lipiodol therapy alone (n=10) or {sup 131}I-Lipiodol combined with a short low-dose cisplatin infusion (n=10), the aim being to evaluate the possible positive influence of a radiosensitiser on toxicity and tumour response. An activity of 1,354-2,128 MBq (mean 1,824 MBq) [36.6-57.5 mCi (mean 49.3 mCi)] {sup 131}I-labelled Lipiodol was administered by selective instillation in the hepatic artery. Cisplatin was given in a dose of 30 mg/m{sup 2} at day -1 and day +6 (day 0: {sup 131}I-Lipiodol). The primary endpoint of this trial was toxicity of therapy; points of secondary interest were tumour response and survival at 6 months. With the use of cisplatin we found a higher percentage of stable or diminished tumour size (90%, vs 40% without). A benefit in group survival at 6 months was not evident. Low-grade stomatitis in one patient and minor changes in ...
This study focuses on the effects of long-term renin-angiotensin system suppression and/or incretin mimetic therapies on the regulation and binding affinity of GLP-1 to its receptor in the coronary...Full Text Available
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 radiation therapy. Radiation dose ranged between 2,000 and 8,000 rad. Patients with pulmonary metastases received bilateral pulmonary RT. Local recurrence rate was analyzed according to ...
BackgroundSeveral studies have demonstrated the efficacy of artemisinin-combination therapy (ACT) across malaria zones of the world. Fixed dose ACT with shorter courses and fewer...Full Text Available
The overall goal of acne management for all patients is to select treatments that effectively address as many pathogenic factors as possible while minimizing side effects. Acne therapy in darker skin...Full Text Available
Topics of this proceedings are: DNA damage and repair; Space research; Cell and tissue radiobiology; Treatment planning 1: The role of clinical RBEs; Treatment planning 2: Dose optimization and inverse planning; Dosimetry; Clinical results of particle therapy and new techniques; Status reports and future developments. Separate abstracts were prepared for 79 chapters. (orig./SR)
Patients with haemarthros of the knee were examined by MRI and arthroscopy to identify the bleeding source and to determine surgical or conservative therapy. A prospective study was performed on 120 patients who underwent MRI and arthroscopy, point lesions and bleeding sources were documented separately on a standardised form. Arthroscopy demonstrated a ruptured anterior cruciate ligament in 86%, meniscal tears in 55%, disruption of collateral ligaments in 17%, osteochondral lesions in 5% and tears of capsule or plicae in 13%. Disruption of cruciate ligaments caused haemorrhage in all but three cases. In contrast, only meniscal tears located very adjacent to the meniscal basement had bled. Those types of osteochondral lesions caused haemorrhage characterised on MRI by destruction of the subchondral plate and overlying cartilage. Severe lesions of the knee were diagnosed by MRI in 71% to 100%, slight lesions in 13% to 40% of the cases. Single, combined and bland ...
Purpose: Evaluation of the diagnostic efficacy and cost-benefit of contrast enhanced CT (CT) and MRI pre- and post-SPIO-particles in focal hepatic disease with consideration of therapeutic outcome. Results: In 34/52 (65.4%) of the cases the correct diagnosis was primarily stated by CT (sensitivity [se.] 85.2%, specificity [sp.] 44.0%). In additional 10/52 of the cases unenhanced MRI (se. 91.4%, sp. 75.0%) enabled correct diagnoses, and in another 6 cases the diagnosis was established only by SPIO-MRI (se. 100%, sp. 86.7%). Considering the possible therapeutic recommendation arising from each modality, CT would have induced needless therapy costs of 191,042 DM, unenhanced MRI of 171,035 DM, and SPIO-MRI of 7,311 DM. In comparison to the real therapy costs of 221,873 DM, this would have corresponded to an unnecessary increase of therapy costs of 86.1%, 77.1%, and 3.3%, respectively. In two cases (91 hemangioma, 1 regenerative ...
Previous investigations have shown promising results in using the directional cross-correlation method to estimate velocity vectors. The velocity vector estimate provides information on both velocity direction and magnitude. The direction is estimated by beamforming signals along directions in the range $[0^{\\circ}; 180^{\\circ}[$ and identifying the direction that produces the largest correlation across emissions. An estimate of the velocity magnitude is obtained from the spatial shift between signals beamformed along the estimated direction. This paper expands these investigations to include estimations of the vector velocities of a larger region by combining the estimations along several scan lines. In combination with a B-mode image, the vector velocities are displayed as an image of the investigated region with a color indicating the magnitude, and arrows showing the direction of the flow. Using the RASMUS experimental ultrasound scanner, measurements have ...
To assess the feasibility of transluminal radiofrequency thermal ablation using a stent-type electrode and to determine, by means of in-vivo and in-vivo animal studies, the appropriate parameters. In-vivo: the radiofrequency electrode used was a self-expandable nitinol stent with 1cm insulated ends. A stent was placed in the portal vein of bovine liver, and ablations at target temperatures of 70, 80, 90, and 100 .deg. C were performed. Ablated sizes were measured longitudinally. In vivo: four mongrel dogs were anesthetized, and a stent was inserted in the common bile duct under fluoroscopic guidance through an ultrasound-guided gall bladder puncture site. The ablation temperature was set at 80 .deg. C, and each dog underwent proximal and distal esophageal ablations lasting 12 minutes. They were sacrificed immediately. In-vivo: ablated sizes showed significant correlation with target temperatures (r>0.04; p<0.05). Although most lesions were fusiform, ...
Purpose: Three-dimensional rotational angiography (3DRA) is a new technique based on a rotational angiographic acquisition able to display arterial vessels in a 3D rendering mode. The system was mainly developed for neuroradiological evaluations but preliminary extracranial experiences have also been reported. The aim of our work was to compare the results of three-dimensional angiography of the carotid arteries done with high-flow injection of contrast medium from the aortic arch with the results of selective angiography. Materials and methods: Twenty patients underwent digital angiography of the supra-aortic vessels in order to quantify a stenosis of the carotid bifurcations previously detected at Doppler Ultrasound. Examinations were performed with the Philips Integris Allura system provided with the rotational angiography (RA) tool connected to a workstation for three-dimensional reconstruction able to display vessels in a 3D fashion (Volume Rendering, Shaded ...
In a prospective study 102 patients with malignant tumors of the tongue, oropharynx, hypopharynx, and larynx were staged by means of MRI. Special attention was directed at those tumour extensions that could influence the treatment strategy. The MR findings were correlated with the results of palpation, endoscopy, ultrasound, computerised tomography and histopathological findings. MRI showed a good delineation of pT{sub 2} to pT{sub 4} tumours. However, visualisation of small tumours in the soft palate, the tonsils, the pyriform sinuses and vocal cords was difficult. In conclusion our results suggest that in addition to endoscopy MRI is a valuable tool for the examination of tumours of tongue, oropharynx, hypopharynx and larynx. (orig.) [Deutsch] In einer prospektiven Studie wurden 102 Patienten mit malignen Tumoren der Mundhoehle, des Oro- und Hypopharynx sowie des Larynx mit der Mgnetresonanztomographie (MRT) untersucht, wobei besonders Wert auf die Bestimmung ...
We wanted to evaluate the status of self-expandable nitinol stents implanted in the P2 and P3 segments of the popliteal artery in Korean patients. We retrospectively analyzed 189 consecutive patients who underwent endovascular treatment for steno occlusive lesions in the femoropopliteal artery from July 2003 to March 2009, and 18 patients who underwent stent placement in popliteal arterial P2 and P3 segments were finally enrolled. Lesion patency was evaluated by ultrasound or CT angiography, and stent fracture was assessed by plain X-rays at 1, 3, 6 and 12 months and annually thereafter. At the 1-month follow-up, stent fracture (Type 2) was seen in one limb (up to P3, 1 of 18, 6%) and it was identified in seven limbs at the 3-month follow-up (Type 2, Type 3, Type 4) (n = 1: up to P2: n = 6: P3). At the 6-month follow-up, one more fracture (Type 1) (up to P3) was noted. At the 1-year follow-up, there were no additional stent fractures. Just four limbs (up to P2) at ...
The present investigation was aimed to assess the usefulness of biliary agents scintigraphy in the diagnosis of hepatocellular carcinoma (HCC) and to ascertain the relationship between the uptake of these agents and the degree of HCC differentiation. Forty-four patients with this hepatic cancer were included in the study. Liver scans were performed 20 min and 3 hr after the administration of 99mTc diisopropyliminodiacetic acid (DISIDA). DISIDA scintigraphy could not be assessed in six cases. In 16 (42%) out of the remaining 38 patients, the tumor exhibited equal or greater radioactivity uptake than the surrounding liver. In six out of these 16 patients, tumor uptake was apparent in the early and delayed hepatic scans, while in the other ten subjects radioactivity uptake by the HCC could only be detected in the 3-hr delayed scans. In the remaining 22 patients, HCC appeared as a cold area. Tumor location by this technique did not differ from that observed by 99mTc-sulfur colloid scan or ...
Pipeline automated ultrasonic testing (AUT) uses fully automated equipment that travels around a pipe on a welding band in a linear scan to allow array pulses to provide ultrasound information on weld zones. Pipeline AUT is also used for zone discrimination as well as with special calibration blocks, dual gate output displays, and rapid defect sizing. AUT allows for the inspection of welds soon after completion, and can save construction costs by process control when combined with engineering critical assessment (ECA) to minimize rejection rates. Ultrasonic phased arrays (UPA) use an array of elements that are all individually wired, pulsed, and time-shifted. Elements are pulsed in groups of approximately 16 elements at a time for pipeline welds. Phased arrays can be used to combine electronic scanning, sectorial scanning and precision focusing to give a practical combination of displays. Optimum angles can be selected for welds and other components, and the ...
The purpose of this study was to evaluate the safety and efficacy of percutaneous ultrasound (US)-guided radiofrequency ablation (RFA) in patients with intrahepatic cholangiocarcinoma (ICCA) in a small, nonrandomized series. From February 2004 to July 2008, six patients (four men and two women; mean age 69.8 years [range 48 to 83]) with ICCA underwent percutaneous US-guided RFA. Preintervetional transarterial embolization was performed in two cases to decrease heat dispersion during RFA in order to increase the area of ablation. The efficacy of RFA was evaluated using contrast-enhanced dynamic computed tomography (CT) 1 month after treatment and then every 3 months thereafter. Nine RFA sessions were performed for six solid hepatic tumors in six patients. The duration of follow-up ranged from 13 to 21 months (mean 17.5). Posttreatment CT showed total necrosis in four of six tumors after one or two RFA sessions. Residual tumor was observed in two patients with larger ...
PPARgamma agonists have been proposed to exert more than metabolic benefits, particularly by anti-inflammatory mechanisms. We hypothesized that pioglitazone might modulate inflammatory and vascular responses to lipopolysaccharide (LPS). In a placebo-controlled parallel-group study in 18 healthy male subjects, the E. coli endotoxin model of inflammation (20 IU/kg i. v.) was employed to test the effect of 60 mg pioglitazone over nine days on inflammatory cytokines. Macrovascular function and microvascular blood flow were assessed by brachial artery ultrasound and retinal blood flow parameters, respectively. Pioglitazone increased brachial artery diameter by 5.6% but had no effect on other outcome parameters under resting conditions. LPS increased cytokine levels to peak concentrations of 91.3+/-22.5 ng/ml (IL-6), 261.4+/-60.0 ng/ml (TNFalpha), and 524.5+/-15.3 ng/ml (VCAM-1). The endotoxin caused microvascular vasodilation and increased retinal white blood cell flux, ...
Purpose: The purpose of this research was to identify the extent and scope of changes to radiography practice. Method: Questionnaires were sent to radiology managers at acute National Health Service (NHS) hospitals in 2000 as a follow-up to an initial survey conducted in 1998. Information was sought on region, teaching/non-teaching status, the nature of extended role tasks undertaken and the year in which these tasks were first undertaken. Results: Some 172 questionnaires were returned from a total of 253 dispatched (68%). In 161 hospitals radiographers administered intravenous injections and performed barium enemas in 119 hospitals, while a red-dot system was in operation in 141 hospitals. Reporting by radiographers had increased since 1998. Replies indicated that, at 124 hospitals, radiographers were reporting in ultrasound. Skeletal reporting was the second most-frequently-reported activity, with 63 hospitals indicating that radiographers reported in this ...
Background: Pleural biopsy and cytology are standard procedures for the investigation of pleural disease. Recent medical literature has suggested that image-guided pleural biopsy shows improved sensitivity for the diagnosis of pleural malignancy, when compared with the more commonly performed reverse bevel needle biopsy such as Abrams' needle. In our centre there has been an increasing trend towards performing image-guided pleural biopsies, and to our knowledge there is no large published series documenting the complication rate and diagnostic yield. Methods: The radiology and pathology databases were searched for all image-guided [computed tomography (CT) and ultrasound (US)] pleural biopsies from January 2001 to December 2004. All imaging and histology were reviewed, and final diagnostic information about patients was obtained from the respiratory multidisciplinary team database and patient notes. A record was made of complications following biopsy, presence of ...
We wanted to evaluate the correlation of mild renal pelvic dilatation (RPD) that is observed to be less than 10 mm on ultrasound (US) with urinary tract infection (UTI) and vesicoureteral reflux (VUR) in neonates. We reviewed 137 kidneys of 107 neonates who had RPD less than 10 mm on US. All the kidneys were divided into two groups: Group I (RPD <= 5.0 mm) and Group II (RPD > 5.0 mm), and we statistically analyzed the RPD change according to UTI and VUR. Seven neonates had VUR (5.1%), and there was no statistical significance between Group I (6 neonates, 5.6%) and Group II (1 neonate, 3.3%). Thirty seven cases (27%) had UTI and there was no statistical significance between Group I (30 cases, 28.0%) and Group II (7 cases, 23.3%). The RPD did not change in 81.8% of the cases, it increased in 4.4% of the cases and it decreased in 13.9% of the cases on follow up US. The incidence of VUR and UTI were not different according to the change of RPD. There were ...
Objective was to assess the accuracy of a single versus combined use of ultrasound (US) or computed tomography (CT) in the localization of diseased parathyroid glands. Forty-one patients with hyper-parathyroidism treated surgically between January 2000 to December 2005 at Jordan University Hospital, Amman, Jordan were included in this study. Preoperative ultrasonographic and CT findings were reviewed and compared to the intraoperative and pathologic diagnosis of diseased parathyroid glands. The mean age of patients was 46 years (range 16-70; 15 males and 26 females). Parathyroid adenoma was confirmed in 33 patients and hyperplasia of the parathyroid glands in 8 patients. Preoperative evaluation was carried out in 32 patients (CT scan) and in 23 patients (US). In 18 cases, the diagnosis of parathyroid disease was based on CT findings alone and in 9 patients the diagnosis was based on a single US finding. Combined CT and US evaluation was carried out in 14 cases and ...
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 radiation therapy (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 of error in photon ...
The main objectives were to evaluate efficacy and acceptability of a developmentally sensitive cognitive behavioral therapy for anxiety-based school refusal in adolescence. Twenty school-refusing adolescents meeting DSM-IV anxiety disorder criteria participated in a non-randomized trial, together with parents and school staff. Outcome was assessed at post-treatment and 2-month follow-up. Treated adolescents showed significant and maintained improvements across primary outcome variables (school attendance; school-related fear; anxiety), with medium to large effect sizes. Half of the adolescents were free of any anxiety disorder at follow-up. Additional improvements were observed across secondary outcome variables (depression; overall functioning; adolescent and parent self-efficacy). The treatment was rated as acceptable by adolescents, parents, and school staff, which may help explain the very low attrition rate. Social anxiety disorder was the most common disorder ...
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 ...
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 catheters are modified ...
Prognosis of 95 consecutive patients with non-small cell lung cancer with brain metastases were evaluated. Three factors, therapy for brain metastases, general performance status (PS) and distant metastases to other organs had significant impact on survival. Among these 3 factors, PS was independent from the other 2 factors. Significant correlation was present, however, between therapy and other organ metastases, and few patients with brain and other distant metastases received aggressive treatment for brain metastases. Cranial irradiation had significant impact on survival even in those patients with brain and other distant metastases. Cranial irradiation also reduced death from brain metastases in responders. Our results indicate that there are several subgroups with different prognosis in patients with non-small cell lung cancer with brain metastases, therefore the most beneficial treatment modality should be selected for each group of ...
Infrainguinal peripheral occlusive disease is increasingly being treated by endovascular techniques. Bare metal stainless steel, self-expanding nitinol stents, drug-eluting and covered stents (stent grafts) are becoming increasingly more important adjuncts to percutaneous translumninal angioplasty in the treatment of peripheral artery disease. In this article the available evidence supporting the use of stents in the femoropopliteal and tibial arteries will be described as well as their limitations. Future stent developments will also be discussed. (orig.) [German] Die endovaskulaere Therapie spielt bei der Therapie der peripheren arteriellen Verschlusskrankheit (PAVK) eine wichtige Rolle. Unbeschichtete ballonexpandierbare Stahlstents, selbstexpandierende Nitinolstents sowie medikamentenbeschichtete und ''covered stents'' (Stentgrafts) haben eine zunehmende Bedeutung als Zusatztherapie zusammen mit der ...
Several configurations of moderating and shielding materials have been designed and measured on the LVR-15 reactor for boron neutron capture therapy (BNCT) purposes. To determine the neutron and gamma ray space-energy distributions in the cylindrical geometry, the two-dimensional code DOT with the coupled neutron-gamma data library DLC-36 was used. The experimental verification of the beam parameters was performed in the LVR-15 reactor thermal column empty space with layers of graphite, aluminium, alumina, lead and bismuth. Attention was paid to establishing techniques and instrumentation for monitoring the neutron and gamma ray dose and beam quality. The thermal and epithermal flux densities were measured by activation foils, the neutron spectrum was determined with a Bonner spectrometer and gamma ray background with a scintillation spectrometer. The distribution of thermal neutrons in the human head phantom was mapped with a small semiconductor detector (Si[sup ...
Several configurations of moderating and shielding materials have been designed and measured on the LVR-15 reactor for boron neutron capture therapy (BNCT) purposes. To determine the neutron and gamma ray space-energy distributions in the cylindrical geometry, the two-dimensional code DOT with the coupled neutron-gamma data library DLC-36 was used. The experimental verification of the beam parameters was performed in the LVR-15 reactor thermal column empty space with layers of graphite, aluminium, alumina, lead and bismuth. Attention was paid to establishing techniques and instrumentation for monitoring the neutron and gamma ray dose and beam quality. The thermal and epithermal flux densities were measured by activation foils, the neutron spectrum was determined with a Bonner spectrometer and gamma ray background with a scintillation spectrometer. The distribution of thermal neutrons in the human head phantom was mapped with a small semiconductor detector (Si"6Li). ...
The present case report documents the hitherto unusual application of camouflage orthodontics in one of our patients. Our female patient had previously been treated orthodontically alio loco and had also undergone bimaxillary orthognathic surgery. She presented with TMJ complaints, with associated pains. Despite a dental Class I and centrally seated condyles, her discs had prolapsed anteriorly without reduction and she had developed a massive degenerative-inflammatory TMJ disease. Skeletally, she was a Class II case despite previous orthognathic surgery. In addition, there was also an initial suspicion of rheumatic involvement that could not be confirmed. We distalized the entire lower dental arch without bicuspid extraction. Then we advanced the mandible with the Mandibular Anterior Repositioning Appliance (MARA).We discuss exactly how the modified camouflage therapy was structured and how the individual treatment steps took place. PMID:20354841
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 radiation detector and to detect a real ...
In the case of total skin electron therapy without the beam guide, the electron beam is scattered just outside the gantry exit, dose uniformity in the field is broken, and dose is spread outside the light field. The aims of this study were to measure the mean energy of the off-axis incident electron beam without the beam guide and to establish a reference for the clinical situation. For the measurement, a 4 MeV electron beam was selected among several energies from the linear accelerator. A scintillating fiber beam energy monitor measured the mean energy of the incident electron beam. This energy monitor is a small, light-weight piece of equipment composed of a wedge absorber, scintillation fiber, and photodiode. We found the relationship between electron energy and the indicated value of the energy monitor by means of the estimation of correction factors for five different kinds of electron energy. The preferable linear correlation of 0.997 of the coefficient of ...
Megavoltage photon intensity-modulated radiation therapy (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 patient with bilateral hip prostheses. The ...
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 were more often ...
In the paper six cases of facial osteomyelitis as a complication of chronic sinusitis in hemophiliac-AIDS patients are reported. Osteomyelitis was suggested by an increasing of erythrocyte sedimentation rate. The diagnosis was confirmed by a positive {sup 99m} Tc MDP scintigraphy. The patients were submitted to clinical treatment. The erythrocyte sedimentation rate and 67-gallium citrate scans were used in the follow-up of the therapy. Three patients had negative gallium after three weeks of organism-specific antibiotic therapy; in two patients the gallium scintigraphy remained positive. One patient did not undergo the radionuclide scan for this clinical conditions. These results suggest that MDP scans showed higher sensitivity and specificity in detection of bone disease in chronic sinusitis. Gallium scans appeared to be valuable tool in the follow-up of the infection. There are no reports in the literature of osteomyelitis as a complication ...
The current study investigated relations among ethnic similarity in caregiver-therapist pairs of youth participating in Multisystemic Therapy, therapist adherence, and youth long-term behavioral and criminal outcomes. Participants were 1,979 youth and families treated by 429 therapists across provider organizations in 45 sites. Relations were found, independently, and in the presence of ethnic similarity, between adherence and reductions in youth externalizing and internalizing behavior problems 1-year posttreatment and youth criminal charges 4 years posttreatment. Relations between ethnic similarity and outcomes were found only for reductions in youth externalizing behavior problems and not when adherence was included in the model. Adherence ratings were higher, however, in ethnically similar caregiver-therapist pairs, and evidence was found that this increased adherence predicted slightly better outcomes for youth. Implications for further research and clinical ...
Early effects of boron neutron capture therapy (BNCT) on malignant glioma are characterized by reduction of the enhancement area and regression of the peritumoral edema radiologically. The aim of this study was to investigate the early histological changes of tumors and inflammatory cells after BNCT in the rat brain. Rats were treated with BNCT using boronophenylalanine (BPA) 7 days after implantation of C6 glioma cells. The tumors were assessed with magnetic resonance imaging and histopathological examination at 4 days after BNCT. The mean tumor volumes were 39#+-#2 mm"3 in the BNCT group and 134#+-#18 mm"3 in the control group. In the BNCT group, tumor cells showed a less pleomorphic appearance with atypical nuclei and mitotic figures. The Ki-67 labeling index was 6.5%#+-#4.7% in the BNCT and 35%#+-#3.8% in the control group. The reactions of the inflammatory cells were examined with ED-1 as macrophage marker and OX42 as microglia marker. ED-1- and OX-42-positive ...
A prototype electron applicator system providing circular and rectangular fields for use in intraoperative electron beam therapy with a Varian Clinac 18 linear accelerator has been fabricated. The dosimetric properties of this system for a variety of electron-beam energies, applicator sizes, and x-ray collimator settings was documented. Significant findings include: (a) surface dose values are in excess of 90% for electron energies of 12 MeV and above; (b) for the 18-MeV beam, the deepest depth where the central axis dose is 90% of its maximum value is in excess of 50 mm for circular applicators whose diameters are in excess of 5 cm; and (c) the treatment time to deliver 1000 rads ''given dose'' (at a given dose rate of 300 MU/min) is on the order of 3--4 min. Cross-field behavior is acceptable for the intended application and x-ray contamination is less than 4% for any applicator/electron energy combination. A system for irregular field blocking and TLD ...
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 ...
The low in vivo transduction efficiency of recombinant adeno-associated virus (rAAV) and the undesirably strong immunogenicity of adenovirus (rAdv) have limited their clinical utilization in cancer gene therapy. We have previously demonstrated that intratumoral injection of rAAV expressing a C-terminal polypeptide of human telomerase reverse transcriptase (rAAV-hTERTC27) effectively inhibits the growth of glioblastoma xenografts in nude mice. To further improve its efficacy, we combined rAAV-hTERTC27 with rAdv and investigated the efficiency of the cocktail vectors in vivo. At a nontherapeutic dose (1 x 108 plaque-forming units (PFUs)), rAdv-null and rAdv-hTERTC27 were equipotent in enhancing the therapeutic efficacy of rAAV-hTERTC27 (1.5 x 1011?v.g.), and complete tumor regression w...
Hematopoietic stem cells (HSCs) have remained at the forefront of stem cell research for the past 50 years, since the therapeutic potential of bone marrow transplantation was realized. Uniquely, among stem and progenitor cells, research progress has been made in parallel between the laboratory benchtop and hospital bedside during this period. Integral to this work has been the role of the transfusion medicine services in the collection, storage, and processing of HSCs. The next decade promises to bring further developments: with new fields of cellular therapies, stem cell vaccination, and stem cell drug testing opening up. This article summarizes exciting areas of research concerning the behavior and potential clinical applications of HSCs. For the purposes of clarity, we describe in turn the trafficking and transfer of HSCs; ex vivo expansion of HSC units from different sources; and finally, applications of specifically selected subsets of hematopoietic cells and ...
Therapeutic effect of p-aminobenzoic acid-N-xyloside Na (K-247) were studied. Eleven patients with a variety of solid tumors were treated with K-247 alone. K-247 was given orally 800 mg daily for 4 weeks. As for side effect of the drug, only mild gastritis was observed in a few patients. Partial response (over 25% reduction of tumor size) with a median duration of two months was observed in 3 patients. These cases were metastatic tumor of lung from the carcinoma of thyroid, metastatic tumors of lung from the carcinoma of kidney, and mediastinal tumor. In eight patients the response was classified as no change and in one patient there was progressive disease. Thus K-247 has some therapeutic activity in patients with solid tumor. Combination therapy of irradiation and administration of K-247 were also studied. In the twelve patients receiving the combination therapy, partial response was observed in 7 patients with complete response in 3 ...
While trauma is still the leading cause of death in the pediatric age range, it is surprising how little the CT appearances of pediatric chest injury have been investigated in the literature. We have reviewed the CT findings of blunt chest trauma in 44 children for whom chest CT examinations were requested to investigate the extent of intrathoracic injury. We noted a propensity for pulmonary contusions to be located posteriorly or posteromedially, and for them to be anatomically nonsegmental and crescentic in shape. This is possibly attributable to the relatively compliant anterior chest wall in children. The CT appearances of other major thoracic injuries are described, including pulmonary lacerations, pneumothoraces, malpositioned chest tubes, mediastinal hematomas, aortic injury, tracheobronchial injury, hemopericardium, and spinal injuries with paraspinal fluid collections. Children demonstrating findings incidental to the actual injury yet important to the subsequent ...
Quantitative bone scintigraphy was performed on 23 white females with post-menopausal osteoporosis and vertebral compression fractures. These patients were then entered into a randomized, double-blind clinical trial or sodium fluoride therapy (NaF=14, placebo=9) which included repeat bone scintigraphy every six months. Scintigraphic images were acquired for 500K counts per image over the total body with computer acquisition over the posterior thoracic and lumbar spine. Images were obtained on a wide field-of-view gamma camera two hours after injecting 15 mCi of Tc-99m MDP. Data analysis showed a significant reduction in the activity ratio of abnormal vertebral body to normal vertebral body in those patients treated with sodium fluoride (paired t-test p=0.0095). No significant change was observed in the control group of (p=0.142). These results suggest that sodium fluoride therapy promotes more rapid healing of osteoporotic vertebral fractures. ...
The research on the therapy of brain tumors and others by the thermal neutron irradiation using research reactors is to kill tumor cells by accumulating boron at a tumor part, and using {alpha} particles and {sup 7}Li generated by {sup 10}B(n, {alpha}){sup 7}Li reaction of thermal neutrons, which is known as boron neutron capture therapy (BNCT). In Japan Atomic Energy Research Institute, the medical irradiation facility was installed in the thermal neutron column of the JRR-2, and as of March, 1994, 22 cases of irradiation have been carried out. In order to monitor the variation of thermal neutron flux during irradiation, the real time measurement using a simultaneous monitor is carried out, but there is the variation of measured values in the Si semiconductor, p-n junction detector possibly due to its direction dependence. The experiment was carried out to quantity the direction dependence of the detector by using the neutron radiography ...
Electron beam therapy of lesions such as cutaneous metastatic carcinoma and reticulum cell sarcoma is performed via multiple portals for a wide irradiation field. However, the dose distribution in border areas is generally uneven, resulting in hot and cold dose areas depending on the intervals of the portals. We performed electron irradiation by the pendulum technique, especially on curved areas, and evaluated the technique in various respects. Pendulum electron beam irradiation is indicated when the length of the cone must be reduced in order to deliver the target volume near the skin surface as well as to avoid the occurrence of hot spots deep in the body. We prepared a 15cm rotating cone by cutting a 30cm fixed irradiation cone. The modification posed no disadvantages in terms of extent and flatness of the beam, or stability during rotation. After determining the relationship between the rotation speed and the dose, the technique was successfully applied to a ...
To quantify the number of cases and clinical courses of Acanthamoeba keratitis treated at the King Khaled Eye Specialist Hospital (KKESH) between December 1982 and May 2005, and to review their clinical course and response to medical and surgical therapy. Retrospective review of medical records of all patients with Acanthamoeba keratitis diagnosed by the KKESH Microbiology or Pathology or Pathology Laboratory since the opening of the hospital. During a period of over 22 years, only six cases of confirmed. Acanthamoeba keratitis were diagnosedand treated at KKESH. In two cases the diagnosis was made by corneal biopsy, while four cases required examination of a histopathology specimen obtained at the time of therapeutic keratoplasty to establish the diagnosis. One eye was cured by medical therapy, while five eyes required one (4eyes) or two (1 eye) therapeutic penetrating keratoplasty (PKP) to achieve a clinical cure. Three eyes achieved good ...
Objective The aim of this study was to analyze the clinical results of our adaptive radiation therapy 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%...
Gantries in the proton/carbon cancer therapy machines represent the major cost and are of the largest size. This report explains a new way to the gantry design. The size and cost of the gantries are reduced and their use is simplified by using the fixed magnetic field. The ''new'' gantry is made of a very large momentum acceptance non-scaling Fixed Field Alternating Gradient (FFAG) quarter and half arc beam lines. The gantry is made of combined function magnets with a very strong focusing and small dispersion function. Additional magnets with a fast response are required to allow adjustments of the beam position for different energies at the beginning of the gantry. Additional strong focusing magnets following the gantry have also to be adjustable to provide required spot size and radial scanning above the patients. The fixed field combined function magnets could be made of small permanent magnets for the proton machine, or of ...
A novel compact CT-guided intensity modulated proton radiotherapy (IMPT) system is described. The system is being designed to deliver fast IMPT so that larger target volumes and motion management can be accomplished. The system will be ideal for large and complex target volumes in young patients. The basis of the design is the dielectric wall accelerator (DWA) system being developed at the Lawrence Livermore National Laboratory (LLNL). The DWA uses fast switched high voltage transmission lines to generate pulsed electric fields on the inside of a high gradient insulating (HGI) acceleration tube. High electric field gradients are achieved by the use of alternating insulators and conductors and short pulse times. The system will produce individual pulses that can be varied in intensity, energy and spot width. The IMPT planning system will optimize delivery characteristics. The system will be capable of being sited in a conventional linac vault and provide intensity modulated rotational ...
Because toxicity with the use of 3000 centiGray (cGy) of total lymphoid irradiation (TLI) was observed in an earlier study, 2000-cGy treatments were delivered in a 2-portal format to 7 patients and in a modified 3-portal fashion to 6 patients, as part of a randomized, investigator-blinded trial of TLI treatment for refractory rheumatoid arthritis. Analysis of combined data from the 13 patients revealed statistically significant improvement in 5 clinical indicators of disease activity at the end of TLI and 6 and 12 months later, accompanied by T4-specific immunosuppression. Management considerations resulted in the introduction of prednisone therapy in 5 patients, methotrexate in 4, and azathioprine in 1 during the interval of 8-12 months post-TLI. Herpes zoster occurred in 5 patients prior to the initiation of this additional therapy. These data indicate that, in patients with rheumatoid arthritis, a TLI dose of 2000 cGy is sufficient to ...
This text-book (electronic book - multi-media CD-ROM) constitutes a course-book - author's collection of lectures. It consists of 13 lectures in which the reader acquaints with the basis of radiobiology: Introduction to radiobiology; Physical fundamentals of radiobiology; Radiation of cells; Modification of radiation damage of cells; Reparation of radiation damage of cells; Radiation syndromes and their modification; Radiation injury; Radiation damage of tissues; Effect of radiation on embryo and fetus; Biological effects of incorporated radionuclides; Therapy of acute irradiation sickness; Delayed consequences of irradiation; Radiation oncology and radiotherapy. This course-book may be interesting for students, post-graduate students of chemistry, biology, physics, medicine as well as for teachers, scientific workers and physicians. (author)
Control of human filarial infections currently depends on chemotherapeutic strategies predominantly directed at microfilariae. Doxycycline therapy in an extended daily dose regimen sterilizes and kills adult stages, but the utility of this drug for routine field use remains an issue of concern. No macrofilaricidal drugs with efficacy after one or two doses are available for use, delaying the achievement of the elimination or eradication of onchocerciasis and lymphatic filariasis. Moxidectin, a macrocyclic lactone, is currently in clinical trials for onchocerciasis. A few other drugs that have already been approved for use in veterinary practice or in human medicine for other indications are available for investigation. Early drug discovery pipelines are poorly populated and the process of ...
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.
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