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Sample records for capture therapy treat

  1. Can epithermal boron neutron capture therapy treat primary and metastatic liver cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Wallace, S.A. [Austin Repatriation Medical Centre, Heidelberg (Australia); Carolan, M.C. [Illawarra Cancer Care Centre, Wollongong (Australia); Allen, B.J. [St George Cancer Care Centre, Kogarah (Australia)

    1996-12-31

    Full text: The poor prognosis of metastatic cancer to the liver calls for the investigation of alternative treatment modalities. This paper analyses the possible use of epithermal boron neutron capture therapy for the palliative treatment of these cancers. We examine possible treatment planning scenarios for selected tumour to liver boron ratios, and specifically for the epithermal beam at the HFR, Petten. It is required that a therapeutic ratio> 1 be achieved over the entire organ. Monte Carlo calculations were performed using the radiation transport code MCNP. The geometrical model used a `variable voxel` technique to reconstruct an anthropomorphic phantom from CT scans. Regions of interest such as the liver were modelled to a resolution of a few millimetres, whereas surrounding regions were modelled with lesser detail thereby facilitating faster computation time. Three dimensional dose distributions were calculated for a frontal beam directed at the liver, and found to be in satisfactory agreement with measurements using bare and cadmium covered gold foils, PIN and MOSFET dosimeters for fast neutron and gamma measurements respectively. Dose distributions were calculated for orthogonal epithermal neutron beams to the front and side, using the parameters of the epithermal beam at Petten, and assumed tumour and normal tissue boron-10 concentrations of 30 ppm and 7.5 ppm boron-10 respectively. The therapeutic ratio (i e the dose to the tumour relative to the maximum dose to normal tissue) was found to be about 1.8, reducing to unity for the limiting condition of a tumour in the posterior liver. This result opens up the possibility of palliative therapy for the management of primary and metastatic liver cancer.

  2. Correlation between radiation dose and histopathological findings in patients with gliblastoma treated with boron neutron capture therapy (BNCT)

    International Nuclear Information System (INIS)

    The purpose of this study was to clarify the correlation between the radiation dose and histopathological findings in patients with glioblastoma multiforme (GBM) treated with boron neutron capture therapy (BNCT). Histopathological studies were performed on specimens from 8 patients, 3 had undergone salvage surgery and 5 were autopsied. For histopathological cure of GBM at the primary site, the optimal minimal dose to the gross tumor volume (GTV) and the clinical target volume (CTV) were 68 Gy(w) and 44 Gy(w), respectively. - Highlights: • It is very important to determine the curable BNCT radiation dose on histopathological aspect in BNCT. • Of 23 patients with GBM treated with BNCT, autopsy was performed in 5, salvage surgery in 3, and histopathological study in 8. • To achieve the histopathological cure of GBM at the primary site, the optimal minimal dose to the GTV and CTV was 68 Gy(w) and 44 Gy(w), respectively

  3. Dynamic infrared imaging of the skin reaction in melanoma patients treated with boron neutron capture therapy

    International Nuclear Information System (INIS)

    As part of the Boron Neutron Capture Therapy (BNCT) project conducted jointly by the Comision Nacional de Energia Atomica and the oncology institute A. Roffo, Argentina, we have recently started a program designed to investigate the ability of dynamic infrared imaging for following-up our cutaneous melanoma patients. BNCT offers a unique opportunity to study the response of the integumentary system to single fractions and high doses of neutrons and heavy ions, providing information that could be potentially important in radiation accidents for people exposed to these kinds of radiation fields. Medical infrared thermography is a non-invasive and functional imaging method, that provides information on the normal and abnormal status and response of the nervous and vascular systems, as well as the local metabolic rate and inflammatory processes that appear as differences in the skin infrared emission. Although it is highly sensitive, it is unspecific, like other conventional imaging techniques. For this reason, infrared thermography must be employed as an adjunct method to other diagnostic procedures and the clinical observation. An infrared camera is employed, with an uncooled ferroelectric focal plane array of 320x240 detector elements, providing a video signal of the infrared emission in the 8-14 μm wavelength band. After patient preparation and acclimation, a basal study of the irradiated region is performed, including high and low dose areas, as well as normal and tumor tissues, and eventually other detectable structures (e.g. scars and veins). Thereafter, a provocation test (a cold stimulus) is applied and the temperature recovery is registered as a function of time. In addition, a 3D computational dosimetry of the irradiated region is performed, which allows a complete representation of the isodose contours mapped onto the 3D reconstruction representing the skin. This reconstruction permits selecting regions of different doses for studying the local response

  4. Neutron capture therapy

    International Nuclear Information System (INIS)

    The overall state of the art related with neutron capture therapy(NCT) is surveyed. Since the field related with NCT is very wide, it is not intended to survey all related subjects in depth. The primary objective of this report is to help those working for the installation of a NCT facility and a PGNAA(prompt gamma ray neutron activation analysis) system for the boron analysis understand overall NCT at Hanaro. Therefore, while the parts of reactor neutron source and PGNAA are dealt in detail, other parts are limited to the level necessary to understand related fields. For example, the subject of chemical compound which requires intensive knowledge on chemistry, is not dealt as a separated item. However, the requirement of a compound for NCT, currently available compounds, their characteristics, etc. could be understood through this report. Although the subject of cancer treated by NCT is out of the capability of the author, it is dealt focussing its characteristics related with the success of NCT. Each detailed subject is expected to be dealt more detail by specialists in future. This report would be helpful for the researchers working for the NCT to understand related fields. (author). 128 refs., 3 tabs., 12 figs

  5. Iodine neutron capture therapy

    Science.gov (United States)

    Ahmed, Kazi Fariduddin

    A new technique, Iodine Neutron Capture Therapy (INCT) is proposed to treat hyperthyroidism in people. Present thyroid therapies, surgical removal and 131I treatment, result in hypothyroidism and, for 131I, involve protracted treatment times and excessive whole-body radiation doses. The new technique involves using a low energy neutron beam to convert a fraction of the natural iodine stored in the thyroid to radioactive 128I, which has a 24-minute half-life and decays by emitting 2.12-MeV beta particles. The beta particles are absorbed in and damage some thyroid tissue cells and consequently reduce the production and release of thyroid hormones to the blood stream. Treatment times and whole-body radiation doses are thus reduced substantially. This dissertation addresses the first of the several steps needed to obtain medical profession acceptance and regulatory approval to implement this therapy. As with other such programs, initial feasibility is established by performing experiments on suitable small mammals. Laboratory rats were used and their thyroids were exposed to the beta particles coming from small encapsulated amounts of 128I. Masses of 89.0 mg reagent-grade elemental iodine crystals have been activated in the ISU AGN-201 reactor to provide 0.033 mBq of 128I. This activity delivers 0.2 Gy to the thyroid gland of 300-g male rats having fresh thyroid tissue masses of ˜20 mg. Larger iodine masses are used to provide greater doses. The activated iodine is encapsulated to form a thin (0.16 cm 2/mg) patch that is then applied directly to the surgically exposed thyroid of an anesthetized rat. Direct neutron irradiation of a rat's thyroid was not possible due to its small size. Direct in-vivo exposure of the thyroid of the rat to the emitted radiation from 128I is allowed to continue for 2.5 hours (6 half-lives). Pre- and post-exposure blood samples are taken to quantify thyroid hormone levels. The serum T4 concentration is measured by radioimmunoassay at

  6. Clinical aspects of boron neutron capture therapy

    International Nuclear Information System (INIS)

    Boron neutron capture therapy is potentially useful in treating malignant tumors of the central nervous system and is technically possible. Additional in vitro and in vivo testing is required to determine toxicities, normal tissue tolerances and tissue responses to treatment parameters. Adequate tumor uptake of the capture agent can be evaluated clinically prior to implementation of a finalized treatment protocol. Phase I and Phase II protocol development, clinical pharmacokinetic studies and neutron beam development

  7. Identification of early and distinct glioblastoma response patterns treated by boron neutron capture therapy not predicted by standard radiographic assessment using functional diffusion map

    International Nuclear Information System (INIS)

    Radiologic response of brain tumors is traditionally assessed according to the Macdonald criteria 10 weeks from the start of therapy. Because glioblastoma (GB) responds in days rather than weeks after boron neutron capture therapy (BNCT) that is a form of tumor-selective particle radiation, it is inconvenient to use the Macdonald criteria to assess the therapeutic efficacy of BNCT by gadolinium-magnetic resonance imaging (Gd-MRI). Our study assessed the utility of functional diffusion map (fDM) for evaluating response patterns in GB treated by BNCT. The fDM is an image assessment using time-dependent changes of apparent diffusion coefficient (ADC) in tumors on a voxel-by-voxel approach. Other than time-dependent changes of ADC, fDM can automatically assess minimum/maximum ADC, Response Evaluation Criteria In Solid Tumors (RECIST), and the volume of enhanced lesions on Gd-MRI over time. We assessed 17 GB patients treated by BNCT using fDM. Additionally, in order to verify our results, we performed a histopathological examination using F98 rat glioma models. Only the volume of tumor with decreased ADC by fDM at 2 days after BNCT was a good predictor for GB patients treated by BNCT (P value = 0.022 by log-rank test and 0.033 by wilcoxon test). In a histopathological examination, brain sections of F98 rat glioma models treated by BNCT showed cell swelling of both the nuclei and the cytoplasm compared with untreated rat glioma models. The fDM could identify response patterns in BNCT-treated GB earlier than a standard radiographic assessment. Early detection of treatment failure can allow a change or supplementation before tumor progression and might lead to an improvement of GB patients’ prognosis

  8. Gadolinium as a Neutron Capture Therapy Agent

    Science.gov (United States)

    Shih, Jing-Luen Allen

    The clinical results of treating brain tumors with boron neutron capture therapy are very encouraging and researchers around the world are once again making efforts to develop this therapeutic modality. Boron-10 is the agent receiving the most attention for neutron capture therapy but ^{157}Gd is a nuclide that also holds interesting properties of being a neutron capture therapy agent. The objective of this study is to evaluate ^{157}Gd as a neutron capture therapy agent. In this study it is determined that tumor concentrations of about 300 mug ^{157}Gd/g tumor can be achieved in brain tumors with some FDA approved MRI contrast agents such as Gd-DTPA and Gd-DOTA, and up to 628 mug ^{157 }Gd/g tumor can be established in bone tumors with Gd-EDTMP. Monte Carlo calculations show that with only 250 ppm of ^{157}Gd in tumor, neutron capture therapy can deliver 2,000 cGy to a tumor of 2 cm diameter or larger with 5 times 10^{12} n/cm ^2 fluence at the tumor. Dose measurements which were made with films and TLD's in phantoms verified these calculations. More extended Monte Carlo calculations demonstrate that neutron capture therapy with Gd possesses comparable dose distribution to B neutron capture therapy. With 5 times 10^{12 } n/cm^2 thermal neutrons at the tumor, Auger electrons from the Gd produced an optical density enhancement on the films that is similar to the effect caused by about 300 cGy of Gd prompt gamma dose which will further enhance the therapeutic effects. A technique that combines brachytherapy with Gd neutron capture therapy has been evaluated. Monte Carlo calculations show that 5,000 cGy of prompt gamma dose can be delivered to a treatment volume of 40 cm^3 with a 3-plane implant of a total of 9 Gd needles. The tumor to normal tissue advantage of this method is as good as ^{60} Co brachytherapy. Measurements of prompt gamma dose with films and TLD-700's in a lucite phantom verify the Monte Carlo evaluation. A technique which displays the Gd

  9. Neutron capture therapy for melanoma

    International Nuclear Information System (INIS)

    The development of boron-containing compounds which localize selectively in tumor may require a tumor-by-tumor type of approach that exploits any metabolic pathways unique to the particular type of tumor. Melanin-producing melanomas actively transport and metabolize aromatic amino acids for use as precursors in the synthesis of the pigment melanin. It has been shown that the boron-containing amino acid analog p-borono-phenylalanine (BPA) is selectively accumulated in melanoma tissue, producing boron concentrations in tumor that are within the range estimated to be necessary for successful boron neutron capture therapy (BNCT). We report here the results of therapy experiments carried out at the Brookhaven Medical Research Reactor (BMRR). 21 refs., 5 figs., 3 tabs

  10. Workshop on neutron capture therapy

    International Nuclear Information System (INIS)

    Potentially optimal conditions for Neutron Capture Therapy (NCT) may soon be in hand due to the anticipated development of band-pass filtered beams relatively free of fast neutron contaminations, and of broadly applicable biomolecules for boron transport such as porphyrins and monoclonal antibodies. Consequently, a number of groups in the US are now devoting their efforts to exploring NCT for clinical application. The purpose of this Workshop was to bring these groups together to exchange views on significant problems of mutual interest, and to assure a unified and effective approach to the solutions. Several areas of preclinical investigation were deemed to be necessary before it would be possible to initiate clinical studies. As neither the monomer nor the dimer of sulfhydryl boron hydride is unequivocally preferable at this time, studies on both compounds should be continued until one is proven superior

  11. Workshop on neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Fairchild, R.G.; Bond, V.P. (eds.)

    1986-01-01

    Potentially optimal conditions for Neutron Capture Therapy (NCT) may soon be in hand due to the anticipated development of band-pass filtered beams relatively free of fast neutron contaminations, and of broadly applicable biomolecules for boron transport such as porphyrins and monoclonal antibodies. Consequently, a number of groups in the US are now devoting their efforts to exploring NCT for clinical application. The purpose of this Workshop was to bring these groups together to exchange views on significant problems of mutual interest, and to assure a unified and effective approach to the solutions. Several areas of preclinical investigation were deemed to be necessary before it would be possible to initiate clinical studies. As neither the monomer nor the dimer of sulfhydryl boron hydride is unequivocally preferable at this time, studies on both compounds should be continued until one is proven superior.

  12. Neutron capture therapy. Principles and applications

    International Nuclear Information System (INIS)

    State of the art report on neutron capture therapy. Summarizes the progress made in recent decades. Multidisciplinary approach. Written by the most experienced specialists Neutron capture therapy (NCT) is based on the ability of the non-radioactive isotope boron-10 to capture thermal neutrons with very high probability and immediately to release heavy particles with a path length of one cell diameter. This in principle allows for tumor cell-selective high-LET particle radiotherapy. NCT is exciting scientifically but challenging clinically, and a key factor in success is close collaboration among very different disciplines. This book provides a comprehensive summary of the progress made in NCT in recent years. Individual sections cover all important aspects, including neutron sources, boron chemistry, drugs for NCT, dosimetry, and radiation biology. The use of NCT in a variety of malignancies and also some non-malignant diseases is extensively discussed. NCT is clearly shown to be a promising modality at the threshold of wider clinical application. All of the chapters are written by experienced specialists in language that will be readily understood by all participating disciplines.

  13. Current status of neutron capture therapy

    International Nuclear Information System (INIS)

    There are about 6000 new glioblastoma multiform brain tumours diagnosed each year in the United States of America alone. This cancer is usually fatal within six months of diagnosis even with current standard treatments. Research on boron neutron capture therapy (BNCT) has been considered as a method of potentially curing such cancers. There is a great interest at under-utilised research reactors institutions to identify new medical utilization, attractive to the general public. Neutron capture therapy is a true multidisciplinary topic with a large variety of individuals involved. This publication attempts to provide current information for all those thinking about being involved with NCT, based on the knowledge and experience of those who have pioneered the treatment. It covers the whole range of NCT from designing reactor conversions or new facilities, through to clinical trials and their effectiveness. However, since most work has been done with boron capture therapy for brain tumours using modified thermal research reactors, this tends to be the focus of the report. One of the factors which need to be addressed at the beginning is the timing of the further development of NCT facilities. It should be emphasised that all current work is still at the research stage. Many of those now involved believe that there is little need for many more research facilities until such time as the treatment shows more promising results. For this and other reasons discussed in the report, very serious consideration should be given by research reactor owners and operators before spending large sums of money converting their facilities for NCT

  14. Recent advances in neutron capture therapy (NCT)

    Energy Technology Data Exchange (ETDEWEB)

    Fairchild, R.G.

    1985-01-01

    The application of the /sup 10/B(n,..cap alpha..)/sup 7/Li reaction to cancer radiotherapy (Neutron Capture therapy, or NCT) has intrigued investigators since the discovery of the neutron. This paper briefly summarizes data describing recently developed boronated compounds with evident tumor specificity and extended biological half-lives. The implication of these compounds to NCT is evaluated in terms of Therapeutic Gain (TG). The optimization of NCT using band-pass filtered beams is described, again in terms of TG, and irradiation times with these less intense beams are estimated. 24 refs., 3 figs., 3 tabs.

  15. Spectromicroscopy in Boron Neutron Capture Therapy Research

    Science.gov (United States)

    Gilbert, Benjamin; Redondo, Jose; Andres, Roger; Suda, Takashi; Neumann, Michael; Steen, Steffi; Gabel, Detlef; Mercanti, Delio; Ciotti, Teresa; Perfetti, Paolo; Margaritondo, Giorgio; de Stasio, Gelsomina

    1998-03-01

    The MEPHISTO synchrotron imaging spectromicroscope can analyse ashed cells or tissue sections to reveal the microdistribution of trace elements. MEPHISTO performs core level x-ray absorption spectroscopy with synchrotron radiation, and uses an electron optics system to provide magnified photoelectron images. An application of the MEPHISTO spectromicroscope is in boron neutron capture therapy (BNCT). BNCT is a binary cancer therapy that will selectively destroy cancer cells provided that compounds containing a boron isotope are selectively accumulated in tumor tissue. Important factors for the success of BNCT include the ability to target every cancer cell, and the distribution of boron inside the cell. To investigate the boron distribution in tissue, sections of human glioblastoma containing a BNCT compound, and stained with nickel against a protein found in the nuclei of proliferating (cancer) cells, were studied with MEPHISTO.

  16. Neutron capture therapy at Brookhaven National Laboratory

    International Nuclear Information System (INIS)

    Application of the 10B(n,α)7Li reaction to cancer radiotherapy (Neutron Capture therapy, or NCT) has intrigued investigators since shortly after the discovery of the neutron. This paper summarizes data describing recently developed boronated compounds designed to serve as vehicles for boron transport to tumor. Whole-body (mouse) Neutron Capture Radiograms (NCR) of some of the most promising compounds are presented; these graphically demonstrate selective uptake in tumor, at times varying from hours to days post administration. Comparison is made to the ubiquitous distribution of inorganic boron compounds used in the first clinical trials of NCT. Since some compounds are now available that allow physiological targeting of boron to tumor at concentrations adequate for therapy, the NCR technique can be used to evaluate important questions concerning the microdistribution of boron within the tumor. The implication of these compounds to NCT is evaluated in terms of Therapeutic Gain (TG). The optimization of NCT by using band-pass filtered neutron beams is described, again in terms of TG, and irradiation times with these less intense beams are estimated. 35 references, 12 figures, 4 tables

  17. Microdosimetry for Boron Neutron Capture Therapy

    International Nuclear Information System (INIS)

    The specific aims of the research proposal were as follows: (1) To design and construct small volume tissue equivalent proportional counters for the dosimetry and microdosimetry of high intensity thermal and epithermal neutron beams used in BNCT, and of modified fast neutron beams designed for boron neutron capture enhanced fast neutron therapy (BNCEFNT). (2) To develop analytical methods for estimating the biological effectiveness of the absorbed dose in BNCT and BNCEFNT based on the measured microdosimetric spectra. (3) To develop an analytical framework for comparing the biological effectiveness of different epithermal neutron beams used in BNCT and BNCEFNT, based on correlated sets of measured microdosimetric spectra and radiobiological data. Specific aims (1) and (2) were achieved in their entirety and are comprehensively documented in Jay Burmeister's Ph.D. dissertation entitled ''Specification of physical and biologically effective absorbed dose in radiation therapies utilizing the boron neutron capture reaction'' (Wayne State University, 1999). Specific aim (3) proved difficult to accomplish because of a lack of sufficient radiobiological data

  18. Considerations for boron neutron capture therapy studies

    International Nuclear Information System (INIS)

    Radiotherapy is indispensable as a mean to eradicate deeply or infiltrating tumor tissue that can not be removed surgically. Therefore, it is not selective and may also kill the surrounding health tissue. The principle of BNCT (Boron Neutron Capture Therapy) consist in targeting a tumor selectively with a boron-10 compound. This nuclide has a large capture cross section for thermal neutrons and the nuclear reaction and the delivered energy in locus will selective the tumor. Since its initial proposal in 1963 BNCT has made much progress, however it is not used in a routine treatment. In this work it was approached some complex procedures, as the obtention of selective boron compounds, the adequate set up of neutron beams, the biodistribution, the in vivo and in vitro studies, and also human patients treatments. This work provide fundamentals about BNCT to professional of different areas of knowledge since it comprises multidisciplinary study. It includes appendixes for the ones not related to the field for a better comprehension of the many aspects involved. It is also presented a glossary containing technical and basic aspects involved. It is also presented a glossary containing technical and basic terms referred in the work. (author). 174 refs, 1 fig, 12 apps

  19. Boron thermal/epithermal neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Fairchild, R.G.

    1982-01-01

    The development of various particle beams for radiotherapy represents an attempt to improve dose distribution, and to provide high LET radiations which are less sensitive to ambient physical and radiobiological factors such as oxygen tension, cell cycle, and dose rate. In general, a compromise is necessary as effective RBE is reduced in order to spread the dose distribution over the anticipated tumor volume. The approach of delivering stable non-toxic isotopes to tumor, and then activating these atoms subsequently via an external radiation beam has mator advantages; problems associated with high uptake of these isotopes in competing cell pools are obviated, and the general tumor volume can be included in the treatment field of the activating beam. As long as the normal tissues supporting tumor show a low uptake of the isotope to be activated, and as long as the range of the reaction products is short, dose will be restricted to tumor, with a consequent high therapeutic ratio. Neutron Capture Therapy (NCT) is generally carried out by activating boron-10 with low energy neutrons. The range of the high LET, low OER particles from the /sup 10/B(n, ..cap alpha..)/sup 7/Li reaction is approx. 10..mu.., or one cell diameter, a situation that is optimal for cell killing. Significant advantages may be gained by using the NCT procedure in conjunction with improved tissue penetration provided with epithermal or filtered beams, and new compounds showing physiological binding to tumor.

  20. Research needs for neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-01

    Key issues and questions addressed by the workshop related to optimization of Boron Neutron Capture Therapy (BNCT), in general, and to the possibility of success of the present BNCT trials at Brookhaven National Laboratory (BNL) and Massachusetts Institute of Technology (MIT), in particular. Both trials use nuclear fission reactors as neutron sources for BNCT of glioblastoma multiforme (BNL) and of deep seated melanoma (MIT). Presentations and discussions focussed on optimal boron-labeled compounds, mainly for brain tumors such as glioblastoma multiforme, and the best mode of compound delivery to the tumor. Also, optimizing neutron irradiation with dose delivery to the tumor cells and the issues of dosimetry of BNCT especially in the brain were discussed. Planning of treatment and of follow-up of patients, coordination of BNCT at various treatment sites, and the potential of delivering BNCT to various types of cancer with an appropriately tailored protocol were additional issues. The need for multicentric interdisciplinary cooperation among the different medical specialties was highlighted.

  1. Research needs for neutron capture therapy

    International Nuclear Information System (INIS)

    Key issues and questions addressed by the workshop related to optimization of Boron Neutron Capture Therapy (BNCT), in general, and to the possibility of success of the present BNCT trials at Brookhaven National Laboratory (BNL) and Massachusetts Institute of Technology (MIT), in particular. Both trials use nuclear fission reactors as neutron sources for BNCT of glioblastoma multiforme (BNL) and of deep seated melanoma (MIT). Presentations and discussions focussed on optimal boron-labeled compounds, mainly for brain tumors such as glioblastoma multiforme, and the best mode of compound delivery to the tumor. Also, optimizing neutron irradiation with dose delivery to the tumor cells and the issues of dosimetry of BNCT especially in the brain were discussed. Planning of treatment and of follow-up of patients, coordination of BNCT at various treatment sites, and the potential of delivering BNCT to various types of cancer with an appropriately tailored protocol were additional issues. The need for multicentric interdisciplinary cooperation among the different medical specialties was highlighted

  2. Neutron capture therapy: Years of experimentation---Years of reflection

    International Nuclear Information System (INIS)

    This report describes early research on neutron capture therapy over a number of years, beginning in 1950, speaking briefly of patient treatments but dwelling mostly on interpretations of our animal experiments. This work carried out over eighteen years, beginning over forty years ago. Yet, it is only fitting to start by relating how neutron capture therapy became part of Brookhaven's Medical Research Center program

  3. Advances in neutron capture therapy 2006. Proceedings of 12th international congress on neutron capture therapy

    International Nuclear Information System (INIS)

    The Twelfth International Congress on Neutron Capture Therapy (ICNCT-12) is being held from October 9th to 13th, 2006 at the Kagawa International Congress Hall in Takamatsu, Kagawa, Japan. The main theme of the congress is From the past to the Future'. Five symposiums were organized to accommodate all the contributions from the international scientific committees of the International Society for Neutron Capture Therapy (ISNCT), and two symposiums were added to balance the number of fields of specialties. The seven symposiums for ICNCT-12 are as follows: 1) Clinical Results of BNCT for Brain Tumors, 2) Dosimetry, 3) Treatment Planning system, 4) Drug Delivery System, 5) Biomedical and General Matters, 6) BNCT Systems using Accelerators, 7) New Applications and Protocols for BNCT. There are a total of 195 presentations in this congress: 3 special lectures, 34 symposium presentations, 10 presentations in two special sessions from the recipients of the Ralph G. Fairchild Award, 70 presentations in the oral parallel sessions and 78 presentations in the poster sessions. A compilation of 169 papers are published in this proceedings. The 165 of the presented papers are indexed individually. (J.P.N.)

  4. Boron neutron capture therapy for recurrent head and neck malignancies

    International Nuclear Information System (INIS)

    To avoid severe impairment of oro-facial structures and functions, it is necessary to explore new treatments for recurrent head and neck malignancies (HNM). Boron neutron capture therapy (BNCT) is tumor-cell targeted radiotherapy that has significant superiority over conventional radiotherapies in principle. So far for 4 years and 3 months, we have treated with 37 times of BNCT for 21 patients (14 squamous cell carcinomas (SCC), 4 salivary gland carcinomas and 3 sarcomas) with a recurrent and far advanced HNM since 2001. Results are (1) 10B concentration of tumor/normal tissue ratio (T/N ratio) of FBPA-PET studies were SCC: 1.8-5.7, sarcoma: 2.5-4.0, parotid tumor: 2.5-3.7. (2) Therapeutic effects were CR: 6cases, PR: 11cases, PD: 3cases NE (not evaluated): 1case. Response rate was 81%. (3) Improvement of QOL such as a relief of severe pain, bleeding, and exudates at the local lesion, improvement of PS, disappearance of ulceration, covered with normal skin and preserved oral and maxillofacial functions and tissues. (4) Survival periods after BNCT were 1-51 months (mean: 9.8 months). 4-year survival rate was 39% by Kaplan-Meier analysis. (5) A few adverse-effects such as transient mucositis, alopecia were recognized. These results indicate that BNCT represents a new and promising treatment approach for advanced HNM. (author)

  5. Treatment Planning for Accelerator-Based Boron Neutron Capture Therapy

    Science.gov (United States)

    Herrera, María S.; González, Sara J.; Minsky, Daniel M.; Kreiner, Andrés J.

    2010-08-01

    Glioblastoma multiforme and metastatic melanoma are frequent brain tumors in adults and presently still incurable diseases. Boron Neutron Capture Therapy (BNCT) is a promising alternative for this kind of pathologies. Accelerators have been proposed for BNCT as a way to circumvent the problem of siting reactors in hospitals and for their relative simplicity and lower cost among other advantages. Considerable effort is going into the development of accelerator-based BNCT neutron sources in Argentina. Epithermal neutron beams will be produced through appropriate proton-induced nuclear reactions and optimized beam shaping assemblies. Using these sources, computational dose distributions were evaluated in a real patient with diagnosed glioblastoma treated with BNCT. The simulated irradiation was delivered in order to optimize dose to the tumors within the normal tissue constraints. Using Monte Carlo radiation transport calculations, dose distributions were generated for brain, skin and tumor. Also, the dosimetry was studied by computing cumulative dose-volume histograms for volumes of interest. The results suggest acceptable skin average dose and a significant dose delivered to tumor with low average whole brain dose for irradiation times less than 60 minutes, indicating a good performance of an accelerator-based BNCT treatment.

  6. Boron neutron capture therapy for recurrent head and neck malignancies

    International Nuclear Information System (INIS)

    Boron neutron capture therapy (BNCT) is a tumor-cell targeted radiotherapy. When 10B absorbs thermal neutrons, the alpha and 7Li particles generated by the 10B (n, α) 7Li reaction are high linear energy transfer (LET) particles, and carry high kinetic energy (2.34 MeV), and have short ranges (4-9 micron-meters) of approximately one-cell diameter, resulting in a large relative biological effectiveness (RBE) and selective destruction of tumor cells containing 10B. We have, for the first time in the world, used BNCT to treat 11 patients with recurrent head and neck malignancies (HNM) after a standard primary therapy since 2001. The 11 patients were composed of 6 squamous cell carcinomas, 3 salivary gland tumors and 2 sarcomas. The results of BNCT were as follows. Regression rates (volume %) were complete response (CR): 2 cases, >90%: 5 cases, 73%: 1 case, 54%: 1 case, progressive disease (PD): 1 case, NE (not evaluated): 1 case. The response rate was 82%. Improvement of quality of life (QOL) was recognized, such as disappearance of tumor ulceration and covering with normal skin: relief of severe pain, bleeding, trismus and dyspnea: improvement of performance status (PS) (from 4 to 2) allowing the patients to return to work and elongate his survival period. Survival periods after BNCT were 1-38 months (mean: 8.5 months). The survival rate was 36% (4 cases). There are a few side-effects such as transient mucositis and alopecia less than Grade-2. These results indicate that BNCT represents a new and promising treatment approach even for a huge or far-advanced HNM. (author)

  7. Recent progress of basic studies for neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Ono, Koji [Kyoto Univ., Kumatori, Osaka (Japan). Research Reactor Inst

    2001-01-01

    Epi-thermal neutron irradiation for malignant brain tumors is the mainstream of recent studies in boron neutron capture therapy. To improve the depth dose distribution in water phantom, a LiF plate (5 mmt, 6 cm {phi}) is located in the front of center axis of KUR irradiation field. Thermal neutron flux at the center surface of the water phantom is shielded by the LiF plate. The depth and peripheral dose distribution of thermal neutron flux becomes to uniform. The boron dose at 6 cm in the depths of the phantom increases to about 1.71 times greater than the usual irradiation field. Two-kinds of nuclear medicines, Na{sub 2}B{sub 12}H{sub 11}SH(BSH) and Borono Phenyl Alanine (BPA), have been used for boron neutron capture therapy. BPA-ol, a new medicine of modified compound of the BPA can be used effectively on hyperthermia of cancer parts to 42 - 43degC. Cell death and mutagenesis of chinese hamster ovary cells (CHO) after pre-incubation with BPA and BSH are investigated for the validity of boron neutron capture therapy. The effects of BSH on the cell death and the mutagenesis are few in comparison with those of BPA. It is thought that the BSH is not accumulated in the cell. The effects of boron neutron capture therapy on sensitivity of intratumor quiescent and total cells are investigated. (Suetake, M.)

  8. Proceedings of the first international symposium on neutron capture therapy

    International Nuclear Information System (INIS)

    This meeting was arranged jointly by MIT and BNL in order to illuminate progress in the synthesis and targeting of boron compounds and to evaluate and document progress in radiobiological and dosimetric aspects of neutron capture therapy. It is hoped that this meeting will facilitate transfer of information between groups working in these fields, and encourage synergistic collaboration

  9. Proceedings of the first international symposium on neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Fairchild, R.G.; Brownell, G.L. (eds.)

    1982-01-01

    This meeting was arranged jointly by MIT and BNL in order to illuminate progress in the synthesis and targeting of boron compounds and to evaluate and document progress in radiobiological and dosimetric aspects of neutron capture therapy. It is hoped that this meeting will facilitate transfer of information between groups working in these fields, and encourage synergistic collaboration.

  10. Medical and biological requirements for boron neutron capture therapy

    International Nuclear Information System (INIS)

    In conventional radiation therapy, tumor doses applied to most solid tumors are limited by the tolerance of normal tissues. The promise of Boron Neutron Capture Therapy lies in its potential to deposit high doses of radiation very specifically to tumor tissue. Theoretically ratios of tumor to normal tissue doses can be achieved significantly higher than conventional radiotherapeutic techniques would allow. Effective dose distributions obtainable are a complex function of the neutron beam characteristics and the macro and micro distributions of boron in tumor and normal tissues. Effective RBE doses are calculated in tumors and normal tissue for thermal, epithermal and 2 keV neutrons

  11. Boron neutron capture therapy for oral precancer: proof of principle in an experimental animal model

    Energy Technology Data Exchange (ETDEWEB)

    A. Monti Hughes; ECC Pozzi; S. Thorp; M. A. Garabalino; R. O. Farias; S. J. Gonzalez; E. M. Heber; M. E. Itoiz; R. F. Aromando; A. J. Molinari; M. Miller; D. W. Nigg; P. Curotto; V. A. Trivillin; A. E. Schwint

    2013-11-01

    Field-cancerized tissue can give rise to second primary tumours, causing therapeutic failure. Boron neutron capture therapy (BNCT) is based on biological targeting and would serve to treat undetectable foci of malignant transformation. The aim of this study was to optimize BNCT for the integral treatment for oral cancer, with particular emphasis on the inhibitory effect on tumour development originating in precancerous conditions, and radiotoxicity of different BNCT protocols in a hamster cheek pouch oral precancer model.

  12. Laryngeal adenocystic carcinoma treated by proton therapy

    International Nuclear Information System (INIS)

    Adenocystic carcinoma most commonly develops in the major salivary glands, on the other hand it is rare for adenocystic carcinoma to develop in the larynx. We report a case of adenocystic carcinoma in the larynx. A 54-year-old male was hospitalized with symptoms of hoarseness and dyspnea on exertion. He presented a tumor that developed at the base of the right arytenoid, and covered over the glottis. It was confirmed to be adenocystic carcinoma (solid type) by biopsy. Positron emission tomography (PET)-CT also revealed a left cervical lymph node metastasis and multiple pulmonary metastases (T1N2cM1). He was treated with proton therapy to the larynx to prevent airway obstruction by growth of the tumor and to preserve the larynx because he had uncontrollable pulmonary metastasis. Although the tumor vanished after the treatment, one month later he had halitosis, dyspnea and bilateral vocal cord palsy. Despite administration of an antibacterial drug and steroid, there was no improvement to the narrowness of the glottis. A tracheotomy was therefore performed three months after the proton therapy. PET-CT, which was performed after the tracheotomy, suggested growth of the residual tumor or laryngeal radionecrosis. This study confirmed that proton therapy is effective for adenocystic carcinoma in the larynx. However, proton therapy also was found to cause laryngeal radionecrosis. These results indicate the importance of evaluating the side effects of radiation therapy and providing that information to the patient. (author)

  13. Could New 'Talk Therapy' Cut Cost of Treating Depression?

    Science.gov (United States)

    ... Could New 'Talk Therapy' Cut Cost of Treating Depression? Behavioral activation would be more accessible than currently ... gold-standard treatment -- cognitive behavioral therapy -- for treating depression in adults, a new study suggests. The researchers ...

  14. Carborane derivative development for boron neutron capture therapy. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Barnum, Beverly A.; Yan Hao; Moore, Roger; Hawthorne, M. Frederick; Baum, Kurt

    1999-04-01

    Boron Neutron Capture Therapy [BNCT] is a binary method of cancer therapy based on the capture of neutrons by a boron-10 atom [{sup 10}B]. Cytotoxic {sup 7}Li nuclei and {alpha}-particles are emitted, with a range in tissue of 9 and 5 {micro}m, respectively, about one cell diameter. The major obstacle to clinically viable BNCT is the selective localization of 5-30 ppm {sup 10}B in tumor cells required for effective therapy. A promising approach to BNCT is based on hydrophilic boron-rich oligomeric phosphate diesters, or ''trailers'' that have been shown to concentrate selectively in tumor tissue. Examples of these compounds were prepared previously at high cost using an automated DNA synthesizer. Direct synthesis methods are needed for the production of gram-scale quantities for further biological evaluation. The work accomplished as a result of the collaboration between Fluorochem, Inc. and UCLA demonstrates that short oligomers containing at least five carborane units with four phosphodiester linkages can be prepared in substantial quantities. This work was accomplished by the application of standard phosphoramidite coupling chemistry.

  15. Boron neutron capture therapy; Radioterapia per cattura neutronica del boro

    Energy Technology Data Exchange (ETDEWEB)

    Mattioda, F. [Turin Politecnico, Turin (Italy); Merlone, A. [Pisa Univ., Pisa (Italy); Agosteo, S. [Milan Politecnico, Milan (Italy); Istituto Nazionale di Fisica Nucleare, Milan (Italy); Burn, K.W.; Tinti, R. [ENEA, Bologna (Italy). Dipt. energia; Capannesi, G.; Rosi, G. [ENEA, Casaccia (Italy). Dipt. innovazione; Casali, F.; Nava, E. [Bologna UNiv., Bologna (Italy); Gambarini, G. [Milan Univ., Milan (Italy)

    1999-08-01

    Boron radiotherapy in cancer treatment and the feasibility of using the Tapiro reactor as a neutron source is discussed. In particle, the article aims to focus attention on the possibility using ENEA's (National Agency for New Technology, Energy and the Environment) Tapiro reactor, appropriately modified, as a suitable neutron source for the experimental phase of boron neutron capture therapy in Italy. [Italian] Sono presentati gli studi sulla radioterapia per cattura neutronica del boro nella cura di alcune neoplasie e l'utilizzo del reattore Tapiro come sorgente di neutroni nel progetto italiano di ricerca condotto dall'ENEA.

  16. Treating cerebral palsy with aculaser therapy

    Science.gov (United States)

    Anwar, Shahzad; Nazir Khan, Malik M.; Nadeem Khan, Malik M.; Qazi, Faiza M.; Awan, Abid H.; Dar, Irfan

    2008-03-01

    A single, open and non comparative study was conducted at Anwar Shah Trust for C.P. & Paralysis in collaboration with the Departments of Neurology and Neurosurgery, Children Hospital Lahore, Pakistan to evaluate the effects of ACULASER THERAPY in childern suffering from Cerebral Palsy (C.P.) and associated Neurological Disorders like epilepsy, cortical blindness, spasticity, hemiplegia, paraplegia, diplegia, quadriplegia, monoplegia, sensory-neural deafness and speech disorders. In all 250 childern were treated and the data was gathered during a period of 3 years from December 2003 till December 2006. These children were further classified according to the type of C.P. (spastic, athetoid, mixed) they suffered from and associated Neurological Disorders. This article shows results in C.P. childern who were treated with ACULASER THERAPY for minimum 6 weeks and more or had minimum of 15 treatment sessions and more. This article also shows that those childern who were given a break in the treatment for 1 month to 1 year did not show any reversal of the signs and symptoms. Analysis of the data showed that out of 171 children with Spasticity and Stiffness 147 showed marked improvement showing 87% success rate, out of 126 children with Epileptic fits, there was a significant reduction in the intensity, frequency and duration of Epileptic fits in 91 children showing 72% success rate, out of 48 children with Cortical Blindness 30 children showed improvement accounting for 63% efficacy rate, out of 105 children with Hearing Difficulties, 63 showed marked improvement accounting for 60% improvement rate, out of 190 children with Speech Disorders 122 showed improvement reflecting 64% improvement rate, out of 96 children with Hemiplegia 71 showed improvement in movement, tone and power accounting for 74% improvement rate, out of 76 children with Quadriplegia 52 showed improvement in gross and fine motor functions showing 69% success rate and out of 58 children with Paraplegia of

  17. SBNCT plan: A 3-dimensional treatment planning system for boron neutron capture therapy

    International Nuclear Information System (INIS)

    The need for accurate and comprehensive 3-dimensional treatment planning for boron neutron capture therapy (BNCT) has been debated for the past several years. Although many argue against the need for elaborate and expensive treatment planning programs which mimic conventional radiotherapy planning systems, it is clear that in order to realize significant gains over conventional fractionated radiation therapy, patients must be treated to the edge of normal tissue tolerance. Just how close to this edge is dictated by the uncertainties in dosimetry. Hence the focus of BNCT planning is the determination of dose distribution throughout normal tissue volumes. Although precise geometric manipulation of the epithermal neutron beam is not achievable, the following variables play an important role in BNCT optimization: patient orientation, dose fractionation, number of fields, megawatt-minutes per fraction, use of surface bolus, and use of collimation. Other variables which are not as easily adjustable and would not, therefore, be part of treatment planning optimization, include external patient contour, internal patient heterogeneities, boron compound distributions, and RBE's. The boron neutron capture therapy planning system developed at SUNY Stony Brook (SBNCT-Plan) was designed as an interactive graphic tool to assist the radiation oncologist in generating the optimum plan for a neutron capture treatment

  18. Selective thermal neutron capture therapy of cancer cells using their specific functional differentiation

    International Nuclear Information System (INIS)

    The theory and the history of selective thermal neutron capture therapy for malignant melanoma, thermal neutron capture therapy which has been developed by authors, synthesis and effects of 10B-compounds accumulating in melanoma cells and absorbing thermal neutron easily, and many experiments concerning this therapy were reviewed and discussed. (Tsunoda, M.)

  19. New compounds for neutron capture therapy (NCT) and their significance

    Energy Technology Data Exchange (ETDEWEB)

    Fairchild, R.G.; Bond, V.P.

    1982-01-01

    Clearly the most effective tumor therapy would be obtained by the selective targeting of cytotoxic agents to tumor cells. Although many biomolecules are known to be taken up in tumors, the targeting of cytotoxic agents to tumors is limited by the fact that other essential cell pools compete with equal or even greater effectiveness. The approach of delivering stable non-toxic isotopes to tumor, with activation by means of an external radiation beam, is advantageous for two reasons: (1) it obviates problems associated with high uptake of isotopes in normal tissues, as these cell pools can be excluded from the radiation field, and (2) the general tumor area can be included in the activating beam field; thus, the possibility exists that all microscopic tumor extensions can be irradiated. As long as range of reaction products is short, dose will be restricted to the tumor, with a resultant high therapeutic ratio. This method can be accomplished with either photon activation therapy (PAT) or Neutron Capture Therapy (NCT), the latter will be emphasized here. The range of the high LET, low OER particles from the /sup 10/B(n,..cap alpha..)/sup 7/Li reaction is approx. 10 ..mu..m, or one cell diameter; hence this reaction is optimal for cell killing. A number of biomolecules have been investigated as possible vehicles for transport of boron to tumors, including phenothiazines, thiouracils, porphyrins, nucleosides, and amino acids. Biodistributions of these compounds show selective concentration in tumor adequate for therapy. The biological halflives are in the order of days, allowing the possibility of fractionated or protracted irradiations. The radiobiological and physical implication of these parameters on NCT are discussed. The possibility of using an approximately-monoenergetic, scandium-filtered beam of about 2 keV, to reduce the dose from background radiations by about 85%, is also discussed. (ERB)

  20. Development of inverse-planning system for neutron capture therapy

    International Nuclear Information System (INIS)

    To lead proper irradiation condition effectively, Japan Atomic Energy Agency (JAEA) is developing an inverse-planning system for neutron capture therapy (NCT-IPS) based on the JAEA computational dosimetry system (JCDS) for BNCT. The leading methodology of an optimum condition in the NCT-IPS has been applied spatial channel theory with adjoint flux solution of Botzman transport. By analyzing the results obtained from the adjoint flux calculations according to the theory, optimum incident point of the beam against the patient can be found, and neutron spectrum of the beam which can generate ideal distribution of neutron flux around tumor region can be determined. The conceptual design of the NCT-IPS was investigated, and prototype of NCT-IPS with JCDS is being developed. (author)

  1. Carborane compounds for neutron capture therapy of malignant melanoma

    International Nuclear Information System (INIS)

    The possibility of using thiouracil as a vehicle for stable nuclei such as 10B for neutron capture therapy (NCT) of melanoma was first discussed by Fairchild and co-workers in 1982. The author's research has been directed towards the design and synthesis of a number of o-carboranyl-thiouracils, the ten boron atoms of the carborane cage having a clear advantage for NCT. The first step was the preparation, previously reported, of thiouracils bearing an alkyl group continuing a triple bond for later elaboration to a carborane. The present paper describes the continuation of this work with the preparation of the carboranes of this series and its extension to the synthesis of a thiouracil in which a carboranylalkyl group is attached to the nitrogen in the 3-position

  2. Physico-technical progress in neutron-capture therapy method

    International Nuclear Information System (INIS)

    This paper describes mainly development studies on the determination method of in vivo 10B for the purpose of employment for neutron capture therapy for malignant melanoma and other tumors. To darify the efficacy of the neutron capture therapy, it is necessary to determine 10B concentration in the diseased part. This study aimed at in vivo 10B concention determination in living sample to the level of ppm order with 10 % of analytical error within 1 hour, and these determination conditions were satified by prompt γ-ray (478 keV) determination of 10B (n, αγ)7Li reaction. This method required no sample pretreatment. Further, data normalization by γ-ray of H(n, γ)D reaction permitted no disturbance by sample shape or size. Lower limit of detection of the proposed method was estimated in terms of measuring time and statistical error by the equations of 10B concentration and error analysis derived by the authors. As for the effect of prompt γ-rays of 23Na(n, γ)24Na and 6Li(n, γ)7Li reactions, it was clarified that the former showed no disturbance but some correction was necessary in case of less than 0.1 g of smaple size owing to the latter reaction. In vivo sample determination showed the proposed method was practical. In this paper some results of phantom experiment for in vivo non-destructive 10B measurement and related simulation calculation, and examination of effect of (γ, n) reaction in heavy water of biomedical irradiation equipment on radiation quality were also described. (Takagi, S.)

  3. Boron Neutron Capture Therapy for Malignant Brain Tumors.

    Science.gov (United States)

    Miyatake, Shin-Ichi; Kawabata, Shinji; Hiramatsu, Ryo; Kuroiwa, Toshihiko; Suzuki, Minoru; Kondo, Natsuko; Ono, Koji

    2016-07-15

    Boron neutron capture therapy (BNCT) is a biochemically targeted radiotherapy based on the nuclear capture and fission reactions that occur when non-radioactive boron-10, which is a constituent of natural elemental boron, is irradiated with low energy thermal neutrons to yield high linear energy transfer alpha particles and recoiling lithium-7 nuclei. Therefore, BNCT enables the application of a high dose of particle radiation selectively to tumor cells in which boron-10 compound has been accumulated. We applied BNCT using nuclear reactors for 167 cases of malignant brain tumors, including recurrent malignant gliomas, newly diagnosed malignant gliomas, and recurrent high-grade meningiomas from January 2002 to May 2014. Here, we review the principle and history of BNCT. In addition, we introduce fluoride-18-labeled boronophenylalanine positron emission tomography and the clinical results of BNCT for the above-mentioned malignant brain tumors. Finally, we discuss the recent development of accelerators producing epithermal neutron beams. This development could provide an alternative to the current use of specially modified nuclear reactors as a neutron source, and could allow BNCT to be performed in a hospital setting.

  4. Boron Neutron Capture Therapy for Malignant Brain Tumors

    Science.gov (United States)

    MIYATAKE, Shin-Ichi; KAWABATA, Shinji; HIRAMATSU, Ryo; KUROIWA, Toshihiko; SUZUKI, Minoru; KONDO, Natsuko; ONO, Koji

    2016-01-01

    Boron neutron capture therapy (BNCT) is a biochemically targeted radiotherapy based on the nuclear capture and fission reactions that occur when non-radioactive boron-10, which is a constituent of natural elemental boron, is irradiated with low energy thermal neutrons to yield high linear energy transfer alpha particles and recoiling lithium-7 nuclei. Therefore, BNCT enables the application of a high dose of particle radiation selectively to tumor cells in which boron-10 compound has been accumulated. We applied BNCT using nuclear reactors for 167 cases of malignant brain tumors, including recurrent malignant gliomas, newly diagnosed malignant gliomas, and recurrent high-grade meningiomas from January 2002 to May 2014. Here, we review the principle and history of BNCT. In addition, we introduce fluoride-18-labeled boronophenylalanine positron emission tomography and the clinical results of BNCT for the above-mentioned malignant brain tumors. Finally, we discuss the recent development of accelerators producing epithermal neutron beams. This development could provide an alternative to the current use of specially modified nuclear reactors as a neutron source, and could allow BNCT to be performed in a hospital setting. PMID:27250576

  5. Boron Neutron Capture Therapy for Malignant Brain Tumors.

    Science.gov (United States)

    Miyatake, Shin-Ichi; Kawabata, Shinji; Hiramatsu, Ryo; Kuroiwa, Toshihiko; Suzuki, Minoru; Kondo, Natsuko; Ono, Koji

    2016-07-15

    Boron neutron capture therapy (BNCT) is a biochemically targeted radiotherapy based on the nuclear capture and fission reactions that occur when non-radioactive boron-10, which is a constituent of natural elemental boron, is irradiated with low energy thermal neutrons to yield high linear energy transfer alpha particles and recoiling lithium-7 nuclei. Therefore, BNCT enables the application of a high dose of particle radiation selectively to tumor cells in which boron-10 compound has been accumulated. We applied BNCT using nuclear reactors for 167 cases of malignant brain tumors, including recurrent malignant gliomas, newly diagnosed malignant gliomas, and recurrent high-grade meningiomas from January 2002 to May 2014. Here, we review the principle and history of BNCT. In addition, we introduce fluoride-18-labeled boronophenylalanine positron emission tomography and the clinical results of BNCT for the above-mentioned malignant brain tumors. Finally, we discuss the recent development of accelerators producing epithermal neutron beams. This development could provide an alternative to the current use of specially modified nuclear reactors as a neutron source, and could allow BNCT to be performed in a hospital setting. PMID:27250576

  6. Cellular uptake and in vitro antitumor efficacy of composite liposomes for neutron capture therapy

    OpenAIRE

    Peters, Tanja; Grunewald, Catrin; Blaickner, Matthias; Ziegner, Markus; Schütz, Christian; Iffland, Dorothee; Hampel, Gabriele; Nawroth, Thomas; Langguth, Peter

    2015-01-01

    Background Neutron capture therapy for glioblastoma has focused mainly on the use of 10B as neutron capture isotope. However, 157Gd offers several advantages over boron, such as higher cross section for thermal neutrons and the possibility to perform magnetic resonance imaging during neutron irradiation, thereby combining therapy and diagnostics. We have developed different liposomal formulations of gadolinium-DTPA (Magnevist®) for application in neutron capture therapy of glioblastoma. The f...

  7. Boron neutron capture therapy in cancer: past, present and future

    Energy Technology Data Exchange (ETDEWEB)

    Pisarev, Mario A.; Dagrosa, Maria Alejandra; Juvenal, Guilermo J. [National Atomic Energy Commission, Buenos Aires (Argentina). Div. of Nuclear Biochemistry; University of Buenos Aires (Argentina). School of Medicine. Dept. of Human Biochemistry

    2007-07-15

    Undifferentiated thyroid cancer (UTC) is a very aggressive tumor with no effective treatment, since it lacks iodine uptake and does not respond to radio or chemotherapy. The prognosis of these patients is bad, due to the rapid growth of the tumor and the early development of metastasis. Boron neutron capture therapy (BNCT) is based on the selective uptake of certain boron non-radioactive compounds by a tumor, and the subsequent irradiation of the area with an appropriate neutron beam. {sup 10}B is then activated to {sup 11}B, which will immediately decay releasing alpha particles and {sup 7}Li, of high linear energy transfer (LET) and limited reach. Clinical trials are being performed in patients with glioblastoma multiform and melanoma. We have explored its possible application to UTC. Our results demonstrated that a cell line of human UTC has a selective uptake of borophenylalanine (BPA) both in vitro and after transplantation to nude mice. Treatment of mice by BNCT led to a complete control of growth and cure of 100% of the animals. Moreover dogs with spontaneous UTC also have a selective uptake of BPA. At the present we are studying the biodistribution of BPA in patients with UTC before its application in humans. (author)

  8. Intervertebral Disc Herniation Treated by Comprehensive Therapy

    Institute of Scientific and Technical Information of China (English)

    SUN Yu; HUANG Guo-qi

    2007-01-01

    In the treatment of 169 cases of the patients sick with intervertebral disc hemiation by integrated application of acupuncture therapy,Chinese massage therapy and herbal fumigation method.the results showed cure in 129 cases.improvement in 33 cases and failure in 7 cases,and the total effective rate was 95.9%.

  9. Treating Psoriasis: Complementary and Alternative Therapies

    Science.gov (United States)

    ... physical therapies, exercise and the ancient arts of acupuncture and tai chi. Much of the evidence supporting ... your risk of heart disease and type 2 diabetes. Your risk for heart disease and type 2 ...

  10. Carboranyl Nucleosides & Oligonucleotides for Neutron Capture Therapy Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Schinazi, Raymond F.

    2004-12-01

    This proposal enabled us to synthesize and develop boron-rich nucleosides and oligonucleotide analogues for boron neutron capture therapy (BNCT) and the treatment of various malignancies. First, we determined the relationship between structure, cellular accumulation and tissue distribution of 5-o-carboranyl-2'-deoxyuridine (D-CDU) and its derivatives D-ribo-CU and 5-o-carboranyluracil (CU), to potentially target brain and other solid tumors for neutron capture therapy. Synthesized carborane containing nucleoside derivatives of CDU, D- and L-enantiomers of CDU, D-ribo-CU and CU were used. We measured tissue disposition in xenografted mice bearing 9479 human prostate tumors xenografts and in rats bearing 9L gliosarcoma isografts in their flanks and intracranially. The accumulation of D-CDU, 1-({beta}-L-arabinosyl)-5-o-carboranyluracil, D-ribo-CU, and CU were also studied in LnCap human prostate tumor cells and their retention was measured in male nude mice bearing LnCap and 9479 human prostate tumor xenografts. D-CDU, D-ribo-CU and CU levels were measured after administration in mice bearing 9479 human prostate tumors in their flanks. D-CDU achieved high cellular concentrations in LnCap cells and up to 2.5% of the total cellular compound was recovered in the 5'-monophosphorylated form. D-CDU cellular concentrations were similar in LnCap and 9479 tumor xenografts. Studies in tumor bearing animals indicated that increasing the number of hydroxyl moieties in the sugar constituent of the carboranyl nucleosides lead to increased rate and extent of renal elimination, a decrease in serum half-lives and an increased tissue specificity. Tumor/brain ratios were greatest for CDU and D-ribo-CU, while tumor/prostate ratios were greatest with CU. CDU and D-ribo-CU have potential for BNCT of brain malignancies, while CU may be further developed for prostate cancer. A method was developed for the solid phase synthesis of oligonucleotides containing (ocarboran-1-yl

  11. Carboranyl Oligonucleotides for Neutron Capture Therapy Final Report

    International Nuclear Information System (INIS)

    This proposal enabled us to synthesize and develop boron-rich nucleosides and oligonucleotide analogues for boron neutron capture therapy (BNCT) and the treatment of various malignancies. First, we determined the relationship between structure, cellular accumulation and tissue distribution of 5-o-carboranyl-2'-deoxyuridine (D-CDU) and its derivatives D-ribo-CU and 5-o-carboranyluracil (CU), to potentially target brain and other solid tumors for neutron capture therapy. Synthesized carborane containing nucleoside derivatives of CDU, D- and L-enantiomers of CDU, D-ribo-CU and CU were used. We measured tissue disposition in xenografted mice bearing 9479 human prostate tumors xenografts and in rats bearing 9L gliosarcoma isografts in their flanks and intracranially. The accumulation of D-CDU, 1-(β-L-arabinosyl)-5-o-carboranyluracil, D-ribo-CU, and CU were also studied in LnCap human prostate tumor cells and their retention was measured in male nude mice bearing LnCap and 9479 human prostate tumor xenografts. D-CDU, D-ribo-CU and CU levels were measured after administration in mice bearing 9479 human prostate tumors in their flanks. D-CDU achieved high cellular concentrations in LnCap cells and up to 2.5% of the total cellular compound was recovered in the 5'-monophosphorylated form. D-CDU cellular concentrations were similar in LnCap and 9479 tumor xenografts. Studies in tumor bearing animals indicated that increasing the number of hydroxyl moieties in the sugar constituent of the carboranyl nucleosides lead to increased rate and extent of renal elimination, a decrease in serum half-lives and an increased tissue specificity. Tumor/brain ratios were greatest for CDU and D-ribo-CU, while tumor/prostate ratios were greatest with CU. CDU and D-ribo-CU have potential for BNCT of brain malignancies, while CU may be further developed for prostate cancer. A method was developed for the solid phase synthesis of oligonucleotides containing (ocarboran-1-yl

  12. A standardized method for beam design in neutron capture therapy

    International Nuclear Information System (INIS)

    A desirable end point for a given beam design for Neutron Capture Therapy (NCT) should be quantitative description of tumour control probability and normal tissue damage. Achieving this goal will ultimately rely on data from NCT human clinical trials. Traditional descriptions of beam designs have used a variety of assessment methods to quantify proposed or installed beam designs. These methods include measurement and calculation of open-quotes free fieldclose quotes parameters, such as neutron and gamma flux intensities and energy spectra, and figures-of-merit in tissue equivalent phantoms. The authors propose here a standardized method for beam design in NCT. This method would allow all proposed and existing NCT beam facilities to be compared equally. The traditional approach to determining a quantitative description of tumour control probability and normal tissue damage in NCT research may be described by the following path: Beam design → dosimetry → macroscopic effects → microscopic effects. Methods exist that allow neutron and gamma fluxes and energy dependence to be calculated and measured to good accuracy. By using this information and intermediate dosimetric quantities such as kerma factors for neutrons and gammas, macroscopic effect (absorbed dose) in geometries of tissue or tissue-equivalent materials can be calculated. After this stage, for NCT the data begins to become more sparse and in some areas ambiguous. Uncertainties in the Relative Biological Effectiveness (RBE) of some NCT dose components means that beam designs based on assumptions considered valid a few years ago may have to be reassessed. A standard method is therefore useful for comparing different NCT facilities

  13. A suggestion for B-10 imaging during boron neutron capture therapy

    OpenAIRE

    Cortesi, M.

    2007-01-01

    Selective accumulation of B-10 compound in tumour tissue is a fundamental condition for the achievement of BNCT (Boron Neutron Capture Therapy), since the effectiveness of therapy irradiation derives just from neutron capture reaction of B-10. Hence, the determination of the B-10 concentration ratio, between tumour and healthy tissue, and a control of this ratio, during the therapy, are essential to optimise the effectiveness of the BNCT, which it is known to be based on the selective uptake ...

  14. [Using alternative therapies in treating sleep disturbance].

    Science.gov (United States)

    Hung, Hsuan-Man; Chen, Chung-Hey

    2011-02-01

    Sleep disturbance is a common health problem among adults, and enhancing sleep quality is an issue of significant importance to healthcare providers. As sleep quality worsens into insomnia, individuals may seek assistance from medication. However, sedative hypnotic drugs pose potentially adverse effects. Also, most medical treatments (e.g., positive pressure assistant ventilators) represent invasive interventions that must be prescribed by physicians. Non-pharmacological alternative therapies are commonly recommended and adopted by community nurses. Alternative therapies for sleep disturbance included exercise, cognitive behavior therapy, multiple strategies, music, and acupressure. In general, moderately intensive walking exercise is the intervention most recommended by professionals to help patients deal with sleep disturbance. Therefore, it is suggested that future researchers devise sleep quality promotion strategies that are suitable for home practice in order to apply the findings and spirit of research already done in this area. PMID:21328208

  15. Therapies for Treating Diabetic Nerve Pain

    Science.gov (United States)

    ... or neuropathy. Neurologists from the American Academy of Neurology are doctors who identify and treat diseases of ... an educational service of the American Academy of Neurology. It is based on an assessment of current ...

  16. Protein Replacement Therapy Shows Promise in Treating Rare Skin Disorder

    Science.gov (United States)

    ... 1999 Spotlight on Research 2014 February 2014 (historical) Protein Replacement Therapy Shows Promise in Treating Rare Skin Disorder Replacing a protein that is crucial to ensuring that the skin’s ...

  17. Impact of individual acid flue gas components on mercury capture by heat-treated activated carbon

    Institute of Scientific and Technical Information of China (English)

    Jian-ming ZHENG; Jin-song ZHOU; Zhong-yang LUO; Ke-fa CEN

    2012-01-01

    Elemental mercury capture on heat-treated activated carbon (TAC) was studied using a laboratory-scale fixed bed reactor.The capability of TAC to perform Hg0 capture under both N2 and baseline gas atmospheres was studied and the effects of common acid gas constituents were evaluated individually to avoid complications resulting from the coexistence of multiple components.The results suggest that surface functional groups (SFGs) on activated carbon (AC) are vital to Hg0 capture in the absence of acid gases.Meanwhile,the presence of acid gas components coupled with defective graphitic lattices on TAC plays an important role in effective Hg0 capture.The presence of HCl,NO2,and NO individually in basic gases markedly enhances Hg0 capture on TAC due to the heterogeneous oxidation of Hg0 on acidic sites created on the carbon surface and catalysis by the defective graphitic lattices on TAC.Similarly,the presence of SO2 improves Hg0 capture by about 20%.This improvement likely results from the deposition of sulfur groups on the AC surface and oxidation of the elemental mercury by SO2 due to catalysis on the carbon surface.Furthermore,O2 exhibits a synergistic effect on Hg0 oxidation and capture when acid gases are present in the flue gases.

  18. Isodose Curves and Treatment Planning for Boron Neutron Capture Therapy.

    Science.gov (United States)

    Liu, Hungyuan B.

    The development of Boron Neutron Capture Therapy (BNCT) has been progressing in both ^{10 }B compound development and testing and neutron beam delivery. Animal tests are now in progress with several ^{10}B compounds and once the results of these animal tests are promising, patient trials can be initiated. The objective of this study is to create a treatment planning method based on the dose calculations by a Monte Carlo code of a mixed radiation field to provide linkage between phantom dosimetry and patient irradiation. The research started with an overall review of the development of BNCT. Three epithermal neutron facilities are described, including the operating Brookhaven Medical Research Reactor (BMRR) beam, the designed Missouri University Research Reactor (MURR) beam, and a designed accelerator based neutron source. The flux and dose distributions in a head model have been calculated for irradiation by these neutron beams. Different beam parameters were inter -compared for effectiveness. Dosimetric measurements in an elliptical lucite phantom and a cylindrical water phantom were made and compared to the MCNP calculations for irradiation by the BMRR beam. Repeated measurements were made and show consistent. To improve the statistical results calculated by MCNP, a neutron source plane was designed to start neutrons at the BMRR irradiation port. The source plane was used with the phantoms for dosimetric calculations. After being verified by different phantom dosimetry and in-air flux measurements at the irradiation port, the source plane was used to calculate the flux and dose distributions in the head model. A treatment planning program was created for use on a PC which uses the MCNP calculated results as input. This program calculates the thermal neutron flux and dose distributions of each component of radiation in the central coronal section of the head model for irradiation by a neutron beam. Different combinations of head orientations and irradiation

  19. [How I treat... chronic insomnia by cognitive and behavioral therapy].

    Science.gov (United States)

    Dethier, M; Blairy, S; Poirrier, R

    2016-04-01

    Today, insomnia is predominantly treated by pharmacotherapy. Yet, cognitive-behavioral therapy has better long-term outcomes. In this paper, we describe the basic principles of this short-term psychotherapeutic treatment. It combines methods of sleep restriction and stimulus control, the learning of relaxation techniques, advices on sleep hygiene and cognitive therapy techniques applied to cognitions that overwhelm insomniac moments. PMID:27295894

  20. Treating the sibling subsystem: an adjunct of divorce therapy.

    Science.gov (United States)

    Schibuk, M

    1989-04-01

    Sibling therapy, frequently overlooked as a method of treatment, is particularly appropriate in situations that require a deliberate focus on the "unit of continuity," or the subsystem that remains intact during a process of family reorganization. For this and other reasons it can be an effective tool in treating children of divorce. A case illustrating this use of sibling therapy is presented.

  1. FiR 1 Reactor in Service for Boron Neutron Capture Therapy (BNCT) and Isotope Production

    International Nuclear Information System (INIS)

    The FiR 1 reactor, a 250 kW Triga reactor, has been in operation since 1962. The main purpose to run the reactor is now the Boron Neutron Capture Therapy (BNCT). Although BNCT dominates the current utilization of the reactor, it also has an important national role in providing local enterprises and research institutions in the fields of industrial measurements, pharmaceuticals, electronics, etc. with isotope produc- tion and activation analysis services. The whole reactor building has been renovated, creating a dedicated clinical BNCT facility at the reactor. Close to 30 patients have been treated since May 1999, when the licence for patient treatment was granted to the responsible BNCT treatment organization. The treatment organization has a close connection to the Helsinki University Central Hospital. (author)

  2. Establishment of optimal thermal neutron capture therapy for 5 types of human malignant melanoma

    International Nuclear Information System (INIS)

    A series of boron neutron capture therapy (BNCT) studies has already germinated in 1972, with a view to establishing the BNCT particularly suited for the treatment of various types of malignant melanoma, and has been succeeded by research teams comprised of multi-disciplinary members. Twelve patients (7 men and 5 women, aged from 50 to 85 years) with malignant melanoma have been treated with BNCT; among them, six patients were completely cured, four had extremely reduced tumors, and two were still in the clinical process. The present Progress Report is a compilation of 39 research presentations for the recent two years. In this report, three patients are described. Of these, one patient had deep-seated lesions in right and left lymph nodes. These lesions were cured by the use of D2O that allowed neutron beams to reach them. Application of positron emission tomography to the diagnosis of melanoma is a highlight in this Report. (N.K.)

  3. Indication and possibility of boron neutron capture therapy in head and neck cancer

    International Nuclear Information System (INIS)

    Background: Boron neutron capture therapy (BNCT) is a targeted type of radiotherapy that has a number of significant advantages over conventional external beam photon irradiation, especially in that radiation can be selectively delivered to tumor cells. We had, first in the world, treated with BNCT for a patient with recurrent head and neck cancer (HNC) in 2001. Methods : From December, 2001 to February, 2013, we had treated 37 patients with recurrent HNC by means of 54 applications of BNCT at Kyoto University Research Reactor Institute (KURRI) and Japan Atomic Energy Agency (JAEA). All of them had received standard therapy and subsequently developed recurrent disease for which there were no other treatment options. Results : All of the (1) Regression rates were complete response (CR) : 19 patients (51%), partial response (PR) : 14(38%), progressive disease (PD) : 3(8%), and not evaluated (NE) : 1(3%) patient. (2) The overall patient response rate was 91%, though all the patients had advanced disease. The 4-year and 7-year OS rates were 42% and 36%, respectively. (3) BNCT improved quality of life (QOL), performance status (PS) and survival times. (4) The primary adverse events were brain necrosis, osteomyelitis and transient mucositis and alopecia. Conclusions : Our results indicate that we could make sure that safety and effectiveness of BNCT, and BNCT represents a new and promising treatment modality in patients for whom there are no other treatment options. (author)

  4. Sonoporation as an enhancing method for boron neutron capture therapy for squamous cell carcinomas

    International Nuclear Information System (INIS)

    Boron neutron capture therapy (BNCT) is a selective radiotherapy that is dependent on the accumulation of 10B compound in tumors. Low-intensity ultrasound produces a transient pore on cell membranes, sonoporation, which enables extracellular materials to enter cells. The effect of sonoporation on BNCT was examined in oral squamous cell carcinoma (SCC) xenografts in nude mice. Tumor-bearing mice were administrated boronophenylalanine (BPA) or boronocaptate sodium (BSH) intraperitoneally. Two hours later, tumors were subjected to sonoporation using microbubbles followed by neutron irradiation. The 10B concentration was higher in tumors treated with sonoporation than in untreated tumors, although the difference was not significant in BPA. When tumors in mice that received BPA intraperitoneally were treated with sonoporation followed by exposure to thermal neutrons, tumor volume was markedly reduced and the survival rate was prolonged. Such enhancements by sonoporation were not observed in mice treated with BSH-mediated BNCT. These results indicate that sonoporation enhances the efficiency of BPA-mediated BNCT for oral SCC. Sonoporation may modulate the microlocalization of BPA and BSH in tumors and increase their intracellular levels

  5. Neutron capture therapy for cancer: development at the National Atomic Energy Commission

    International Nuclear Information System (INIS)

    Boron neutron capture therapy (BNCT) involves the concurrent presence of a flux of neutrons of adequate energy and Boron 10 as a capture agent. They interact to damage tumor cells but fail to produce significant damage to healthy tissue because the destructive effect occurs mainly in the tumor cells that have selectively accumulated boron. This technique is applied for the treatment of brain tumors of the glioblastoma multiform type and melanoma in different locations. The aim of this project at CNEA is to develop the technological, scientific, clinical know-how and facilities to undertake clinical trials in Argentina. The development of the irradiation facility, the clinical beam and dosimetry was developed at the RA-6 reactor, Bariloche Atomic Center. Treatment planning, instrumentation for the neutron beam, boron measurements, neutron beam for small animal irradiation at the RA-1 reactor and basic research in radiobiology, microdosimetry and autoradiography were developed at Constituyentes Atomic Center. It is also conducted an intense activity in accelerator based BNCT. The infusions to be injected to the patients are prepared at Ezeiza Atomic Center. The clinics of BNCT radiotherapy is developed at the Roffo Institute of Oncology and the neurosurgery at the Argerich Hospital. At present, the project is close to start in the following months to treat melanoma in the limbs, when the authorization procedure is completed. (author)

  6. Tetrakis(p-carboranylthio-tetrafluorophenyl)chlorin (TPFC): application for photodynamic therapy and boron neutron capture therapy.

    Science.gov (United States)

    Hiramatsu, Ryo; Kawabata, Shinji; Tanaka, Hiroki; Sakurai, Yoshinori; Suzuki, Minoru; Ono, Koji; Miyatake, Shin-ichi; Kuroiwa, Toshihiko; Hao, Erhong; Vicente, M Graça H

    2015-03-01

    Carboranyl-containing chlorins have emerged as promising dual sensitizers for use in both photodynamic therapy (PDT) and boron neutron capture therapy (BNCT), by virtue of their known tumor affinity, low cytotoxicity in dark conditions, and their strong absorptions in the red region of the optical spectrum. Tetrakis(p-carboranylthio-tetrafluorophenyl)chlorin (TPFC) is a new synthetic carboranyl-containing chlorin of high boron content (24% by weight). To evaluate TPFC's applicability as sensitizer for both PDT and BNCT, we performed an in vitro and in vivo study using F98 rat glioma cells and F98 rat glioma-bearing brain tumor models. For the in vivo BNCT study, we used boronophenylalanine (BPA), which is currently used in clinical BNCT studies, via intravenous administration (i.v.) and/or used TPFC via convection-enhanced delivery (CED), a method for local drug infusion directly into the brain. In the in vitro PDT study, the cell surviving fraction following laser irradiation (9 J/cm(2) ) was 0.035 whereas in the in vitro BNCT study, the cell surviving fraction following neutron irradiation (thermal neutron = 1.73 × 10(12) n/cm(2) ) was 0.04. In the in vivo BNCT study, the median survival time following concomitant administration of BPA (i.v.) and TPFC (CED) was 42 days (95% confidence interval; 37-43 days).

  7. Tomographic image of prompt gamma ray from boron neutron capture therapy: A Monte Carlo simulation study

    International Nuclear Information System (INIS)

    The resulting neutron captures in 10B are used for radiation therapy. The occurrence point of the characteristic 478 keV prompt gamma rays agrees with the neutron capture point. If these prompt gamma rays are detected by external instruments such as a gamma camera or single photon emission computed tomography (SPECT), the therapy region can be monitored during the treatment using images. A feasibility study and analysis of a reconstructed image using many projections (128) were conducted. The optimization of the detection system and a detailed neutron generator simulation were beyond the scope of this study. The possibility of extracting a 3D BNCT-SPECT image was confirmed using the Monte Carlo simulation and OSEM algorithm. The quality of the prompt gamma ray SPECT image obtained from BNCT was evaluated quantitatively using three different boron uptake regions and was shown to depend on the location and size relations. The prospects for obtaining an actual BNCT-SPECT image were also estimated from the quality of the simulated image and the simulation conditions. When multi tumor regions should be treated using the BNCT method, a reasonable model to determine how many useful images can be obtained from SPECT can be provided to the BNCT facilities based on the preceding imaging research. However, because the scope of this research was limited to checking the feasibility of 3D BNCT-SPECT image reconstruction using multiple projections, along with an evaluation of the image, some simulation conditions were taken from previous studies. In the future, a simulation will be conducted that includes optimized conditions for an actual BNCT facility, along with an imaging process for motion correction in BNCT. Although an excessively long simulation time was required to obtain enough events for image reconstruction, the feasibility of acquiring a 3D BNCT-SPECT image using multiple projections was confirmed using a Monte Carlo simulation, and a quantitative image analysis was

  8. Boron neutron capture therapy for advanced salivary gland carcinoma in head and neck

    International Nuclear Information System (INIS)

    Boron neutron capture therapy (BNCT) is a among the radiation treatments known to have a selective lethal effect on tumor cells. This study summarizes the tumor responses and the acute and late adverse effects of BNCT in the treatment of patients with both recurrent and newly diagnosed T4 salivary gland carcinoma. Two patients with recurrent cancer and 3 with newly diagnosed T4 advanced malignancy were registered between October 2003 and September 2007, with the approval of the medical ethics committees of Kawasaki Medical School and Kyoto University. BNCT was performed, in a single fraction using an epithermal beam, at Japan Research Reactor 4. All patients achieved a complete response within 6 months of treatment. The median duration of the complete response was 24.0 months; the median overall survival time was 32.0 months. Three of the 5 patients are still alive; the other 2 died of distant metastatic disease. Open biopsy of the parotid gland after BNCT was performed in 1 patient and revealed no residual viable cancer cells and no serious damage to the normal glandular system. Although mild alopecia, xerostomia, and fatigue occurred in all patients, there were no severe adverse effects of grade 3 or greater. Our preliminary results demonstrate that BNCT is a potential curative therapy for patients with salivary gland carcinoma. The treatment does not cause any serious adverse effects, and may be used regardless of whether the primary tumor has been previously treated. (author)

  9. Carborane derivatives loaded into liposomes as efficient delivery systems for boron neutron capture therapy.

    Science.gov (United States)

    Altieri, S; Balzi, M; Bortolussi, S; Bruschi, P; Ciani, L; Clerici, A M; Faraoni, P; Ferrari, C; Gadan, M A; Panza, L; Pietrangeli, D; Ricciardi, G; Ristori, S

    2009-12-10

    Boron neutron capture therapy (BNCT) is an anticancer therapy based on the incorporation of (10)B in tumors, followed by neutron irradiation. Recently, the synthesis and delivery of new boronated compounds have been recognized as some of the main challenges in BNCT application. Here, we report on the use of liposomes as carriers for BNCT active compounds. Two carborane derivatives, i.e., o-closocarboranyl beta-lactoside (LCOB) and 1-methyl-o-closocarboranyl-2-hexylthioporphyrazine (H(2)PzCOB), were loaded into liposomes bearing different surface charges. The efficacy of these formulations was tested on model cell cultures, that is, DHD/K12/TRb rat colon carcinoma and B16-F10 murine melanoma. These induce liver and lung metastases, respectively, and are used to study the uptake of standard BNCT drugs, including borophenylalanine (BPA). Boron concentration in treated cells was measured by alpha spectrometry at the TRIGA mark II reactor (University of Pavia). Results showed high performance of the proposed formulations. In particular, the use of cationic liposomes increased the cellular concentration of (10)B by at least 30 times more than that achieved by BPA. PMID:19954249

  10. Accumulation of MRI contrast agents in malignant fibrous histiocytoma for gadolinium neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Fujimoto, T. [Department of Orthopaedic Surgery, Hyogo Cancer Center, Akashi 673-0021 (Japan)], E-mail: fujitaku@hp.pref.hyogo.jp; Ichikawa, H. [Faculty of Pharmaceutical Sciences and Cooperative Research Center of Life Sciences, Kobe Gakuin University, Kobe 650-8586 (Japan); Akisue, T. [Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017 (Japan); Fujita, I. [Department of Orthopaedic Surgery, Hyogo Cancer Center, Akashi 673-0021 (Japan); Kishimoto, K.; Hara, H. [Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017 (Japan); Imabori, M. [Department of Orthopaedic Surgery, Hyogo Cancer Center, Akashi 673-0021 (Japan); Kawamitsu, H. [Department of Radiology, Kobe University Graduate School of Medicine, Kobe 650-0017 (Japan); Sharma, P.; Brown, S.C.; Moudgil, B.M. [Particle Engineering Research Center, University of Florida, Gainesville, FL32611 (United States); Fujii, M. [Department of Radiology, Kobe University Graduate School of Medicine, Kobe 650-0017 (Japan); Yamamoto, T. [Department of Orthopaedic Surgery, Kagawa University, Kagawa 761-0793 (Japan); Kurosaka, M. [Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017 (Japan); Fukumori, Y. [Faculty of Pharmaceutical Sciences and Cooperative Research Center of Life Sciences, Kobe Gakuin University, Kobe 650-8586 (Japan)

    2009-07-15

    Neutron-capture therapy with gadolinium (Gd-NCT) has therapeutic potential, especially that gadolinium is generally used as a contrast medium in magnetic resonance imaging (MRI). The accumulation of gadolinium in a human sarcoma cell line, malignant fibrosis histiocytoma (MFH) Nara-H, was visualized by the MRI system. The commercially available MRI contrast medium Gd-DTPA (Magnevist, dimeglumine gadopentetate aqueous solution) and the biodegradable and highly gadopentetic acid (Gd-DTPA)-loaded chitosan nanoparticles (Gd-nanoCPs) were prepared as MRI contrast agents. The MFH cells were cultured and collected into three falcon tubes that were set into the 3-tesra MRI system to acquire signal intensities from each pellet by the spin echo method, and the longitudinal relaxation time (T1) was calculated. The amount of Gd in the sample was measured by inductively coupled plasma atomic emission spectrography (ICP-AES). The accumulation of gadolinium in cells treated with Gd-nanoCPs was larger than that in cells treated with Gd-DTPA. In contrast, and compared with the control, Gd-DTPA was more effective than Gd-nanoCPs in reducing T1, suggesting that the larger accumulation exerted the adverse effect of lowering the enhancement of MRI. Further studies are warranted to gain insight into the therapeutic potential of Gd-NCT.

  11. Gadolinium as an element for neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Brugger, R.M.; Liu, H.B.; Laster, B.H.; Gordon, C.R.; Greenberg, D.D.; Warkentien, L.S.

    1992-01-01

    At BNL, preparations are being made to test in vitro compounds containing Gd and compare their response to the response of GD-DTPA to determine if one or several compounds can be located that enter the cells and enhance the Auger effect. Two similar rotators with positions for cell vials that have been constructed for these tests. The first rotator is made of only paraffin which simulates healthy tissue and provides control curves. The second rotator has 135 ppM of Gd-157 in the paraffin to simulate a Gd loaded tumor. Cells are irradiated in vials in the paraffin rotator and in the Gd-paraffin rotator at the epithermal beam of the Brookhaven Medical Research Reactor (BMRR). This produces an irradiation similar to what a patient would receive In an actual treatment. A combination of irradiations are made with both rotators; with no Gd compound or IdUrd In the cell media, with only Gd compound in the cell media and with both Gd compound and IdUrd in the cell media. The first set shows the effects of gamma rays from the H(n,gamma) reaction and the prompt gamma rays from capture of neutrons by Gd. The second set shows if there is any effect of Gd being in the cell media or inside the cells, i.e., an Auger effect. The third set shows the effect of enhancement by the IdUrd produced by the gamma rays from neutrons captured by either H or Gd. The fourth set combines all of the reactions and enhancements. Preliminary calculations and physical measurements of the doses that the cells will receive In these rotators have been made.

  12. Gadolinium as an element for neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Brugger, R.M.; Liu, H.B.; Laster, B.H.; Gordon, C.R.; Greenberg, D.D.; Warkentien, L.S.

    1992-12-31

    At BNL, preparations are being made to test in vitro compounds containing Gd and compare their response to the response of GD-DTPA to determine if one or several compounds can be located that enter the cells and enhance the Auger effect. Two similar rotators with positions for cell vials that have been constructed for these tests. The first rotator is made of only paraffin which simulates healthy tissue and provides control curves. The second rotator has 135 ppM of Gd-157 in the paraffin to simulate a Gd loaded tumor. Cells are irradiated in vials in the paraffin rotator and in the Gd-paraffin rotator at the epithermal beam of the Brookhaven Medical Research Reactor (BMRR). This produces an irradiation similar to what a patient would receive In an actual treatment. A combination of irradiations are made with both rotators; with no Gd compound or IdUrd In the cell media, with only Gd compound in the cell media and with both Gd compound and IdUrd in the cell media. The first set shows the effects of gamma rays from the H(n,gamma) reaction and the prompt gamma rays from capture of neutrons by Gd. The second set shows if there is any effect of Gd being in the cell media or inside the cells, i.e., an Auger effect. The third set shows the effect of enhancement by the IdUrd produced by the gamma rays from neutrons captured by either H or Gd. The fourth set combines all of the reactions and enhancements. Preliminary calculations and physical measurements of the doses that the cells will receive In these rotators have been made.

  13. Boron neutron capture therapy (BNCT) for glioblastoma multiforme using the epithermal neutron beam at the Brookhaven Medical Research Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Capala, J. [Brookhaven National Lab., Upton, NY (United States); Diaz, A.Z.; Chadha, M. [Univ. Hospital, State Univ. of New York, NY (United States)] [and others

    1997-12-31

    The abstract describes evaluation of boron neutron capture therapy (BNCT) for two groups of glioblastoma multiforme patients. From September 1994 to February 1996 15 patients have been treated. In September 1997 another 34 patients were examined. Authors determined a safe starting dose for BNCT using epithermal neutrons and BPA-F. They have also evaluated adverse effects of BNCT at this starting dose. Therapeutic effectiveness of this starting dose has been evaluated. No significant side effects from BPA-F infusion or BNCT treatment were observed in normal brains.

  14. Dosimetric implications of new compounds for neutron capture therapy (NCT)

    Energy Technology Data Exchange (ETDEWEB)

    Fairchild, R.G.

    1982-01-01

    Systemic application of radiolabeled or cytotoxic agents should allow targeting of primary and metastatic neoplasms on a cellular level. In fact, drug uptake in non-target cell pools often exceeds toxic levels before sufficient amounts are delivered to tumor. In addition, at the large concentration of molecules necessary for therapy, effects of saturation are often found. Application of NCT can circumvent problems associated with high uptake in competing non-target cell pools, as the /sup 10/B(n,..cap alpha..)/sup 7/Li reaction is activated only within the radiation field. A comparison with other modes of particle therapy indicated that NCT provides significant advantages. It is however, difficult to obtain vehicles for boron transport which demonstrate both the tumor specificity and concentration requisite for NCT. A number of biomolecules have been investigated which show both the necessary concentration and specificity. These include chlorpromazine, thiouracil, porphyrins, amino acids, and nucleosides. However, these analogs have yet to be made available for NCT. Dosimetric implications of binding sites are considered, as well as alternate neutron sources. (ERB)

  15. Medical aspects of boron-slow neutron capture therapy

    International Nuclear Information System (INIS)

    Earlier radiations of patients with cerebral tumors disclosed the need: (1) to find a carrier of the boron compound which would leave the blood and concentrate in the tumor, (2) to use a more penetrating neutron beam, and (3) to develop a much faster method for assaying boron in blood and tissue. To some extent number1 has been accomplished in the form of Na2 B12 H11 SH, number2 has yet to be achieved, and number3 has been solved by the measurement of the 478-keV gamma ray when the 10B atom disintegrates following its capture of a slow neutron. The hitherto unreported data in this paper describe through the courtesy of Professor Hiroshi Hatanaka his studies on the pharmacokinetics and quality control of Na2 B12 H11SH based on 96 boron infusions in 86 patients. Simultaneous blood and tumor data are plotted here for 30 patients with glioblastomas (Grade III-IV gliomas), illustrating remarkable variability. Detailed autopsy findings on 18 patients with BNCT showed radiation injury in only 1. Clinical results in 12 of the most favorably situated glioblastomas reveal that 5 are still alive with a 5-year survival rate of 58% and the excellent Karnofsky performance rating of 87%. For the first time evidence is presented that slow-growing astrocytomas may benefit from BNCT. 10 references, 8 figures, 5 tables

  16. Selective uptake of p-boronophenylalanine by osteosarcoma cells for boron neutron capture therapy

    International Nuclear Information System (INIS)

    Osteosarcoma is the most common non-hematologic primary cancer type that develops in bone. Current osteosarcoma treatments combine multiagent chemotherapy with extensive surgical resection, which in some cases makes necessary the amputation of the entire limb. Nevertheless its infiltrative growth leads to a high incidence of local and distant recurrences that reduce the percentage of cured patients to less than 60%. These poor data required to set up a new therapeutic approach aimed to restrict the surgical removal meanwhile performing a radical treatment. Boron neutron capture therapy (BNCT), a particular radiotherapy based on the nuclear capture and fission reactions by atoms of 10B, when irradiated with thermal neutrons, could be a valid alternative or integrative option in case of osteosarcoma management, thanks to its peculiarity in selectively destroying neoplastic cells without damaging normal tissues. Aim of the present work is to investigate the feasibility of employing BNCT to treat the limb osteosarcoma. Boronophenylalanine (BPA) is used to carry 10B inside the neoplastic cells. As a first step the endocellular BPA uptake is tested in vitro on the UMR-106 osteosarcoma cell line. The results show an adequate accumulation capability. For the in vivo experiments, an animal tumor model is developed in Sprague-Dawley rats by means of an intrafemoral injection of UMR-106 cells at the condyle site. The absolute amounts of boron loading and the tumor to normal tissue 10B ratio are evaluated 2 h after the i.v. administration of BPA. The boron uptake by the neoplastic tissue is almost twice the normal one. However, higher values of boron concentration in tumor are requested before upholding BNCT as a valid therapeutic option in the treatment of osteosarcoma.

  17. A colorimetric determination of boron in biological sample for boron neutron capture therapy (BNCT)

    International Nuclear Information System (INIS)

    The boron neutron capture therapy (BNCT) has shown better prognosis in the treatment of glyemas and gluoblastomas grade III and IV than other therapies. During the treatment the levels of Na210B12H11SH must be known in several compartiments of the organism and with this purpose the method of colorimetric determination of boron using curcumine was established. This method is simple, reprodutible and adequate sensitivity for this control. (author)

  18. FiR 1 reactor in service for boron neutron capture therapy (BNCT) and isotope production

    International Nuclear Information System (INIS)

    The FiR 1 reactor, a 250 kW Triga reactor, has been in operation since 1962. The main purpose for the existence of the reactor is now the Boron Neutron Capture Therapy (BNCT), but FiR 1 has also an important national role in providing local enterprises and research institutions in the fields of industrial measurements, pharmaceuticals, electronics etc. with isotope production and activation analysis services. In the 1990's a BNCT treatment facility was built at the FiR 1 reactor located at Technical Research Centre of Finland. A special new neutron moderator material FluentalTM (Al+AlF3+Li) developed at VTT ensures the superior quality of the neutron beam. Also the treatment environment is of world top quality after a major renovation of the whole reactor building in 1997. Recently the lithiated polyethylene neutron shielding of the beam aperture was modified to ease the positioning of the patient close to the beam aperture. Increasing the reactor power to 500 kW would allow positioning of the patient further away from the beam aperture. Possibilities to accomplish a safety analysis for this is currently under considerations. Over thirty patients have been treated at FiR 1 since May 1999, when the license for patient treatment was granted to the responsible BNCT treatment organization, Boneca Corporation. Currently three clinical trial protocols for tumours in the brain as well as in the head and neck region are recruiting patients. (author)

  19. Boron neutron capture therapy outcomes for advanced or recurrent head and neck cancer

    International Nuclear Information System (INIS)

    We retrospectively review outcomes of applying boron neutron capture therapy (BNCT) to unresectable advanced or recurrent head and neck cancers. Patients who were treated with BNCT for either local recurrent or newly diagnosed unresectable head or neck cancers between December 2001 and September 2007 were included. Clinicopathological characteristics and clinical outcomes were retrieved from hospital records. Either a combination of borocaptate sodium and boronophenylalanine (BPA) or BPA alone were used as boron compounds. In all the treatment cases, the dose constraint was set to deliver a dose <10–12 Gy-eq to the skin or oral mucosa. There was a patient cohort of 62, with a median follow-up of 18.7 months (range, 0.7–40.8). A total of 87 BNCT procedures were performed. The overall response rate was 58% within 6 months after BNCT. The median survival time was 10.1 months from the time of BNCT. The 1- and 2-year overall survival (OS) rates were 43.1% and 24.2%, respectively. The major acute Grade 3 or 4 toxicities were hyperamylasemia (38.6%), fatigue (6.5%), mucositis/stomatitis (9.7%) and pain (9.7%), all of which were manageable. Three patients died of treatment-related toxicity. Three patients experienced carotid artery hemorrhage, two of whom had coexistent infection of the carotid artery. This study confirmed the feasibility of our dose-estimation method and that controlled trials are warranted. (author)

  20. Effectiveness of boron neutron capture therapy for recurrent head and neck malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Itsuro [Department of Oral and Maxillofacial Surgery, II Osaka University, Graduate School of Dentistry, Osaka (Japan)], E-mail: katoitsu@dent.osaka-u.ac.jp; Fujita, Yusei [Department of Oral and Maxillofacial Surgery, II Osaka University, Graduate School of Dentistry, Osaka (Japan); Maruhashi, Akira [Radiation Oncology Research Laboratory, Research Reactor Institut, Kyoto University, Osaka (Japan); Kumada, Hiroaki [Japan Atomic Energy Agency, Tokai Research and Development Center, Ibaraki (Japan); Ohmae, Masatoshi [Department of Oral and Maxillofacial Surgery, Izimisano Municipal Hospital, Rinku General Hospital, Izumisano, Osaka (Japan); Kirihata, Mitsunori [Graduate School of Environment and Life Science, Osaka prefectural University, Osaka (Japan); Imahori, Yoshio [Department of Neurosurgery, Kyoto Prefectural University, Kyoto (Japan); CEO of Cancer Intelligence Care Systems, Inc., Tokyo (Japan); Suzuki, Minoru [Radiation Oncology Research Laboratory, Research Reactor Institut, Kyoto University, Osaka (Japan); Sakrai, Yoshinori [Graduate School of Medicine, Sapporo Medical University of Medicine, Hokkaido (Japan); Sumi, Tetsuro; Iwai, Soichi; Nakazawa, Mitsuhiro [Department of Oral and Maxillofacial Surgery, II Osaka University, Graduate School of Dentistry, Osaka (Japan); Murata, Isao; Miyamaru, Hiroyuki [Division of Electrical, Electronic and Information Engineering, Graduate School of Engineering, Osaka University (Japan); Ono, Koji [Radiation Oncology Research Laboratory, Research Reactor Institut, Kyoto University, Osaka (Japan)

    2009-07-15

    It is necessary to explore new treatments for recurrent head and neck malignancies (HNM) to avoid severe impairment of oro-facial structures and functions. Boron neutron capture therapy (BNCT) is tumor-cell targeted radiotherapy that has significant superiority over conventional radiotherapies in principle. We have treated with BNCT 42 times for 26 patients (19 squamous cell carcinomas (SCC), 4 salivary gland carcinomas and 3 sarcomas) with a recurrent and far advanced HNM since 2001. Results of (1) {sup 10}B concentration of tumor/normal tissue ratios (T/N ratio) of FBPA-PET studies were SCC: 1.8-5.7, sarcoma: 2.5-4.0, parotid tumor: 2.5-3.7. (2) Therapeutic effects were CR: 12 cases, PR: 10 cases, PD: 3 cases NE (not evaluated): 1 case. Response rate was 85%. (3) Improvement of QOL such as a relief of severe pain, bleeding, and exudates at the local lesion, improvement of PS, disappearance of ulceration, covered with normal skin and preserved oral and maxillofacial functions and tissues. (4) Survival periods after BNCT were 1-72 months (mean: 13.6 months). Six-year survival rate was 24% by Kaplan-Meier analysis. (5) Adverse-events were transient mucositis and alopecia in most of the cases; three osteomyelitis and one brain necrosis were recognized. These results indicate that BNCT represents a new and promising treatment approach for advanced HNM.

  1. A novel reactor concept for boron neutron capture therapy: annular low-low power reactor (ALLPR)

    Energy Technology Data Exchange (ETDEWEB)

    Petrovic, B.; Levine, S.H. [Department of Nuclear Engineering, Pennsylvania State University, University Park, PA 16802 (United States)

    1998-07-01

    Boron Neutron Capture Therapy (BNC), originally proposed in 50's, has been getting renewed attention over the last {approx}10 years. This is in particular due to its potential for treating deep-seated brain tumors by employing epithermal neutron beams. Large (several MW) research reactors are currently used to obtain epithermal beams for BNCT, but because of cost and licensing issues it is not likely that such high-power reactors can be placed in regular medical centers. This paper describes a novel reactor concept for BNCT devised to overcome this obstacle. The design objective was to produce a beam of epithermal neutrons of sufficient intensity for BNCT at <50 kW using low enriched uranium. It is achieved by the annular reactor design, which is called Annular Low-Low Power Reactor (ALLPR). Preliminary studies using Monte Carlo simulations are summarized in this paper. The ALLPR should be relatively economical to build, and safe and easy to operate. This novel concept may increase the viability of using BNCT in medical centers worldwide. (author)

  2. Current Controversies in Newer Therapies to Treat Birth Asphyxia

    Directory of Open Access Journals (Sweden)

    Pia Wintermark

    2011-01-01

    Full Text Available Despite major advances in monitoring technology and knowledge of fetal and neonatal pathophysiology, neonatal hypoxic-ischemic encephalopathy (HIE remains one of the main causes of severe adverse neurological outcome in children. Until recently, there were no therapies other than supportive measures. Over the past several years, mild hypothermia has been proven to be safe to treat HIE. Unfortunately, this neuroprotective strategy seems efficient in preventing brain injury in some asphyxiated newborns, but not in all of them. Thus, there is increasing interest to rapidly understand how to refine hypothermia therapy and add neuroprotective or neurorestorative strategies. Several promising newer treatments to treat birth asphyxia and prevent its devastating neurological consequences are currently being tested. In this paper, the physiopathology behind HIE, the currently available treatment, the potential alternatives, and the next steps before implementation of these other treatments are reviewed.

  3. Trend of Pharmacopuncture Therapy for Treating Cervical Disease in Korea

    OpenAIRE

    Seok-Hee Kim; Da-Jung Jung; Yoo-Min Choi; Jong-Uk Kim; Tae-Han Yook

    2014-01-01

    Objectives: The purpose of this study is to analyze trends in domestic studies on pharmacopuncture therapy for treating cervical disease. Methods: This study was carried out on original copies and abstracts of theses listed in databases or published until July 2014. The search was made on the Oriental medicine Advanced Searching Integrated System (OASIS) the National Digital Science Library (NDSL), and the Korean traditional knowledge portal. Search words were ‘pain on cervical spine’, ‘ce...

  4. Treating Bony craters by osseous resection in periodontics: Crater therapy

    OpenAIRE

    V. Selahi Moghadam

    1989-01-01

    Treating bony craters by surgical method needs elimination or reduction of bony lesions as well as providing sufficient bone by minimum osteotomy in order to preserve supporting bone. Furcation preservation is very important. Most mandibular molars are overtreated from buccal aspect that leads to inverted morphology and affects buccal forcation. Identifying anatomical structures and their relation to lesions is essential. In crater therapy, furcation and tooth trunk are two ...

  5. Health status in patients treated with cardiac resynchronization therapy

    DEFF Research Database (Denmark)

    Schiffer, Angélique A; Denollet, Johan; Pedersen, Susanne S.;

    2008-01-01

    Cardiac resynchronization therapy (CRT) is a promising treatment in chronic heart failure (CHF). However, a subgroup of patients still report impaired health status, cardiac symptoms, and feelings of disability following CRT. The aims of this study were to examine (1) whether CHF patients treated...... with CRT improved in patient-centered outcomes and functional capacity, and (2) whether personality traits exert a stable effect on these outcomes over two months....

  6. Boron neutron capture therapy (BNCT) using fast neutrons: Effects in two human tumor cell lines

    International Nuclear Information System (INIS)

    The results demonstrate that the effect of fast neutrons on cell survival in cell culture can be enhanced by boron neutron capture reaction. Even with lower enhancement ratios, the concept of NCT assisted fast neutron therapy may successfully be applied for tumor treatment with the Essen cyclotron. (orig.)

  7. Proceedings of workshop on 'boron science and boron neutron capture therapy'

    Energy Technology Data Exchange (ETDEWEB)

    Kitaoka, Y. [ed.

    1998-12-01

    This volume contains the abstracts and programs of the 8th (1996), 9th (1997) and 10th (1998) of the workshop on 'the Boron Science and Boron Neutron Capture Therapy' and the recent progress reports especially subscribed. The 11 of the presented papers are indexed individually. (J.P.N.)

  8. Further development of thermal neutron capture therapy for metastatic and deeply-invasive human malignant melanoma

    International Nuclear Information System (INIS)

    This issue is the collection of the papers presented thermal neutron capture therapy for metastatic and deeply-invasive human malignant melanoma. Separate abstracts were prepared for 2 of the papers in this report. The remaining 32 papers were considered outside the subject scope of INIS. (J.P.N.)

  9. To gadolinium using for neutron capture therapy researches at WWR-SM reactor

    International Nuclear Information System (INIS)

    The analysis of using gadolinium (isotope and natural) for the medical purposes in neutron-capture therapy of cancer diseases is carried out. Results of definition of the epithermal neutron beam irradiation dose for biological objects with gadolinium-containing preparations are presented by using the WWR-SM reactor. (authors)

  10. The Boron Neutron Capture Therapy (BNCT) Project at the TRIGA Reactor in Mainz, Germany

    DEFF Research Database (Denmark)

    Hampel, G.; Grunewald, C.; Schütz, C.;

    2011-01-01

    The thermal column of the TRIGA reactor in Mainz is being used very effectively for medical and biological applications. The BNCT (boron neutron capture therapy) project at the University of Mainz is focussed on the treatment of liver tumours, similar to the work performed at Pavia (Italy) a few...

  11. Implant therapy on patients treated with oral bisphosphonates

    Directory of Open Access Journals (Sweden)

    Aris Petros Tripodakis

    2012-03-01

    Full Text Available Aim: Bisphosphonates represent a group of drugs with a significant effect on bone structure preventing bone remodelling. They can be administered for the treatment of osteoporosis, Paget’s disease, osteogenesis imperfecta, osteopenia and bone metastases. The aim of this study was to discuss the necessary precautions for successful implant therapy on patients treated with per os bisphosphonates. Case reports: Two female patients, both in the seventh decade of life, requested implant therapy. Their medical history was significant for osteoporosis, managed with per os bisphosphonates (Risedronate and Alendronate, respectively, without other risk factors for osteonecrosis. The duration of bisphosphonate administration was 4 years and 2 months respectively. After consultation with the treating physician, the patients stopped the bisphosphonates 3 months before and 3 months after the placement of the implants. The patients received antibiotic coverage for the surgical interventions. The treatment plan was completed uneventfully with placement of fixed prostheses without complications during a 2-year follow-up period. Conclusion: The greatest dental treatment-related risk for patients on bisphosphonate therapy is bisphosphonate-associated osteonecrosis, which presents with exposure of avascular bone of the jaws and, according to the clinical stage, pain, inflammation, fractures and/or extensive osteolysis. Most of reported cases of bisphosphonate-associated osteonecrosis consist of patients on intravenous drug therapy who had undergone dentoalveolar surgery. Patients on per os bisphosphonates may undergo all types of dentoalveolar surgery, including implant placement, as long as the necessary precautions (bisphosphonate discontinuation, antibiotic coverage, meticulous oral hygiene are taken.

  12. Neutron capture therapy of ocular melanoma: dosimetry and microdosimetry approaches; Therapie par capture de neutrons des melanomes oculaires: approches dosimetrique et microdosimetrique

    Energy Technology Data Exchange (ETDEWEB)

    Pignol, J.P.; Methlin, G. [Centre Paul Strauss, 67 - Strasbourg (France); Abbe, J.C. [Strasbourg-1 Univ., 67 (France). Centre de Recherches Nucleaires; Stampfler, A. [Strasbourg-1 Univ., 67 (France); Lefebvre, O. [Faculte de Medecine, 67 - Strasbourg (France); Sahel, J. [Centre Hospitalier Universitaire, 67 - Strasbourg (France)

    1994-06-01

    Neutron capture therapy (NCT) aims at destroying cancerous cells with the {alpha} and {sup 7}Li particles produced by the neutron capture reaction on {sup 10}B. This note reports on the study of the boron distribution in tissues on an animal model (nude mice) xenografted with a human ocular melanoma after an i.p.injection of 2g/kg of {sup 10}B-BPA and in cells cultured in the presence of 530 {mu}mol/l of {sup 10}B-BPA. A concentration of 64 ppm of {sup 10}B in the active part of the tumour with a ratio of concentrations versus the skin of 3.7 are observed. Investigations on cells reveal the presence of boron in the cytoplasm. The biological, dosimetric and microdosimetric consequences of these findings are discussed. (authors). 15 refs., 2 tabs., 2 figs.

  13. Accelerator Based Neutron Beams for Neutron Capture Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Yanch, Jacquelyn C.

    2003-04-11

    The DOE-funded accelerator BNCT program at the Massachusetts Institute of Technology has resulted in the only operating accelerator-based epithermal neutron beam facility capable of generating significant dose rates in the world. With five separate beamlines and two different epithermal neutron beam assemblies installed, we are currently capable of treating patients with rheumatoid arthritis in less than 15 minutes (knee joints) or 4 minutes (finger joints) or irradiating patients with shallow brain tumors to a healthy tissue dose of 12.6 Gy in 3.6 hours. The accelerator, designed by Newton scientific Incorporated, is located in dedicated laboratory space that MIT renovated specifically for this project. The Laboratory for Accelerator Beam Applications consists of an accelerator room, a control room, a shielded radiation vault, and additional laboratory space nearby. In addition to the design, construction and characterization of the tandem electrostatic accelerator, this program also resulted in other significant accomplishments. Assemblies for generating epithermal neutron beams were designed, constructed and experimentally evaluated using mixed-field dosimetry techniques. Strategies for target construction and target cooling were implemented and tested. We demonstrated that the method of submerged jet impingement using water as the coolant is capable of handling power densities of up to 6 x 10(sup 7) W/m(sup 2) with heat transfer coefficients of 10(sup 6)W/m(sup 2)-K. Experiments with the liquid metal gallium demonstrated its superiority compared with water with little effect on the neutronic properties of the epithermal beam. Monoenergetic proton beams generated using the accelerator were used to evaluate proton RBE as a function of LET and demonstrated a maximum RBE at approximately 30-40 keV/um, a finding consistent with results published by other researchers. We also developed an experimental approach to biological intercomparison of epithermal beams and

  14. Boron neutron capture therapy induces apoptosis of glioma cells through Bcl-2/Bax

    Directory of Open Access Journals (Sweden)

    Mao Xinggang

    2010-12-01

    Full Text Available Abstract Background Boron neutron capture therapy (BNCT is an alternative treatment modality for patients with glioma. The aim of this study was to determine whether induction of apoptosis contributes to the main therapeutic efficacy of BNCT and to compare the relative biological effect (RBE of BNCT, γ-ray and reactor neutron irradiation. Methods The neutron beam was obtained from the Xi'an Pulsed Reactor (XAPR and γ-rays were obtained from [60Co] γ source of the Fourth Military Medical University (FMMU in China. Human glioma cells (the U87, U251, and SHG44 cell lines were irradiated by neutron beams at the XAPR or [60Co] γ-rays at the FMMU with different protocols: Group A included control nonirradiated cells; Group B included cells treated with 4 Gy of [60Co] γ-rays; Group C included cells treated with 8 Gy of [60Co] γ-rays; Group D included cells treated with 4 Gy BPA (p-borono-phenylalanine-BNCT; Group E included cells treated with 8 Gy BPA-BNCT; Group F included cells irradiated in the reactor for the same treatment period as used for Group D; Group G included cells irradiated in the reactor for the same treatment period as used for Group E; Group H included cells irradiated with 4 Gy in the reactor; and Group I included cells irradiated with 8 Gy in the reactor. Cell survival was determined using the 3-(4,5-dimethylthiazol-2-yl-2,5-diphenyltetrazolium (MTT cytotoxicity assay. The morphology of cells was detected by Hoechst33342 staining and transmission electron microscope (TEM. The apoptosis rate was detected by flow cytometer (FCM. The level of Bcl-2 and Bax protein was measured by western blot analysis. Results Proliferation of U87, U251, and SHG44 cells was much more strongly inhibited by BPA-BNCT than by irradiation with [60Co] γ-rays (P 60Co] γ-rays (P P Conclusions Compared with ��-ray and reactor neutron irradiation, a higher RBE can be achieved upon treatment of glioma cells with BNCT. Glioma cell apoptosis induced by

  15. Implications for clinical treatment from the micrometer site dosimetric calculations in boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Nichols, Trent L. [Department of Physics and Astronomy, University of Tennessee, Knoxville, TN 37901 (United States)], E-mail: tnichol2@utk.edu; Kabalka, George W. [Department of Chemistry, University of Tennessee, Knoxville, TN 37901 (United States); Miller, Laurence F. [Department of Nuclear and Radiological Engineering, University of Tennessee, Knoxville, TN 37901 (United States); McCormack, Michael T. [Department of Medicine, University of Tennessee Graduate School of Medicine, Knoxville, TN 37920 (United States); Johnson, Andrew [Rush University Medical Center, Chicago, IL 60612 (United States)

    2009-07-15

    Boron neutron capture therapy has now been used for several malignancies. Most clinical trials have addressed its use for the treatment of glioblastoma multiforme. A few trials have focused on the treatment of malignant melanoma with brain metastases. Trial results for the treatment of glioblastoma multiforme have been encouraging, but have not achieved the success anticipated. Results of trials for the treatment of malignant melanoma have been very promising, though with too few patients for conclusions to be drawn. Subsequent to these trials, regimens for undifferentiated thyroid carcinoma, hepatic metastases from adenocarcinoma of the colon, and head and neck malignancies have been developed. These tumors have also responded well to boron neutron capture therapy. Glioblastoma is an infiltrative tumor with distant individual tumor cells that might create a mechanism for therapeutic failure though recurrences are often local. The microdosimetry of boron neutron capture therapy can provide an explanation for this observation. Codes written to examine the micrometer scale energy deposition in boron neutron capture therapy have been used to explore the effects of near neighbor cells. Near neighbor cells can contribute a significantly increased dose depending on the geometric relationships. Different geometries demonstrate that tumors which grow by direct extension have a greater near neighbor effect, whereas infiltrative tumors lose this near neighbor dose which can be a significant decrease in dose to the cells that do not achieve optimal boron loading. This understanding helps to explain prior trial results and implies that tumors with small, closely packed cells that grow by direct extension will be the most amenable to boron neutron capture therapy.

  16. Boron nanoparticles inhibit turnour growth by boron neutron capture therapy in the murine B16-OVA model

    DEFF Research Database (Denmark)

    Petersen, Mikkel Steen; Petersen, Charlotte Christie; Agger, Ralf;

    2008-01-01

    Background: Boron neutron capture therapy usually relies on soluble, rather than particulate, boron compounds. This study evaluated the use of a novel boron nanoparticle for boron neutron capture therapy. Materials and Methods: Two hundred and fifty thousand B16-OVA tumour cells, pre...

  17. Stem cell therapy. Use of differentiated pluripotent stem cells as replacement therapy for treating disease

    DEFF Research Database (Denmark)

    Fox, Ira J; Daley, George Q; Goldman, Steven A;

    2014-01-01

    Pluripotent stem cells (PSCs) directed to various cell fates holds promise as source material for treating numerous disorders. The availability of precisely differentiated PSC-derived cells will dramatically affect blood component and hematopoietic stem cell therapies and should facilitate......, and industry is critical for generating new stem cell-based therapies....... treatment of diabetes, some forms of liver disease and neurologic disorders, retinal diseases, and possibly heart disease. Although an unlimited supply of specific cell types is needed, other barriers must be overcome. This review of the state of cell therapies highlights important challenges. Successful...

  18. Formulation and preliminary evaluation of delivery vehicles for the boron neutron capture therapy of cancer

    OpenAIRE

    Olusanya, Temidayo; Stich, Theresia; Higgins, Samantha Caroline; Lloyd, Rhiannon Eleanor Iris; Smith, James Richard; Fatouros, Dimitrios; Calabrese, Gianpiero; Pilkington, Geoffrey John; Tsibouklis, John

    2015-01-01

    Boron neutron capture therapy (BNCT) is a method for selectively destroying malignant (normally glioma) cells whilst sparing normal tissue1. Irradiation of 10B (large neutron capture cross-section) with thermal neutrons effects the nuclear fission reaction: 10B + 1n → → 7Li+ + α + γ; where the penetration of α-particles and 7Li+ is only 8 and 5 µm, respectively, i.e., within a single cell thickness, assuming 10B can be preferentially located within glioma cells2. Poor selectivity is the main ...

  19. Formulation and preliminary evaluation of delivery vehicles for the boron neutron capture therapy of cancer

    OpenAIRE

    Olusanya, Temidayo Olajumoke Bolanle

    2015-01-01

    Boron neutron capture therapy (BNCT) is a method for selectively destroying malignant (normally glioma) cells whilst sparing normal tissue. Irradiation of 10B (large neutron capture cross-section) with thermal neutrons effects the nuclear fission reaction: 10B + 1n → → 7Li+ + α + γ; where the penetration of -particles and 7Li+ is only 8 and 5 μm, respectively, i.e., within a single cell thickness, assuming 10B can be preferentially located within glioma cells. Poor selectivity is the main r...

  20. Cellular uptake and in vitro antitumor efficacy of composite liposomes for neutron capture therapy

    International Nuclear Information System (INIS)

    Neutron capture therapy for glioblastoma has focused mainly on the use of 10B as neutron capture isotope. However, 157Gd offers several advantages over boron, such as higher cross section for thermal neutrons and the possibility to perform magnetic resonance imaging during neutron irradiation, thereby combining therapy and diagnostics. We have developed different liposomal formulations of gadolinium-DTPA (Magnevist®) for application in neutron capture therapy of glioblastoma. The formulations were characterized physicochemically and tested in vitro in a glioma cell model for their effectiveness. Liposomes entrapping gadolinium-DTPA as neutron capture agent were manufactured via lipid/film-extrusion method and characterized with regard to size, entrapment efficiency and in vitro release. For neutron irradiation, F98 and LN229 glioma cells were incubated with the newly developed liposomes and subsequently irradiated at the thermal column of the TRIGA reactor in Mainz. The dose rate derived from neutron irradiation with 157Gd as neutron capturing agent was calculated via Monte Carlo simulations and set in relation to the respective cell survival. The liposomal Gd-DTPA reduced cell survival of F98 and LN229 cells significantly. Differences in liposomal composition of the formulations led to distinctly different outcome in cell survival. The amount of cellular Gd was not at all times proportional to cell survival, indicating that intracellular deposition of formulated Gd has a major influence on cell survival. The majority of the dose contribution arises from photon cross irradiation compared to a very small Gd-related dose. Liposomal gadolinium formulations represent a promising approach for neutron capture therapy of glioblastoma cells. The liposome composition determines the uptake and the survival of cells following radiation, presumably due to different uptake pathways of liposomes and intracellular deposition of gadolinium-DTPA. Due to the small range of the

  1. Exogenous lipoid pneumonia successfully treated with bronchoscopic segmental lavage therapy.

    Science.gov (United States)

    Nakashima, Shota; Ishimatsu, Yuji; Hara, Shintaro; Kitaichi, Masanori; Kohno, Shigeru

    2015-01-01

    A 65-y-old Japanese man was referred to the respiratory medicine department because of abnormal radiologic findings. High-resolution chest computed tomography scans revealed a geographic distribution of ground-glass opacities and associated thickening of the interlobular septa (crazy-paving patterns) in both lower lobes. He had a habit of drinking 400-500 mL of milk and 400-800 mL of canned coffee with milk every day. A swallowing function test revealed liquid dysphagia. Bronchoalveolar lavage fluid cytology findings showed multiple lipid-laden macrophages. Taken together, these findings revealed exogenous lipoid pneumonia. We performed bronchoscopic segmental lavage therapy 3 times in the left lung. After the treatment, the radiologic findings improved in both lungs. The patient has not experienced a recurrence of lipoid pneumonia in 2 y to date. In conclusion, a case of exogenous lipoid pneumonia was successfully treated with bronchoscopic segmental lavage therapy. PMID:25161297

  2. Addison disease in patients treated with glucocorticoid therapy.

    LENUS (Irish Health Repository)

    Cronin, C C

    2012-02-03

    Acute adrenal crisis in patients with unrecognized chronic adrenocortical failure is difficult to diagnose and potentially fatal. We describe 2 patients with acute adrenal crisis whose diagnoses were hindered because of concomitant glucocorticoid treatment. Acute adrenal insufficiency is primarily a state of mineralocorticoid deficiency. Prednisolone and prednisone, the most frequently prescribed anti-inflammatory corticosteroid agents, have minimal mineralocorticoid activity. Several conditions that may be treated with pharmacological glucocorticoids are associated with an increased risk of Addison disease. An acute adrenal crisis, against which concurrent glucocorticoid therapy does not confer adequate protection, may develop in such patients.

  3. Iatrogenic systemic air embolism treated with hyperbaric oxygen therapy

    DEFF Research Database (Denmark)

    Jørgensen, Thomas Bech; Sørensen, Allan Martini Ibsen; Jansen, Erik C.

    2008-01-01

    Air embolism is a rare and potentially severe complication of surgical and invasive procedures. Emboli large enough to produce symptoms require immediate treatment because of the risk of 'gas lock' in the right side of the heart and subsequent circulatory failure. If air is transmitted to the art...... to the arterial circulation through a shunt, it may cause cerebral emboli with neurological symptoms. We present two cases with venous air emboli and concurrent cerebral arterial emboli. Both patients were successfully treated with hyperbaric oxygen therapy Udgivelsesdato: 2008/4...

  4. Temporomandibular Joint Syndrome Treated by Tuina Therapy plus Acupuncture

    Institute of Scientific and Technical Information of China (English)

    CHENG Xiao; HUANG Guo-qi

    2005-01-01

    @@ Temporomandibular joint syndrome is one of the commonly encountered diseases in the department of stomatology and is mainly caused by improper chewing or by subluxation of the temporomandibular joint and is mostly seen in young adults from 20-40 years old. The main symptoms are plucking sound, pain and abnormal mouth-opening movement in the temporomandibular joint, and it often occurs on one side or on two sides. The author has treated 20 cases of temporomandibular joint syndrome by Tuina therapy plus acupuncture.

  5. Head and Neck Soft Tissue Sarcomas Treated with Radiation Therapy

    Science.gov (United States)

    Vitzthum, Lucas K.; Brown, Lindsay C.; Rooney, Jessica W.; Foote, Robert L.

    2016-01-01

    Head and neck soft tissue sarcomas (HNSTSs) are rare and heterogeneous cancers in which radiation therapy (RT) has an important role in local tumor control (LC). The purpose of this study was to evaluate outcomes and patterns of treatment failure in patients with HNSTS treated with RT. A retrospective review was performed of adult patients with HNSTS treated with RT from January 1, 1998, to December 31, 2012. LC, locoregional control (LRC), disease-free survival (DFS), overall survival (OS), and predictors thereof were assessed. Forty-eight patients with HNSTS were evaluated. Five-year Kaplan-Meier estimates of LC, LRC, DFS, and OS were 87, 73, 63, and 83%, respectively. Angiosarcomas were found to be associated with worse LC, LRC, DFS, and OS. Patients over the age of 60 had lower rates of DFS. HNSTSs comprise a diverse group of tumors that can be managed with various treatment regimens involving RT. Angiosarcomas have higher recurrence and mortality rates. PMID:27441072

  6. Antiproliferative effect and apoptosis induction in melanoma treatment by boron neutron capture therapy (BCNT)

    Energy Technology Data Exchange (ETDEWEB)

    Faiao-Flores, Fernanda; Coelho, Paulo; Arruda-Neto, Joao; Maria, Durvanei [University of Sao Paulo (USP), SP (Brazil)

    2011-07-01

    Full text: Introduction: Boron neutron capture therapy (BNCT) is an experimental radiotherapy where a compound having {sup 10}B is administered to cancer patients and is accumulated in tumor tissues. Thus, the tumor is irradiated with thermal neutrons, {sup 10}B absorbs and destroys them, producing alpha radiation. Boronophenylalanine (BPA) is the agent responsible for delivering boron to the tumor tissue. After BPA administration, BNCT is used as a localized radiotherapy for many tumors treatment, mainly melanoma, which has a high mortality rate among all types of tumors. The aim of this study was to evaluate in vitro antiproliferative and antitumor effects of BNCT application in human melanoma treatment. Materials and Methods: MEWO cells (human melanoma) were cultured and treated with different concentrations of BPA (8.36 to 0.52 mg/ml). After 90 minutes, they were irradiated with thermal neutron flux up to a dose of 8.4 Gy. The parameters analyzed were free radical production, cell cycle progression, cell death signaling pathways, cycling D1, caspase-3 and extracellular matrix synthesis produced, beyond the mitochondrial electric potential analysis. Results: After BNCT treatment, MEWO cells showed an amount of free radical increase about 10 times. Still, there was a significant decrease of cyclin D1, G0/G1 proliferation, synthesis and G2/M cell cycle phases. BNCT induced a mitochondrial electrical potential decrease, as well as fibrillar proteins of extracellular matrix. BNCT had a significant number of dead cell increase, mainly by necrosis. However, BNCT induced phosphorylated caspase 3 increase. Discussion/Conclusion: BNCT induced cell death increase by necrosis, mitochondrial electric potential decrease and free radical production increase. BNCT is cytotoxic to melanoma cells. Besides necrosis, phosphorylated caspase 3 increase was observed, accompanied by a proliferative response decrease regulated by the G1/S checkpoint and matrix extracellular synthesis

  7. Growth inhibition of human pancreatic cancer grafts in nude mice by boron neutron capture therapy

    International Nuclear Information System (INIS)

    Cell destruction in boron neutron capture therapy (BNCT) is due to the nuclear reaction between 10B and thermal neutrons to release alpha-particles (4He) and lithium-7 ions (7Li). The 4He kills cells in the range of 10 μm from the site of 4He generation. Therefore, it is theoretically possible to kill tumor cells without affecting adjacent healthy tissues, if 10B-compounds could be selectively delivered. We have described that 10B atoms delivered by immunoliposomes exerted cytotoxic effect on human pancreatic carcinoma cells (AsPC-1) in a dose-dependent manner by thermal neutron irradiation in vitro as reported previously. In the present study, the cytotoxic effect of a locally injected 10B compound solution or multilamellar liposomes containing a 10B compound to human pancreatic carcinoma xenograft in nude mice was evaluated after thermal neutron irradiation. AsPC-1 cells (1 x 107) injected subcutaneously into a nude mouse grew to a tumor weighing 100-300 mg after 2 weeks. At this time 200 μg 10B compounds was locally injected in the tumor and irradiated with 2 x 1012 n/cm2 thermal neutron. Tumor growth of 10B-treated groups was suppressed as compared with control group. Histopathologically, hyalinization and necrosis were found in the tumor tissues. For effective tumor destruction, 10B dose more than 60 μg was necessary. The tumor tissue injected with saline only and irradiated showed neither destruction nor necrosis. These data indicate that the accumulation of 10B atoms to the tumor site is mandatory for the cytotoxic effect by thermal neutron irradiation. (author)

  8. Initiation of a phase-I trial of neutron capture therapy at the MIT research reactor

    International Nuclear Information System (INIS)

    The Massachusetts Institute of Technology (MIT), the New England Medical Center (NEMC), and Boston University Medical Center (BUMC) initiated a phase-1 trial of boron neutron capture therapy (BNCT) on September 6, 1994, at the 5-MW(thermal) MIT research reactor (MITR). A novel form of experimental cancer therapy, BNCT is being developed for certain types of highly malignant brain tumors such as glioblastoma and melanoma. The results of the phase-1 trials on patients with tumors in the legs or feet are described

  9. The relationship between boron neutron capture therapy (BNCT) and positron emission tomography (PET) for malignant brain tumors

    International Nuclear Information System (INIS)

    Boron neutron capture therapy (BNCT) is a particle irradiation therapy that is theoretically available for selective radiation of tumor cells. Boronophenylalanine-positron emission tomography (18F-BPA-PET) was used in this study. Boron is used as a tracer compound for the neutron capture reaction and has been particularly useful for the recent noncraniotomy BNCT. In this report, we introduce this type of PET as a principal axis in BNCT and relationship with PET. We calculated the drug accumulation to the tumor before neutron irradiation to individualize the treatment. We decided the indication for BNCT on the basis of a PET study and are now expanding the indications to other systemic cancers, including head and neck, lung, and liver cancers. In addition, other irradiation modalities have developed a radiation plan on the basis of a PET study, and several studies attempted improving the results; however, the lesion is exposed to high radiation doses and appear as high accumulation on BPA-PET during BNCT. We determined the neutron exposure time from the dosage for normal tissue in the actual treatment, but the lesion/normal tissue ratio obtained from BPA-PET is for evaluating the tumor dose and following the treatment plan. We also found that a PET study was useful in the follow-up stage to aid in diagnosis of pathologic conditions such as increase in tumor volume, recurrence, or radiation necrosis and for patients who had already been treated for malignant brain tumor. (author)

  10. Design and preparation of ethyl cellulose microcapsules of gadopentetate dimeglumine for neutron-capture therapy using the Wurster process.

    Science.gov (United States)

    Fukumori, Y; Ichikawa, H; Tokumitsu, H; Miyamoto, M; Jono, K; Kanamori, R; Akine, Y; Tokita, N

    1993-06-01

    Microcapsules of hygroscopic, highly water-soluble gadopentetate dimeglumine (Gd-DTPA-DM) for use in preliminary in vivo experiments for neutron-capture therapy were designed. They were prepared with such properties as a particle size small enough to be suspended and injected through a syringe, a negligible release of Gd-DTPA-DM, and a high drug content by means of the Wurster process, a spray coating method using a spouted bed with a draft tube. They were composed of lactose cores of 53-63 microm, an undercoat of ethyl cellulose (EC) and polyvinylpyrrolidone (PVP), a drug-layer of Gd-DTPA-DM, EC and PVP, a waterproof coat and a release-sustaining overcoat of EC and cholesterol (1:1), and a surface treated with hydrogenated egg lecithin. By curing at 110 degrees C for 30 min after mixing with 20% pulverized mannitol powder, the 20% overcoating suppressed the release of Gd-DTPA-DM from 75-106 microm microcapsules to less than 10% for the first 20 min, which was the period required to prepare a suspension, inject it and irradiate the neutron. The microcapsules could be used to confirm that the intracellular presence of Gd is not critical in gadolinium neutron-capture therapy. PMID:8370113

  11. Power Burst Facility/Boron Neutron Capture Therapy Program for cancer treatment

    Energy Technology Data Exchange (ETDEWEB)

    Ackermann, A.L. (ed.); Dorn, R.V. III.

    1990-08-01

    This report discusses monthly progress in the Power Boron Facility/Boron Neutron Capture Therapy (PBF/BNCT) Program for Cancer Treatment. Highlights of the PBF/BNCT Program during August 1990 include progress within the areas of: Gross Boron Analysis in Tissue, Blood, and Urine, boron microscopic (subcellular) analytical development, noninvasive boron quantitative determination, analytical radiation transport and interaction modeling for BNCT, large animal model studies, neutron source and facility preparation, administration and common support and PBF operations.

  12. Studying infrared light therapy for treating Alzheimer's disease

    Science.gov (United States)

    Han, Mengmeng; Wang, Qiyan; Zeng, Yuhui; Meng, Qingqiang; Zhang, Jun; Wei, Xunbin

    2016-03-01

    Alzheimer's disease (AD) is an extensive neurodegenerative disease. It is generally believed that there are some connections between AD and amyloid protein plaques in the brain. AD is a chronic disease that usually starts slowly and gets worse over time. The typical symptoms are memory loss, language disorders, mood swings and behavioral issues. Gradual losses of somatic functions eventually lead patients to death. Currently, the main therapeutic method is pharmacotherapy, which may temporarily reduce symptoms, but has many side effects. No current treatment can reverse AD's deterioration. Infrared (IR) light therapy has been studied in a range of single and multiple irradiation protocols in previous studies and was found beneficial for neuropathology. In our research, we have verified the effect of infrared light on AD through Alzheimer's disease mouse model. This transgenic mouse model is made by co-injecting two vectors encoding mutant amyloid precursor protein (APP) and mutant presenilin-1 (PSEN1). We designed an experimental apparatus for treating mice, which primarily includes a therapeutic box and a LED array, which emits infrared light. After the treatment, we assessed the effects of infrared light by testing cognitive performance of the mice in Morris water maze. Our results show that infra-red therapy is able to improve cognitive performance in the mouse model. It might provide a novel and safe way to treat Alzheimer's disease.

  13. Treating hearing disorders with cell and gene therapy

    Science.gov (United States)

    Gillespie, Lisa N.; Richardson, Rachael T.; Nayagam, Bryony A.; Wise, Andrew K.

    2014-12-01

    Hearing loss is an increasing problem for a substantial number of people and, with an aging population, the incidence and severity of hearing loss will become more significant over time. There are very few therapies currently available to treat hearing loss, and so the development of new therapeutic strategies for hearing impaired individuals is of paramount importance to address this unmet clinical need. Most forms of hearing loss are progressive in nature and therefore an opportunity exists to develop novel therapeutic approaches to slow or halt hearing loss progression, or even repair or replace lost hearing function. Numerous emerging technologies have potential as therapeutic options. This paper details the potential of cell- and gene-based therapies to provide therapeutic agents to protect sensory and neural cells from various insults known to cause hearing loss; explores the potential of replacing lost sensory and nerve cells using gene and stem cell therapy; and describes the considerations for clinical translation and the challenges that need to be overcome.

  14. Trend of Pharmacopuncture Therapy for Treating Cervical Disease in Korea

    Directory of Open Access Journals (Sweden)

    Seok-Hee Kim

    2014-12-01

    Full Text Available Objectives: The purpose of this study is to analyze trends in domestic studies on pharmacopuncture therapy for treating cervical disease. Methods: This study was carried out on original copies and abstracts of theses listed in databases or published until July 2014. The search was made on the Oriental medicine Advanced Searching Integrated System (OASIS the National Digital Science Library (NDSL, and the Korean traditional knowledge portal. Search words were ‘pain on cervical spine’, ‘cervical pain’, ‘ruptured cervical disk’, ‘cervical disc disorder’, ‘stiffness of the neck’, ‘cervical disk’, ‘whiplash injury’, ‘cervicalgia’, ‘posterior cervical pain’, ‘neck disability’, ‘Herniated Nucleus Pulposus (HNP’, and ‘Herniated Intervertebral Disc (HIVD’. Results: Twenty-five clinical theses related to pharmacopuncture were selected and were analyzed by year according to the type of pharmacopuncture used, the academic journal in which the publication appeared, and the effect of pharmacopuncture therapy. Conclusion: The significant conclusions are as follows: (1 Pharmacopunctures used for cervical pain were Bee venom pharmacopuncture, Carthami-flos pharmacopuncture, Scolopendra pharmacopuncture, Ouhyul pharmacopuncturen, Hwangryun pharmacopuncture, Corpus pharmacopuncture, Soyeom pharmacopuncture, Hwangryunhaedoktang pharmacopuncture, Shinbaro phamacopuncture. (2 Randomized controlled trials showed that pharmacopuncture therapy combined with other methods was more effective. (3 In the past, studies oriented toward Bee venom pharmacopuncture were actively pursued, but the number of studies on various other types of pharmacopuncture gradually began to increase. (4 For treating a patient with cervical pain, the type of pharmacopuncture to be used should be selected based on the cause of the disease and the patient’s condition.

  15. Development and in vitro testing of liposomal gadolinium-formulations for neutron capture therapy of glioblastoma multiforme

    International Nuclear Information System (INIS)

    For the improvement of current neutron capture therapy, several liposomal formulations of neutron capture agent gadolinium were developed and tested in a glioma cell model. Formulations were analyzed regarding physicochemical and biological parameters, such as size, zeta potential, uptake into cancer cells and performance under neutron irradiation. The neutron and photon dose derived from intracellular as well as extracellular Gd was calculated via Monte Carlo simulations and set in correlation with the reduction of cell survival after irradiation. To investigate the suitability of Gd as a radiosensitizer for photon radiation, cells were also irradiated with synchrotron radiation in addition to clinically used photons generated by linear accelerator. Irradiation with neutrons led to significantly lower survival for Gd-liposome-treated F98 and LN229 cells, compared to irradiated control cells and cells treated with non-liposomal Gd-DTPA. Correlation between Gd-content and -dose and respective cell survival displayed proportional relationship for most of the applied formulations. Photon irradiation experiments showed the proof-of-principle for the radiosensitizer approach, although the photon spectra currently used have to be optimized for higher efficiency of the radiosensitizer. In conclusion, the newly developed Gd-liposomes show great potential for the improvement of radiation treatment options for highly malignant glioblastoma.

  16. Plastic scintillation dosimetry for radiation therapy: minimizing capture of Cerenkov radiation noise

    International Nuclear Information System (INIS)

    Over the last decade, there has been an increased interest in scintillation dosimetry using small water-equivalent plastic scintillators, because of their favourable characteristics when compared with other more commonly used detector systems. Although plastic scintillators have been shown to have many desirable dosimetric properties, as yet there is no successful commercial detector system of this type available for routine clinical use in radiation oncology. The main factor preventing this new technology from realizing its full potential in commercial applications is the maximization of signal coupling efficiency and the minimization of noise capture. A principal constituent of noise is Cerenkov radiation. This study reports the calculated capture of Cerenkov radiation by an optical fibre in the special case where the radiation is generated by a relativistic particle on the fibre axis and the fibre axis is parallel to the Cerenkov cone. The fraction of radiation captured is calculated as a function of the fibre core refractive index and the refractive index difference between the core and the cladding of the fibre for relativistic particles. This is then used to deduce the relative intensity captured for a range of fibre core refractive indices and fibre core-cladding refractive index differences. It is shown that the core refractive index has little effect on the amount of radiation captured compared to the refractive index difference. The implications of this result for the design of radiation therapy plastic scintillation dosimeters are considered

  17. Carcinoma of the nasal vestibule treated with radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Mendenhall, N.P.; Parsons, J.T.; Cassisi, N.J.; Million, R.R.

    1987-05-01

    Twenty-two patients with squamous carcinoma of the nasal vestibule were treated at the University of Florida Division of Radiation Therapy with curative intent. Fifteen lesions were de novo and seven recurrent after surgery. By AJCC classification, 7 lesions were Tx or T1, 2 were T2, 2 were T3, and 11 were T4. Management of the primary tumor and regional lymphatic drainage was highly individualized. Local control was achieved in 19 out of 22 lesions. The ultimate regional lymph node control rate was 22 out of 22, although two patients required radical neck dissection after development of lymph node disease in untreated regional lymphatics. Two patients have died of cancer and three of intercurrent disease. Cosmetic results are generally excellent but may be compromised by previous surgery in recurrent lesions or tumor destruction of normal tissues in advanced lesions. Complications of treatment are minimal.

  18. Carcinoma of the nasal vestibule treated with radiation therapy

    International Nuclear Information System (INIS)

    Twenty-two patients with squamous carcinoma of the nasal vestibule were treated at the University of Florida Division of Radiation Therapy with curative intent. Fifteen lesions were de novo and seven recurrent after surgery. By AJCC classification, 7 lesions were Tx or T1, 2 were T2, 2 were T3, and 11 were T4. Management of the primary tumor and regional lymphatic drainage was highly individualized. Local control was achieved in 19 out of 22 lesions. The ultimate regional lymph node control rate was 22 out of 22, although two patients required radical neck dissection after development of lymph node disease in untreated regional lymphatics. Two patients have died of cancer and three of intercurrent disease. Cosmetic results are generally excellent but may be compromised by previous surgery in recurrent lesions or tumor destruction of normal tissues in advanced lesions. Complications of treatment are minimal

  19. Treating the untreatable: a single case study of a psychopathic inpatient treated with schema therapy.

    Science.gov (United States)

    Chakhssi, Farid; Kersten, Truus; de Ruiter, Corine; Bernstein, David P

    2014-09-01

    From its first conceptualization in modern psychiatry, psychopathy has been considered difficult if not impossible to treat. Schema Therapy (ST) is a psychotherapeutic approach that has shown efficacy in patients with borderline personality disorder. ST has recently been adapted for personality disordered forensic patients, including patients with high levels of psychopathy. The present case study examined the process of individual ST, combined with movement therapy and milieu therapy by the nursing staff, with a forensic inpatient with psychopathic features (Psychopathy Checklist-Revised total score = 28.4). The patient had been sentenced to a mandatory treatment order in relation to a sexual assault. We assessed change using independent assessments of psychopathic traits, cognitive schemas, and risk-related behaviors over the 4-year treatment period and a 3-year follow-up. We also assessed the quality of the working alliance. Reliable change analyses showed significant improvements in psychopathic traits, cognitive schemas, and risk-related outcomes. At 3 years posttreatment, the patient was living independently outside of the forensic institution without judicial supervision and he had not reoffended. While many questions remain about the effectiveness of psychotherapeutic treatment for psychopathic patients, our study challenges the view that they are untreatable.

  20. Pancreatic adenocarcinoma: treating a systemic disease with systemic therapy.

    Science.gov (United States)

    Sohal, Davendra P S; Walsh, R Matthew; Ramanathan, Ramesh K; Khorana, Alok A

    2014-03-01

    Pancreatic adenocarcinoma, even when resectable, remains highly lethal. Although surgical outcomes have improved considerably, median overall survival after surgery and adjuvant therapy such as single-agent gemcitabine remains less than 2 years. We discuss preclinical and clinical data supporting the contention that even early-stage pancreatic cancer is a systemic disease. Autopsy series reveal that 70% to 85% of patients die of systemic recurrence, rather than local disease, after pancreatic cancer resection. Preclinical studies using genomics and mouse models reveal evidence of metastatic spread even before histopathologic evidence of a pancreatic tumor. Analogous to breast cancer, we propose that the Halstedian approach of treating pancreatic cancer as a local, surgical problem should be replaced by Fisher's alternative hypothesis of cancer as a systemic disease. Newer multiagent chemotherapy regimens have shown meaningful response rates and improvement in overall survival in the metastatic setting and, for the first time, offer investigators an opportunity to use effective systemic therapy. We emphasize that a surgery-first approach is not resonant with our current understanding of pancreatic adenocarcinoma biology and that an upfront systemic approach for even resectable pancreatic cancer warrants testing in clinical trials.

  1. Design of a boron neutron capture enhanced fast neutron therapy assembly

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Zhonglu

    2006-08-01

    The use of boron neutron capture to boost tumor dose in fast neutron therapy has been investigated at several fast neutron therapy centers worldwide. This treatment is termed boron neutron capture enhanced fast neutron therapy (BNCEFNT). It is a combination of boron neutron capture therapy (BNCT) and fast neutron therapy (FNT). It is believed that BNCEFNT may be useful in the treatment of some radioresistant brain tumors, such as glioblastoma multiform (GBM). A boron neutron capture enhanced fast neutron therapy assembly has been designed for the Fermilab Neutron Therapy Facility (NTF). This assembly uses a tungsten filter and collimator near the patient's head, with a graphite reflector surrounding the head to significantly increase the dose due to boron neutron capture reactions. The assembly was designed using Monte Carlo radiation transport code MCNP version 5 for a standard 20x20 cm{sup 2} treatment beam. The calculated boron dose enhancement at 5.7-cm depth in a water-filled head phantom in the assembly with a 5x5 cm{sup 2} collimation was 21.9% per 100-ppm {sup 10}B for a 5.0-cm tungsten filter and 29.8% for a 8.5-cm tungsten filter. The corresponding dose rate for the 5.0-cm and 8.5-cm thick filters were 0.221 and 0.127 Gy/min, respectively; about 48.5% and 27.9% of the dose rate of the standard 10x10 cm{sup 2} fast neutron treatment beam. To validate the design calculations, a simplified BNCEFNT assembly was built using four lead bricks to form a 5x5 cm{sup 2} collimator. Five 1.0-cm thick 20x20 cm{sup 2} tungsten plates were used to obtain different filter thicknesses and graphite bricks/blocks were used to form a reflector. Measurements of the dose enhancement of the simplified assembly in a water-filled head phantom were performed using a pair of tissue-equivalent ion chambers. One of the ion chambers is loaded with 1000-ppm natural boron (184-ppm {sup 10}B) to measure dose due to boron neutron capture. The measured dose enhancement at 5.0-cm depth

  2. Design of a boron neutron capture enhanced fast neutron therapy assembly

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Zhonglu [Georgia Inst. of Technology, Atlanta, GA (United States)

    2006-12-01

    The use of boron neutron capture to boost tumor dose in fast neutron therapy has been investigated at several fast neutron therapy centers worldwide. This treatment is termed boron neutron capture enhanced fast neutron therapy (BNCEFNT). It is a combination of boron neutron capture therapy (BNCT) and fast neutron therapy (FNT). It is believed that BNCEFNT may be useful in the treatment of some radioresistant brain tumors, such as glioblastoma multiform (GBM). A boron neutron capture enhanced fast neutron therapy assembly has been designed for the Fermilab Neutron Therapy Facility (NTF). This assembly uses a tungsten filter and collimator near the patient's head, with a graphite reflector surrounding the head to significantly increase the dose due to boron neutron capture reactions. The assembly was designed using Monte Carlo radiation transport code MCNP version 5 for a standard 20x20 cm2 treatment beam. The calculated boron dose enhancement at 5.7-cm depth in a water-filled head phantom in the assembly with a 5x5 cm2 collimation was 21.9% per 100-ppm 10B for a 5.0-cm tungsten filter and 29.8% for a 8.5-cm tungsten filter. The corresponding dose rate for the 5.0-cm and 8.5-cm thick filters were 0.221 and 0.127 Gy/min, respectively; about 48.5% and 27.9% of the dose rate of the standard 10x10 cm2 fast neutron treatment beam. To validate the design calculations, a simplified BNCEFNT assembly was built using four lead bricks to form a 5x5 cm2 collimator. Five 1.0-cm thick 20x20 cm2 tungsten plates were used to obtain different filter thicknesses and graphite bricks/blocks were used to form a reflector. Measurements of the dose enhancement of the simplified assembly in a water-filled head phantom were performed using a pair of tissue-equivalent ion chambers. One of the ion chambers is loaded with 1000-ppm natural boron (184-ppm 10B) to measure dose due to boron neutron capture. The

  3. Head and neck soft tissue sarcomas treated with radiation therapy

    Directory of Open Access Journals (Sweden)

    Lucas K. Vitzthum

    2016-06-01

    Full Text Available Head and neck soft tissue sarcomas (HNSTSs are rare and heterogeneous cancers in which radiation therapy (RT has an important role in local tumor control (LC. The purpose of this study was to evaluate outcomes and patterns of treatment failure in patients with HNSTS treated with RT. A retrospective review was performed of adult patients with HNSTS treated with RT from January 1, 1998, to December 31, 2012. LC, locoregional control (LRC, disease-free survival (DFS, overall survival (OS, and predictors thereof were assessed. Forty-eight patients with HNSTS were evaluated. Five-year Kaplan-Meier estimates of LC, LRC, DFS, and OS were 87, 73, 63, and 83%, respectively. Angiosarcomas were found to be associated with worse LC, LRC, DFS, and OS. Patients over the age of 60 had lower rates of DFS. HNSTSs comprise a diverse group of tumors that can be managed with various treatment regimens involving RT. Angiosarcomas have higher recurrence and mortality rates.

  4. Apoptosis-based therapy to treat pulmonary arterial hypertension

    Science.gov (United States)

    Suzuki, Yuichiro J.; Ibrahim, Yasmine F.; Shults, Nataliia V.

    2016-01-01

    Pulmonary arterial hypertension (PAH) is rare, but patients who are diagnosed with this disease still suffer from a lack of satisfactory treatment strategies to prolong survival. While currently approved drugs for PAH have some benefits, these vasodilators only have limited efficacy for eliminating pulmonary vascular remodeling and reducing mortality. Thus, our laboratory has been exploring the use of aggressive drugs, which are capable of causing apoptotic cell death, to treat PAH. We have so far found that three classes of anti-tumor agents, including anthracyclines, taxanes, and proteasome inhibitors, are capable of reducing pulmonary vascular thickness in rats with PAH. These drugs kill cells in remodeled pulmonary vessels without affecting the normal, healthy pulmonary vasculature, revealing that proliferating vascular cells in PAH patients are more sensitive to drug-induced apoptosis compared to the differentiated phenotype that is physiologically important for smooth muscle contraction. Since many apoptosis-inducing drugs cause cardiotoxicity in cancer patients, and because PAH patients already have a weakened heart, we focus on finding biological mechanisms that may reverse pulmonary vascular remodeling without promoting cardiotoxicity. We found two agents, dexrazoxane and pifithrin-α, that selectively inhibit cardiac muscle apoptosis without affecting the drug-induced apoptosis of the proliferating pulmonary vascular cells. Thus, we propose that the addition of apoptosis-inducing drugs and cardioprotectants to PAH therapies may be effective in treating patients and preventing right heart failure.

  5. A suggestion for B-10 imaging during boron neutron capture therapy

    CERN Document Server

    Cortesi, M

    2007-01-01

    Selective accumulation of B-10 compound in tumour tissue is a fundamental condition for the achievement of BNCT (Boron Neutron Capture Therapy), since the effectiveness of therapy irradiation derives just from neutron capture reaction of B-10. Hence, the determination of the B-10 concentration ratio, between tumour and healthy tissue, and a control of this ratio, during the therapy, are essential to optimise the effectiveness of the BNCT, which it is known to be based on the selective uptake of B-10 compound. In this work, experimental methods are proposed and evaluated for the determination in vivo of B-10 compound in biological samples, in particular based on neutron radiography and gammaray spectroscopy by telescopic system. Measures and Monte Carlo calculations have been performed to investigate the possibility of executing imaging of the 10B distribution, both by radiography with thermal neutrons, using 6LiF/ZnS:Ag scintillator screen and a CCD camera, and by spectroscopy, based on the revelation of gamm...

  6. Boron neutron capture therapy of malignant brain tumors at the Brookhaven Medical Research Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Joel, D.D.; Coderre, J.A.; Chanana, A.D. [Brookhaven National Lab., Upton, NY (United States). Medical Dept.

    1996-12-31

    Boron neutron capture therapy (BNCT) is a bimodal form of radiation therapy for cancer. The first component of this treatment is the preferential localization of the stable isotope {sup 10}B in tumor cells by targeting with boronated compounds. The tumor and surrounding tissue is then irradiated with a neutron beam resulting in thermal neutron/{sup 10}B reactions ({sup 10}B(n,{alpha}){sup 7}Li) resulting in the production of localized high LET radiation from alpha and {sup 7}Li particles. These products of the neutron capture reaction are very damaging to cells, but of short range so that the majority of the ionizing energy released is microscopically confined to the vicinity of the boron-containing compound. In principal it should be possible with BNCT to selectively destroy small nests or even single cancer cells located within normal tissue. It follows that the major improvements in this form of radiation therapy are going to come largely from the development of boron compounds with greater tumor selectivity, although there will certainly be advances made in neutron beam quality as well as the possible development of alternative sources of neutron beams, particularly accelerator-based epithermal neutron beams.

  7. Synthesis and biological evaluation of boronated polyglycerol dendrimers as potential agent for neutron capture therapy

    International Nuclear Information System (INIS)

    In this work, the polyglycerol dendrimer (PGLD) generation 5 was used to obtain a boronated macromolecule for boron neutron capture therapy. The PGLD dendrimer was synthesized by the ring opening polymerization of deprotonated glycidol using polyglycerol as core functionality in a step-growth processes denominated divergent synthesis. The PGLD dendritic structure was confirmed by gel permeation chromatography, nuclear magnetic resonance (1H-NMR, 13C-NMR) and matrix assisted laser desorption/ionization techniques. The synthesized dendrimer presented low dispersion in molecular weights (Mw/Mn = 1.05) and a degree of branching of 0.82, which characterize the polymer dendritic structure. Quantitative neutron capture radiography was used to investigate the boron-10 enrichment of the polyglycerol dendrimer. The in vitro cytotoxicity to Chinese hamster ovary cells of 10B-PGLD dendrimer indicate lower cytotoxicity, suggesting that the macromolecule is a biocompatible material. (author)

  8. Early clinical experience of boron neutron capture therapy for glioblastoma multiforme

    International Nuclear Information System (INIS)

    Boron neutron capture therapy (BNCT) is a binary treatment modality that can selectively irradiate tumor tissue. BNCT uses drugs containing a stable isotope of boron. 10B, to sensitize tumor cells to irradiation by low energy (thermal) neutrons. The interaction of the 10B with a thermal neutron (neutron capture) causes the 10B nucleus to split, releasing an alpha particle and a lithium nucleus. These products of the 10B(n, α)7Li reaction are very damaging to cells but have a combined path length in tissue of approximately 14 μm, or roughly the diameter of one or two cells. Thus, most of the ionizing energy imparted to tissue is localized to 10B-loaded cells

  9. Single photon image from position emission tomography with insertable collimator for boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Joo Young; Yoo, Do Kun; Suh, Tae Suk [Dept. of Biomedical Engineering and Research Institute of Biomedical Engineering, College of Medicine, Catholic University of Korea, Seoul (Korea, Republic of); Hong, Key Jo [Molecular Imaging Program at Stanford (MIPS), Dept. of Radiology, Stanford University, Stanford (United States)

    2014-04-15

    The aim of our proposed system is to confirm the feasibility of extraction of two types of images from one positron emission tomography (PET) module with an insertable collimator for brain tumor treatment during the boron neutron capture therapy (BNCT). The BNCT theory and conceptual diagram of our proposed system are shown fig.1. Data from the PET module, neutron source, and collimator was entered in the Monte Carlon-particle extende source code. We attempted to acquire the PET and SPECT images simultaneously using only PET without an additional isotope. Single photon images were acquired using an insertable collimator on a PET detector.

  10. Boron neutron capture therapy for advanced and/or recurrent cancers in the oral cavity

    International Nuclear Information System (INIS)

    This preliminary study of 5 patients with advanced and/or recurrent cancer in the oral cavity was performed to evaluate the effectiveness of Boron Neutron Capture Therapy (BNCT). The patients received therapy with the 10B-carrier p-boronophenylalanine (BPA) with or without borocaptate sodium (BSH) and irradiation thereafter with epithermal neutrons. All underwent 18F-BPA PET studies before receiving BNCT to determine the accumulation ratios of BPA in tumor and normal tissues. The tumor mass was decreased in size and at minimum a transient partial response was achieved in all cases, though rapid tumor re-growth was observed in 2. Although tentative clinical responses and improvements in quality of life were recognized, obliteration of the tumor was not obtained in any of the cases. Additional studies are required to determine the utility and indication of BNCT for oral cancer. (author)

  11. Study of characteristics for heavy water photoneutron source in boron neutron capture therapy

    CERN Document Server

    Salehi, Danial; Sardari, Dariush

    2013-01-01

    Bremsstrahlung photon beams produced by medical linear accelerators are currently the most commonly used method of radiation therapy for cancerous tumors. Photons with energies greater than 8-10 MeV potentially generate neutrons through photonuclear interactions in the accelerator's treatment head, patient's body, and treatment room ambient. Electrons impinging on a heavy target generate a cascade shower of bremsstrahlung photons, the energy spectrum of which shows an end point equal to the electron beam energy. By varying the target thickness, an optimum thickness exists for which, at the given electron energy, maximum photon flux is achievable. If a source of high-energy photons i.e. bremsstrahlung, is conveniently directed to a suitable D2O target, a novel approach for production of an acceptable flux of filterable photoneturons for boron neutron capture therapy (BNCT) application is possible. This study consists of two parts. 1. Comparison and assessment of deuterium photonuclear cross section data. 2. Ev...

  12. Boron neutron capture therapy as new treatment for clear cell sarcoma: Trial on different animal model

    International Nuclear Information System (INIS)

    Clear cell sarcoma (CCS) is a rare malignant tumor with a poor prognosis. In our previous study, the tumor disappeared under boron neutron capture therapy (BNCT) on subcutaneously-transplanted CCS-bearing animals. In the present study, the tumor disappeared under this therapy on model mice intramuscularly implanted with three different human CCS cells. BNCT led to the suppression of tumor-growth in each of the different model mice, suggesting its potentiality as an alternative to, or integrative option for, the treatment of CCS. - Highlights: • BNCT with the use of L-BPA was applied for three human clear cell sarcoma (CCS) cell lines. • BNCT trial was performed on a newly established intramuscularly CCS-bearing animal model. • A significant decrease of the tumor-volume was seen by single BNCT with the use of L-BPA. • A multiple BNCT application would be required for controlling the growth of any residual tumors

  13. Physical Therapy to Treat Torn Meniscus Comparable to Surgery for Many Patients

    Science.gov (United States)

    ... 1999 Spotlight on Research 2013 August 2013 (historical) Physical Therapy to Treat Torn Meniscus Comparable to Surgery for ... to avoid surgery and achieve comparable relief from physical therapy, according to a recent, multisite study funded by ...

  14. Dose Determination using alanine detectors in a Mixed Neutron and Gamma Field for Boron Neutron Capture Therapy of Liver Malignancies

    DEFF Research Database (Denmark)

    Schmitz, T.; Blaickner, M.; Ziegner, M.;

    2011-01-01

    Introduction Boron Neutron Capture Therapy for liver malignancies is being investigated at the University of Mainz. One important aim is the set-up of a reliable dosimetry system. Alanine dosimeters have previously been applied for dosimetry of mixed radiation fields in antiproton therapy, and may...

  15. Choroidal neovascular membrane associated with choroidal osteoma (CO treated with trans-pupillary thermo therapy.

    Directory of Open Access Journals (Sweden)

    Sharma Sumita

    2004-01-01

    Full Text Available Choroidal neovascular membrane, a known complication of choroidal osteoma causing visual loss when located subfoveally, can be successfully treated with transpupillary thermo therapy.

  16. Proceedings of workshop on 'boron chemistry and boron neutron capture therapy'

    International Nuclear Information System (INIS)

    This volume contains the proceedings of the 4th Workshop on 'the Boron Chemistry and Boron Neutron Capture Therapy' held on February 24 in 1992. First, clinical experiences of BNCT in the Kyoto University Research Reactor in 1992 were briefly reported. Then, the killing effects of boron cluster-containing nucleic acid precursors on tumor cells were shown (Chap. 2). The various trials of the optical resolution of B-p-boronophenylalanine for neutron capture therapy were made (Chap. 3). The borate-dextran gel complexes were investigated by the nuclear magnetic resonance spectroscopy. The stability constants of borate complexes were listed, and are useful in the solution chemistry of boron compounds (Chap. 4). The interactions between boron compounds and biological materials were studied by the paper electrophoresis which had been developed by us (Chap. 5). Molecular design of boron-10 carriers and their organic synthesis were reported (Chap. 6). Carborane-containing aziridine boron carriers which were directed to the DNA alkylation were synthesized and their cancer cell killing efficacies were tested (Chap. 7). The solution chemistry of deuterium oxide which is a good neutron moderator was reported, relating to the BNCT (Chap. 8). (author)

  17. Carcinoma of the cervical esophagus treated with radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Mendenhall, W.M.; Parsons, J.T.; Vogel, S.B.; Cassisi, N.J.; Million, R.R.

    1988-07-01

    This is an analysis of 34 patients with carcinoma of the cervical esophagus treated with radiation therapy with curative intent at the University of Florida between September 1966 and May 1985. All patients have a minimum 2-year follow-up and 28 (82%) have at least 5 years of follow-up. Patients were staged according to the recommendations of the AJCC. Patients who died within 2 years of treatment with the primary site continuously disease-free were excluded from the local control analysis; all patients were included in the analysis of complications and survival. Irradiation resulted in control of the primary lesion in 1 of 2 patients who presented with T1 lesions, in 4 of the 12 patients with T2 lesions, and 3 of 17 patients who presented with T3 lesions. One patient with a T3 lesion that recurred locally was successfully salvaged by an operation. The 5-year absolute survival rates by stage were as follows: no patients with stage I lesions survived; of 11 stage II patients, one survived; and of 16 stage III patients, three survived. Interestingly, all four of the 5-year survivors were women.

  18. User's manual of a supporting system for treatment planning in boron neutron capture therapy. JAERI computational dosimetry system

    CERN Document Server

    Kumada, H

    2002-01-01

    A boron neutron capture therapy (BNCT) with epithermal neutron beam is expected to treat effectively for malignant tumor that is located deeply in the brain. It is indispensable to estimate preliminarily the irradiation dose in the brain of a patient in order to perform the epithermal neutron beam BNCT. Thus, the JAERI Computational Dosimetry System (JCDS), which can calculate the dose distributions in the brain, has been developed. JCDS is a software that creates a 3-dimensional head model of a patient by using CT and MRI images and that generates a input data file automatically for calculation neutron flux and gamma-ray dose distribution in the brain by the Monte Carlo code: MCNP, and that displays the dose distribution on the head model for dosimetry by using the MCNP calculation results. JCDS has any advantages as follows; By treating CT data and MRI data which are medical images, a detail three-dimensional model of patient's head is able to be made easily. The three-dimensional head image is editable to ...

  19. A Framework for Treating Cumulative Trauma with Art Therapy

    Science.gov (United States)

    Naff, Kristina

    2014-01-01

    Cumulative trauma is relatively undocumented in art therapy practice, although there is growing evidence that art therapy provides distinct benefits for resolving various traumas. This qualitative study proposes an art therapy treatment framework for cumulative trauma derived from semi-structured interviews with three art therapists and artistic…

  20. Spectromicroscopy of boron for the optimization of boron neutron capture therapy (BNCT) for cancer

    Science.gov (United States)

    Gilbert, B.; Redondo, J.; Baudat, P.-A.; Lorusso, G. F.; Andres, R.; Van Meir, E. G.; Brunet, J.-F.; Hamou, M.-F.; Suda, T.; Mercanti, Delio; Ciotti, M. Teresa; Droubay, T. C.; Tonner, B. P.; Perfetti, P.; Margaritondo, M.; DeStasio, Gelsomina

    1998-10-01

    We used synchrotron spectromicroscopy to study the microscopic distribution of boron in rat brain tumour and healthy tissue in the field of boron neutron capture therapy (BNCT). The success of this experimental cancer therapy depends on the preferential uptake of ? in tumour cells after injection of a boron compound (in our case ?, or BSH). With the Mephisto (microscope à emission de photoélectrons par illumination synchrotronique de type onduleur) spectromicroscope, high-magnification imaging and chemical analysis was performed on brain tissue sections from a rat carrying an implanted brain tumour and the results were compared with inductively coupled plasma-atomic emission spectroscopy (ICP-AES) detection of boron in bulk tissue. Boron was found to have been taken up more favourably by regions of tumour rather than healthy tissue, but the resulting boron distribution in the tumour was inhomogeneous. The results demonstrate that Mephisto can perform microchemical analysis of tissue sections, detect and localize the presence of boron with submicron spatial resolution. The application of this technique to boron in brain tissue can therefore be used to evaluate the current efforts to optimize BNC therapy.

  1. Spectromicroscopy of boron for the optimization of boron neutron capture therapy (BNCT) for cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gilbert, B.; Redondo, J.; Baudat, P-A. [Institut de Physique Appliquee, Ecole Polytechnique Federale, Lausanne (Switzerland)] [and others

    1998-10-07

    We used synchrotron spectromicroscopy to study the microscopic distribution of boron in rat brain tumour and healthy tissue in the field of boron neutron capture therapy (BNCT). The success of this experimental cancer therapy depends on the preferential uptake of {sup 10}B in tumour cells after injection of a boron compound (in our case B{sub 12}H{sub 11}SH, or BSH). With the Mephisto (microscope a emission de photoelectrons par illumination synchrotronique de type onduleur) spectromicroscope, high-magnification imaging and chemical analysis was performed on brain tissue sections from a rat carrying an implanted brain tumour and the results were compared with inductively coupled plasma-atomic emission spectroscopy (ICP-AES) detection of boron in bulk tissue. Boron was found to have been taken up more favourably by regions of tumour rather than healthy tissue, but the resulting boron distribution in the tumour was inhomogeneous. The results demonstrate that Mephisto can perform microchemical analysis of tissue sections, detect and localize the presence of boron with submicron spatial resolution. The application of this technique to boron in brain tissue can therefore be used to evaluate the current efforts to optimize BNC therapy. (author)

  2. Long-term follow-up of cancer patients treated with gene therapy medicinal products.

    Science.gov (United States)

    Galli, Maria Cristina

    2012-06-01

    European Union requirements are discussed for the long-term follow-up of advanced therapy medicinal products, as well as how they can be applied to cancer patients treated with gene therapy medicinal products in the context of clinical trials, as described in a specific guideline issued by Gene Therapy Working Party at the European Medicine Agency.

  3. Using Acceptance and Commitment Therapy to Treat Distressed Couples: A Case Study With Two Couples

    Science.gov (United States)

    Peterson, Brennan D.; Eifert, Georg H.; Feingold, Tal; Davidson, Sarah

    2009-01-01

    Although the field of couple therapy has made significant strides in recent years, there continues to be a need for theoretically sound and empirically supported treatments. The current case study examines whether Acceptance and Commitment Therapy (ACT), an experiential acceptance-based behavior therapy, can be effective in treating distressed…

  4. Optimal Neutron Source and Beam Shaping Assembly for Boron Neutron Capture Therapy

    CERN Document Server

    Vujic, J L; Greenspan, E; Guess, S; Karni, Y; Kastenber, W E; Kim, L; Leung, K N; Regev, D; Verbeke, J M; Waldron, W L; Zhu, Y

    2003-01-01

    There were three objectives to this project: (1) The development of the 2-D Swan code for the optimization of the nuclear design of facilities for medical applications of radiation, radiation shields, blankets of accelerator-driven systems, fusion facilities, etc. (2) Identification of the maximum beam quality that can be obtained for Boron Neutron Capture Therapy (BNCT) from different reactor-, and accelerator-based neutron sources. The optimal beam-shaping assembly (BSA) design for each neutron source was also to e obtained. (3) Feasibility assessment of a new neutron source for NCT and other medical and industrial applications. This source consists of a state-of-the-art proton or deuteron accelerator driving and inherently safe, proliferation resistant, small subcritical fission assembly.

  5. Gel dosimeters as useful dose and thermal-fluence detectors in Boron Neutron Capture Therapy (BNCT)

    Energy Technology Data Exchange (ETDEWEB)

    Gambarini, G.; Valente, M. [Department of Physics of the University and INFN, Via Celoria 16, I-20133 Milan (Italy); Moss, R.L.; Daquino, G.G.; Nievaart, V.A. [Joint Research Centre, Institute for Energy, P.O. Box 2, NL-1755ZG Petten, The Netherlands (Netherlands); Mariani, M.; Vanossi, E. [Department of Nuclear Engineering of Polytechnic, CESNEF, Via Ponzio, 34/3 - I-20133 Milan (Italy); Carrara, M. [Medical Physics Department, National Cancer Institute, Via Venezian 1, I-20131, Milan (Italy)

    2006-07-01

    The dosimetry method based on Fricke-Xylenol-Orange-infused gels in form of layers has shown noticeable potentiality for in-phantom or in-free-beam dose and thermal flux profiling and imaging in the high fluxes of thermal or epithermal neutrons utilised for boron neutron capture therapy (BNCT). Gel-dosimeters in form of layers give the possibility not only of obtaining spatial dose distributions but also of achieving measurements of each dose contribution in neutron fields. The discrimination of the various dose components is achieved by means of pixel-to-pixel manipulations of pairs of images obtained with gel-dosimeters having different isotopic composition. It is possible to place large dosimeters, detecting in such a way large dose images, because the layer geometry of dosimeters avoids sensitive variation of neutron transport due to the gel isotopic composition. Some results obtained after the last improvements of the method are reported. (Author)

  6. Biological models in vivo for boron neutronic capture studies as tumors therapy

    International Nuclear Information System (INIS)

    The use of experimental models for Boron Neutronic Capture studies as Tumors Therapy have as two main objectives: 1) To contribute to the basic knowledge of the biological mechanisms involved to increase the method therapeutical advantage, and 2) To explore the possible application of this therapeutic method to other pathologies. In this frame it was studied the carcinogenesis model of hamster cheek pouch, a type of human buccal cancer. Biodistribution studies of boron compound were performed in tumor, blood and in different precancerous and normal tissues as well as BNCT studies. Results validated this method for BNCT studies and show the capacity of the oral mucosa tumors of selectively concentrate the boron compound, showing a deleterious clear effect on the tumor after 24 hours with BNCT treatment. (author)

  7. New concepts for compact accelerator/target for Boron Neutron Capture Therapy

    International Nuclear Information System (INIS)

    Two new target concepts, NIFTI and DISCOS, that enable a large reduction in the proton beam current needed to produce epithermal neutrons for BNCT (Boron Neutron Capture Therapy) are described. In the NIFTI concept, high energy neutrons produced by (p, n) reactions of 2.5 MeV protons on Li are down scattered to treatment energies (∼ 20 keV) by relatively thin layers of PbF2 and iron. In the DISCOS concept, treatment energy neutrons are produced directly in a succession of thin (∼ 1 micron) liquid Li films on rotating Be foils. These foils interact with a proton beam that operates just above threshold for the (p, n) reaction, with an applied DC field to re-accelerate the proton beam between the target foils

  8. Optimal Neutron Source and Beam Shaping Assembly for Boron Neutron Capture Therapy

    International Nuclear Information System (INIS)

    There were three objectives to this project: (1) The development of the 2-D Swan code for the optimization of the nuclear design of facilities for medical applications of radiation, radiation shields, blankets of accelerator-driven systems, fusion facilities, etc. (2) Identification of the maximum beam quality that can be obtained for Boron Neutron Capture Therapy (BNCT) from different reactor-, and accelerator-based neutron sources. The optimal beam-shaping assembly (BSA) design for each neutron source was also to e obtained. (3) Feasibility assessment of a new neutron source for NCT and other medical and industrial applications. This source consists of a state-of-the-art proton or deuteron accelerator driving and inherently safe, proliferation resistant, small subcritical fission assembly

  9. Accelerator based neutron source for the neutron capture therapy at hospital

    International Nuclear Information System (INIS)

    Accelerator source of epithermal neutrons for the hospital-based boron neutron capture therapy is proposed and discussed. Kinematically collimated neutrons are produced via near-threshold 7Li(p, n)7Be reaction at proton energies of 1.883 - 1.9 MeV. Steady-state accelerator current of 40 mA allows to provide therapeutically useful beams with treatment times of tens of minutes. The basic components of the facility are a hydrogen negative ion source, an electrostatic tandem accelerator with vacuum insulation, a sectioned rectifier, and a thin lithium neutron generating target on the surface of tungsten disk cooled by liquid metal heat carrier. Design features of facility components are discussed. The possibility of stabilization of proton energy is considered. At proton energy of 2.5 MeV the neutron beam production for NCT usage after moderation is also considered. (author)

  10. Gel dosimeters as useful dose and thermal-fluence detectors in Boron Neutron Capture Therapy (BNCT)

    International Nuclear Information System (INIS)

    The dosimetry method based on Fricke-Xylenol-Orange-infused gels in form of layers has shown noticeable potentiality for in-phantom or in-free-beam dose and thermal flux profiling and imaging in the high fluxes of thermal or epithermal neutrons utilised for boron neutron capture therapy (BNCT). Gel-dosimeters in form of layers give the possibility not only of obtaining spatial dose distributions but also of achieving measurements of each dose contribution in neutron fields. The discrimination of the various dose components is achieved by means of pixel-to-pixel manipulations of pairs of images obtained with gel-dosimeters having different isotopic composition. It is possible to place large dosimeters, detecting in such a way large dose images, because the layer geometry of dosimeters avoids sensitive variation of neutron transport due to the gel isotopic composition. Some results obtained after the last improvements of the method are reported. (Author)

  11. Incorporation and characterization of boron neutron capture therapy agents into mesoporous silicon and silicon nanowires

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, Ke; Coffer, Jeffery L. [Department of Chemistry, Texas Christian University, Fort Worth, TX 76129 (United States); Loni, Armando; Canham, Leigh T. [PSi Medica Ltd., Malvern, Worcestershire, WR14 3SZ (United Kingdom); Intrinsiq Materials Ltd., Malvern, Worcestershire, WR14 3SZ (United Kingdom)

    2009-06-15

    The tunable pore size, biodegradability, and surface chemistry of mesoporous silicon (BioSilicon trademark) are important to a broad spectrum of uses for drug delivery. For the case of Boron Neutron Capture Therapy (BNCT), encapsulation of a given boron-containing drug molecule within a porous BioSilicon trademark microparticle provides a vehicle for a brachytherapy method that avoids the necessity of drug modification. In this work, the loading and characterization of three clinically approved BNCT drugs into mesoporous Si is demonstrated. Because of difficulties associated with light element detection, a method based on a Beer's Law analysis of selected FTIR vibrational bands has been developed to estimate boron-containing drug loading in these materials. As a complementary nanostructural platform, a cathodic deposition process for the surface enriched growth of selected drugs onto the surface of silicon nanowires is also described. (copyright 2009 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim) (orig.)

  12. Optimal Neutron Source & Beam Shaping Assembly for Boron Neutron Capture Therapy

    Energy Technology Data Exchange (ETDEWEB)

    J. Vujic; E. Greenspan; W.E. Kastenber; Y. Karni; D. Regev; J.M. Verbeke, K.N. Leung; D. Chivers; S. Guess; L. Kim; W. Waldron; Y. Zhu

    2003-04-30

    There were three objectives to this project: (1) The development of the 2-D Swan code for the optimization of the nuclear design of facilities for medical applications of radiation, radiation shields, blankets of accelerator-driven systems, fusion facilities, etc. (2) Identification of the maximum beam quality that can be obtained for Boron Neutron Capture Therapy (BNCT) from different reactor-, and accelerator-based neutron sources. The optimal beam-shaping assembly (BSA) design for each neutron source was also to e obtained. (3) Feasibility assessment of a new neutron source for NCT and other medical and industrial applications. This source consists of a state-of-the-art proton or deuteron accelerator driving and inherently safe, proliferation resistant, small subcritical fission assembly.

  13. A microdosimetric study of {sup 10}B(n,{alpha}){sup 7}Li and {sup 157}Gd(n,{gamma}) reactions for neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Wang, C.K.C.; Sutton, M.; Evans, T.M. [Georgia Inst. of Tech., Atlanta, GA (United States); Laster, B.H. [Brookhaven National Lab., Upton, NY (United States). Medical Dept.

    1999-01-01

    This paper presents the microdosimetric analysis for the most interesting cell survival experiment recently performed at the Brookhaven National Laboratory (BNL). In this experiment, the cells were first treated with a gadolinium (Gd) labeled tumor-seeking boronated porphyrin (Gd-BOPP) or with BOPP alone, and then irradiated with thermal neutrons. The resulting cell-survival curves indicate that the {sup 157}Gd(n,{gamma}) reactions are very effective in cell killing. The death of a cell treated with Gd-BOPP was attributed to either the {sup 10}B(n,{alpha}){sup 7}Li reactions or the {sup 157}Gd(n,{gamma}) reactions (or both). However, the quantitative relationship between the two types of reaction and the cell-survival fraction was not clear. This paper presents the microdosimetric analysis for the BNL experiment based on the measured experimental parameters, and the results clearly suggest a quantitative relationship between the two types of reaction and the cell survival fraction. The results also suggest new research in gadolinium neutron capture therapy (GdNCT) which may lead to a more practical modality than the boron neutron capture therapy (BNCT) for treating cancers.

  14. Electroporation increases the effect of borocaptate (10B-BSH) in neutron capture therapy

    International Nuclear Information System (INIS)

    Purpose: The cell membrane permeability of borocaptate (10B-BSH) and its extent of accumulation in cells are controversial. This study was performed to elucidate these points. Methods and Materials: Two different treatments were applied to SCCVII tumor cells. The first group of tumor cells was incubated in culture medium with 10B-BSH or 10B-enriched boric acid, and was exposed to neutrons from the heavy water facility of the Kyoto University Reactor (KUR). More than 99% of neutrons were thermal neutrons at flux base. The second group was pretreated by electroporation in combination with 10B-BSH, and thereafter the cells were irradiated with neutrons. The cell killing effects of boron neutron capture therapy (BNCT) using BSH were investigated by colony formation assay. Results: Surviving cell fraction decreased exponentially with neutron fluence, and addition of BSH significantly enhanced the cell killing effect of neutron capture therapy (NCT) depending on 10B concentration. The effect of BSH-BNCT also increased with preincubation time of cells in the medium containing BSH. The electroporation of cells with BSH at 10 ppm 10B markedly enhanced BSH-BNCT effects in comparison with that of preincubation alone. The effect of BSH-BNCT with electroporation was equal to that of BNCT using 10B-boric acid at a same 10B concentration (10 ppm). Conclusions: BSH is suggested to penetrate the cells slowly and remained after washing. Electroporation can introduce BSH into the cells very efficiently, and BSH stays in the cells and is not lost by washing. Therefore, if electroporation is applied to tumors after BSH injection, 10B remains in tumors but is cleared from normal tissues, and selective accumulation of 10B in tumors will be achieved after an adequate waiting time

  15. DNA damage induced by boron neutron capture therapy is partially repaired by DNA ligase IV.

    Science.gov (United States)

    Kondo, Natsuko; Sakurai, Yoshinori; Hirota, Yuki; Tanaka, Hiroki; Watanabe, Tsubasa; Nakagawa, Yosuke; Narabayashi, Masaru; Kinashi, Yuko; Miyatake, Shin-ichi; Hasegawa, Masatoshi; Suzuki, Minoru; Masunaga, Shin-ichiro; Ohnishi, Takeo; Ono, Koji

    2016-03-01

    Boron neutron capture therapy (BNCT) is a particle radiation therapy that involves the use of a thermal or epithermal neutron beam in combination with a boron ((10)B)-containing compound that specifically accumulates in tumor. (10)B captures neutrons and the resultant fission reaction produces an alpha ((4)He) particle and a recoiled lithium nucleus ((7)Li). These particles have the characteristics of high linear energy transfer (LET) radiation and therefore have marked biological effects. High-LET radiation is a potent inducer of DNA damage, specifically of DNA double-strand breaks (DSBs). The aim of the present study was to clarify the role of DNA ligase IV, a key player in the non-homologous end-joining repair pathway, in the repair of BNCT-induced DSBs. We analyzed the cellular sensitivity of the mouse embryonic fibroblast cell lines Lig4-/- p53-/- and Lig4+/+ p53-/- to irradiation using a thermal neutron beam in the presence or absence of (10)B-para-boronophenylalanine (BPA). The Lig4-/- p53-/- cell line had a higher sensitivity than the Lig4+/+ p53-/-cell line to irradiation with the beam alone or the beam in combination with BPA. In BNCT (with BPA), both cell lines exhibited a reduction of the 50 % survival dose (D 50) by a factor of 1.4 compared with gamma-ray and neutron mixed beam (without BPA). Although it was found that (10)B uptake was higher in the Lig4+/+ p53-/- than in the Lig4-/- p53-/- cell line, the latter showed higher sensitivity than the former, even when compared at an equivalent (10)B concentration. These results indicate that BNCT-induced DNA damage is partially repaired using DNA ligase IV. PMID:26573366

  16. The design, construction and performance of a variable collimator for epithermal neutron capture therapy beams

    Science.gov (United States)

    Riley, K. J.; Binns, P. J.; Ali, S. J.; Harling, O. K.

    2004-05-01

    A patient collimator for the fission converter based epithermal neutron beam (FCB) at the Massachusetts Institute of Technology Research Reactor (MITR-II) was built for clinical trials of boron neutron capture therapy (BNCT). A design was optimized by Monte Carlo simulations of the entire beam line and incorporates a modular construction for easy modifications in the future. The device was formed in-house by casting a mixture of lead spheres (7.6 mm diameter) in epoxy resin loaded with either 140 mg cm-3 of boron carbide or 210 mg cm-3 of lithium fluoride (95% enriched in 6Li). The cone shaped collimator allows easy field placement anywhere on the patient and is equipped with a laser indicator of central axis, beam's eye view optics and circular apertures of 80, 100, 120 and 160 mm diameter. Beam profiles and the collateral dose in a half-body phantom were measured for the 160 mm field using fission counters, activation foils as well as tissue equivalent (A-150) and graphite walled ionization chambers. Leakage radiation through the collimator contributes less than 10% to the total collateral dose up to 0.15 m beyond the edge of the aperture and becomes relatively more prominent with lateral displacement. The measured whole body dose equivalent of 24 ± 2 mSv per Gy of therapeutic dose is comparable to doses received during conventional therapy and is due principally (60-80%) to thermal neutron capture reactions with boron. These findings, together with the dose distributions for the primary beam, demonstrate the suitability of this patient collimator for BNCT.

  17. Proceedings of workshop on 'boron chemistry and boron neutron capture therapy'

    International Nuclear Information System (INIS)

    This volume contains the proceedings of the 5th Workshop on 'the Boron Chemistry and Boron Neutron Capture Therapy' held on February 22 in 1993. The solubility of the boron carrier play an important role in the BNCT. New water-soluble p-boronophenylalanine derivatives are synthesized and their biological activities are investigated (Chap. 2 and 3). Some chemical problems on the BNCT were discussed, and the complex formation reaction of hydroxylboryl compounds were studied by the paper electrophoresis (Chap. 4). The results of the medical investigation on the BNCT using BSH compounds are shown in Chap. 5. Syntheses of o- and m-boronophenylalanine were done and their optical resolution was tried (Chap. 6). The complex formation reaction of p-boronophenylalanine (BPA) with L-DOPA and the oxidation reaction of the analogs are found in Chap. 7. The pka of BPA were determined by the isotachophoresis (Chap. 8). The chemical nature of dihydroxyboryl compounds were investigated by an infrared spectroscopy and electrophoresis (Chap. 9). New synthetic methods of BPA and p-boronophenylserine using ester of isocyanoacetic acid are described in Chap. 10. The induction of chromosomal aberations by neutron capture reaction are discussed from a point of the biological view. The a of the presented papers are indexed individually. (J.P.N.)

  18. Using Music Therapy Techniques To Treat Teacher Burnout.

    Science.gov (United States)

    Cheek, James R.; Bradley, Loretta J.; Parr, Gerald; Lan, William

    2003-01-01

    This study was conducted to determine the effectiveness of music therapy techniques as an intervention for teacher burnout. Results of the study indicated that teachers who participated in school-based counseling groups, using music therapy techniques in conjunction with cognitive behavioral interventions, reported lower levels of burnout symptoms…

  19. Treating acute stress disorder and posttraumatic stress disorder with cognitive behavioral therapy or structured writing therapy: A randomized controlled trial

    NARCIS (Netherlands)

    A.A.P. van Emmerik; J.H. Kamphuis; P.M.G. Emmelkamp

    2008-01-01

    Background: Writing assignments have shown promising results in treating traumatic symptomatology. Yet no studies have compared their efficacy to the current treatment of choice, cognitive behavior therapy (CBT). The present study evaluated the efficacy of structured writing therapy (SWT) and CBT as

  20. Final Report: 8th International Symposium on Neutron Capture Therapy (NCT) for Cancer, May 15, 1998 - May 15, 1999

    International Nuclear Information System (INIS)

    The 8th International Symposium on Neutron Capture Therapy for Cancer (8th ISNCTC) was held in La Jolla, CA on Sept. 13-18, 1998. This biennial meeting of the International Society for Neutron Capture Therapy (ISNCT) was hosted by Society President M.F. Hawthorne (UCLA Dept. of Chemistry and Biochemistry). The Symposium brought together scientists (300 registrants from 21 countries) from diverse fields to report the latest developments in NCT. Topics of the 275 papers presented (30 plenary lectures, 81 oral presentations, and 164 posters) included the physics of neutron sources, chemistry of tumor-targeting agents, dosimetry, radiobiological studies, and clinical applications

  1. Potential of using boric acid as a boron drug for boron neutron capture therapy for osteosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, C.F.; Lin, S.Y. [Institute of Nuclear Engineering and Science, National Tsing Hua University, Taiwan (China); Peir, J.J. [Nuclear Science and Technology Development Center, National Tsing Hua University, Taiwan (China); Liao, J.W. [Graduate Institute of Veterinary Pathobiology, National Chung Hsing University, Taiwan (China); Lin, Y.C. [Department of Veterinary Medicine, National Chung Hsing University, Taiwan (China); Chou, F.I., E-mail: fichou@mx.nthu.edu.tw [Institute of Nuclear Engineering and Science, National Tsing Hua University, Taiwan (China)] [Nuclear Science and Technology Development Center, National Tsing Hua University, Taiwan (China)

    2011-12-15

    Osteosarcoma is a malignant tumor commonly found in human and animals. The ability of boric acid (BA) to accumulate in osteosarcoma due to the mechanism of the bone formation of cancer cells would make boron neutron capture therapy (BNCT) an alternative therapy for osteosarcoma. This study evaluated the feasibility of using BA as the boron drug for BNCT of bone cancer. The cytotoxicity of BA to L929 cells exceeded that of UMR-106 cells. With 25 {mu}g {sup 10}B/mL medium of BA treatment, the boron concentration in UMR-106 cells was higher than that in L929 cells. The biodistribution and pharmacokinetics of BA in Sprague-Dawley (SD) rats were studied by administrating 25 mg {sup 10}B/kg body weight to SD rats. Blood boron level decreased rapidly within one hour after BA injection. Boron concentration in the long bone was 4-6 time higher than that of blood. Results of this study suggest that BA may be a potential drug for BNCT for osteosarcoma.

  2. Synthesis and evaluation of boron folates for Boron-Neutron-Capture-Therapy (BNCT)

    Energy Technology Data Exchange (ETDEWEB)

    Kettenbach, Kathrin; Schieferstein, Hanno; Grunewald, Catrin; Hampel, Gabriele; Schuetz, Christian L. [Mainz Univ. (Germany). Inst. of Nuclear Chemistry; Iffland, Dorothee; Bings, Nicolas H. [Mainz Univ. (Germany). Inst. of Inorganic Chemistry and Analytical Chemistry; Reffert, Laura M. [Hannover Medical School (Germany). Radiopharmaceutical Chemistry; Ross, Tobias L. [Mainz Univ. (Germany). Inst. of Nuclear Chemistry; Hannover Medical School (Germany). Radiopharmaceutical Chemistry

    2015-07-01

    Boron neutron capture therapy (BNCT) employs {sup 10}B-pharmaceuticals administered for the treatment of malignancies, and subsequently irradiated with thermal neutrons. So far, clinical established pharmaceuticals like boron phenylalanine (BPA) or sodium boron mercaptate (BSH) use imperfect (BPA) or passive (BSH) targeting for accumulation at target sites. Due to the need of a selective transportation of boron drugs into cancer cells and sparing healthy tissues, we combined the BNCT approach with the specific and effective folate receptor (FR) targeting concept. The FR is overexpressed on many human carcinomas and provides a selective and specific target for molecular imaging as well as for tumor therapy. We synthesized and characterized a carborane-folate as well as a BSH-folate to study their in vitro characteristics and their potential as new boron-carriers for BNCT. Uptake studies were carried out using human KB cells showing a significant increase of the boron content in cells and demonstrating the successful combination of active FR-targeting and BNCT.

  3. Potential of using boric acid as a boron drug for boron neutron capture therapy for osteosarcoma

    International Nuclear Information System (INIS)

    Osteosarcoma is a malignant tumor commonly found in human and animals. The ability of boric acid (BA) to accumulate in osteosarcoma due to the mechanism of the bone formation of cancer cells would make boron neutron capture therapy (BNCT) an alternative therapy for osteosarcoma. This study evaluated the feasibility of using BA as the boron drug for BNCT of bone cancer. The cytotoxicity of BA to L929 cells exceeded that of UMR-106 cells. With 25 μg 10B/mL medium of BA treatment, the boron concentration in UMR-106 cells was higher than that in L929 cells. The biodistribution and pharmacokinetics of BA in Sprague–Dawley (SD) rats were studied by administrating 25 mg 10B/kg body weight to SD rats. Blood boron level decreased rapidly within one hour after BA injection. Boron concentration in the long bone was 4–6 time higher than that of blood. Results of this study suggest that BA may be a potential drug for BNCT for osteosarcoma.

  4. Characteristics of a heavy water photoneutron source in boron neutron capture therapy

    Institute of Scientific and Technical Information of China (English)

    Danial Salehi; Dariush Sardari; M.Salehi Jozani

    2013-01-01

    Bremsstrahlung photon beams produced by medical linear accelerators are currently the most commonly used method of radiation therapy for cancerous tumors.Photons with energies greater than 8-10 MeV potentially generate neutrons through photonuclear interactions in the accelerator's treatment head,patient's body,and treatment room ambient.Electrons impinging on a heavy target generate a cascade shower of bremsstrahlung photons,the energy spectrum of which shows an end point equal to the electron beam energy.By varying the target thickness,an optimum thickness exists for which,at the given electron energy,maximum photon flux is achievable.If a source of high-energy photons i.e.bremsstrahlung,is conveniently directed to a suitable D2O target,a novel approach for production of an acceptable flux of filterable photoneturons for boron neutron capture therapy (BNCT) application is possible.This study consists of two parts.1.Comparison and assessment of deuterium photonuclear cross section data.2.Evaluation of the heavy water photonuclear source.

  5. Accelerator-based neutron source for the neutron-capture and fast neutron therapy at hospital

    Science.gov (United States)

    Bayanov, B. F.; Belov, V. P.; Bender, E. D.; Bokhovko, M. V.; Dimov, G. I.; Kononov, V. N.; Kononov, O. E.; Kuksanov, N. K.; Palchikov, V. E.; Pivovarov, V. A.; Salimov, R. A.; Silvestrov, G. I.; Skrinsky, A. N.; Soloviov, N. A.; Taskaev, S. Yu.

    The proton accelerator complex for neutron production in lithium target discussed, which can operate in two modes. The first provides a neutron beam kinematically collimated with good forward direction in 25° and average energy of 30 keV, directly applicable for neutron-capture therapy with high efficiency of proton beam use. The proton energy in this mode is 1.883-1.890 MeV that is near the threshold of the 7Li( p, n) 7Be reaction. In the second mode, at proton energy of 2.5 MeV, the complex-produced neutron beam with maximum energy board of 790 keV which can be used directly for fast neutron therapy and for neutron-capture therapy after moderation. The project of such a neutron source is based on the 2.5 MeV original electrostatic accelerator tandem with vacuum insulation developed at BINP which is supplied with a high-voltage rectifier. The rectifier is produced in BINP as a part of ELV-type industrial accelerator. Design features of the tandem determining its high reliability in operation with a high-current (up to 40 mA) H - ion beam are discussed. They are: the absence of ceramic accelerator columns around the beam passage region, good conditions for pumping out of charge-exchange gaseous target region, strong focusing optics and high acceleration rate minimizing the space charge effects. The possibility of stabilization of protons energy with an accuracy level of 0.1% necessary for operation in the near threshold region is considered. The design description of H - continuous ion source with a current of 40 mA is also performed. To operate with a 100 kW proton beam it is proposed to use liquid-lithium targets. A thin lithium layer on the surface of a tungsten disk cooled intensively by a liquid metal heat carrier is proposed for use in case of the vertical beam, and a flat liquid lithium jet flowing through the narrow nozzle - for the horizontal beam.

  6. Application of generalized perturbation theory to sensitivity analysis in boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Garcia, Vanessa S. [Universidade Federal Fluminense (EEIMVR/UFF-RJ), Volta Redonda, RJ (Brazil). Escola de Engenharia Industrial e Metalurgica. Programa de Pos-Graduacao em Modelagem Computacional em Ciencia e Tecnologia; Silva, Fernando C.; Silva, Ademir X., E-mail: fernando@con.ufrj.b, E-mail: ademir@con.ufrj.b [Coordenacao dos Programas de Pos-Graduacao de Engenharia (PEN/COPPE/UFRJ), Rio de Janeiro, RJ (Brazil). Programa de Engenharia Nuclear; Alvarez, Gustavo B. [Universidade Federal Fluminense (EEIMVR/UFF-RJ), Volta Redonda, RJ (Brazil). Escola de Engenharia Industrial e Metalurgica. Dept. de Ciencias Exatas

    2011-07-01

    Boron neutron capture therapy - BNCT - is a binary cancer treatment used in brain tumors. The tumor is loaded with a boron compound and subsequently irradiated by thermal neutrons. The therapy is based on the {sup 10}B (n, {alpha}) {sup 7}Li nuclear reaction, which emits two types of high-energy particles, {alpha} particle and the {sup 7}Li nuclei. The total kinetic energy released in this nuclear reaction, when deposited in the tumor region, destroys the cancer cells. Since the success of the BNCT is linked to the different selectivity between the tumor and healthy tissue, it is necessary to carry out a sensitivity analysis to determinate the boron concentration. Computational simulations are very important in this context because they help in the treatment planning by calculating the lowest effective absorbed dose rate to reduce the damage to healthy tissue. The objective of this paper is to present a deterministic method based on generalized perturbation theory (GPT) to perform sensitivity analysis with respect to the {sup 10}B concentration and to estimate the absorbed dose rate by patients undergoing this therapy. The advantage of the method is a significant reduction in computational time required to perform these calculations. To simulate the neutron flux in all brain regions, the method relies on a two-dimensional neutron transport equation whose spatial, angular and energy variables are discretized by the diamond difference method, the discrete ordinate method and multigroup formulation, respectively. The results obtained through GPT are consistent with those obtained using other methods, demonstrating the efficacy of the proposed method. (author)

  7. Combination Therapy Shows Promise for Treating Advanced Breast Cancer

    Science.gov (United States)

    Adding the drug everolimus (Afinitor®) to exemestane helped postmenopausal women whose advanced breast cancer had stopped responding to hormonal therapy live about 4 months longer without the disease progressing than women who received exemestane alone.

  8. Treating Women Drug Abusers: Action Therapy and Trauma Assessment

    OpenAIRE

    Uhler, Ann S.; Parker, Olga V.

    2002-01-01

    The authors suggest that action therapy, a group of techniques including psychodrama, drama therapy, and role training, warrants research attention to determine whether it is well suited to the special characteristics and needs of women clients. In addition, the authors call on researchers to develop a new standardized tool for counselors to use during initial interviews to determine whether women presenting for drug abuse treatment also have significant issues related to trauma. The authors ...

  9. Advances in gene therapy technologies to treat retinitis pigmentosa

    OpenAIRE

    Petrs-Silva, Hilda

    2013-01-01

    Hilda Petrs-Silva, Rafael LindenInstitute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, BrazilAbstract: Retinitis pigmentosa (RP) is a class of diseases that leads to progressive degeneration of the retina. Experimental approaches to gene therapy for the treatment of inherited retinal dystrophies have advanced in recent years, inclusive of the safe delivery of genes to the human retina. This review is focused on the development of gene therapy for RP using recombinant a...

  10. Boron neutron capture therapy for undifferentiated thyroid carcinoma: preliminary results with the combined use of BPA and BOPP

    Energy Technology Data Exchange (ETDEWEB)

    Viaggi, M. E-mail: viaggi@cnea.gov.ar; Dagrosa, M.A.; Longhino, J.; Blaumann, H.; Calzetta, O.; Kahl, S.B.; Juvenal, G.J.; Pisarev, M.A

    2004-11-01

    We have shown the selective uptake of borophenylalanine (BPA) by undifferentiated human thyroid cancer (UTC) ARO cells both in vitro and in vivo. Moreover, a 50% histologic cure of mice bearing the tumor was observed when the complete boron neutron capture therapy was applied. More recently we have analyzed the biodistribution of BOPP (tetrakis-carborane carboxylate ester of 2,4-bis-({alpha},{beta}-dihydroxyethyl)-deutero-porphyrin IX) and showed that when BOPP was injected 5 days before BPA, and the animals were sacrificed 60 min after the i.p. injection of BPA, a significant increase in boron uptake by the tumor was found (38-45 ppm with both compounds vs. 20 ppm with BPA alone). Five days post the i.p BOPP injection and 1 h after BPA the ratios were: tumor/blood 3.75; tumor/distal skin 2. Other important ratios were tumor/thyroid 6.65 and tumor/lung 3.8. The present studies were performed in mice transplanted with ARO cells and injected with BOPP and BPA. Only in mice treated with the neutron beam and injected with the boronated compounds we observed a 100% control of tumor growth. Two groups of mice received different total absorbed doses: 3.00 and 6.01 Gy, but no further improvement in the outcome was found compared to the previous results using BPA alone (4.3 Gy)

  11. Boron neutron capture therapy design calculation of a 3H(p,n reaction based BSA for brain cancer setup

    Directory of Open Access Journals (Sweden)

    Bassem Elshahat

    2015-09-01

    Full Text Available Purpose: Boron neutron capture therapy (BNCT is a promising technique for the treatment of malignant disease targeting organs of the human body. Monte Carlo simulations were carried out to calculate optimum design parameters of an accelerator based beam shaping assembly (BSA for BNCT of brain cancer setup.Methods: Epithermal beam of neutrons were obtained through moderation of fast neutrons from 3H(p,n reaction in a high density polyethylene moderator and a graphite reflector. The dimensions of the moderator and the reflector were optimized through optimization of epithermal / fast neutron intensity ratio as a function of geometric parameters of the setup. Results: The results of our calculation showed the capability of our setup to treat the tumor within 4 cm of the head surface. The calculated peak therapeutic ratio for the setup was found to be 2.15. Conclusion: With further improvement in the polyethylene moderator design and brain phantom irradiation arrangement, the setup capabilities can be improved to reach further deep-seated tumor.

  12. The role of metabolic therapy in treating glioblastoma multiforme

    Directory of Open Access Journals (Sweden)

    Joseph C Maroon

    2015-01-01

    Full Text Available Glioblastoma multiforme (GBM is an aggressive and nearly uniformly fatal malignancy of the central nervous system. Despite extensive research and clinical trials over the past 50 years, very little progress has been made to significantly alter its lethal prognosis. The current standard of care (SOC includes maximal surgical resection, radiation therapy and chemotherapy and temozolomide (TMZ, including the selective use of glucocorticoids for symptom control. These same treatments, however, have the potential to create an environment that may actually facilitate tumor growth and survival. Research investigating the unique metabolic needs of tumor cells has led to the proposal of a new metabolic treatment for various cancers including GBMs that may enhance the effectiveness of the SOC. The goal of metabolic cancer therapy is to restrict GBM cells of glucose, their main energy substrate. By recognizing the underlying energy production requirements of cancer cells, newly proposed metabolic therapy is being used as an adjunct to standard GBM therapies. This review will discuss the calorie restricted ketogenic diet (CR-KD as a promising potential adjunctive metabolic therapy for patients with GBMs. The effectiveness of the CR-KD is based on the "Warburg Effect" of cancer metabolism and the microenvironment of GBM tumors. We will review recent case reports, clinical studies, review articles, and animal model research using the CR-KD and explain the principles of the Warburg Effect as it relates to CR-KD and GBMs.

  13. The role of metabolic therapy in treating glioblastoma multiforme.

    Science.gov (United States)

    Maroon, Joseph C; Seyfried, Thomas N; Donohue, Joseph P; Bost, Jeffrey

    2015-01-01

    Glioblastoma multiforme (GBM) is an aggressive and nearly uniformly fatal malignancy of the central nervous system. Despite extensive research and clinical trials over the past 50 years, very little progress has been made to significantly alter its lethal prognosis. The current standard of care (SOC) includes maximal surgical resection, radiation therapy and chemotherapy and temozolomide (TMZ), including the selective use of glucocorticoids for symptom control. These same treatments, however, have the potential to create an environment that may actually facilitate tumor growth and survival. Research investigating the unique metabolic needs of tumor cells has led to the proposal of a new metabolic treatment for various cancers including GBMs that may enhance the effectiveness of the SOC. The goal of metabolic cancer therapy is to restrict GBM cells of glucose, their main energy substrate. By recognizing the underlying energy production requirements of cancer cells, newly proposed metabolic therapy is being used as an adjunct to standard GBM therapies. This review will discuss the calorie restricted ketogenic diet (CR-KD) as a promising potential adjunctive metabolic therapy for patients with GBMs. The effectiveness of the CR-KD is based on the "Warburg Effect" of cancer metabolism and the microenvironment of GBM tumors. We will review recent case reports, clinical studies, review articles, and animal model research using the CR-KD and explain the principles of the Warburg Effect as it relates to CR-KD and GBMs. PMID:25949849

  14. A review of maggot debridement therapy to treat chronic wounds.

    Science.gov (United States)

    Hall, Sarah

    This literature review aims to clarify whether using maggot debridement therapy (MDT) for the removal of devitalized and infected tissue in chronic wounds is a valuable tool for healing. To undertake a literature review, the British Nursing Index, Ovid-Medline and the CINAHL databases were searched from January 1960 to June 2010 using the following terms: maggot debridement therapy, chronic wounds, granulation, infection, and cost-effective. The evidence suggests that MDT is more effective than other methods of debridement for wound bed preparation, although it has not been proven to eliminate problems associated with recurrent infections. This therapy has also not been proven to accelerate the healing process; however, more research needs to be undertaken into this and the cost-effectiveness of treatment.

  15. Treating Hypothyroidism with Thyroxine/Triiodothyronine Combination Therapy in Denmark

    DEFF Research Database (Denmark)

    Michaelsson, Luba Freja; Medici, Bjarke Borregaard; la Cour, Jeppe Lerche;

    2015-01-01

    BACKGROUND: Five to ten percent of patients with hypothyroidism describe persistent symptoms despite being biochemically well regulated on levothyroxine (L-T4). Thyroxine (T4)/triiodothyronine (T3) combination therapy [L-T4/liothyronine (L-T3) or desiccated thyroid] are still regarded as experime......BACKGROUND: Five to ten percent of patients with hypothyroidism describe persistent symptoms despite being biochemically well regulated on levothyroxine (L-T4). Thyroxine (T4)/triiodothyronine (T3) combination therapy [L-T4/liothyronine (L-T3) or desiccated thyroid] are still regarded...... after a patient published a book describing her experiences with hypothyroidism and treatment. OBJECTIVE: To investigate current Danish trends in the use of T4/T3 combination therapy. METHODS: We used an Internet-based questionnaire, distributed as a link via two Danish patient fora. Further...

  16. Dog-assisted therapy to treat emotional management in teenagers

    Directory of Open Access Journals (Sweden)

    Xóchitl Ortiz Jiménez

    2012-12-01

    Full Text Available The emotional changes in adolescence are related to the difficulty to perceive, understand and regulate emotions, which negatively impacts on self-esteem and the management of emotions. Dog-assisted therapy can help improve self-esteem and help in the management of emotions. The aim of this study was to analyze the effects of dog-assisted therapy on self-esteem and components of emotions in a group of adolescents with emotional problems. The results showed significant changes in the attentional emotion component of emotions, which means, in the ability to perceive their emotions.

  17. Dog-assisted therapy to treat emotional management in teenagers

    OpenAIRE

    Xóchitl Ortiz Jiménez; René Landero Hernández; Mónica González Ramírez

    2012-01-01

    The emotional changes in adolescence are related to the difficulty to perceive, understand and regulate emotions, which negatively impacts on self-esteem and the management of emotions. Dog-assisted therapy can help improve self-esteem and help in the management of emotions. The aim of this study was to analyze the effects of dog-assisted therapy on self-esteem and components of emotions in a group of adolescents with emotional problems. The results showed significant changes in the attention...

  18. Hemorrhage in mouse tumors induced by dodecaborate cluster lipids intended for boron neutron capture therapy

    Directory of Open Access Journals (Sweden)

    Schaffran T

    2014-07-01

    Full Text Available Tanja Schaffran,1 Nan Jiang,1 Markus Bergmann,2,3 Ekkehard Küstermann,4 Regine Süss,5 Rolf Schubert,5 Franz M Wagner,6 Doaa Awad,7 Detlef Gabel1,2,8 1Department of Chemistry, University of Bremen, 2Institute of Neuropathology, Klinikum Bremen-Mitte; 3Cooperative Center Medicine, University of Bremen, 4“In-vivo-MR” AG, FB2, University of Bremen, Bremen, 5Pharmaceutical Technology, University of Freiburg, Freiburg im Breisgau, 6Forschungsneutronenquelle Heinz Maier-Leibnitz (FRM II, Technische Unversitaet Muenchen, Garching, Germany; 7Department of Biochemistry, Alexandria University, Alexandria, Egypt; 8School of Engineering and Science, Jacobs University Bremen, Bremen, Germany Abstract: The potential of boron-containing lipids with three different structures, which were intended for use in boron neutron capture therapy, was investigated. All three types of boron lipids contained the anionic dodecaborate cluster as the headgroup. Their effects on two different tumor models in mice following intravenous injection were tested; for this, liposomes with boron lipid, distearoyl phosphatidylcholine, and cholesterol as helper lipids, and containing a polyethylene glycol lipid for steric protection, were administered intravenously into tumor-bearing mice (C3H mice for SCCVII squamous cell carcinoma and BALB/c mice for CT26/WT colon carcinoma. With the exception of one lipid (B-THF-14, the lipids were well tolerated, and no other animal was lost due to systemic toxicity. The lipid which led to death was not found to be much more toxic in cell culture than the other boron lipids. All of the lipids that were well tolerated showed hemorrhage in both tumor models within a few hours after administration. The hemorrhage could be seen by in vivo magnetic resonance and histology, and was found to occur within a few hours. The degree of hemorrhage depended on the amount of boron administered and on the tumor model. The observed unwanted effect of the lipids

  19. Advances in gene therapy technologies to treat retinitis pigmentosa

    Directory of Open Access Journals (Sweden)

    Petrs-Silva H

    2013-12-01

    Full Text Available Hilda Petrs-Silva, Rafael LindenInstitute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, BrazilAbstract: Retinitis pigmentosa (RP is a class of diseases that leads to progressive degeneration of the retina. Experimental approaches to gene therapy for the treatment of inherited retinal dystrophies have advanced in recent years, inclusive of the safe delivery of genes to the human retina. This review is focused on the development of gene therapy for RP using recombinant adenoassociated viral vectors, which show a positive safety record and have so far been successful in several clinical trials for congenital retinal disease. Gene therapy for RP is under development in a variety of animal models, and the results raise expectations of future clinical application. Nonetheless, the translation of such strategies to the bedside requires further understanding of the mutations and mechanisms that cause visual defects, as well as thorough examination of potential adverse effects. Keywords: retinitis pigmentosa, photoreceptor, gene therapy, AAV

  20. Depression in acromegaly treated with escitalopram and cognitive therapy

    Directory of Open Access Journals (Sweden)

    De Sousa Avinash

    2009-01-01

    Full Text Available Depression is one of the commonest disorders encountered in general hospital psychiatry. Acromegaly is a condition with excessive growth hormone secretion that may at times present with oversychopathology. We present the case of a 33-year-old lady with depression and acromegaly that successfully resolved after treatment with escitalopram and cognitive therapy.

  1. Treating Social Anxiety in Adolescents: Ten Group Therapy Lesson Plans

    Science.gov (United States)

    Mazur-Elmer, Alison; McBride, Dawn

    2009-01-01

    This project provides a comprehensive overview of the research literature on social anxiety disorder (SAD) in adolescents and concludes by offering a set of 10 group therapy lesson plans for SAD that therapists can use in their practice. The overview includes a description of social anxiety disorder and highlights various theories of anxiety. The…

  2. Hyperbaric oxygen therapy for treating acute surgical and traumatic wounds

    NARCIS (Netherlands)

    A. Eskes; D.T. Ubbink; M. Lubbers; C. Lucas; H. Vermeulen

    2010-01-01

    Hyperbaric oxygen therapy (HBOT) is used as a treatment for acute wounds (such as those arising from surgery and trauma) however the effects of HBOT on wound healing are unclear. To determine the effects of HBOT on the healing of acute surgical and traumatic wounds. We searched the Cochrane Wounds G

  3. Dosimetric evaluation of neutron capture therapy for local advanced breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yanagie, H. [Department of Nuclear Engineering and Management, Graduate School of Engineering, University of Tokyo, Tokyo (Japan); Cooperative Unit of Medicine and Engineering, University of Tokyo Hospital, Tokyo (Japan)], E-mail: yanagie@n.t.u-tokyo.ac.jp; Kumada, H. [Japan Atomic Research Institute, Ibaraki (Japan); Sakurai, Y. [Research Reactor Institute, Kyoto University, Osaka (Japan); Nakamura, T. [Japan Atomic Research Institute, Ibaraki (Japan); Department of Nuclear Physics, Ibaraki University, Ibaraki (Japan); Furuya, Y. [Department of Surgery, Satukidai Hospital, Chiba (Japan); Sugiyama, H. [Cooperative Unit of Medicine and Engineering, University of Tokyo Hospital, Tokyo (Japan); Ono, K. [Research Reactor Institute, Kyoto University, Osaka (Japan); Takamoto, S. [Cooperative Unit of Medicine and Engineering, University of Tokyo Hospital, Tokyo (Japan); Department of Cardiac Surgery, University of Tokyo Hospital, Tokyo (Japan); Eriguchi, M. [Cooperative Unit of Medicine and Engineering, University of Tokyo Hospital, Tokyo (Japan); Department of Microbiology, Syowa University School of Pharmaceutical Sciences, Tokyo (Japan); Takahashi, H. [Department of Nuclear Engineering and Management, Graduate School of Engineering, University of Tokyo, Tokyo (Japan); Cooperative Unit of Medicine and Engineering, University of Tokyo Hospital, Tokyo (Japan)

    2009-07-15

    Local recurrence breast cancer is one of the most difficult conditions to cure and there is a need for new therapy. If sufficient boron compound can be targeted to the tumor, boron neutron capture therapy (BNCT) can be applied to local recurrent breast cancer. In this study, we performed a preliminary dosimetry with a phantom model of the mammary gland at Kyoto University Research Reactor (KUR), and a feasibility dosimetry with JAERI Computational Dosimetry System (JCDS) at JRR4 reactor of Japan Atomic Research Institute. We performed preliminary dosimetry of a phantom model of the mammary gland with thermal neutron irradiation (OO-0011 mode) on LiF collimation at KUR. The thermal neutron flux was 5.16 E+08 cm{sup -2} s{sup -1} at the surface of phantom. The blood boron concentration is estimated to be 30 ppm; tumor boron concentration is also estimated to be 90 ppm according to tumor/blood ratio 3 and skin/blood ratio 1.2. Tumor RBE dose is estimated to be 47 Gy/h, and skin RBE dose is 12.4 Gy/h. In case of advanced breast cancer, we performed the feasibility estimation of 3D construction of tumor according to the MRI imaging of a patient with epithermal neutron mode at JRR4. The blood boron concentration (ppm) and tumor/normal tissue ratio are estimated to be 24 and 3.5, respectively. Skin RBE dose is restricted to 10 Gy/h, the maximum tumor RBE dose, minimum tumor RBE dose, and mean tumor RBE dose are 42.2, 11.3, and 28.9 Gy-Eq, respectively, in half hour irradiation. In this study, we showed the possibility to apply BNCT to local recurrent breast cancer. We can irradiate tumors selectively and as safely as possible, reducing the effects on neighboring healthy tissues.

  4. FORTY CASES OF INSOMNIA TREATED WITH ACUPUNCTURE, MASSAGE AND MUSIC THERAPY

    Institute of Scientific and Technical Information of China (English)

    WANG Lin-yu

    2005-01-01

    @@ Insomnia is a commonly encountered sleep disorder in clinical practice. The author of the present paper treated 40 cases of insomnia with acupuncture and massage combined with music therapy and achieved satisfied outcomes. Following is the report.

  5. Insights into the use of gadolinium and gadolinium/boron-based agents in imaging-guided neutron capture therapy applications.

    Science.gov (United States)

    Deagostino, Annamaria; Protti, Nicoletta; Alberti, Diego; Boggio, Paolo; Bortolussi, Silva; Altieri, Saverio; Crich, Simonetta Geninatti

    2016-05-01

    Gadolinium neutron capture therapy (Gd-NCT) is currently under development as an alternative approach for cancer therapy. All of the clinical experience to date with NCT is done with (10)B, known as boron neutron capture therapy (BNCT), a binary treatment combining neutron irradiation with the delivery of boron-containing compounds to tumors. Currently, the use of Gd for NCT has been getting more attention because of its highest neutron cross-section. Although Gd-NCT was first proposed many years ago, its development has suffered due to lack of appropriate tumor-selective Gd agents. This review aims to highlight the recent advances for the design, synthesis and biological testing of new Gd- and B-Gd-containing compounds with the task of finding the best systems able to improve the NCT clinical outcome. PMID:27195428

  6. Development of the JAERI computational dosimetry system (JCDS) for boron neutron capture therapy. Cooperative research

    CERN Document Server

    Kumada, H; Matsumura, A; Nakagawa, Y; Nose, T; Torii, Y; Uchiyama, J; Yamamoto, K; Yamamoto, T

    2003-01-01

    The Neutron Beam Facility at JRR-4 enables us to carry out boron neutron capture therapy with epithermal neutron beam. In order to make treatment plans for performing the epithermal neutron beam BNCT, it is necessary to estimate radiation doses in a patient's head in advance. The JAERI Computational Dosimetry System (JCDS), which can estimate distributions of radiation doses in a patient's head by simulating in order to support the treatment planning for epithermal neutron beam BNCT, was developed. JCDS is a software that creates a 3-dimentional head model of a patient by using CT and MRI images, and that generates a input data file automatically for calculation of neutron flux and gamma-ray dose distributions in the brain with the Monte Carlo code MCNP, and that displays these dose distributions on the head model for dosimetry by using the MCNP calculation results. JCDS has any advantages as follows; By using CT data and MRI data which are medical images, a detail three-dimensional model of patient's head is...

  7. An accelerator-based epithermal photoneutron source for boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Mitchell, H.E.

    1996-04-01

    Boron neutron capture therapy is an experimental binary cancer radiotherapy modality in which a boronated pharmaceutical that preferentially accumulates in malignant tissue is first administered, followed by exposing the tissue in the treatment volume to a thermal neutron field. Current usable beams are reactor-based but a viable alternative is the production of an epithermal neutron beam from an accelerator. Current literature cites various proposed accelerator-based designs, most of which are based on proton beams with beryllium or lithium targets. This dissertation examines the efficacy of a novel approach to BNCT treatments that incorporates an electron linear accelerator in the production of a photoneutron source. This source may help to resolve some of the present concerns associated with accelerator sources, including that of target cooling. The photoneutron production process is discussed as a possible alternate source of neutrons for eventual BNCT treatments for cancer. A conceptual design to produce epithermal photoneutrons by high photons (due to bremsstrahlung) impinging on deuterium targets is presented along with computational and experimental neutron production data. A clinically acceptable filtered epithermal neutron flux on the order of 10{sup 7} neutrons per second per milliampere of electron current is shown to be obtainable. Additionally, the neutron beam is modified and characterized for BNCT applications by employing two unique moderating materials (an Al/AlF{sub 3} composite and a stacked Al/Teflon design) at various incident electron energies.

  8. Role of the Tapiro Fast Research Reactor in Neutron Capture Therapy in Italy Calculations and Measurements

    International Nuclear Information System (INIS)

    Thermal-neutron research reactors are currently the most common source of neutron beams for both research and clinical trials of neutron capture therapy (NCT). Neutron spectra suitable for NCT are typically produced either by beam filtering or spectrum shifting techniques. However, fast-neutron reactors are also being considered for NCT application as it is recognized that they may allow for improved beam quality. TAPIRO is a low power, high flux, highly enriched (93.5% 235U) fast reactor. The power is 5 kW and the maximum neutron flux in the core is 3x1012 cm-2.s-1. Both a thermal and an epithermal column have been designed and constructed, aimed at dosimetry and animal experiments. The configurations of the columns have been designed by means of Monte Carlo calculations. The columns have been characterized by means of measurements performed with activation techniques and thermoluminescence and gel dosimeters. Experimental results have shown good consistency with calculations. Moreover, they have confirmed the good quality of the beams obtainable with such a reactor. An epithermal column for clinical trials of patients with brain gliomas has been designed and is under construction. The treatment planning figures-of-merit in an anthropomorphic phantom look very satisfactory. (author)

  9. Thermal neutron irradiation field design for boron neutron capture therapy of human explanted liver.

    Science.gov (United States)

    Bortolussi, S; Altieri, S

    2007-12-01

    The selective uptake of boron by tumors compared to that by healthy tissue makes boron neutron capture therapy (BNCT) an extremely advantageous technique for the treatment of tumors that affect a whole vital organ. An example is represented by colon adenocarcinoma metastases invading the liver, often resulting in a fatal outcome, even if surgical resection of the primary tumor is successful. BNCT can be performed by irradiating the explanted organ in a suitable neutron field. In the thermal column of the Triga Mark II reactor at Pavia University, a facility was created for this purpose and used for the irradiation of explanted human livers. The neutron field distribution inside the organ was studied both experimentally and by means of the Monte Carlo N-particle transport code (MCNP). The liver was modeled as a spherical segment in MCNP and a hepatic-equivalent solution was used as an experimental phantom. In the as-built facility, the ratio between maximum and minimum flux values inside the phantom ((phi(max)/phi(min)) was 3.8; this value can be lowered to 2.3 by rotating the liver during the irradiation. In this study, the authors proposed a new facility configuration to achieve a uniform thermal neutron flux distribution in the liver. They showed that a phi(max)/phi(min) ratio of 1.4 could be obtained without the need for organ rotation. Flux distributions and dose volume histograms were reported for different graphite configurations. PMID:18196797

  10. Improvement of dose distribution by central beam shielding in boron neutron capture therapy

    Science.gov (United States)

    Sakurai, Yoshinori; Ono, Koji

    2007-12-01

    Since boron neutron capture therapy (BNCT) with epithermal neutron beams started at the Kyoto University Reactor (KUR) in June 2002, nearly 200 BNCT treatments have been carried out. The epithermal neutron irradiation significantly improves the dose distribution, compared with the previous irradiation mainly using thermal neutrons. However, the treatable depth limit still remains. One effective technique to improve the limit is the central shield method. Simulations were performed for the incident neutron energies and the annular components of the neutron source. It was clear that thermal neutron flux distribution could be improved by decreasing the lower energy neutron component and the inner annular component of the incident beam. It was found that a central shield of 4-6 cm diameter and 10 mm thickness is effective for the 12 cm diameter irradiation field. In BNCT at KUR, the depth dose distribution can be much improved by the central shield method, resulting in a relative increase of the dose at 8 cm depth by about 30%. In addition to the depth dose distribution, the depth dose profile is also improved. As the dose rate in the central area is reduced by the additional shielding, the necessary irradiation time, however, increases by about 30% compared to normal treatment.

  11. GPU-based prompt gamma ray imaging from boron neutron capture therapy

    International Nuclear Information System (INIS)

    Purpose: The purpose of this research is to perform the fast reconstruction of a prompt gamma ray image using a graphics processing unit (GPU) computation from boron neutron capture therapy (BNCT) simulations. Methods: To evaluate the accuracy of the reconstructed image, a phantom including four boron uptake regions (BURs) was used in the simulation. After the Monte Carlo simulation of the BNCT, the modified ordered subset expectation maximization reconstruction algorithm using the GPU computation was used to reconstruct the images with fewer projections. The computation times for image reconstruction were compared between the GPU and the central processing unit (CPU). Also, the accuracy of the reconstructed image was evaluated by a receiver operating characteristic (ROC) curve analysis. Results: The image reconstruction time using the GPU was 196 times faster than the conventional reconstruction time using the CPU. For the four BURs, the area under curve values from the ROC curve were 0.6726 (A-region), 0.6890 (B-region), 0.7384 (C-region), and 0.8009 (D-region). Conclusions: The tomographic image using the prompt gamma ray event from the BNCT simulation was acquired using the GPU computation in order to perform a fast reconstruction during treatment. The authors verified the feasibility of the prompt gamma ray image reconstruction using the GPU computation for BNCT simulations

  12. Basic study for development of new tumor specific agents for neutron capture therapy

    International Nuclear Information System (INIS)

    New tissue specific agents for neutron capture therapy was studied. Monoclonal labeled gadolinium-DTPA (Gd-MoAb) and porphyrin (ATN-10)-Gd-DTPA (Gd-ATN10) were studied as possible agents by using 9-L experimental brain tumor model. The tissue concentration were analyzed with magnetic resonance imaging (MRI) and inductively coupled plasma (ICP) analyzer. Gd-MoAb showed persistent retention in the tumor on MRI, but tissue gadolinium concentration was not detectable in the tumor by ICP analyzer, while there was high accumulation of Gd-MoAb in the liver. Gd-ATN10 showed prolonged and high accumulation in the tumor up to 48 hours on MRI. Gadolinium concentration reached up to 9 ppm in the tumor by 0.02 mmol/kg administration, but it disappeared within 6 hours after administration. This dissociation between MRI and ICP analysis was due to separation of ATN-10 and Gd-DTPA. As conclusions, the porphyrin compounds are potential agents for delivering gadolinium or boron specific to the tumor tissue, thus further improvement such as more stable conjugation between porphyrinfic to the tumor tissue, thus further improvement such as more stable conjugation between porphyrin and Gd-DTPA is needed. (author)

  13. An accelerator-based epithermal photoneutron source for boron neutron capture therapy

    International Nuclear Information System (INIS)

    Boron neutron capture therapy is an experimental binary cancer radiotherapy modality in which a boronated pharmaceutical that preferentially accumulates in malignant tissue is first administered, followed by exposing the tissue in the treatment volume to a thermal neutron field. Current usable beams are reactor-based but a viable alternative is the production of an epithermal neutron beam from an accelerator. Current literature cites various proposed accelerator-based designs, most of which are based on proton beams with beryllium or lithium targets. This dissertation examines the efficacy of a novel approach to BNCT treatments that incorporates an electron linear accelerator in the production of a photoneutron source. This source may help to resolve some of the present concerns associated with accelerator sources, including that of target cooling. The photoneutron production process is discussed as a possible alternate source of neutrons for eventual BNCT treatments for cancer. A conceptual design to produce epithermal photoneutrons by high photons (due to bremsstrahlung) impinging on deuterium targets is presented along with computational and experimental neutron production data. A clinically acceptable filtered epithermal neutron flux on the order of 107 neutrons per second per milliampere of electron current is shown to be obtainable. Additionally, the neutron beam is modified and characterized for BNCT applications by employing two unique moderating materials (an Al/AlF3 composite and a stacked Al/Teflon design) at various incident electron energies

  14. Design of an accelerator-based neutron source for neutron capture therapy

    International Nuclear Information System (INIS)

    The boron neutron capture therapy is mainly suited in the treatment of some tumor kinds which revealed ineffective to the traditional radiotherapy. In order to take advantage of such a therapeutic modality in hospital environments, neutron beams of suitable energy and flux levels provided by compact size facilities are needed. The advantages and drawbacks of several neutron beams are here analysed in terms of therapeutic gains. In detail the GEANT-3/MICAP simulations show that high tumor control probability, with sub-lethal dose at healthy tissues, can be achieved by using neutron beams of few keV energy having a flux of about 109 neutrons/(cm2 s). To produce such a neutron beam, the feasibility of a proton accelerator is investigated. In particular an appropriate choice of the radiofrequency parameters (modulation, efficiency of acceleration, phase shift, etc.) allows the development of relatively compact accelerators, having a proton beam current of 30 mA and an energy of 2 MeV, which could eventually lead to setting up of hospital-based neutron facilities.

  15. A fundamental study on hyper-thermal neutrons for neutron capture therapy.

    Science.gov (United States)

    Sakurai, Y; Kobayashi, T; Kanda, K

    1994-12-01

    The utilization of hyper-thermal neutrons, which have an energy spectrum with a Maxwellian distribution at a higher temperature than room temperature (300 K), was studied in order to improve the thermal neutron flux distribution at depth in a living body for neutron capture therapy. Simulation calculations were carried out using a Monte Carlo code 'MCNP-V3' in order to investigate the characteristics of hyper-thermal neutrons, i.e. (i) depth dependence of the neutron energy spectrum, and (ii) depth distribution of the reaction rate in a water phantom for materials with 1/v neutron absorption. It is confirmed that hyper-thermal neutron irradiation can improve the thermal neutron flux distribution in the deeper areas in a living body compared with thermal neutron irradiation. When hyper-thermal neutrons with a 3000 K Maxwellian distribution are incident on a body, the reaction rates of 1/v materials such as 14N, 10B etc are about twice that observed for incident thermal neutrons at 300 K, at a depth of 5 cm. The limit of the treatable depth for tumours having 30 ppm 10B is expected to be about 1.5 cm greater by utilizing hyper-thermal neutrons at 3000 K compared with the incidence of thermal neutrons at 300 K.

  16. High-power liquid-lithium target prototype for accelerator-based boron neutron capture therapy.

    Science.gov (United States)

    Halfon, S; Paul, M; Arenshtam, A; Berkovits, D; Bisyakoev, M; Eliyahu, I; Feinberg, G; Hazenshprung, N; Kijel, D; Nagler, A; Silverman, I

    2011-12-01

    A prototype of a compact Liquid-Lithium Target (LiLiT), which will possibly constitute an accelerator-based intense neutron source for Boron Neutron Capture Therapy (BNCT) in hospitals, was built. The LiLiT setup is presently being commissioned at Soreq Nuclear Research Center (SNRC). The liquid-lithium target will produce neutrons through the (7)Li(p,n)(7)Be reaction and it will overcome the major problem of removing the thermal power generated using a high-intensity proton beam (>10 kW), necessary for sufficient neutron flux. In off-line circulation tests, the liquid-lithium loop generated a stable lithium jet at high velocity, on a concave supporting wall; the concept will first be tested using a high-power electron beam impinging on the lithium jet. High intensity proton beam irradiation (1.91-2.5 MeV, 2-4 mA) will take place at Soreq Applied Research Accelerator Facility (SARAF) superconducting linear accelerator currently in construction at SNRC. Radiological risks due to the (7)Be produced in the reaction were studied and will be handled through a proper design, including a cold trap and appropriate shielding. A moderator/reflector assembly is planned according to a Monte Carlo simulation, to create a neutron spectrum and intensity maximally effective to the treatment and to reduce prompt gamma radiation dose risks.

  17. Transurethral electrolaser complex therapy to treat chronic prostatitis

    Science.gov (United States)

    Zharov, Vladimir P.

    2000-05-01

    According to the world statistics, from 30 to 60 percent of elderly male population suffer from chronic prostatitis in different countries. This disease has a number of consequences such as urino-genital inflammation, dysuria, perineal pain, reduction in the physiological activity of smooth muscles, blockage of the anus passages with micro-organism vital activity products, appearance of stagnant zones and low blood circulation complicated by disorders of the sexual function. Most of these features make it difficult to use standard drug therapies with antibiotics or immunocorrectors. For that reason, the objective of this study is to develop and to investigate a novel combined electrolaser therapy which improves drug delivery in the prostate gland and simultaneously provides an independent physiotherapeutic effect. The main feature of this therapy is the utilization of two diode lasers emitting in the red (0.67 micrometer, 10 mW) and in the infrared (0.85 micrometer, 1 W) spectrum ranges in combination with transurethral electrostimulation. An electrolaser catheter containing both hollow cylindrical electrodes and an axial optical fiber to deliver laser radiation was brought along the urethra to the seminal vesicles. The red laser in combination with a photosensitizer ('Photosens,' Russia) was used to realize the antibacterial treatment of the urethra. The infrared laser was employed to heat the prostate gland and to stimulate the blood perfusion without thermal damage of tissues. The laser heating of the prostate at a local tissue temperature of 41 degrees Celsius in combination with the electrostimulation provided approximately a 4.5-fold increase in the blood flow. The realization of an additional mode of photovacuum therapy inside the urethra together with the electrostimulation made it possible to 'clean' the anus passages and to improve the DNA diagnosis reliability in respect of the urogenital infectious remainder. The clinical data obtained in 980 patients

  18. Transcriptionally targeted gene therapy to detect and treat cancer

    OpenAIRE

    Wu, Lily; Johnson, Mai; Sato, Makoto

    2003-01-01

    The greatest challenge in cancer treatment is to achieve the highest levels of specificity and efficacy. Cancer gene therapy could be designed specifically to express therapeutic genes to induce cancer cell destruction. Cancer-specific promoters are useful tools to accomplish targeted expression; however, high levels of gene expression are needed to achieve therapeutic efficacy. Incorporating an imaging reporter gene in tandem with the therapeutic gene will allow tangible proof of principle t...

  19. Modelling collimator of radial beam port Kartini reactor for boron neutron capture therapy

    International Nuclear Information System (INIS)

    One of the cancer therapy methods is BNCT (Boron Neutron Capture Therapy). BNCT utilizes neutron nature by 10B deposited on cancer cells. The superiority of BNCT compared to the radiation therapy is the high level of selectivity since its level is within cell. This study was carried out on collimator modelling in radial beam port of reactor Kartini for BNCT. The modelling was conducted by simulation using software of Monte Carlo N-Particle version 5 (MCNP 5). MCNP5 is a package of the programs for both simulating and calculating the problem of particle transport by following the life cycle of a neutron since its birth from fission reaction, transport on materials, until eventually lost due to the absorption reaction or out from the system. The collimator modelling used materials which varied in size in order to generate the value of each of the parameters in accordance with the recommendation of the IAEA, the epithermal neutron flux (ϕepi) > 1.0 x 109n.cm-2s-1, the ratio between the neutron dose rate fast and epithermal neutron flux (Df/ϕepi) < 2.0 x 10-13 Gy.cm2.n-1, the ratio of gamma dose rate and epithermal neutron flux (Dγ/ϕepi) < 2.0 X10-13 Gy.cm2.n-1, the ratio between the thermal and epithermal neutron flux (ϕTh/ϕepi)< 0.05 and the ratio between the current and flux of the epithermal neutron (J/ϕepi) > 0.7. Based on the results of the optimization of the modeling, the materials and sizes of the collimator construction obtained were 0.75 cm Ni as collimator wall, 22 cm Al as a moderator and 4.5 cm Bi as a gamma shield. The outputs of the radiation beam generated from collimator modeling of the radial beam port were ϕepi = 5.25 x 106 n.cm-2.s-1, Df/ϕepi = 1.17 x 10-13Gy.cm2.n-1, Dγ/ϕepi = 1.70 x 10-12 Gy.cm2.n-1, ϕTh/ϕepi = 1.51 and J/ϕepi = 0.731. Based on this study, the result of the beam radiation coming out of the radial beam port dis not fully meet the criteria recommended by IAEA so need to continue this study to get the criteria of IAEA

  20. [Schema Therapy: An Approach for Treating Narcissistic Personality Disorder].

    Science.gov (United States)

    Dieckmann, E; Behary, W

    2015-08-01

    In this article, we review the history of the construct of narcissism and the diagnostic criteria for narcissistic personality disorder. We then discuss some etiological models of narcissism and introduce the model of Jeffrey Young, who developed Schema Therapy (ST) as an alternative to standard cognitive therapy for patients with personality disorders. ST differs from standard cognitive therapies in important respects, including limited reparenting, a focus on the patient's basic needs, and emotional activating techniques in addition to cognitive and behavioral ones. We then discuss Young's theory of basic needs, early maladaptive schemas, and schema modes. According to ST theory, narcissists are traumatized in the schema domain having to do with attachment needs. They are prone to vulnerable emotions in response to narcissistic injuries, although they often do not show these emotions directly. Instead, they use maladaptive coping strategies, resulting in emotional states, known as "schema modes". This includes the Self-Aggrandizer mode and Detached Self-Soother mode, in which a superior, arrogant self-presentation and addictive or compulsive behavior serve a self-regulatory function. These concepts are illustrated by case examples of patients with Narcissistic Personality Disorder.

  1. Maggot debridement therapy as primary tool to treat chronic wound of animals

    OpenAIRE

    Vijayata Choudhary; Mukesh Choudhary; Sunanda Pandey; Chauhan, Vandip D.; Hasnani, J. J.

    2016-01-01

    Maggot debridement therapy (MDT) is a safe, effective, and controlled method of healing of chronic wounds by debridement and disinfection. In this therapy live, sterile maggots of green bottle fly, Lucilia (Phaenicia) sericata are used, as they prefer necrotic tissues over healthy for feeding. Since centuries, MDT is used in human beings to treat chronic wounds. Lately, MDT came out as a potent medical aid in animals. In animals, although, this therapy is still limited and clinical studies ar...

  2. A Case of Plummer Disease Treated With Radioiodine Therapy

    OpenAIRE

    池田, 新; 横川, 正樹; 川口, 篤哉; 森山, 正浩; 守田, 美和; 山内, 美香; 杉本, 利嗣; 内田, 伸恵

    2012-01-01

    A case of Plummer disease treated with radioactive iodine was described. A 74-year-old woman was examined for her thyroid mass, which had been unattended for 7 years, and was diagnosed as having Plummer disease. Laboratory tests showed high and low levels of thyroid hormones and TSH, respectively, but no clinical manifestation of hyperthyroidism was observed. Technetium 99m scintigraphy showed strong accumulation to the mass and suppressed accumulation to the normal part of the thyroid....

  3. Mindfulness-based cognitive therapy to treat multiple chemical sensitivities

    DEFF Research Database (Denmark)

    Skovbjerg, S; Hauge, Christian Riis; Rasmussen, Alice;

    2012-01-01

    of an 8-week mindfulness-based cognitive therapy program (MBCT) for adults with MCS and to evaluate possible effects on psychological distress and illness perception. The study design was a randomized clinical trial. The MBCT programme comprised 8 weekly sessions of 2½ hours. Forty-two adults were......Multiple chemical sensitivities (MCS) is a medically unexplained and socially disabling disorder characterized by negative health effects attributed to exposure to common airborne chemicals. Currently, there is no evidence-based treatment. The objectives of the study were to assess the feasibility...

  4. [How I treat....Recommendations for stopping a pharmacological therapy].

    Science.gov (United States)

    Scheen, A J

    2014-12-01

    To interrupt a pharmacological treatment is sometimes warranted in clinical practice. It may appear as an easy task, simpler to undertake than the initiation of a new therapy, and, yet, it requires that some conditions be fulfilled and some precautions be taken: (1) the reasons why the medication is interrupted should be clearly explained; (2) the physician should make sure that the interruption, even if transient, is without danger; (3) the modalities of interruption should be clearly determined (immediate cessation vs progressive dose reduction), and, finally, (4) an appropriate follow-up of the duly informed patient should be scheduled.

  5. Patient with intractable delirium successfully treated with electroconvulsive therapy

    DEFF Research Database (Denmark)

    Lindgren, Eske; Hageman, Ida

    2014-01-01

    Delirium is a frequent and serious condition often seen in hospitalized patients, especially the elderly. Treatment of the somatic illness causing the delirium, and antipsychotic medication will usually resolve the condition. Sometimes, however, the condition is refractory towards medical treatment...... and in this situation electroconvulsive therapy (ECT) can be a quick and efficient treatment. In this case report of a 26-year-old man a post-operative intractable delirium persisting for three weeks was efficiently and swiftly relieved by three consecutive ECTs. The patient was discharged without need for further...

  6. Treating Verbs in Aphasia: Exploring the Impact of Therapy at the Single Word and Sentence Levels

    Science.gov (United States)

    Webster, Janet; Whitworth, Anne

    2012-01-01

    Background: In recent years there has been significant interest in the differential processing of nouns and verbs in people with aphasia, but more limited consideration about whether the differences have implications for therapy. It remains unclear whether verbs can be treated in a similar way to nouns or should be treated using approaches that…

  7. Reducing the Burden of Difficult-to-Treat Major Depressive Disorder: Revisiting Monoamine Oxidase Inhibitor Therapy

    OpenAIRE

    Culpepper, Larry

    2013-01-01

    Objective: Difficult-to-treat depression (eg, depression with atypical or anxious symptoms, treatment-resistant depression, or depression with frequent recurrence) is a challenging real-world health issue. This critical review of the literature focuses on monoamine oxidase inhibitor (MAOI) therapy and difficult-to-treat forms of depression.

  8. Intramedullary spinal neurocysticercosis treated successfully with medical therapy.

    Science.gov (United States)

    Ahmed, Shameem; Paul, Siba Prosad

    2014-12-01

    Neurocysticercosis caused by Taenia solium and is a common parasitic disease of the cental nervous system. It usually presents with seizures, headaches, progressively worsening focal neurologic symptoms, visual disturbances, loss of bladder control, etc. However, acute onset symptoms may also be seen. MRI scans can accurately diagnose spinal or cerebral lesions and is also helpful in monitoring progress while on treatment. Albendazole is currently the drug of choice along with steroids for medical management of neurocysticercosis. The case of intramedullary spinal neurocysticercosis was treated with praziquantel.

  9. Accelerator based-boron neutron capture therapy (BNCT)-clinical QA and QC

    International Nuclear Information System (INIS)

    Alpha-particle and recoil Li atom yielded by the reaction (10B, n), due to their high LET properties, efficiently and specifically kill the cancer cell that has incorporated the boron. Efficacy of this boron neutron capture therapy (BNCT) has been demonstrated mainly in the treatment of recurrent head/neck and malignant brain cancers in Kyoto University Research Reactor Institute (KUR). As the clinical trial of BNCT is to start from 2009 based on an accelerator (not on the Reactor), this paper describes the tentative outline of the standard operation procedure of BNCT for its quality assurance (QA) and quality control (QC) along the flow of its clinical practice. Personnel concerned in the practice involve the attending physician, multiple physicians in charge of BNCT, medical physicists, nurses and reactor stuff. The flow order of the actual BNCT is as follows: Pre-therapeutic evaluation mainly including informed consent and confirmation of the prescription; Therapeutic planning including setting of therapy volume, and of irradiation axes followed by meeting for stuffs' agreement, decision of irradiating field in the irradiation room leading to final decision of the axis, CT for the planning, decision of the final therapeutic plan according to Japan Atomic Energy Agency-Computational Dosimetry System (JCDS) and meeting of all related personnel for the final confirmation of therapeutic plan; and BNCT including the transport of patient to KUR, dripping of boronophenylalanine, setting up of the patient on the machine, blood sampling for pharmacokinetics, boron level measurement for decision of irradiating time, switch on/off of the accelerator, confirmation of patient's movement in the irradiated field after the neutron irradiation, blood sampling for confirmation of the boron level, and patient's leave from the room. The QA/QC check is principally to be conducted with the two-person rule. The purpose of the clinical trial is to establish the usefulness of BNCT, and

  10. Boron Neutron Capture Therapy (BNCT) in an experimental model of lung metastases in BDIX rats

    International Nuclear Information System (INIS)

    Boron Neutron Capture Therapy (BNCT) in an experimental model of lung metastases in BDIX rats Introduction: Boron Neutron Capture Therapy (BNCT) is based on selective tumor uptake of boron compounds, followed by neutron irradiation. BNCT was proposed for the treatment of unresectable, diffuse lung metastases. The aim of the present study was to perform BNCT studies in an experimental model of lung metastases. Materials and Methods: 3 x 106/0.5 ml colon carcinoma cells (DHD/K12/TRb) were injected iv in syngeneic BDIX rats. Three weeks post-inoculation, rats with diffuse lung metastases were used for in vivo BNCT studies in the RA-3 Nuclear Reactor. Based on previous biodistribution studies and computational dosimetry with Monte Carlo simulation, 2 doses were prescribed, i.e. 4 Gy and 8 Gy minimum absorbed dose to tumor. The animals were assigned to 5 experimental groups (n= 4 to 8) at each dose level: T0 (euthanized pre-treatment), BPA-BNCT, Comb-BNCT (BPA+GB-10), Beam only (background dose) and Sham (same manipulation, no treatment). Boron concentration was measured in a blood sample taken pre-irradiation to verify that the value was in the range established in previous biodistribution studies. The animals were followed clinically for 2 weeks after neutron irradiation and then euthanized to assess the response of tumor and normal lung, macroscopically and histologically. To date we have evaluated the end-point weight of lung (normal lung + metastases) and % lung weight/body weight as an indicator of tumor growth. Results: The statistical analysis (ANOVA) of % lung weight/body weight showed statistically significant differences (p<0.05) between groups T0 (0.79 ± 0.38) and Sham (1.87 ± 0.91). No statistically significant differences were observed between the Beam only groups (at both dose levels) and Sham. Similar and statistically significant tumor control was induced in the groups BPA-BNCT Low dose (LD) (0.56 ± 0.11), BPA-BNCT High dose (HD) (0.80 ± 0.16), Comb

  11. Role of p53 mutation in the effect of boron neutron capture therapy on oral squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    Ohnishi Ken

    2009-12-01

    Full Text Available Abstract Background Boron neutron capture therapy (BNCT is a selective radiotherapy, being effective for the treatment of even advanced malignancies in head and neck regions as well as brain tumors and skin melanomas. To clarify the role of p53 gene, the effect of BNCT on oral squamous cell carcinoma (SCC cells showing either wild- (SAS/neo or mutant-type (SAS/mp53 p53 was examined. Methods Cells were exposed to neutron beams in the presence of boronophenylalanine (BPA at Kyoto University Research Reactor. Treated cells were monitored for modulations in colony formation, proliferation, cell cycle, and expression of cell cycle-associated proteins. Results When SAS/neo and SAS/mp53 cells were subjected to BNCT, more suppressive effects on colony formation and cell viability were observed in SAS/neo compared with SAS/mp53 cells. Cell cycle arrest at the G1 checkpoint was observed in SAS/neo, but not in SAS/mp53. Apoptotic cells increased from 6 h after BNCT in SAS/neo and 48 h in SAS/mp53 cells. The expression of p21 was induced in SAS/neo only, but G2 arrest-associated proteins including Wee1, cdc2, and cyclin B1 were altered in both cell lines. Conclusion These results indicate that oral SCC cells with mutant-type are more resistant to BNCT than those with wild-type p53, and that the lack of G1 arrest and related apoptosis may contribute to the resistance. At a physical dose affecting the cell cycle, BNCT inhibits oral SCC cells in p53-dependent and -independent manners.

  12. The combined effect of electroporation and borocaptate in boron neutron capture therapy for murine solid tumors

    International Nuclear Information System (INIS)

    10B-Enriched borocaptate (BSH) was administered intraperitoneally to SCCVII tumor-bearing C3H/He mice. Electroporation (EP) was conducted by using a tweezers-type electrode. The 10B contents in tumors were measured by prompt γ-ray spectrometry. The colony formation assay was applied to investigate the antitumor effects of boron neutron capture therapy (BNCT) and thereby to estimate the intratumor localization of BSH. The 10B concentrations in tumors decreased with time following BSH administration, falling to 5.4(±0.1) ppm at 3 h, whereas EP treatment (3 repetitions) 15 min after BSH injection delayed the clearance of BSH from tumors, and the 10B level remained at 19.4(±0.9) ppm at 3 h. The effect of BNCT increased with the 10B concentration in tumors, and the combination with EP showed a remarkably large cell killing effect even at 3 h after BSH injection. The effect of BNCT, i.e., slope coefficient of the cell survival curve of tumors, without EP was proportional to tumor 10B level (r=0.982), and that of BSH-BNCT combined with EP lay close to the same correlation line. However, tumors subjected to EP after BSH injection did not show high radiosensitivity when irradiated after conversion to a single cell suspension by enzymatic digestion. This indicates that the increase of the BNCT effect by EP was a consequence of enclosure of BSH in the interstitial space of tumor tissue and not within tumor cells. This is different from a previous in vitro study. The combination of EP and BNCT may be clinically useful, if a procedure to limit EP to the tumor region becomes available or if an alternative similar method is employed. (author)

  13. Epithermal neutron beam adoption for liver cancer treatment by boron and gadolinium neutron capture therapy

    International Nuclear Information System (INIS)

    Comparative evaluation was made on depth-dose distribution in boron neutron capture therapy (B-NCT) and gadolinium one (Gd-NCT) for the treatments of liver cancers. At present, epithermal neutron beam is expected to be applicable to the treatment of deep and widespread tumors. ICRU computational model of ADAM and EVA was used as a liver phantom loading a tumor at depth of 6 cm in its central region. Epithermal neutron beam of Musashi reactor was used as the primary neutron beam for the depth-dose calculation. Calculation was conducted using the three-dimensional continuous-energy Monte Carlo code MCNP4A. The doses observed in both NCTs were bumped over the tumor region but the dose for Gd-NCT was not so tumor-specific compared with that for BNCT because radiation in Gd-NCT was due to γ-ray. The mean physical dose was 4 Gy/h for boron 30 ppm and 5 Gy/h for Gd 1000 ppm when exposed to an epithermal neutron flux of 5x108 n/cm-2/sec and the dose ratio of tumor-to normal tissue was 2.7 for boron and 2.5 for Gd. The lethal dose of 50 Gy for the liver can be accomplished under conditions where the dose has not reached 25 Gy, the tolerance dose of the normal tissue. This seems very encouraging and indicating that both B-NCT and Gd-NCT are applicable for the treatment for liver cancer. However, if normal tissue contain 1/4 of the tumor concentration of boron or Gd, the BNCT would still possible when considering a large RBE value for 10B(n, α) reaction but the Gd-NCT would impossible for deep liver treatment. (M.N.)

  14. Epithermal neutron beam adoption for liver cancer treatment by boron and gadolinium neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Matsumoto, Tetsuo [Musashi Inst. of Tech., Kawasaki, Kanagawa (Japan). Atomic Energy Research Lab

    2001-06-01

    Comparative evaluation was made on depth-dose distribution in boron neutron capture therapy (B-NCT) and gadolinium one (Gd-NCT) for the treatments of liver cancers. At present, epithermal neutron beam is expected to be applicable to the treatment of deep and widespread tumors. ICRU computational model of ADAM and EVA was used as a liver phantom loading a tumor at depth of 6 cm in its central region. Epithermal neutron beam of Musashi reactor was used as the primary neutron beam for the depth-dose calculation. Calculation was conducted using the three-dimensional continuous-energy Monte Carlo code MCNP4A. The doses observed in both NCTs were bumped over the tumor region but the dose for Gd-NCT was not so tumor-specific compared with that for BNCT because radiation in Gd-NCT was due to {gamma}-ray. The mean physical dose was 4 Gy/h for boron 30 ppm and 5 Gy/h for Gd 1000 ppm when exposed to an epithermal neutron flux of 5x10{sup 8} n/cm{sup -2}/sec and the dose ratio of tumor-to normal tissue was 2.7 for boron and 2.5 for Gd. The lethal dose of 50 Gy for the liver can be accomplished under conditions where the dose has not reached 25 Gy, the tolerance dose of the normal tissue. This seems very encouraging and indicating that both B-NCT and Gd-NCT are applicable for the treatment for liver cancer. However, if normal tissue contain 1/4 of the tumor concentration of boron or Gd, the BNCT would still possible when considering a large RBE value for {sup 10}B(n, {alpha}) reaction but the Gd-NCT would impossible for deep liver treatment. (M.N.)

  15. Dosimetric analysis of BNCT - Boron Neutron Capture Therapy - coupled to 252Cf brachytherapy

    International Nuclear Information System (INIS)

    The incidence of brain tumors is increasing in world population; however, the treatments employed in this type of tumor have a high rate of failure and in some cases have been considered palliative, depending on histology and staging of tumor. Its necessary to achieve the control tumor dose without the spread irradiation cause damage in the brain, affecting patient neurological function. Stereotactic radiosurgery is a technique that achieves this; nevertheless, other techniques that can be used on the brain tumor control must be developed, in order to guarantee lower dose on health surroundings tissues other techniques must be developing. The 252Cf brachytherapy applied to brain tumors has already been suggested, showing promising results in comparison to photon source, since the active source is placed into the tumor, providing greater dose deposition, while more distant regions are spared. BNCT - Boron Neutron Capture Therapy - is another technique that is in developing to brain tumors control, showing theoretical superiority on the rules of conventional treatments, due to a selective irradiation of neoplasics cells, after the patient receives a borate compound infusion and be subjected to a epithermal neutrons beam. This work presents dosimetric studies of the coupling techniques: BNCT with 252Cf brachytherapy, conducted through computer simulation in MCNP5 code, using a precise and well discretized voxel model of human head, which was incorporated a representative Glioblastoma Multiform tumor. The dosimetric results from MCNP5 code were exported to SISCODES program, which generated isodose curves representing absorbed dose rate in the brain. Isodose curves, neutron fluency, and dose components from BNCT and 252Cf brachytherapy are presented in this paper. (author)

  16. An international dosimetry exchange for boron neutron capture therapy. Part I: Absorbed dose measurements.

    Science.gov (United States)

    Binns, P J; Riley, K J; Harling, O K; Kiger, W S; Munck af Rosenschöld, P M; Giusti, V; Capala, J; Sköld, K; Auterinen, I; Serén, T; Kotiluoto, P; Uusi-Simola, J; Marek, M; Viererbl, L; Spurny, F

    2005-12-01

    An international collaboration was organized to undertake a dosimetry exchange to enable the future combination of clinical data from different centers conducting neutron capture therapy trials. As a first step (Part I) the dosimetry group from the Americas, represented by MIT, visited the clinical centers at Studsvik (Sweden), VTT Espoo (Finland), and the Nuclear Research Institute (NRI) at Rez (Czech Republic). A combined VTT/NRI group reciprocated with a visit to MIT. Each participant performed a series of dosimetry measurements under equivalent irradiation conditions using methods appropriate to their clinical protocols. This entailed in-air measurements and dose versus depth measurements in a large water phantom. Thermal neutron flux as well as fast neutron and photon absorbed dose rates were measured. Satisfactory agreement in determining absorbed dose within the experimental uncertainties was obtained between the different groups although the measurement uncertainties are large, ranging between 3% and 30% depending upon the dose component and the depth of measurement. To improve the precision in the specification of absorbed dose amongst the participants, the individually measured dose components were normalized to the results from a single method. Assuming a boron concentration of 15 microg g(-1) that is typical of concentrations realized clinically with the boron delivery compound boronophenylalanine-fructose, systematic discrepancies in the specification of the total biologically weighted dose of up to 10% were apparent between the different groups. The results from these measurements will be used in future to normalize treatment plan calculations between the different clinical dosimetry protocols as Part II of this study. PMID:16475772

  17. Development of the JAERI computational dosimetry system (JCDS) for boron neutron capture therapy. Cooperative research

    Energy Technology Data Exchange (ETDEWEB)

    Kumada, Hiroaki; Yamamoto, Kazuyoshi; Torii, Yoshiya; Uchiyama, Junzo [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment; Matsumura, Akira; Yamamoto, Tetsuya; Nose, Tadao [Tsukuba Univ., Tsukuba, Ibaraki (Japan); Nakagawa, Yoshinobu [National Sanatorium Kagawa-Children' s Hospital, Kagawa (Japan); Kageji, Teruyoshi [Tokushima Univ., Tokushima (Japan)

    2003-03-01

    The Neutron Beam Facility at JRR-4 enables us to carry out boron neutron capture therapy with epithermal neutron beam. In order to make treatment plans for performing the epithermal neutron beam BNCT, it is necessary to estimate radiation doses in a patient's head in advance. The JAERI Computational Dosimetry System (JCDS), which can estimate distributions of radiation doses in a patient's head by simulating in order to support the treatment planning for epithermal neutron beam BNCT, was developed. JCDS is a software that creates a 3-dimentional head model of a patient by using CT and MRI images, and that generates a input data file automatically for calculation of neutron flux and gamma-ray dose distributions in the brain with the Monte Carlo code MCNP, and that displays these dose distributions on the head model for dosimetry by using the MCNP calculation results. JCDS has any advantages as follows; By using CT data and MRI data which are medical images, a detail three-dimensional model of patient's head is able to be made easily. The three-dimensional head image is editable to simulate the state of a head after its surgical processes such as skin flap opening and bone removal in the BNCT with craniotomy that are being performed in Japan. JCDS can provide information for the Patient Setting System which can support to set the patient to an actual irradiation position swiftly and accurately. This report describes basic design of JCDS and functions in several processing, calculation methods, characteristics and performance of JCDS. (author)

  18. A benchmark analysis of radiation flux distribution for Boron Neutron Capture Therapy of canine brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Moran, J.M.

    1992-02-01

    Calculations of radiation flux and dose distributions for Boron Neutron Capture Therapy (BNCT) of brain tumors are typically performed using sophisticated three-dimensional analytical models based on either a homogeneous approximation or a simplified few-region approximation to the actual highly-heterogeneous geometry of the irradiation volume. Such models should be validated by comparison with calculations using detailed models in which all significant macroscopic tissue heterogeneities and geometric structures are explicitly represented as faithfully as possible. This work describes a validation exercise for BNCT of canine brain tumors. Geometric measurements of the canine anatomical structures of interest for this work were performed by dissecting and examining two essentially identical Labrador Retriever heads. Chemical analyses of various tissue samples taken during the dissections were conducted to obtain measurements of elemental compositions for tissues of interest. The resulting geometry and tissue composition data were then used to construct a detailed heterogeneous calculational model of the Labrador Retriever head. Calculations of three-dimensional radiation flux distributions pertinent to BNCT were performed for the model using the TORT discrete-ordinates radiation transport code. The calculations were repeated for a corresponding volume-weighted homogeneous tissue model. Comparison of the results showed that the peak neutron and photon flux magnitudes were quite similar for the two models (within 5%), but that the spatial flux profiles were shifted in the heterogeneous model such that the fluxes in some locations away from the peak differed from the corresponding fluxes in the homogeneous model by as much as 10-20%. Differences of this magnitude can be therapeutically significant, emphasizing the need for proper validation of simplified treatment planning models.

  19. Three-dimensional radiation dose distribution analysis for boron neutron capture therapy

    International Nuclear Information System (INIS)

    This paper reports that calculation of physically realistic radiation dose distributions for boron neutron capture therapy (BNCT) is a complex, three-dimensional problem. Traditional one-dimensional (slab) and two-dimensional (cylindrical) models, while useful for neutron beam design and performance analysis, do not provide sufficient accuracy for actual clinical use because the assumed symmetries inherent in such models do not ordinarily exist in the real world. Fortunately, however, it is no longer necessary to make these types of simplifying assumptions. Recent dramatic advances in computing technology have brought full three-dimensional dose distribution calculations for BNCT into the realm of practicality for a wide variety of routine applications. Once a geometric model and the appropriate material compositions have been determined, either stochastic (Monte Carlo) or deterministic calculations of all dose components of interest can now be performed more rapidly and inexpensively for the true three-dimensional geometries typical of actual clinical applications of BNCT. Demonstrations of both Monte Carlo and Deterministic techniques for performing three-dimensional dose distribution analysis for BNCT are provided. Calculated results are presented for a three-dimensional Lucite canine-head phantom irradiated in the epithermal neutron beam available at the Brookhaven Medical Research Reactor. The deterministic calculations are performed using the three-dimensional discrete ordinates method. The Monte Carlo calculations employ a novel method for obtaining spatially detailed radiation flux and dose distributions without the use of flux-at-a-point estimators. The calculated results are in good agreement with each other and with thermal neutron flux measurements taken using copper-gold flux wires placed at various locations in the phantom

  20. Application of HVJ envelope system to boron neutron capture therapy (BNCT)

    International Nuclear Information System (INIS)

    Boron Neutron Capture Therapy (BNCT) has been used clinically for the treatment of malignant tumors. Two drugs, p-boronophenylalanine (BPA) and sulfhydral borane (BSH), have been used as boron delivery agents. These drugs seem to be taken up preferentially in solid tumors, but it is uncertain whether therapeutic quantities of boron atoms are taken up by micro-invasive or distant tumor cells. High accumulation and high selective delivery of boron into tumor tissues are the most important requirements to achieve efficient BNCT for malignant tumor. The HVJ envelope (HVJ-E) vector system is a novel fusion-mediated gene delivery system based on inactivated hemagglutinating virus of Japan (HVJ; Sendai virus). Although we developed this vector system for gene transfer, it can also deliver proteins, synthetic oligonucleotides, and drugs. HVJ-liposome, which is liposome fused with HVJ-E, has higher boron trapping efficiency than HVJ-E alone. We report the boron delivery into cultured cells with HVJ-liposome systems. The cellular 10B concentration after 60 min incubation with HVJ-E containing BSH was 24.9 μg/g cell pellet for BHK-21 cells (baby hamster kidney cells) and 19.4 μg/g cell pellet for SCC VII cells (murine squamous cell carcinoma). These concentrations are higher than that of 60 min incubated cells with BSH containing (100μg 10B/ml) medium. These results indicate the HVJ-E fused with tumor cell membrane and rapidly delivered boron agents, and that the HVJ-E-mediated delivery system could be applicable to BNCT. Plans are underway to begin neutron radiation experiments in vivo and in vitro. (author)

  1. A benchmark analysis of radiation flux distribution for Boron Neutron Capture Therapy of canine brain tumors

    International Nuclear Information System (INIS)

    Calculations of radiation flux and dose distributions for Boron Neutron Capture Therapy (BNCT) of brain tumors are typically performed using sophisticated three-dimensional analytical models based on either a homogeneous approximation or a simplified few-region approximation to the actual highly-heterogeneous geometry of the irradiation volume. Such models should be validated by comparison with calculations using detailed models in which all significant macroscopic tissue heterogeneities and geometric structures are explicitly represented as faithfully as possible. This work describes a validation exercise for BNCT of canine brain tumors. Geometric measurements of the canine anatomical structures of interest for this work were performed by dissecting and examining two essentially identical Labrador Retriever heads. Chemical analyses of various tissue samples taken during the dissections were conducted to obtain measurements of elemental compositions for tissues of interest. The resulting geometry and tissue composition data were then used to construct a detailed heterogeneous calculational model of the Labrador Retriever head. Calculations of three-dimensional radiation flux distributions pertinent to BNCT were performed for the model using the TORT discrete-ordinates radiation transport code. The calculations were repeated for a corresponding volume-weighted homogeneous tissue model. Comparison of the results showed that the peak neutron and photon flux magnitudes were quite similar for the two models (within 5%), but that the spatial flux profiles were shifted in the heterogeneous model such that the fluxes in some locations away from the peak differed from the corresponding fluxes in the homogeneous model by as much as 10-20%. Differences of this magnitude can be therapeutically significant, emphasizing the need for proper validation of simplified treatment planning models

  2. The radiobiology of boron neutron capture therapy: Are ''photon-equivalent'' doses really photon-equivalent?

    International Nuclear Information System (INIS)

    Boron neutron capture therapy (BNCT) produces a mixture of radiation dose components. The high-linear energy transfer (LET) particles are more damaging in tissue than equal doses of low-LET radiation. Each of the high-LET components can multiplied by an experimentally determined factor to adjust for the increased biological effectiveness and the resulting sum expressed in photon-equivalent units (Gy-Eq). BNCT doses in photon-equivalent units are based on a number of assumptions. It may be possible to test the validity of these assumptions and the accuracy of the calculated BNCT doses by 1) comparing the effects of BNCT in other animal or biological models where the effects of photon radiation are known, or 2) if there are endpoints reached in the BNCT dose escalation clinical trials that can be related to the known response to photons of the tissue in question. The calculated Gy-Eq BNCT doses delivered to dogs and to humans with BPA and the epithermal neutron beam of the Brookhaven Medical Research Reactor were compared to expected responses to photon irradiation. The data indicate that Gy-Eq doses in brain may be underestimated. Doses to skin are consistent with the expected response to photons. Gy-Eq doses to tumor are significantly overestimated. A model system of cells in culture irradiated at various depths in a lucite phantom using the epithermal beam is under development. Preliminary data indicate that this approach can be used to detect differences in the relative biological effectiveness of the beam. The rat 9L gliosarcoma cell survival data was converted to photon-equivalent doses using the same factors assumed in the clinical studies. The results superimposed on the survival curve derived from irradiation with Cs-137 photons indicating the potential utility of this model system. (author)

  3. Application of an ultraminiature thermal neutron monitor for irradiation field study of accelerator-based neutron capture therapy

    OpenAIRE

    Ishikawa, Masayori; Tanaka, Kenichi; Endo, Satrou; Hoshi, Masaharu

    2015-01-01

    Phantom experiments to evaluate thermal neutron flux distribution were performed using the Scintillator with Optical Fiber (SOF) detector, which was developed as a thermal neutron monitor during boron neutron capture therapy (BNCT) irradiation. Compared with the gold wire activation method and Monte Carlo N-particle (MCNP) calculations, it was confirmed that the SOF detector is capable of measuring thermal neutron flux as low as 105 n/cm2/s with sufficient accuracy. The SOF detector will be u...

  4. Application of an ultraminiature thermal neutron monitor for irradiation field study of accelerator-based neutron capture therapy

    OpenAIRE

    Ishikawa, Masayori; Tanaka, Kenichi; Endo, Satrou; Hoshi, Masaharu

    2015-01-01

    Phantom experiments to evaluate thermal neutron flux distribution were performed using the Scintillator with Optical Fiber (SOF) detector, which was developed as a thermal neutron monitor during boron neutron capture therapy (BNCT) irradiation. Compared with the gold wire activation method and Monte Carlo N-particle (MCNP) calculations, it was confirmed that the SOF detector is capable of measuring thermal neutron flux as low as 105 n/cm2/s with sufficient accuracy. The SOF detector ...

  5. Proton nuclear magnetic resonance measurement of p-boronophenylalanine (BPA): A therapeutic agent for boron neutron capture therapy

    OpenAIRE

    Zuo, C. S.; Prasad, P V; Busse, Paul; L. Tang; Zamenhof, R. G.

    1999-01-01

    Noninvasive in vivo quantitation of boron is necessary for obtaining pharmacokinetic data on candidate boronated delivery agents developed for boron neutron capture therapy (BNCT). Such data, in turn, would facilitate the optimization of the temporal sequence of boronated drug infusion and neutron irradiation. Current approaches to obtaining such pharmacokinetic data include: positron emission tomography employing F-18 labeled boronated delivery agents (e.g., p-boronophenylalanine), ex vivo n...

  6. Boron neutron capture therapy applied to advanced breast cancers: Engineering simulation and feasibility study of the radiation treatment protocol

    Science.gov (United States)

    Sztejnberg Goncalves-Carralves, Manuel Leonardo

    This dissertation describes a novel Boron Neutron Capture Therapy (BNCT) application for the treatment of human epidermal growth factor receptor type 2 positive (HER2+) breast cancers. The original contribution of the dissertation is the development of the engineering simulation and the feasibility study of the radiation treatment protocol for this novel combination of BNCT and HER2+ breast cancer treatment. This new concept of BNCT, representing a radiation binary targeted treatment, consists of the combination of two approaches never used in a synergism before. This combination may offer realistic hope for relapsed and/or metastasized breast cancers. This treatment assumes that the boronated anti-HER2 monoclonal antibodies (MABs) are administrated to the patient and accumulate preferentially in the tumor. Then the tumor is destroyed when is exposed to neutron irradiation. Since the use of anti-HER2 MABs yields good and promising results, the proposed concept is expected to amplify the known effect and be considered as a possible additional treatment approach to the most severe breast cancers for patients with metastasized cancer for which the current protocol is not successful and for patients refusing to have the standard treatment protocol. This dissertation makes an original contribution with an integral numerical approach and proves feasible the combination of the aforementioned therapy and disease. With these goals, the dissertation describes the theoretical analysis of the proposed concept providing an integral engineering simulation study of the treatment protocol. An extensive analysis of the potential limitations, capabilities and optimization factors are well studied using simplified models, models based on real CT patients' images, cellular models, and Monte Carlo (MCNP5/X) transport codes. One of the outcomes of the integral dosimetry assessment originally developed for the proposed treatment of advanced breast cancers is the implementation of BNCT

  7. Use of boron cluster-containing redox nanoparticles with ROS scavenging ability in boron neutron capture therapy to achieve high therapeutic efficiency and low adverse effects.

    Science.gov (United States)

    Gao, Zhenyu; Horiguchi, Yukichi; Nakai, Kei; Matsumura, Akira; Suzuki, Minoru; Ono, Koji; Nagasaki, Yukio

    2016-10-01

    A boron delivery system with high therapeutic efficiency and low adverse effects is crucial for a successful boron neutron capture therapy (BNCT). In this study, we developed boron cluster-containing redox nanoparticles (BNPs) via polyion complex (PIC) formation, using a newly synthesized poly(ethylene glycol)-polyanion (PEG-polyanion, possessing a (10)B-enriched boron cluster as a side chain of one of its segments) and PEG-polycation (possessing a reactive oxygen species (ROS) scavenger as a side chain of one of its segments). The BNPs exhibited high colloidal stability, selective uptake in tumor cells, specific accumulation, and long retention in tumor tissue and ROS scavenging ability. After thermal neutron irradiation, significant suppression of tumor growth was observed in the BNP-treated group, with only 5-ppm (10)B in tumor tissues, whereas at least 20-ppm (10)B is generally required for low molecular weight (LMW) (10)B agents. In addition, increased leukocyte levels were observed in the LMW (10)B agent-treated group after thermal neutron irradiation, and not in BNP-treated group, which might be attributed to its ROS scavenging ability. No visual metastasis of tumor cells to other organs was observed 1 month after irradiation in the BNP-treated group. These results suggest that BNPs are promising for enhancing the BNCT performance. PMID:27467416

  8. The survival analysis on localized prostate cancer treated with neoadjuvant endocrine therapy followed by intensity modulated radiation therapy

    International Nuclear Information System (INIS)

    Objective: To retrospectively investigate clinical outcomes and prognostic factors in localized prostate cancer treated with neoadjuvant endocrine therapy followed by intensity modulated radiotherapy (IMRT). Methods: Between March 2003 and October 2008, 54 localized prostate cancer treated by IMRT were recruited. All patients had received endocrine therapy before IMRT. The endocrine therapy included surgical castration or medical castration in combination with antiandrogens. The target of IMRT was the prostate and seminal vesicles with or without pelvis. The biochemical failure was defined according to the phoenix definition. By using the risk grouping standard proposed by D'Amico, patients were divided into three groups: low-risk group (n = 5), intermediate-risk group (n = 12), and high-risk group (n = 37). Kaplan-Meier method was used to calculate the overall survival rate. Prognostic factors were analyzed by univariate and multiple Cox regression analysis. Results: The follow-up rate was 98%. The number of patients under follow-up was 39 at 3 years and 25 at 5 years. Potential prognostic factors, including risk groups, mode of endocrine therapy, time of endocrine therapy, phoenix grouping before IMRT, the prostate specific antigen doubling time (PSADT) before radiotherapy, PSA value before IMRT, interval of endocrine therapy and IMRT, irradiation region, and irradiation dose were analyzed by survival analysis. In univariate analysis, time of endocrine therapy (75 % vs 95 %, χ2= 6. 45, P = 0. 011), phoenix grouping before IMRT (87% vs 96%, χ2 = 4. 36, P = 0. 037), interval of endocrine therapy and IMRT (80% vs 95%, χ2= 11.60, P= 0. 001), irradiation dose (75% vs 91%, χ2=5.92, P= 0. 015) were statistically significant prognostic factors for 3 - year overall survival , and risk groups (85 vs 53 vs 29, χ2= 6. 40, P =0. 041) and PSADT before IMRT (62 vs 120, U =24. 50, P =0. 003) were significant factors for the median survival time. In the multiple Cox

  9. Tension - Type - Headache treated by Positional Release Therapy: a case report.

    Science.gov (United States)

    Mohamadi, Marzieh; Ghanbari, Ali; Rahimi Jaberi, Abbas

    2012-10-01

    Tension Type Headache (T.T.H) is the most prevalent headache. Myofascial abnormalities & trigger points are important in this type of headache which can be managed by Positional Release Therapy (PRT). This is a report of a 47 years old female patient with Tension Type Headache treated by Positional Release Therapy for her trigger points. She had a constant dull headache, which continued all the day for 9 months. A physiotherapist evaluated the patient and found active trigger points in her cervical muscles. Then, she received Positional Release Therapy for her trigger points. After 3 treatment sessions, the patient's headache stopped completely. During the 8 months following the treatment she was without pain, and did not use any medication. Positional Release Therapy was effective in treating Tension Type Headache. This suggests that PRT could be an alternative treatment to medication in patients with T.T.H if the effectiveness of that can be confirmed by further studies.

  10. Comparison of the radiobiological effects of Boron neutron capture therapy (BNCT) and conventional Gamma Radiation

    International Nuclear Information System (INIS)

    BNCT is an experimental radiotherapeutic modality that uses the capacity of the isotope 10B to capture thermal neutrons leading to the production of 4He and 7Li, particles with high linear energy transfer (LET). The aim was to evaluate and compare in vitro the mechanisms of response to the radiation arising of BNCT and conventional gamma therapy. We measured the survival cell fraction as a function of the total physical dose and analyzed the expression of p27/Kip1 and p53 by Western blotting in cells of colon cancer (ARO81-1). Exponentially growing cells were distributed into the following groups: 1) BPA (10 ppm 10B) + neutrons; 2) BOPP (10 ppm 10B) + neutrons; 3) neutrons alone; 4) gamma-rays. A control group without irradiation for each treatment was added. The cells were irradiated in the thermal neutron beam of the RA-3 (flux= 7.5 109 n/cm2 sec) or with 60Co (1Gy/min) during different times in order to obtain total physical dose between 1-5 Gy (±10 %). A decrease in the survival fraction as a function of the physical dose was observed for all the treatments. We also observed that neutrons and neutrons + BOPP did not differ significantly and that BPA was the more effective compound. Protein extracts of irradiated cells (3Gy) were isolated to 24 h and 48 h post radiation exposure. The irradiation with neutrons in presence of 10BPA or 10BOPP produced an increase of p53 at 24 h maintain until 48 h. On the contrary, in the groups irradiated with neutrons alone or gamma the peak was observed at 48 hr. The level of expression of p27/Kip1 showed a reduction of this protein in all the groups irradiated with neutrons (neutrons alone or neutrons plus boron compound), being more marked at 24 h. These preliminary results suggest different radiobiological response for high and low let radiation. Future studies will permit establish the role of cell cycle in the tumor radio sensibility to BNCT. (author)

  11. Reference dosimetry calculations for neutron capture therapy with comparison of analytical and voxel models.

    Science.gov (United States)

    Goorley, J T; Kiger, W S; Zamenhof, R G

    2002-02-01

    As clinical trials of Neutron Capture Therapy (NCT) are initiated in the U.S. and other countries, new treatment planning codes are being developed to calculate detailed dose distributions in patient-specific models. The thorough evaluation and comparison of treatment planning codes is a critical step toward the eventual standardization of dosimetry, which, in turn, is an essential element for the rational comparison of clinical results from different institutions. In this paper we report development of a reference suite of computational test problems for NCT dosimetry and discuss common issues encountered in these calculations to facilitate quantitative evaluations and comparisons of NCT treatment planning codes. Specifically, detailed depth-kerma rate curves were calculated using the Monte Carlo radiation transport code MCNP4B for four different representations of the modified Snyder head phantom, an analytic, multishell, ellipsoidal model, and voxel representations of this model with cubic voxel sizes of 16, 8, and 4 mm. Monoenergetic and monodirectional beams of 0.0253 eV, 1, 2, 10, 100, and 1000 keV neutrons, and 0.2, 0.5, 1, 2, 5, and 10 MeV photons were individually simulated to calculate kerma rates to a statistical uncertainty of neutron beam with a broad neutron spectrum, similar to epithermal beams currently used or proposed for NCT clinical trials, was computed for all models. The thermal neutron, fast neutron, and photon kerma rates calculated with the 4 and 8 mm voxel models were within 2% and 4%, respectively, of those calculated for the analytical model. The 16 mm voxel model produced unacceptably large discrepancies for all dose components. The effects from different kerma data sets and tissue compositions were evaluated. Updating the kerma data from ICRU 46 to ICRU 63 data produced less than 2% difference in kerma rate profiles. The depth-dose profile data, Monte Carlo code input, kerma factors, and model construction files are available

  12. Late-onset spinal deformities in children treated by laminectomy and radiation therapy for malignant tumours

    OpenAIRE

    de Jonge, Tamás; Slullitel, Hernan; Dubousset, Jean; MILADI, Lotfi; Wicart, Philip; Illés, Tamás

    2005-01-01

    This is a retrospective study of 76 children who had had malignant tumours treated with laminectomy or laminoplasty and/or radiation therapy affecting the spine. Spinal tumours in children are extremely rare. However, their treatment can result in progressive spinal deformity. Radiation therapy affecting the growing spine can lead to asymmetric vertebral growth, causing kyphosis and/or scoliosis. These spinal deformities pose one of the most challenging problems for the spine surgeon. The aim...

  13. Treating intrusions, promoting resilience: an overview of therapies for trauma-related psychological disorders

    OpenAIRE

    Schnyder, Ulrich

    2014-01-01

    The efficacy of psychotherapeutic approaches in the treatment of posttraumatic stress disorder (PTSD) can be regarded as empirically demonstrated. Overall, effect sizes appear to be higher for psychotherapy than for medication. Many well-controlled trials with a mixed variety of trauma survivors have demonstrated that trauma-focused cognitive-behavioral therapy (TF-CBT) is effective in treating PTSD. Prolonged exposure therapy (PE) is currently seen as the treatment with the strongest evidenc...

  14. Design of a plate type fuel based - low power medical reactor for boron neutron capture therapy

    International Nuclear Information System (INIS)

    The interest in the boron neutron capture therapy (BNCT) has been renewed for cancer therapy with some indication of its potential efficacy in recent years. To solve the most important problem that thermal neutrons are attenuated rapidly in tissue due to absorption and scattering, thermal neutron beams are replaced by epithermal neutron beams. Thus, epithermal neutron beams are directed towards a patient's head, during their passage through tissue these neutrons rapidly lose energy by elastic scattering until they end up as thermal neutrons in target tumor volume. The thermal neutrons thus formed, are captured by the 10B atoms which become 11B atoms in the excited state for a very short time 10-12 sec. The 11B atoms then decay producing alpha particles, 7Li recoil nuclei and gamma rays. Tumor cells are killed selectively by the energetic alpha particles and 7Li fission products. We propose a 300kW slab type reactor core having thin and large surface areas so that most of the neutrons emerging from the faces and entering moderator region are fission spectrum neutrons to acquire high intense epithermal neutron beam with high quality. All faces of the slab core, East-West region and North-South region, were considered for epithermal neutron beam collimators. Plate-type U3Si2-Al dispersion fuel having high uranium density is very compatible with composing of a slab type core. The reactor core is loaded with 3.89kg U235 and has the dimension of about 23.46cm width, 31.28cm length and 64.8cm height, with 216 locations to place 204 fuel elements, eight control plates and four safety plates. The general-purpose MCNP 4B code was used to carry out the neutron and photon transport computations. Both keff criticality and fixed source problems were computed. We could reduce at least 7 times long computer time (105 to 140 h in a run) needed to initiate enough neutrons in a run ( 6000 to 8000 cycles in a run with 3000 neutrons per cycle) using the PVM (Parallel Virtual

  15. Treating wounds in small animals with maggot debridement therapy: a survey of practitioners.

    Science.gov (United States)

    Sherman, Ronald A; Stevens, Howard; Ng, David; Iversen, Eve

    2007-01-01

    Many small animals succumb to complications of serious wounds. Sometimes infection and sepsis overwhelm the animal; sometimes the costs of intensive care overwhelm the owner. Maggot therapy, a method of wound debridement using live fly larvae, could provide effective, simple, low cost wound care. All eight US veterinarians who had been provided with medicinal maggots were surveyed to determine if this treatment was being used for small animals, and for what indications. At least two dogs, four cats and one rabbit were treated with maggot therapy between 1997 and 2003. The most common indications for using maggot therapy were to effect debridement and control infection, especially if the wound failed to respond to conventional medical and/or surgical therapy. Practitioners reported the treatments as safe and often beneficial. Amputation and euthanasia may have been avoided. It is concluded that maggot therapy may have utility for small animals, and should be evaluated further. PMID:16386439

  16. Tumor growth suppression by gadolinium-neutron capture therapy using gadolinium-entrapped liposome as gadolinium delivery agent.

    Science.gov (United States)

    Dewi, Novriana; Yanagie, Hironobu; Zhu, Haito; Demachi, Kazuyuki; Shinohara, Atsuko; Yokoyama, Kazuhito; Sekino, Masaki; Sakurai, Yuriko; Morishita, Yasuyuki; Iyomoto, Naoko; Nagasaki, Takeshi; Horiguchi, Yukichi; Nagasaki, Yukio; Nakajima, Jun; Ono, Minoru; Kakimi, Kazuhiro; Takahashi, Hiroyuki

    2013-07-01

    Neutron capture therapy (NCT) is a promising non-invasive cancer therapy approach and some recent NCT research has focused on using compounds containing gadolinium as an alternative to currently used boron-10 considering several advantages that gadolinium offers compared to those of boron. In this study, we evaluated gadolinium-entrapped liposome compound as neutron capture therapy agent by in vivo experiment on colon-26 tumor-bearing mice. Gadolinium compound were injected intravenously via tail vein and allowed to accumulate into tumor site. Tumor samples were taken for quantitative analysis by ICP-MS at 2, 12, and 24 h after gadolinium compound injection. Highest gadolinium concentration was observed at about 2 h after gadolinium compound injection with an average of 40.3 μg/g of wet tumor tissue. We performed neutron irradiation at JRR-4 reactor facility of Japan Atomic Energy Research Institute in Tokaimura with average neutron fluence of 2×10¹² n/cm². The experimental results showed that the tumor growth suppression of gadolinium-injected irradiated group was revealed until about four times higher compared to the control group, and no significant weight loss were observed after treatment suggesting low systemic toxicity of this compound. The gadolinium-entrapped liposome will become one of the candidates for Gd delivery system on NCT.

  17. For boron neutron capture therapy,synthesizing boron-polymer compounds and testing in laboratory conditions

    International Nuclear Information System (INIS)

    The aim of this project is to establish a focus point at Turkish Atomic Energy Authority (TAEA) in the field of Boron Neutron Capture Therapy which is a binary radiotherapy method for brain tumours. Moreover in the scope of the project, a new alternative of 10B-carrier compounds will be synthesized, the neutron source will be determined and the infrastructure to start the clinical trials of BNCT in our country will be established. BNCT is a binary radiotherapy method and the successful of this method is depend on the synthesized boron compounds which have the selective targeting property with tumour cells and neutron optimization. The water-soluble polymer based boron compounds having biochemical and physiological properties will be synthesized and cell culture experiment will be done. In addition, after the neutron source is set up in our country, the infrastructure studies will be started in order to start the clinical trials of BNCT. In this project, there are three different groups as boron compounds, neutron physics and medical group. Neutron physics group is starting the calculations of neutron beam parameters using in BNCT application. But, medical group has no active studies yet. Boron compounds group has been carried out two different experimental studies. In the first experimental study, functional groups have been bound to boron containing polymers to enhance the selectively targeting property and characterized by various analysis methods. Later, cell culture experiment will be done. The first study has been carried out with Hacettepe University. Up to present, completed studies are listed as: -Maleic anhydride oligomer was synthesized and then 2-aminoethyl diphenyl borate (2-AEPB) and monomethoxy poly(ethylene glycol) (PEG) was bound to this oligomer, respectively. Thus, [MAH]n-g1-2-AEPB-g2-PEG was synthesized. -2-AEPB compound were bound to poly(acrylic acid) polymer at different three mole ratio.Then, the selected Poli(Ac)-g1-2-AEPB polymer was

  18. Boron-Containing Compounds for Liposome-Mediated Tumor Localization and Application to Neutron Capture Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hawthorne, M. Frederick [Univ. of California, Los Angeles, CA (United States)

    2005-04-07

    Medical application of boron neutron capture therapy (BNCT) has been significantly hindered by the slow development of boron drug-targeting methodologies for the selective delivery of high boron concentration sto malignant cells. We have successfully sought to fill this need by creating liposomes suitable as in vivo boron delivery vehicles for BNCT. Delivery of therapeutic quantities of boron to tumors in murine models has been achieved with small unilamellar boron-rich liposomes. Subsequently, attempts have been made to improve delivery efficiency of liposomes encapsulating boron-containing water-soluble species into their hollow core by incorporating lipophilic boron compounds as addenda to the liposome bilayer, incorporating boron compounds as structural components of the bilayer (which however, poses the risk of sacrificing some stability), and combinations thereof. Regardless of the method, approximately 90% of the total liposome mass remains therapeutically inactive and comprised of the vehicle's construction materials, while less than 5% is boron for neutron targeting. Following this laboratory's intensive study, the observed tumor specificity of certain liposomes has been attributed to their diminutive size of these liposomes (30-150 nm), which enables these small vesicles to pass through the porous, immature vasculature of rapidly growing tumor tissue. We surmised that any amphiphilic nanoparticle of suitable size could possess some tumor selectivity. Consequently, the discovery of a very boron-rich nanoparticle delivery agent with biodistribution performance similar to unilamellar liposomes became one of our goals. Closomers, a new class of polyhedral borane derivatives, attracted us as an alternative BNCT drug-delivery system. We specifically envisioned dodeca (nido-carboranyl)-substituted closomers as possibly having a great potential role in BNCT drug delivery. They could function as extraordinarily boron-rich BNCT drugs since they are

  19. Boron-Containing Compounds for Liposome-Mediated Tumor Localization and Application to Neutron Capture Therapy

    International Nuclear Information System (INIS)

    Medical application of boron neutron capture therapy (BNCT) has been significantly hindered by the slow development of boron drug-targeting methodologies for the selective delivery of high boron concentration sto malignant cells. We have successfully sought to fill this need by creating liposomes suitable as in vivo boron delivery vehicles for BNCT. Delivery of therapeutic quantities of boron to tumors in murine models has been achieved with small unilamellar boron-rich liposomes. Subsequently, attempts have been made to improve delivery efficiency of liposomes encapsulating boron-containing water-soluble species into their hollow core by incorporating lipophilic boron compounds as addenda to the liposome bilayer, incorporating boron compounds as structural components of the bilayer (which however, poses the risk of sacrificing some stability), and combinations thereof. Regardless of the method, approximately 90% of the total liposome mass remains therapeutically inactive and comprised of the vehicle's construction materials, while less than 5% is boron for neutron targeting. Following this laboratory's intensive study, the observed tumor specificity of certain liposomes has been attributed to their diminutive size of these liposomes (30-150 nm), which enables these small vesicles to pass through the porous, immature vasculature of rapidly growing tumor tissue. We surmised that any amphiphilic nanoparticle of suitable size could possess some tumor selectivity. Consequently, the discovery of a very boron-rich nanoparticle delivery agent with biodistribution performance similar to unilamellar liposomes became one of our goals. Closomers, a new class of polyhedral borane derivatives, attracted us as an alternative BNCT drug-delivery system. We specifically envisioned dodeca (nido-carboranyl)-substituted closomers as possibly having a great potential role in BNCT drug delivery. They could function as extraordinarily boron-rich BNCT drugs since they are amphiphilic

  20. Dosimetry and dose planning in boron neutron capture therapy : Monte Carlo studies

    Energy Technology Data Exchange (ETDEWEB)

    Koivunoro, H.

    2012-07-01

    Boron neutron capture therapy (BNCT) is a biologically targeted radiotherapy modality. So far, 249 cancer patients have received BNCT at the Finnish Research Reactor 1 (FiR 1) in Finland. The effectiveness and safety of radiotherapy are dependent on the radiation dose delivered to the tumor and healthy tissues, and on the accuracy of the doses. At FiR 1, patient dose calculations are performed with the Monte Carlo (MC) -based treatmentplanning system (TPS), Simulation Environment for Radiotherapy Applications (SERA). Initially, BNCT was applied to head and neck cancer, brain tumors, and malignant melanoma. To evaluate the applicability of the new target tumors for BNCT, calculation dosimetry studies are needed. So far, clinical BNCT has been performed with the neutrons from a nuclear reactor, while an accelerator based neutron sources applicable for hospital operation would be preferable. In this thesis, BNCT patient dose calculation practice in Finland was evaluated against reference calculations and experimental data in several cases. Calculations with two TPSs applied in clinical BNCT were compared. The suitability of the deuterium-deuterium (DD) and deuterium-tritium (D-T) fusion reaction-based compact neutron sources for BNCT were evaluated. In addition, feasibility of BNCT for noninvasive liver tumor treatments was examined. The deviation between SERA and the reference calculations was within 4% in the phantoms studied and in a brain cancer patient model elsewhere, except on the phantom or skin surface, for the boron, nitrogen, and photon dose components. These dose components produce 99% of the tumor dose and > 90% of the healthy tissue dose at points of relevance for treatment at the FiR 1 facility. The reduced voxel cell size ({<=} 0.5 cm) in the SERA edit mesh improved calculation accuracy on the surface. The erratic biased fastneutron run option in SERA led to significant underestimation (up to 30-60%) of the fastneutron dose, while more accurate fast

  1. A theoretical model for the production of Ac-225 for cancer therapy by neutron capture transmutation of Ra-226.

    Science.gov (United States)

    Melville, G; Melville, P

    2013-02-01

    Radium needles that were once implanted into tumours as a cancer treatment are now obsolete and constitute a radioactive waste problem, as their half-life is 1600 years. We are investigating the reduction of radium by transmutation by bombarding Ra-226 with high-energy neutrons from a neutron source to produce Ra-225 and hence Ac-225, which can be used as a generator to produce Bi-213 for use in 'Targeted Alpha Therapy' for cancer. This paper examines the possibility of producing Ac-225 by neutron capture using a theoretical model in which neutron energy is convoluted with the corresponding neutron cross sections of Ra-226. The total integrated yield can then be obtained. This study shows that an intense beam of high-energy neutrons could initiate neutron capture on Ra-226 to produce Ra-225 and hence practical amounts of Ac-225 and a useful reduction of Ra-226.

  2. Baseline Characteristics in the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT)

    NARCIS (Netherlands)

    Pfeffer, Marc A.; Burdmann, Emmanuel A.; Chen, Chao-Yin; Cooper, Mark E.; de Zeeuw, Dick; Eckardt, Kai-Uwe; Ivanovich, Peter; Kewalramani, Reshma; Levey, Andrew S.; Lewis, Eldrin F.; McGill, Janet; McMurray, John J. V.; Parfrey, Patrick; Parving, Hans-Henrik; Remuzzi, Giuseppe; Singh, Ajay K.; Solomon, Scott D.; Toto, Robert; Uno, Hajime

    2009-01-01

    Background: Anemia augments the already high rates of fatal and major nonfatal cardiovascular and renal events in individuals with type 2 diabetes. In 2004, we initiated the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT). This report presents the baseline characteristics and ther

  3. Oxidative Imbalance in HIV-1 Infected Patients Treated with Antiretroviral Therapy

    Directory of Open Access Journals (Sweden)

    Antonella Mandas

    2009-01-01

    Full Text Available It is generally accepted that oxidative stress is involved in HIV infection. However, the role in oxidative balance of Highly Active Antiretroviral Therapy (HAART is still debated. In our study we assessed serum oxidant and antioxidant levels in an HIV-1-infected population treated with HAART, and compared them with those of untreated HIV-1 patients and HIV-1-negative subjects. The study included 116 HIV-1-infected patients (86 HAART-treated and 30 untreated, and 46 HIV-negative controls. Serum oxidant levels were significantly higher in the HIV-1 treated group as compared to untreated and control groups. In addition, a decrease of serum total antioxidant status was observed in the HIV-1 treated group. To be noted is that patients who rigorously follow antiretroviral therapy (optimal HAART adherence have significantly higher oxidative status than those who do not closely follow the therapy (poor HAART adherence. Analysis of variance revealed no significant further increase in oxidative status in HIV-1-infected patients taking antiretroviral and other drugs with the exception of psychiatric drugs (e.g. anxiolytics or antidepressants. Taken together, our results indicate that HAART may affect oxidative stress in HIV-1-infected patients and suggest that antiretroviral therapy plays an important role in the synergy of HIV infection and oxidative stress.

  4. Forty Cases of Insomnia Treated by Multi-output Electric Pulsation and Auricular Plaster Therapy

    Institute of Scientific and Technical Information of China (English)

    Liu Weizhe

    2007-01-01

    @@ The writer has treated 40 cases of insomnia by the method of multi-output electric pulsation in combination with auricular plaster therapy (with a seed of Vaccariae segetalis 王不留行 taped tightly to a particular ear point and pressed) and received satisfactory therapeutic effects. A report follows.

  5. Treating internet addiction with cognitive-behavioral therapy: a thematic analysis of the experiences of therapists.

    NARCIS (Netherlands)

    Rooij, A.J. van; Zinn, M.F.; Schoenmakers, T.M.; Mheen, D. van de

    2012-01-01

    In 2009, one of the major Dutch addiction care organizations initiated a pilot program to explore the possibility of using an existing Cognitive Behavioral Therapy and Motivational Interviewing based treatment program (‘Lifestyle Training’) to treat internet addiction. The current study evaluates th

  6. Treating Internet Addiction with Cognitive-Behavioral Therapy: A Thematic Analysis of the Experiences of Therapists

    Science.gov (United States)

    van Rooij, Antonius J.; Zinn, Mieke F.; Schoenmakers, Tim M.; van de Mheen, Dike

    2012-01-01

    In 2009, one of the major Dutch addiction care organizations initiated a pilot program to explore the possibility of using an existing Cognitive Behavioral Therapy and Motivational Interviewing based treatment program ("Lifestyle Training") to treat internet addiction. The current study evaluates this pilot treatment program by providing a…

  7. Follow-up study of patients treated by iodine-131 therapy for hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Sasaki, Takehito; Sakamoto, Kiyohiko; Hoshino, Fumihiko

    1987-08-01

    Two hundred and seventy-one patients (70 male and 201 female) treated by radioiodine-131 therapy for hyperthyroidism during 29 years from 1955 to 1983 were surveyed with respect to induction of thyroid tumors and hypothyroidism. Mean values of quantity of radioiodine administered, dose to thyroid gland, years after treatment were 4.7 mCi, 59.2 Sv and 6.2 years, respectively. No thyroid cancer, 2 cases of thyroid adenoma and 7 cases of hypothyroidism were observed. Twenty-seven patients were still hyperthyroid at the time of this survey. Both years after therapy and product of dose to thyroid and years after therapy were significantly higher in hypothyroid patients than hyperthyroid patients. Incidence of thyroid adenoma and hypothyroidism was apparently lower than that reported from western countries. Simple regression analysis between scores of thyroid function and each of 7 variables including age, quantity of /sup 131/I, dose to thyroid, years after therapy, product of dose and years after therapy, rate of /sup 131/I uptake and effective half-life was performed. Regression equation for each of 4 variables including years after therapy, dose to thyroid, quantity of /sup 131/I and product of dose and years after therapy (Sv center dot year) was statistically significant when analyzed for all patients. However, multiple regression analysis indicated that product of dose and years after therapy is only one independent variable which significantly influences thyroid function.

  8. Clinical Comparative Study on Massage Therapy and Cisapride in Treating Functional Dyspepsia

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jia-fu; LIN Qiang; LIU Hong-bo; ZHOU Ping; XIAO Yuan-chun

    2007-01-01

    To observe the clinical efficacy of massage therapy and Cisapride in the treatment of functional dyspepsia (FD).Methods:Eighty subjects were randomized into two groups:treatment group in which 40 cases were treated by massage therapy and control group in which 40 cases were treated by Cisapride,with a course of 4 weeks;meanwhile,another 40 healthy people were taken as normal group.Abdominal fullness,acid regurgitation,diminished appetite and anorexia,nausea and vomiting and health survey were observed;symptom scores were recorded.Results:These two treatment methods were effective for FD.Conclusion:Mental disorder is one cause of FD;massage therapy is quite effective for it.

  9. Proton magnetic resonance spectroscopy of a boron neutron capture therapy 10B-carrier, L-p-boronophenylalanine-fructose complex

    Energy Technology Data Exchange (ETDEWEB)

    Timonen, M.

    2010-07-01

    Boron neutron capture therapy (BNCT) is a radiotherapy that has mainly been used to treat malignant brain tumours, melanomas, and head and neck cancer. In BNCT, the patient receives an intravenous infusion of a 10B-carrier, which accumulates in the tumour area. The tumour is irradiated with epithermal or thermal neutrons, which result in a boron neutron capture reaction that generates heavy particles to damage tumour cells. In Finland, boronophenylalanine fructose (BPA-F) is used as the 10B-carrier. Currently, the drifting of boron from blood to tumour as well as the spatial and temporal accumulation of boron in the brain, are not precisely known. Proton magnetic resonance spectroscopy (1H MRS) could be used for selective BPA-F detection and quantification as aromatic protons of BPA resonate in the spectrum region, which is clear of brain metabolite signals. This study, which included both phantom and in vivo studies, examined the validity of 1H MRS as a tool for BPA detection. In the phantom study, BPA quantification was studied at 1.5 and 3.0 T with single voxel 1H MRS, and at 1.5 T with magnetic resonance imaging (MRSI). The detection limit of BPA was determined in phantom conditions at 1.5 T and 3.0 T using single voxel 1H MRS, and at 1.5 T using MRSI. In phantom conditions, BPA quantification accuracy of +- 5% and +- 15% were achieved with single voxel MRS using external or internal (internal water signal) concentration references, respectively. For MRSI, a quantification accuracy of <5% was obtained using an internal concentration reference (creatine). The detection limits of BPA in phantom conditions for the PRESS sequence were 0.7 (3.0 T) and 1.4 mM (1.5 T) mM with 20 x 20 single voxel MRS, and 1.0 mM with acquisition-weighted MRSI, respectively. In the in vivo study, an MRSI or single voxel MRS or both was performed for ten patients (patients 1-10) on the day of BNCT. Three patients had glioblastoma multiforme (GBM), and five patients had a recurrent or

  10. A NEW SINGLE-CRYSTAL FILTERED THERMAL NEUTRON SOURCE FOR NEUTRON CAPTURE THERAPY RESEARCH AT THE UNIVERSITY OF MISSOURI

    Energy Technology Data Exchange (ETDEWEB)

    John D. Brockman; David W. Nigg; M. Frederick Hawthorne

    2008-09-01

    Parameter studies, design calculations and initial neutronic performance measurements have been completed for a new thermal neutron beamline to be used for neutron capture therapy cell and small-animal radiobiology studies at the University of Missouri Research Reactor. The beamline features the use of single-crystal silicon and bismuth sections for neutron filtering and for reduction of incident gamma radiation. The calculated and measured thermal neutron flux produced at the irradiation location is on the order of 9.5x108 neutrons/cm2-s, with a measured cadmium ratio (Au foils) of 105, indicating a well-thermalized spectrum.

  11. Molecular Medicine: Synthesis and In Vivo Detection of Agents for use in Boron Neutron Capture Therapy. Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Kabalka, G. W.

    2005-06-28

    The primary objective of the project was the development of in vivo methods for the detection and evaluation of tumors in humans. The project was focused on utilizing positron emission tomography (PET) to monitor the distribution and pharamacokinetics of a current boron neutron capture therapy (BNCT) agent, p-boronophenylalanine (BPA) by labeling it with a fluorine-18, a positron emitting isotope. The PET data was then used to develop enhanced treatment planning protocols. The study also involved the synthesis of new tumor selective BNCTagents that could be labeled with radioactive nuclides for the in vivo detection of boron.

  12. In-phantom dosimetry using the 13C(d,n)14N reaction for BNCT (boron neutron capture therapy)

    International Nuclear Information System (INIS)

    The use of the 13 C(d,n)14 N reaction at Ed =1.5 MeV for accelerator-based boron neutron capture therapy is investigated. The 13 C(d,n)14 N reaction presents the advantages of carbon as a target material and its large cross section. The deuteron beam was produced by a tandem accelerator at MIT's Laboratory for Accelerator Beam Applications. The resulting neutron spectra were evaluated in terms of RBE-dose rates at different depths inside a water-filled brain phantom using a heavy water moderator and lead reflector assembly. All results were simulated using the code MCNP. (author)

  13. An X-ray photoelectron spectroscopy study of surface changes on brominated and sulfur-treated activated carbon sorbents during mercury capture: performance of pellet versus fiber sorbents.

    Science.gov (United States)

    Saha, Arindom; Abram, David N; Kuhl, Kendra P; Paradis, Jennifer; Crawford, Jenni L; Sasmaz, Erdem; Chang, Ramsay; Jaramillo, Thomas F; Wilcox, Jennifer

    2013-12-01

    This work explores surface changes and the Hg capture performance of brominated activated carbon (AC) pellets, sulfur-treated AC pellets, and sulfur-treated AC fibers upon exposure to simulated Powder River Basin-fired flue gas. Hg breakthrough curves yielded specific Hg capture amounts by means of the breakthrough shapes and times for the three samples. The brominated AC pellets showed a sharp breakthrough after 170-180 h and a capacity of 585 μg of Hg/g, the sulfur-treated AC pellets exhibited a gradual breakthrough after 80-90 h and a capacity of 661 μg of Hg/g, and the sulfur-treated AC fibers showed no breakthrough even after 1400 h, exhibiting a capacity of >9700 μg of Hg/g. X-ray photoelectron spectroscopy was used to analyze sorbent surfaces before and after testing to show important changes in quantification and oxidation states of surface Br, N, and S after exposure to the simulated flue gas. For the brominated and sulfur-treated AC pellet samples, the amount of surface-bound Br and reduced sulfur groups decreased upon Hg capture testing, while the level of weaker Hg-binding surface S(VI) and N species (perhaps as NH4(+)) increased significantly. A high initial concentration of strong Hg-binding reduced sulfur groups on the surface of the sulfur-treated AC fiber is likely responsible for this sorbent's minimal accumulation of S(VI) species during exposure to the simulated flue gas and is linked to its superior Hg capture performance compared to that of the brominated and sulfur-treated AC pellet samples.

  14. Stem cell therapy emerging as the key player in treating type 1 diabetes mellitus.

    Science.gov (United States)

    Vanikar, Aruna V; Trivedi, Hargovind L; Thakkar, Umang G

    2016-09-01

    Type 1 diabetes mellitus (T1DM) is an autoimmune disease causing progressive destruction of pancreatic β cells, ultimately resulting in loss of insulin secretion producing hyperglycemia usually affecting children. Replacement of damaged β cells by cell therapy can treat it. Currently available strategies are insulin replacement and islet/pancreas transplantation. Unfortunately these offer rescue for variable duration due to development of autoantibodies. For pancreas/islet transplantation a deceased donor is required and various shortfalls of treatment include quantum, cumbersome technique, immune rejection and limited availability of donors. Stem cell therapy with assistance of cellular reprogramming and β-cell regeneration can open up new therapeutic modalities. The present review describes the history and current knowledge of T1DM, evolution of cell therapies and different cellular therapies to cure this condition.

  15. Clinical Observation of 82 Cases of Enuresis Treated by Ginger-partitioned Moxibustion plus Cupping Therapy

    Institute of Scientific and Technical Information of China (English)

    ZHU Wei-ping; HUANG Guo-qi

    2003-01-01

    Purpose: To observe the clinical therapeutic effect in the treatment of enuresis by ginger-partitioned moxibustion plus cupping therapy. Methods: Ginger-par -titioned moxibustion was applied on Guanyuan (CV 4)and bilateral Zusanli (ST 36) and cupping therapy was applied on Shenque (CV 8) in the treatment of 82 cases of enuresis, in comparison with 76 cases treated by Chinese herbal medicine. Results: The effective rate was 84.1% in the treatment by ginger-partitioned moxibustion plus cupping therapy and was 64.5% in the treatment by Chinese herbal medicine. Conclusion: Ginger-partitio -ned moxibustion plus cupping therapy was better than Chinese herbal medicine in the treatment of enuresis (P <0.05).

  16. Stem cell therapy emerging as the key player in treating type 1 diabetes mellitus.

    Science.gov (United States)

    Vanikar, Aruna V; Trivedi, Hargovind L; Thakkar, Umang G

    2016-09-01

    Type 1 diabetes mellitus (T1DM) is an autoimmune disease causing progressive destruction of pancreatic β cells, ultimately resulting in loss of insulin secretion producing hyperglycemia usually affecting children. Replacement of damaged β cells by cell therapy can treat it. Currently available strategies are insulin replacement and islet/pancreas transplantation. Unfortunately these offer rescue for variable duration due to development of autoantibodies. For pancreas/islet transplantation a deceased donor is required and various shortfalls of treatment include quantum, cumbersome technique, immune rejection and limited availability of donors. Stem cell therapy with assistance of cellular reprogramming and β-cell regeneration can open up new therapeutic modalities. The present review describes the history and current knowledge of T1DM, evolution of cell therapies and different cellular therapies to cure this condition. PMID:27424148

  17. Clinical results evaluation of dentinary hypersensitivity patients treated with laser therapy

    Science.gov (United States)

    Brugnera, Aldo, Jr.; Cruz, Fabio M.; Zanin, Fatima A. A.; Pecora, Jesus D.

    1999-05-01

    The purpose of this investigation was to show the percentage of cured patients treated with low level laser therapy clinically diagnosed dentinary hypersensitivity. The authors report on this investigation more than 300 human teeth treated at the Laser Center of Camilo Castelo Branco University during the years of 1995, 1996 and 1997. Pulpal vitality was verified using thermal tests, and only reversible process was treated. The teeth were dried with cotton pellets and laser beam was applied, using He-Ne (632.8 nm)laser, and ArGaAl Lasers(780 nm and 830 nm). All teeth received 4 joules/session, and were treated until 5 sessions. 79.13% of our patients were treated in 3 sessions with success; 8.58% were cure in 4 sessions; and 4.29% were successfully treated in 5 sessions, obtaining a 92% of success. The authors concluded that low level laser therapy is an effective and useful treatment to dentinary hypersensibility.

  18. Acupuncture in Treating Dry Mouth Caused By Radiation Therapy in Patients With Head and Neck Cancer | Division of Cancer Prevention

    Science.gov (United States)

    RATIONALE: Acupuncture may help relieve dry mouth caused by radiation therapy. PURPOSE: This randomized phase III trial is studying to see how well one set of acupuncture points work in comparison to a different set of acupuncture points or standard therapy in treating dry mouth caused by radiation therapy in patients with head and neck cancer. |

  19. Conceptual study of a compact accelerator-driven neutron source for radioisotope production, boron neutron capture therapy and fast neutron therapy

    CERN Document Server

    Angelone, M; Rollet, S

    2002-01-01

    The feasibility of a compact accelerator-driven device for the generation of neutron spectra suitable for isotope production by neutron capture, boron neutron capture therapy and fast neutron therapy, is analyzed by Monte Carlo simulations. The device is essentially an extension of the activator proposed by Rubbia left bracket CERN/LHC/97-04(EET) right bracket , in which fast neutrons are diffused and moderated within a properly sized lead block. It is shown that by suitable design of the lead block, as well as of additional elements of moderating and shielding materials, one can generate and exploit neutron fluxes with the spectral features required for the above applications. The linear dimensions of the diffusing-moderating device can be limited to about 1 m. A full-scale device for all the above applications would require a fast neutron source of about 10**1**4 s**-**1, which could be produced by a 1 mA, 30 MeV proton beam impinging on a Be target. The concept could be tested at the Frascati Neutron Gener...

  20. Maggot debridement therapy as primary tool to treat chronic wound of animals.

    Science.gov (United States)

    Choudhary, Vijayata; Choudhary, Mukesh; Pandey, Sunanda; Chauhan, Vandip D; Hasnani, J J

    2016-04-01

    Maggot debridement therapy (MDT) is a safe, effective, and controlled method ofhealing of chronic wounds by debridement and disinfection. In this therapy live, sterile maggots of green bottle fly, Lucilia (Phaenicia) sericata are used, as they prefernecrotic tissues over healthy for feeding. Since centuries, MDT is used in humanbeings to treat chronic wounds. Lately, MDT came out as a potent medical aid in animals. In animals, although, this therapy is still limited and clinical studies are few. However, with the increasing antibiotic resistance and chronic wound infections in veterinary medicine, maggot therapy may even become the first line of treatment for some infections. This paper will present a brief discussion of MDT and its role in veterinary medicine that may add one more treatment method to utilize in non-healing wounds of animals and overcome the use of amputation and euthanasia. The objective of this review paper is to assemble relevant literature on maggot therapy to form a theoretical foundation from which further steps toward clinical use of maggot therapy in animals for chronic wounds can be taken.

  1. Maggot debridement therapy as primary tool to treat chronic wound of animals

    Directory of Open Access Journals (Sweden)

    Vijayata Choudhary

    2016-04-01

    Full Text Available Maggot debridement therapy (MDT is a safe, effective, and controlled method of healing of chronic wounds by debridement and disinfection. In this therapy live, sterile maggots of green bottle fly, Lucilia (Phaenicia sericata are used, as they prefer necrotic tissues over healthy for feeding. Since centuries, MDT is used in human beings to treat chronic wounds. Lately, MDT came out as a potent medical aid in animals. In animals, although, this therapy is still limited and clinical studies are few. However, with the increasing antibiotic resistance and chronic wound infections in veterinary medicine, maggot therapy may even become the first line of treatment for some infections. This paper will present a brief discussion of MDT and its role in veterinary medicine that may add one more treatment method to utilize in non-healing wounds of animals and overcome the use of amputation and euthanasia. The objective of this review paper is to assemble relevant literature on maggot therapy to form a theoretical foundation from which further steps toward clinical use of maggot therapy in animals for chronic wounds can be taken.

  2. The Role of Hypofractionated Radiation Therapy with Photons, Protons and Heavy Ions for Treating Extracranial Lesions

    Directory of Open Access Journals (Sweden)

    Aaron Michael Laine

    2016-01-01

    Full Text Available Traditionally, the ability to deliver large doses of ionizing radiation to a tumor has been limited by radiation induced toxicity to normal surrounding tissues. This was the initial impetus for the development of conventionally fractionated radiation therapy, where large volumes of healthy tissue received radiation and were allowed the time to repair the radiation damage. However, advances in radiation delivery techniques and image guidance have allowed for more ablative doses of radiation to be delivered in a very accurate, conformal and safe manner with shortened fractionation schemes. Hypofractionated regimens with photons have already transformed how certain tumor types are treated with radiation therapy. Additionally, hypofractionation is able to deliver a complete course of ablative radiation therapy over a shorter period of time compared to conventional fractionation regimens making treatment more convenient to the patient and potentially more cost-effective. Recently there has been an increased interest in proton therapy because of the potential further improvement in dose distributions achievable due to their unique physical characteristics. Furthermore, with heavier ions the dose conformality is increased and in addition there is potentially a higher biological effectiveness compared to protons and photons. Due to the properties mentioned above, charged particle therapy has already become an attractive modality to further investigate the role of hypofractionation in the treatment of various tumors. This review will discuss the rationale and evolution of hypofractionated radiation therapy, the reported clinical success with initially photon and then charged particle modalities, and further potential implementation into treatment regimens going forward.

  3. Radiation bronchitis in lung cancer patient treated with stereotactic radiation therapy

    International Nuclear Information System (INIS)

    We report a case of chronic radiation bronchitis that developed in a patient with lung cancer treated with fractionated stereotactic radiation therapy. A 73-year-old woman with a medically inoperable T1N0M0 adenocarcinoma of the lung was treated with stereotactic radiation therapy. By using eight non-coplanar ports, 50 Gy/5 fractions was delivered in two weeks. At four weeks, a partial response was obtained with no acute adverse reaction. She developed severe cough at six months. Fiberoptic bronchoscopy revealed thick circumferentially coated bronchial mucosa in close proximity to the tumor site. At 12 months, follow-up study confirmed marked stenotic change in the B6 segmental bronchus without tumor progression. (author)

  4. Baseline characteristics in the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT)

    DEFF Research Database (Denmark)

    Pfeffer, Marc A; Burdmann, Emmanuel A; Chen, Chao-Yin;

    2009-01-01

    : the composite end point of death or cardiovascular morbidity (nonfatal myocardial infarction, congestive heart failure, stroke, or hospitalization for myocardial ischemia). The composite end point of death or need for long-term renal replacement therapy also is a primary end point. CONCLUSIONS: With several......BACKGROUND: Anemia augments the already high rates of fatal and major nonfatal cardiovascular and renal events in individuals with type 2 diabetes. In 2004, we initiated the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT). This report presents the baseline characteristics......-fold more patient-years and a placebo arm, TREAT will provide a robust estimate of the safety and efficacy of darbepoetin alfa and generate prospective data regarding the risks of major cardiovascular and renal events in a contemporarily managed cohort of patients with type 2 diabetes, CKD, and anemia....

  5. Combination of internal radiation therapy and hyperthermia to treat liver cancer

    Energy Technology Data Exchange (ETDEWEB)

    Grady, E.D.; McLaren, J.; Auda, S.P.; McGinley, P.H.

    1983-09-01

    Sixteen patients were treated for liver cancer (primary and metastatic) by a combination of internal radiation therapy with intra-arterial yttrium 90 microspheres and regional hyperthermia with electromagnetic radiation. Four patients have their liver disease apparently controlled; two had a partial regression of more than 50%; and two had a partial regression of less than 50%. The complications consisted of one case of radiation hepatitis and one of peptic ulcer.

  6. A case of metastatic bladder cancer in both lungs treated with korean medicine therapy alone.

    Science.gov (United States)

    Lee, Dong-Hyun; Kim, Sung-Su; Seong, Shin; Woo, Chang-Ryoul; Han, Jae-Bok

    2014-05-01

    This case report is aimed to investigate the effects of Korean medicine therapy (KMT) including oral herbal medicine and herb nebulizer therapy in treating metastatic bladder cancer in the lungs. A 74-year-old man was diagnosed with metastatic bladder cancer in both lungs in August 2013. He refused any chemotherapy and was admitted to our hospital in a much progressed state on January 11, 2014. Since then, he was treated with KMT until May 17, 2014. The main oral herbal medicines were Hyunamdan made of heat-processed ginseng, Hangamdan S made of Cordyceps militaris, Panax ginseng radix, Commiphora myrrha, calculus bovis, margarita, Boswellia carteri, Panax notoginseng radix and Cremastra appendiculata tuber, and nebulizer therapy with Soram nebulizer solution made of wild ginseng and Cordyceps sinensis distillate. Their effect was evaluated considering the change of the main symptoms and using serial chest X-ray. The size and number of multiple metastatic nodules in both lungs were markedly decreased and the symptoms had disappeared. These results suggest that KMT can be an effective method to treat metastatic bladder cancer in the lungs.

  7. A Case of Metastatic Bladder Cancer in Both Lungs Treated with Korean Medicine Therapy Alone

    Directory of Open Access Journals (Sweden)

    Dong-Hyun Lee

    2014-07-01

    Full Text Available This case report is aimed to investigate the effects of Korean medicine therapy (KMT including oral herbal medicine and herb nebulizer therapy in treating metastatic bladder cancer in the lungs. A 74-year-old man was diagnosed with metastatic bladder cancer in both lungs in August 2013. He refused any chemotherapy and was admitted to our hospital in a much progressed state on January 11, 2014. Since then, he was treated with KMT until May 17, 2014. The main oral herbal medicines were Hyunamdan made of heat-processed ginseng, Hangamdan S made of Cordyceps militaris, Panax ginseng radix, Commiphora myrrha, calculus bovis, margarita, Boswellia carteri, Panax notoginseng radix and Cremastra appendiculata tuber, and nebulizer therapy with Soram nebulizer solution made of wild ginseng and Cordyceps sinensis distillate. Their effect was evaluated considering the change of the main symptoms and using serial chest X-ray. The size and number of multiple metastatic nodules in both lungs were markedly decreased and the symptoms had disappeared. These results suggest that KMT can be an effective method to treat metastatic bladder cancer in the lungs.

  8. Brainstem Infarction and Panuveitis due to Sarcoidosis Successfully Treated with Steroid Pulse Therapy

    Directory of Open Access Journals (Sweden)

    Natsuyo Yoshida-Hata

    2012-01-01

    Full Text Available A 36-year-old man visited our hospital because of blurred vision and redness of the conjunctiva. Slit-lamp examination showed panuveitis. Two days later, he suddenly experienced dizziness, speech disturbance, paralysis of his right extremities, and gait disturbances. Neurological examinations suggested that his symptoms were caused by a left lateral medullary lesion. He also had erythema mainly on his trunk. Magnetic resonance imaging (MRI of his brain demonstrated a small infarct on the left side of the medulla oblongata. Clinical presentation and MRI findings were consistent with the diagnosis of a Wallenberg’s syndrome. He also had bilateral hilar lymphadenopathy. A skin biopsy showed granulomatous nodular dermatitis compatible with sarcoidosis. He was treated with steroid pulse therapy and his neurological and ocular symptoms immediately improved. Only seven similar cases of intracranical sarcoidosis have been reported, but none had been treated with steroid pulse therapy. We recommend that steroid pulse therapy be considered to treat patients with sarcoidosis with signs of lesions in the central nervous system.

  9. GPU-based prompt gamma ray imaging from boron neutron capture therapy

    International Nuclear Information System (INIS)

    This reaction can be applied to the therapy and diagnosis about the tumor simultaneously. After the compound labeled with the boron is accumulated at the tumor site, the alpha particle induced by the reaction between the thermal neutron and the boron induces tumor cell death. Also, the 478 keV prompt gamma ray is emitted from the same reaction point. If this single prompt photon is detected by single photon emission computed tomography (SPECT), the tomographic image of the therapy region can be monitored during the radiation treatment. However, in order to confirm the therapy region using the image during the treatment, the image needs to be provided promptly. Due to a relatively long acquisition time required to get SPECT images, both reduced number of projections and the fast image reconstruction schemes are needed to provide the images during radiation treatment. The computation time for image reconstruction using the GPU with the modified OSEM algorithm was measured and compared with the computation time using CPU. Through the results, we confirmed the feasibility of the image reconstruction for prompt gamma ray image using GPU for the BNCT. In the further study, the development of the algorithm for faster reconstruction of the prompt gamma ray image during the BNCT using the GPU computation will be conducted. Also, the analysis of the target to background level about the reconstructed image will be performed using the extracted image profile

  10. GPU-based prompt gamma ray imaging from boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Do-Kun; Jung, Joo-Young; Suh, Tae Suk [College of Medicine, Catholic University of Korea, Seoul (Korea, Republic of)

    2015-05-15

    This reaction can be applied to the therapy and diagnosis about the tumor simultaneously. After the compound labeled with the boron is accumulated at the tumor site, the alpha particle induced by the reaction between the thermal neutron and the boron induces tumor cell death. Also, the 478 keV prompt gamma ray is emitted from the same reaction point. If this single prompt photon is detected by single photon emission computed tomography (SPECT), the tomographic image of the therapy region can be monitored during the radiation treatment. However, in order to confirm the therapy region using the image during the treatment, the image needs to be provided promptly. Due to a relatively long acquisition time required to get SPECT images, both reduced number of projections and the fast image reconstruction schemes are needed to provide the images during radiation treatment. The computation time for image reconstruction using the GPU with the modified OSEM algorithm was measured and compared with the computation time using CPU. Through the results, we confirmed the feasibility of the image reconstruction for prompt gamma ray image using GPU for the BNCT. In the further study, the development of the algorithm for faster reconstruction of the prompt gamma ray image during the BNCT using the GPU computation will be conducted. Also, the analysis of the target to background level about the reconstructed image will be performed using the extracted image profile.

  11. Successful therapy with tonsillectomy plus pulse therapy for the relapse of pediatric IgA nephropathy treated with multi-drugs combination therapy.

    Science.gov (United States)

    Sakai, Nobuko; Kawasaki, Yukihiko; Waragai, Tomoko; Oikawa, Tomoko; Kaneko, Masatoshi; Sato, Tomoko; Suyama, Kazuhide; Hosoya, Mitsuaki

    2016-06-01

    Immunoglobulin A nephropathy (IgAN) is the most common form of chronic glomerulonephritis worldwide. In Japan, the treatment for use as an initial therapy was established in Guidelines for the Treatment of Childhood IgA nephropathy; however, no rescue therapy for recurrent or steroid-resistant pediatric IgAN was established. We report here a 15-year-old boy with severe IgAN, who was treated with combination therapy involving prednisolone, mizoribine, warfarin, and dilazep dihydrochloride for 2 years. The response to the combination therapy was good and both proteinuria and hematuria disappeared. The pathological findings at the second renal biopsy were improved and PSL was discontinued. However, due to nonadherence to the treatment regimen and tonsillitis, macrohematuria and an increase of proteinuria were again observed and the pathological findings at the third renal biopsy showed clear deterioration. The patient was, therefore, diagnosed with recurrent IgAN. Tonsillectomy plus methylprednisolone pulse therapy (TMP) was performed as a rescue therapy for the recurrence of severe IgAN. Both the proteinuria or hematuria subsequently disappeared, and no proteinuria or hematuria has been observed and kidney function has remained normal during a 5-year follow-up. The patient experienced no severe side effects associated with the drug regimens. In conclusion, our case suggests that TMP may be an effective and useful rescue therapy for recurrent IgAN after multi-drug combination therapy. PMID:27210310

  12. Recurrent rectal carcinoma treated with high dose rate intraluminal Brach therapy

    International Nuclear Information System (INIS)

    A 65 years old man with recurrent rectal cancer was treated with remote after loading High Dose Rate Intraluminal Brach therapy (HDRILB). After eight weeks of HDRILB there was complete regression of the tumor. Bleeding per rectum and pain in the perineum were greatly improved. He died of myocardial infarction after 41 months of treatment with HDRILB. The treated lesions were incomplete remission at the time of death. The procedure was well tolerated. The only treatment associated toxicity was grade 2 proctitis, which was treated conservatively. HDRILB can be used as one of the treatment options in patients with recurrent rectal cancers who have undergone previous abdominal surgery and external beam irradiation, as exhibited in our limited experience.(author)

  13. Predicting Radiation Pneumonitis After Stereotactic Ablative Radiation Therapy in Patients Previously Treated With Conventional Thoracic Radiation Therapy

    International Nuclear Information System (INIS)

    Purpose: To determine the incidence of and risk factors for radiation pneumonitis (RP) after stereotactic ablative radiation therapy (SABR) to the lung in patients who had previously undergone conventional thoracic radiation therapy. Methods and Materials: Seventy-two patients who had previously received conventionally fractionated radiation therapy to the thorax were treated with SABR (50 Gy in 4 fractions) for recurrent disease or secondary parenchymal lung cancer (T 10 and mean lung dose (MLD) of the previous plan and the V10-V40 and MLD of the composite plan were also related to RP. Multivariate analysis revealed that ECOG PS scores of 2-3 before SABR (P=.009), FEV1 ≤65% before SABR (P=.012), V20 ≥30% of the composite plan (P=.021), and an initial PTV in the bilateral mediastinum (P=.025) were all associated with RP. Conclusions: We found that severe RP was relatively common, occurring in 20.8% of patients, and could be predicted by an ECOG PS score of 2-3, an FEV1 ≤65%, a previous PTV spanning the bilateral mediastinum, and V20 ≥30% on composite (previous RT+SABR) plans. Prospective studies are needed to validate these predictors and the scoring system on which they are based.

  14. Determination of boron in biological samples for the needs of neutron capture therapy

    International Nuclear Information System (INIS)

    Monitoring the actual concentration of 10B in a patient's blood is a prerequisite for determining the start and length of patient irradiation. The Prompt Gamma Ray Analysis (PGRA) method enables this nuclide to be determined rapidly and reliably within the region of 1 to 100 ppm. In this method, the characteristic line at 478 keV from the nuclear reaction 10B+n → 7Li+α+γ during sample exposure to thermal neutrons is used to determine boron. The facility which has been built up for this purpose comprises, in particular, a large-volume semiconductor detector for recording gamma rays emerging from the radiative neutron capture on the target

  15. Treating intrusions, promoting resilience: an overview of therapies for trauma-related psychological disorders

    Directory of Open Access Journals (Sweden)

    Ulrich Schnyder

    2014-12-01

    Full Text Available The efficacy of psychotherapeutic approaches in the treatment of posttraumatic stress disorder (PTSD can be regarded as empirically demonstrated. Overall, effect sizes appear to be higher for psychotherapy than for medication. Many well-controlled trials with a mixed variety of trauma survivors have demonstrated that trauma-focused cognitive-behavioral therapy (TF-CBT is effective in treating PTSD. Prolonged exposure therapy (PE is currently seen as the treatment with the strongest evidence for its efficacy. Cognitive therapy (CT and cognitive processing therapy (CPT, with their stronger emphasis on cognitive techniques, and Eye Movement Desensitization and Reprocessing (EMDR seem equally effective. More recent developments include brief eclectic psychotherapy for PTSD (BEPP and narrative exposure therapy (NET. Emerging evidence shows that TF-CBT can successfully be applied in PTSD patients suffering from severe comorbidities such as borderline personality disorder or substance abuse disorder (Schnyder & Cloitre, 2015. There is also a trend towards developing “mini-interventions,” that is, short modules tailored to approach specific problems. Moreover, evidence-based approaches should be complemented by interventions that aim at promoting human resilience to stress. Finally, given the globalization of our societies (Schnyder, 2013, culture-sensitive psychotherapists should try to understand the cultural components of a patient's illness and help-seeking behaviors, as well as their expectations with regard to treatment.

  16. Treating intrusions, promoting resilience: an overview of therapies for trauma-related psychological disorders.

    Science.gov (United States)

    Schnyder, Ulrich

    2014-01-01

    The efficacy of psychotherapeutic approaches in the treatment of posttraumatic stress disorder (PTSD) can be regarded as empirically demonstrated. Overall, effect sizes appear to be higher for psychotherapy than for medication. Many well-controlled trials with a mixed variety of trauma survivors have demonstrated that trauma-focused cognitive-behavioral therapy (TF-CBT) is effective in treating PTSD. Prolonged exposure therapy (PE) is currently seen as the treatment with the strongest evidence for its efficacy. Cognitive therapy (CT) and cognitive processing therapy (CPT), with their stronger emphasis on cognitive techniques, and Eye Movement Desensitization and Reprocessing (EMDR) seem equally effective. More recent developments include brief eclectic psychotherapy for PTSD (BEPP) and narrative exposure therapy (NET). Emerging evidence shows that TF-CBT can successfully be applied in PTSD patients suffering from severe comorbidities such as borderline personality disorder or substance abuse disorder (Schnyder & Cloitre, 2015). There is also a trend towards developing "mini-interventions," that is, short modules tailored to approach specific problems. Moreover, evidence-based approaches should be complemented by interventions that aim at promoting human resilience to stress. Finally, given the globalization of our societies (Schnyder, 2013), culture-sensitive psychotherapists should try to understand the cultural components of a patient's illness and help-seeking behaviors, as well as their expectations with regard to treatment. PMID:25511725

  17. Self-shielding effects in neutron spectra measurements for neutron capture therapy by means of activation foils.

    Science.gov (United States)

    Pytel, Krzysztof; Józefowicz, Krystyna; Pytel, Beatrycze; Koziel, Alina

    2004-01-01

    The design and optimisation of a neutron beam for neutron capture therapy (NCT) is accompanied by the neutron spectra measurements at the target position. The method of activation detectors was applied for the neutron spectra measurements. Epithermal neutron energy region imposes the resonance structure of activation cross sections resulting in strong self-shielding effects. The neutron self-shielding correction factor was calculated using a simple analytical model of a single absorption event. Such a procedure has been applied to individual cross sections from pointwise ENDF/B-VI library and new corrected activation cross sections were introduced to a spectra unfolding algorithm. The method has been verified experimentally both for isotropic and for parallel neutron beams. Two sets of diluted and non-diluted activation foils covered with cadmium were irradiated in the neutron field. The comparison of activation rates of diluted and non-diluted foils has demonstrated the correctness of the applied self-shielding model.

  18. Functionalization and cellular uptake of boron carbide nanoparticles. The first step toward T cell-guided boron neutron capture therapy.

    Science.gov (United States)

    Mortensen, M W; Björkdahl, O; Sørensen, P G; Hansen, T; Jensen, M R; Gundersen, H J G; Bjørnholm, T

    2006-01-01

    In this paper we present surface modification strategies of boron carbide nanoparticles, which allow for bioconjugation of the transacting transcriptional activator (TAT) peptide and fluorescent dyes. Coated nanoparticles can be translocated into murine EL4 thymoma cells and B16 F10 malignant melanoma cells in amounts as high as 0.3 wt. % and 1 wt. %, respectively. Neutron irradiation of a test system consisting of untreated B16 cells mixed with B16 cells loaded with boron carbide nanoparticles were found to inhibit the proliferative capacity of untreated cells, showing that cells loaded with boron-containing nanoparticles can hinder the growth of neighboring cells upon neutron irradiation. This could provide the first step toward a T cell-guided boron neutron capture therapy.

  19. IMPROVED COMPUTATIONAL CHARACTERIZATION OF THE THERMAL NEUTRON SOURCE FOR NEUTRON CAPTURE THERAPY RESEARCH AT THE UNIVERSITY OF MISSOURI

    Energy Technology Data Exchange (ETDEWEB)

    Stuart R. Slattery; David W. Nigg; John D. Brockman; M. Frederick Hawthorne

    2010-05-01

    Parameter studies, design calculations and initial neutronic performance measurements have been completed for a new thermal neutron beamline to be used for neutron capture therapy cell and small-animal radiobiology studies at the University of Missouri Research Reactor. The beamline features the use of single-crystal silicon and bismuth sections for neutron filtering and for reduction of incident gamma radiation. The computational models used for the final beam design and performance evaluation are based on coupled discrete-ordinates and Monte Carlo techniques that permit detailed modeling of the neutron transmission properties of the filtering crystals with very few approximations. This is essential for detailed dosimetric studies required for the anticipated research program.

  20. A Small-Animal Irradiation Facility for Neutron Capture Therapy Research at the RA-3 Research Reactor

    International Nuclear Information System (INIS)

    The National Atomic Energy Commission of Argentina (CNEA) has constructed a thermal neutron source for use in Boron Neutron Capture Therapy (BNCT) applications at the RA-3 research reactor facility located in Buenos Aires. The Idaho National Laboratory (INL) and CNEA have jointly conducted some initial neutronic characterization measurements for one particular configuration of this source. The RA-3 reactor (Figure 1) is an open pool type reactor, with 20% enriched uranium plate-type fuel and light water coolant. A graphite thermal column is situated on one side of the reactor as shown. A tunnel penetrating the graphite structure enables the insertion of samples while the reactor is in normal operation. Samples up to 14 cm height and 15 cm width are accommodated

  1. Experimental and Simulated Characterization of a Beam Shaping Assembly for Accelerator- Based Boron Neutron Capture Therapy (AB-BNCT)

    International Nuclear Information System (INIS)

    In the frame of the construction of a Tandem Electrostatic Quadrupole Accelerator facility devoted to the Accelerator-Based Boron Neutron Capture Therapy, a Beam Shaping Assembly has been characterized by means of Monte-Carlo simulations and measurements. The neutrons were generated via the 7Li(p, n)7Be reaction by irradiating a thick LiF target with a 2.3 MeV proton beam delivered by the TANDAR accelerator at CNEA. The emerging neutron flux was measured by means of activation foils while the beam quality and directionality was evaluated by means of Monte Carlo simulations. The parameters show compliance with those suggested by IAEA. Finally, an improvement adding a beam collimator has been evaluated.

  2. Optimal timing of neutron irradiation for boron neutron capture therapy after intravenous infusion of sodium borocaptate in patients with glioblastoma

    International Nuclear Information System (INIS)

    Purpose: A cooperative study in Europe and Japan was conducted to determine the pharmacokinetics and boron uptake of sodium borocaptate (BSH: Na2B12H11SH), which has been introduced clinically as a boron carrier for boron neutron capture therapy in patients with glioblastoma. Methods and Materials: Data from 56 patients with glioblastoma who received BSH intravenous infusion were retrospectively reviewed. The pharmacokinetics were evaluated in 50 patients, and boron uptake was investigated in 47 patients. Patients received BSH doses between 12 and 100 mg/kg of body weight. For the evaluation, the infused boron dose was scaled linearly to 100 mg/kg BSH. Results: In BSH pharmacokinetics, the average value for total body clearance, distribution volume of steady state, and mean residence time was 3.6±1.5 L/h, 223.3±160.7 L, and 68.0±52.5 h, respectively. The average values of the boron concentration in tumor adjusted to 100 mg/kg BSH, the boron concentration in blood adjusted to 100 mg/kg BSH, and the tumor/blood boron concentration ratio were 37.1±35.8 ppm, 35.2±41.8 ppm, and 1.53±1.43, respectively. A good correlation was found between the logarithmic value of Tadj and the interval from BSH infusion to tumor tissue sampling. About 12-19 h after infusion, the actual values for Tadj and tumor/blood boron concentration ratio were 46.2±36.0 ppm and 1.70±1.06, respectively. The dose ratio between tumor and healthy tissue peaked in the same interval. Conclusion: For boron neutron capture therapy using BSH administered by intravenous infusion, this work confirms that neutron irradiation is optimal around 12-19 h after the infusion is started

  3. Dosimetry and stability studies of the boron neutron capture therapy agent F-BPA-Fr using PET and MRI

    Science.gov (United States)

    Dyke, Jonathan Paul

    The treatment of deep seated brain tumors such as glioblastoma Multiforme has been unsuccessful for many patients. Surgical debulking, chemotherapy and standard radiotherapy have met with limited success. Boron neutron capture therapy offers a binary mode brachytherapy based on the following capture reaction that may provide an innovative alternative to standard forms of treatment:10B + n /to/ 11B /to 7Li + 4He + 2.31 MeVBoron is chemically attached to a tumor binding compound creating a non-toxic neutron absorber. A dose of epithermal neutrons provides the catalyst to produce the lithium and alpha particles which destroy any tissue within a length of one cell diameter from the boron compound. This dissertation uses 19F-MRI and 18F-PET to provide answers to the localization and biodistribution questions that arise in such a treatment modality. Practical patient dosimetry and actual treatment planning using the PET data is also examined. Finally, theoretical work done in the areas of compartmental modelling dealing with pharmacokinetic uptake of the PET radiotracer and dose analysis in microdosimetry is also presented.

  4. Considerations for boron neutron capture therapy studies; Consideracoes sobre o estudo da BNCT (terapia de captura neutronica por boro)

    Energy Technology Data Exchange (ETDEWEB)

    Faria Gaspar, P. de

    1994-12-31

    Radiotherapy is indispensable as a mean to eradicate deeply or infiltrating tumor tissue that can not be removed surgically. Therefore, it is not selective and may also kill the surrounding health tissue. The principle of BNCT (Boron Neutron Capture Therapy) consist in targeting a tumor selectively with a boron-10 compound. This nuclide has a large capture cross section for thermal neutrons and the nuclear reaction and the delivered energy in locus will selective the tumor. Since its initial proposal in 1963 BNCT has made much progress, however it is not used in a routine treatment. In this work it was approached some complex procedures, as the obtention of selective boron compounds, the adequate set up of neutron beams, the biodistribution, the in vivo and in vitro studies, and also human patients treatments. This work provide fundamentals about BNCT to professional of different areas of knowledge since it comprises multidisciplinary study. It includes appendixes for the ones not related to the field for a better comprehension of the many aspects involved. It is also presented a glossary containing technical and basic aspects involved. It is also presented a glossary containing technical and basic terms referred in the work. (author). 174 refs, 1 fig, 12 apps.

  5. Investigation of current status in Europe and USA on boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-11-01

    This report describes on the spot investigation results of current status of medical irradiation in Europe and USA at Feb. 1999. In HFR (Netherlands), the phase 1 study with the Joint Research Centre (JRC) of the EU had been already finished in those days, at the same time, an improvement of medical irradiation field of VTT(Finland) had been finishing and then clinical trial research had been about to start. On the other hand, phase 1 studies by two groups of BNL (Brook heaven National Laboratory) and MIT (Nuclear Engineering of Massachusetts Institute of Technology) in US were now in almost final stage, and they would start on phase 2 study. Either reactors of MIT and BNL were in modification to increase neutron flux, especially that employing fission converter into the irradiation facility and installation of irradiation room were carrying out in the former. In Europe and USA, the accelerator-based BNCT planes are now in progress vigorously, and will have reality. A reform of dynamitron accelerator at University of Birmingham was progressed, and the clinical treatment would be started from September 2000. The accelerator group at MIT has a small type of tandem accelerator, and they were performing basic experiment for BNCS (Boron Neutron Capture Synovectomy) with this accelerator. The concept design for an accelerator and a moderator had been finished at Lawrence Berkeley National Laboratory and University of Berkeley. (author)

  6. Investigation of current status in Europe and USA on boron neutron capture therapy

    International Nuclear Information System (INIS)

    This report describes on the spot investigation results of current status of medical irradiation in Europe and USA at Feb. 1999. In HFR (Netherlands), the phase 1 study with the Joint Research Centre (JRC) of the EU had been already finished in those days, at the same time, an improvement of medical irradiation field of VTT(Finland) had been finishing and then clinical trial research had been about to start. On the other hand, phase 1 studies by two groups of BNL (Brook heaven National Laboratory) and MIT (Nuclear Engineering of Massachusetts Institute of Technology) in US were now in almost final stage, and they would start on phase 2 study. Either reactors of MIT and BNL were in modification to increase neutron flux, especially that employing fission converter into the irradiation facility and installation of irradiation room were carrying out in the former. In Europe and USA, the accelerator-based BNCT planes are now in progress vigorously, and will have reality. A reform of dynamitron accelerator at University of Birmingham was progressed, and the clinical treatment would be started from September 2000. The accelerator group at MIT has a small type of tandem accelerator, and they were performing basic experiment for BNCS (Boron Neutron Capture Synovectomy) with this accelerator. The concept design for an accelerator and a moderator had been finished at Lawrence Berkeley National Laboratory and University of Berkeley. (author)

  7. ImmunoPET imaging of phosphatidylserine in pro-apoptotic therapy treated tumor models

    International Nuclear Information System (INIS)

    An immunoPET imaging probe for the detection of phosphatidylserine was developed and tested in animal models of human cancer treated with pro-apoptotic therapy. We hypothesized that the relatively long plasma half-life of a probe based on a full-length antibody coupled with a residualizing radionuclide would be able to catch the wave of drug-induced apoptosis and lead to a specific accumulation in apoptotic tumor tissue. Methods: The imaging probe is based on a 89Zr-labeled monoclonal antibody PGN635 targeting phosphatidylserine. The probe was evaluated pre-clinically in four tumor xenograft models: one studied treatment with paclitaxel to trigger the intrinsic apoptotic pathway, and three others interrogated treatment with an agonistic death-receptor monoclonal antibody to engage the extrinsic apoptotic pathway. Results: High accumulation of 89Zr-PGN635 was observed in treated tumors undergoing apoptosis reaching 30 %ID/g and tumor-to-blood ratios up to 13. The tumor uptake in control groups treated with vehicle or imaged with a non-binding antibody probe was significantly lower. Conclusions: The results demonstrate the ability of 89Zr-PGN635 to image drug-induced apoptosis in animal models and corroborate our hypothesis that radiolabeled antibodies binding to intracellular targets transiently exposed on the cell surface during apoptosis can be employed for detection of tumor response to therapy.

  8. Boron neutron capture therapy induces cell cycle arrest and cell apoptosis of glioma stem/progenitor cells in vitro

    International Nuclear Information System (INIS)

    Glioma stem cells in the quiescent state are resistant to clinical radiation therapy. An almost inevitable glioma recurrence is due to the persistence of these cells. The high linear energy transfer associated with boron neutron capture therapy (BNCT) could kill quiescent and proliferative cells. The present study aimed to evaluate the effects of BNCT on glioma stem/progenitor cells in vitro. The damage induced by BNCT was assessed using cell cycle progression, apoptotic cell ratio and apoptosis-associated proteins expression. The surviving fraction and cell viability of glioma stem/progenitor cells were decreased compared with differentiated glioma cells using the same boronophenylalanine pretreatment and the same dose of neutron flux. BNCT induced cell cycle arrest in the G2/M phase and cell apoptosis via the mitochondrial pathway, with changes in the expression of associated proteins. Glioma stem/progenitor cells, which are resistant to current clinical radiotherapy, could be effectively killed by BNCT in vitro via cell cycle arrest and apoptosis using a prolonged neutron irradiation, although radiosensitivity of glioma stem/progenitor cells was decreased compared with differentiated glioma cells when using the same dose of thermal neutron exposure and boronophenylalanine pretreatment. Thus, BNCT could offer an appreciable therapeutic advantage to prevent tumor recurrence, and may become a promising treatment in recurrent glioma

  9. From radiation-induced chromosome damage to cell death: modelling basic mechanisms and applications to boron neutron capture therapy.

    Science.gov (United States)

    Ballarini, F; Bortolussi, S; Clerici, A M; Ferrari, C; Protti, N; Altieri, S

    2011-02-01

    Cell death is a crucial endpoint in radiation-induced biological damage: on one side, cell death is a reference endpoint to characterise the action of radiation in biological targets; on the other side, any cancer therapy aims to kill tumour cells. Starting from Lea's target theory, many models have been proposed to interpret radiation-induced cell killing; after briefly discussing some of these models, in this paper, a mechanistic approach based on an experimentally observed link between chromosome aberrations and cell death was presented. More specifically, a model and a Monte Carlo code originally developed for chromosome aberrations were extended to simulate radiation-induced cell death applying an experimentally observed one-to-one relationship between the average number of 'lethal aberrations' (dicentrics, rings and deletions) per cell and -ln S, S being the fraction of surviving cells. Although such observation was related to X rays, in the present work, the approach was also applied to protons and alpha particles. A good agreement between simulation outcomes and literature data provided a model validation for different radiation types. The same approach was then successfully applied to simulate the survival of cells enriched with boron and irradiated with thermal neutrons at the Triga Mark II reactor in Pavia, to mimic a typical treatment for boron neutron capture therapy. PMID:21159746

  10. Innovative Use of Cr(VI) Plume Depictions and Pump-and-Treat Capture Analysis to Estimate Risks of Contaminant Discharge to Surface Water at Hanford Reactor Areas

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Chuck W.; Hanson, James P.; Ivarson, Kristine A.; Tonkin, M.

    2015-01-14

    The Hanford Site nuclear reactor operations required large quantities of high-quality cooling water, which was treated with chemicals including sodium dichromate dihydrate for corrosion control. Cooling water leakage, as well as intentional discharge of cooling water to ground during upset conditions, produced extensive groundwater recharge mounds consisting largely of contaminated cooling water and resulted in wide distribution of hexavalent chromium (Cr[VI]) contamination in the unconfined aquifer. The 2013 Cr(VI) groundwater plumes in the 100 Areas cover approximately 6 km2 (1500 acres), primarily in the 100-HR-3 and 100-KR-4 groundwater operable units (OUs). The Columbia River is a groundwater discharge boundary; where the plumes are adjacent to the Columbia River there remains a potential to discharge Cr(VI) to the river at concentrations above water quality criteria. The pump-and-treat systems along the River Corridor are operating with two main goals: 1) protection of the Columbia River, and 2) recovery of contaminant mass. An evaluation of the effectiveness of the pump-and-treat systems was needed to determine if the Columbia River was protected from contamination, and also to determine where additional system modifications may be needed. In response to this need, a technique for assessing the river protection was developed which takes into consideration seasonal migration of the plume and hydraulic performance of the operating well fields. Groundwater contaminant plume maps are generated across the Hanford Site on an annual basis. The assessment technique overlays the annual plume and the capture efficiency maps for the various pump and treat systems. The river protection analysis technique was prepared for use at the Hanford site and is described in detail in M.J. Tonkin, 2013. Interpolated capture frequency maps, based on mapping dynamic water level observed in observation wells and derived water levels in the vicinity of extraction and injection wells

  11. Clinical observation of treating 62 patients with severe aplastic anemia failing in immunosuppressive therapy by integrative medicine

    Institute of Scientific and Technical Information of China (English)

    苏尔云

    2013-01-01

    Objective To explore treatment methods for patients with severe aplastic anemia(SAA) failing in immunosuppressive therapy(IST). Methods Totally 62 SAA patients failing in IST were treated by integrative medicine(IM).

  12. Combined use of radioiodine therapy and radiofrequency ablation in treating postsurgical thyroid remnant of differentiated thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Bin Long

    2015-01-01

    Conclusion: Combined use of RAI therapy and radiofrequency ablation in treating excessive postsurgical thyroid remnant of DTC can be an effective approach and avoids re-operation. Long-term efficacy monitoring would further determine its feasibility.

  13. Boron determination in biological samples - Intercomparison of three analytical methods to assist development of a treatment protocol for neoplastic diseases of the liver with Boron Neutron Capture Therapy

    OpenAIRE

    Schütz, Christian L.

    2012-01-01

    Die Bor-Neuroneneinfang-Therapie (engl.: Boron Neutron Capture Therapy, BNCT) ist eine indirekte Strahlentherapie, welche durch die gezielte Freisetzung von dicht ionisierender Strahlung Tumorzellen zerstört. Die freigesetzten Ionen sind Spaltfragmente einer Kernreaktion, bei welcher das Isotop 10B ein niederenergetisches (thermisches) Neutron einfängt. Das 10B wird durch ein spezielles Borpräparat in den Tumorzellen angereichert, welches selbst nicht radioaktiv ist. rnAn der Johannes Gutenbe...

  14. Clinical Observation of Tuina Therapy in Treating 47 Cases of Vertigo

    Institute of Scientific and Technical Information of China (English)

    耿中文

    2008-01-01

    In order to observe the clinical effect of Tuina therapy for vertigo, 47 cases of the patients with vertigo were treated by massaging Triple Energizer Meridian and Gallbladder Meridian on the head, and the results showed cure in 36 cases, improvement in 11 cases and the total effective rate was 100%.%为观察推拿治疗眩晕的临床疗效,以推拿头部三焦经及胆经为主,治疗眩晕患者47例,结果痊愈36例,好转11例,总有效率100%.

  15. Electroconvulsive therapy for treating schizophrenia: a chart review of patients from two catchment areas

    DEFF Research Database (Denmark)

    Kristensen, Diana; Bauer, Jeanett; Pedersen, Ida Hageman;

    2011-01-01

    To examine disease and treatment characteristics of patients with schizophrenia treated with electroconvulsive therapy (ECT). We examined charts from 79 patients diagnosed with schizophrenia (n = 55), persistent delusional disorders (n = 7), and schizoaffective disorders (n = 17) between 2003...... and 2008. We recorded age, sex, indication for ECT, number of ECT sessions, ECT series, outcome, maintenance ECT, use of antipsychotics, duration of illness, and duration of the current exacerbation. All patients were taking antipsychotics at the time of enrolment in the study. Acute ECT included 2...

  16. Negative Pressure Wound Therapy With Low Pressure and Gauze Dressings to Treat Diabetic Foot Wounds

    OpenAIRE

    Lavery, Lawrence A.; Murdoch, Douglas P.; Kim, Paul J; Fontaine, Javier La; Thakral, Gaurav; Davis, Kathryn E.

    2014-01-01

    This study was a prospective cohort study to evaluate negative pressure wound therapy (NPWT) with low pressure and a gauze dressing to treat diabetic foot wounds. Thirty patients with diabetic foot wounds were consented to a prospective study to evaluate wound closure and complications to evaluate NPWT with low pressure (80 mmHg) and a gauze dressing interface (EZCare, Smith and Nephew) for up to 5 weeks. NPWT was changed 3 times a week. Study subjects were evaluated once a week for adverse e...

  17. Warfarin-induced skin necrosis diagnosed on clinical grounds and treated with maggot debridement therapy.

    Science.gov (United States)

    Biscoe, Anna Louise; Bedlow, Alison

    2013-01-01

    A patient with a history of deep vein thrombosis presented with painful bruising and blistering on his left leg 7-10 days after warfarin treatment. A complicated 2-month treatment followed, where vasculitis was originally diagnosed from histological findings before the final diagnosis of warfarin-induced skin necrosis (WISN) was made on clinical grounds. Warfarin was stopped, reversed and low molecular weight heparin started but, the lesions had progressed to full thickness necrosis. This was originally treated with conventional surgical debridement before introducing maggot debridement therapy (MDT) in an effort to try to salvage the limb.

  18. Imaging Changes in Pediatric Intracranial Ependymoma Patients Treated With Proton Beam Radiation Therapy Compared to Intensity Modulated Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Gunther, Jillian R. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Sato, Mariko; Chintagumpala, Murali [Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Texas Children' s Cancer Center, Houston, Texas (United States); Ketonen, Leena [Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Jones, Jeremy Y. [Department of Pediatric Radiology, Texas Children' s Hospital, Houston, Texas (United States); Allen, Pamela K. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Paulino, Arnold C. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Texas Children' s Cancer Center, Houston, Texas (United States); Okcu, M. Fatih; Su, Jack M. [Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Texas Children' s Cancer Center, Houston, Texas (United States); Weinberg, Jeffrey [Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Boehling, Nicholas S. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Khatua, Soumen [Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Adesina, Adekunle [Department of Pathology, Baylor College of Medicine, Texas Children' s Hospital, Houston, Texas (United States); Dauser, Robert; Whitehead, William E. [Department of Neurosurgery, Texas Children' s Hospital, Houston, Texas (United States); Mahajan, Anita, E-mail: amahajan@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2015-09-01

    Purpose: The clinical significance of magnetic resonance imaging (MRI) changes after radiation therapy (RT) in children with ependymoma is not well defined. We compared imaging changes following proton beam radiation therapy (PBRT) to those after photon-based intensity modulated RT (IMRT). Methods and Materials: Seventy-two patients with nonmetastatic intracranial ependymoma who received postoperative RT (37 PBRT, 35 IMRT) were analyzed retrospectively. MRI images were reviewed by 2 neuroradiologists. Results: Sixteen PBRT patients (43%) developed postradiation MRI changes at 3.8 months (median) with resolution by 6.1 months. Six IMRT patients (17%) developed changes at 5.3 months (median) with 8.3 months to resolution. Mean age at radiation was 4.4 and 6.9 years for PBRT and IMRT, respectively (P=.06). Age at diagnosis (>3 years) and time of radiation (≥3 years) was associated with fewer imaging changes on univariate analysis (odds ratio [OR]: 0.35, P=.048; OR: 0.36, P=.05). PBRT (compared to IMRT) was associated with more frequent imaging changes, both on univariate (OR: 3.68, P=.019) and multivariate (OR: 3.89, P=.024) analyses. Seven (3 IMRT, 4 PBRT) of 22 patients with changes had symptoms requiring intervention. Most patients were treated with steroids; some PBRT patients also received bevacizumab and hyperbaric oxygen therapy. None of the IMRT patients had lasting deficits, but 2 patients died from recurrent disease. Three PBRT patients had persistent neurological deficits, and 1 child died secondarily to complications from radiation necrosis. Conclusions: Postradiation MRI changes are more common with PBRT and in patients less than 3 years of age at diagnosis and treatment. It is difficult to predict causes for development of imaging changes that progress to clinical significance. These changes are usually self-limiting, but some require medical intervention, especially those involving the brainstem.

  19. Boron Neutron Capture Therapy in the Treatment of Locally Recurred Head-and-Neck Cancer: Final Analysis of a Phase I/II Trial

    Energy Technology Data Exchange (ETDEWEB)

    Kankaanranta, Leena [Department of Oncology, Helsinki University Central Hospital, Helsinki (Finland); Seppaelae, Tiina; Koivunoro, Hanna [Department of Physics, University of Helsinki, Helsinki (Finland); Boneca Corporation, Helsinki (Finland); Saarilahti, Kauko [Department of Oncology, Helsinki University Central Hospital, Helsinki (Finland); Atula, Timo [Department of Otorhinolaryngology, Helsinki University Central Hospital, Helsinki (Finland); Collan, Juhani [Department of Oncology, Helsinki University Central Hospital, Helsinki (Finland); Salli, Eero; Kortesniemi, Mika [Helsinki and Uusimaa Hospital District Medical Imaging Center, Helsinki University Central Hospital, Helsinki (Finland); Uusi-Simola, Jouni [Department of Physics, University of Helsinki, Helsinki (Finland); Helsinki and Uusimaa Hospital District Medical Imaging Center, Helsinki University Central Hospital, Helsinki (Finland); Vaelimaeki, Petteri [Department of Physics, University of Helsinki, Helsinki (Finland); Boneca Corporation, Helsinki (Finland); Maekitie, Antti [Department of Otorhinolaryngology, Helsinki University Central Hospital, Helsinki (Finland); Seppaenen, Marko [Turku PET Centre, Turku University Hospital, Turku (Finland); Minn, Heikki [Department of Oncology, Turku University Central Hospital, Turku (Finland); Revitzer, Hannu [Aalto University School of Science and Technology, Esopo (Finland); Kouri, Mauri [Department of Oncology, Helsinki University Central Hospital, Helsinki (Finland); Kotiluoto, Petri; Seren, Tom; Auterinen, Iiro [VTT Technical Research Centre of Finland, Espoo (Finland); Savolainen, Sauli [Department of Physics, University of Helsinki, Helsinki (Finland); Helsinki and Uusimaa Hospital District Medical Imaging Center, Helsinki University Central Hospital, Helsinki (Finland); Joensuu, Heikki, E-mail: heikki.joensuu@hus.fi [Department of Oncology, Helsinki University Central Hospital, Helsinki (Finland)

    2012-01-01

    Purpose: To investigate the efficacy and safety of boron neutron capture therapy (BNCT) in the treatment of inoperable head-and-neck cancers that recur locally after conventional photon radiation therapy. Methods and Materials: In this prospective, single-center Phase I/II study, 30 patients with inoperable, locally recurred head-and-neck cancer (29 carcinomas and 1 sarcoma) were treated with BNCT. Prior treatments consisted of surgery and conventionally fractionated photon irradiation to a cumulative dose of 50 to 98 Gy administered with or without concomitant chemotherapy. Tumor responses were assessed by use of the RECIST (Response Evaluation Criteria in Solid Tumors) and adverse effects by use of the National Cancer Institute common terminology criteria version 3.0. Intravenously administered L-boronophenylalanine-fructose (400 mg/kg) was administered as the boron carrier. Each patient was scheduled to be treated twice with BNCT. Results: Twenty-six patients received BNCT twice; four were treated once. Of the 29 evaluable patients, 22 (76%) responded to BNCT, 6 (21%) had tumor growth stabilization for 5.1 and 20.3 months, and 1 (3%) progressed. The median progression-free survival time was 7.5 months (95% confidence interval, 5.4-9.6 months). Two-year progression-free survival and overall survival were 20% and 30%, respectively, and 27% of the patients survived for 2 years without locoregional recurrence. The most common acute Grade 3 adverse effects were mucositis (54% of patients), oral pain (54%), and fatigue (32%). Three patients were diagnosed with osteoradionecrosis (each Grade 3) and one patient with soft-tissue necrosis (Grade 4). Late Grade 3 xerostomia was present in 3 of the 15 evaluable patients (20%). Conclusions: Most patients who have inoperable, locally advanced head-and-neck carcinoma that has recurred at a previously irradiated site respond to boronophenylalanine-mediated BNCT, but cancer recurrence after BNCT remains frequent. Toxicity was

  20. Baseline Serum Testosterone in Men Treated With Androgen Deprivation Therapy and Radiotherapy for Localized Prostate Cancer

    International Nuclear Information System (INIS)

    Introduction: It is believed that men diagnosed with prostate cancer and a low baseline serum testosterone (BST) may have more aggressive disease, and it is frequently recommended they forgo testosterone replacement therapy. We used two large Phase III trials involving androgen deprivation therapy and external beam radiation therapy to assess the significance of a BST. Methods and Materials: All patients with a BST and complete data (n = 2,478) were included in this analysis and divided into four categories: 'Very Low BST' (VLBST) ≤16.5th percentile of BST (≤248 ng/dL; n = 408); 'Low BST' (LBST) >16.5th percentile and ≤33rd percentile (>248 ng/dL but ≤314 ng/dL; n = 415); 'Average BST' (ABST) >33rd percentile and ≤67th percentile (314-437 ng/dL; n = 845); and 'High BST' (HBST) >67th percentile (>437 ng/dL; n = 810). Outcomes included overall survival, distant metastasis, biochemical failure, and cause-specific survival. All outcomes were adjusted for the following covariates: treatment arm, BST, age (<70 vs. ≥70), prostate-specific antigen (PSA; <10 vs. 10 ≤ PSA <20 vs. 20 ≤), Gleason score (2-6 vs. 7 vs. 8-10); T stage (T1-T2 vs. T3-T4), and Karnofsky Performance Status (60-90 vs. 100). Results: On multivariable analysis age, Gleason score, and PSA were independently associated with an increased risk of biochemical failure, distant metastasis and a reduced cause-specific and overall survival (p < 0.05), but BST was not. Conclusions: BST does not affect outcomes in men treated with external beam radiation therapy and androgen deprivation therapy for prostate cancer.

  1. Treating gastro-oesophageal reflux disease during pregnancy and lactation: what are the safest therapy options?

    Science.gov (United States)

    Broussard, C N; Richter, J E

    1998-10-01

    Gastro-oesophageal reflux and heartburn are reported by 45 to 85% of women during pregnancy. Typically, the heartburn of pregnancy is new onset and is precipitated by the hormonal effects of estrogen and progesterone on lower oesophageal sphincter function. In mild cases, the patient should be reassured that reflux is commonly encountered during a normal pregnancy: lifestyle and dietary modifications may be all that are required. In a pregnant woman with moderate to severe reflux symptoms, the physician must discuss with the patient the benefits versus the risks of using drug therapy. Medications used for treating gastro-oesophageal reflux are not routinely or vigorously tested in randomised, controlled trials in women who are pregnant because of ethical and medico-legal concerns. Safety data are based on animal studies, human case reports and cohort studies as offered by physicians, pharmaceutical companies and regulatory authorities. If drug therapy is required, first-line therapy should consist of nonsystemically absorbed medications, including antacids or sucralfate, which offer little, if any, risk to the fetus. Systemic therapy with histamine H2 receptor antagonists (avoiding nizatidine) or prokinetic drugs (metoclopramide, cisapride) should be reserved for patients with more severe symptoms. Proton pump inhibitors are not recommended during pregnancy except for severe intractable cases of gastrooesophageal reflux or possibly prior to anaesthesia during labour and delivery. In these rare situations, animal teratogenicity studies suggests that lansoprazole may be the best choice. Use of the least possible amount of systemic drug needed to ameliorate the patient's symptoms is clearly the best for therapy. If reflux symptoms are intractable or atypical, endoscopy can safely be performed with conscious sedation and careful monitoring the mother and fetus.

  2. Electrostatic design and beam transport for a folded tandem electrostatic quadrupole accelerator facility for accelerator-based boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Thatar Vento, V., E-mail: Vladimir.ThatarVento@gmail.com [Gerencia de Investigacion y Aplicaciones, CNEA, Av. Gral. Paz 1499 (1650), San Martin, Buenos Aires (Argentina)] [CONICET, Av. Rivadavia 1917 (1033), Ciudad Autonoma de Buenos Aires (Argentina); Bergueiro, J.; Cartelli, D. [Gerencia de Investigacion y Aplicaciones, CNEA, Av. Gral. Paz 1499 (1650), San Martin, Buenos Aires (Argentina)] [CONICET, Av. Rivadavia 1917 (1033), Ciudad Autonoma de Buenos Aires (Argentina); Valda, A.A. [Gerencia de Investigacion y Aplicaciones, CNEA, Av. Gral. Paz 1499 (1650), San Martin, Buenos Aires (Argentina)] [Escuela de Ciencia y Tecnologia, UNSAM, M. Irigoyen 3100 (1650), San Martin, Buenos Aires (Argentina); Kreiner, A.J. [Gerencia de Investigacion y Aplicaciones, CNEA, Av. Gral. Paz 1499 (1650), San Martin, Buenos Aires (Argentina)] [CONICET, Av. Rivadavia 1917 (1033), Ciudad Autonoma de Buenos Aires (Argentina)] [Escuela de Ciencia y Tecnologia, UNSAM, M. Irigoyen 3100 (1650), San Martin, Buenos Aires (Argentina)

    2011-12-15

    Within the frame of an ongoing project to develop a folded Tandem-Electrostatic-Quadrupole (TESQ) accelerator facility for Accelerator-Based Boron Neutron Capture Therapy (AB-BNCT), we discuss here the electrostatic design of the machine, including the accelerator tubes with electrostatic quadrupoles and the simulations for the transport and acceleration of a high intensity beam.

  3. Preparation and characterization of Boron carbide nanoparticles for use as a novel agent in T cell-guided boron neutron capture therapy

    DEFF Research Database (Denmark)

    Mortensen, M. W.; Sørensen, P. G.; Björkdahl, O.;

    2006-01-01

    Boron carbide nanoparticles are proposed as a system for T cell-guided boron neutron capture therapy. Nanoparticles were produced by ball milling in various atmospheres of commercially available boron carbide. The physical and chemical properties of the particles were investigated using...

  4. Demografic and clinical characteristics of the patients treated with electroconvulsive therapy

    Directory of Open Access Journals (Sweden)

    Meliha Zengin Eroğlu

    2012-09-01

    Full Text Available Objectives: The aim of this study was to determine thefrequency of electroconvulsive therapy (ECT use andthe features of patients who underwent ECT treatmentamong psychiatric inpatients with mood disorders in anuniversity hospital setting.Materials and methods: Ninety three patients (49 women,44 men who had been hospitalized with a diagnosisof mood disorder in Cukurova University Faculty ofMedicine Psychiatry Clinic between 2006 and 2007 wereincluded in the study.Results: Among the 93 patients treated at the inpatientunit; 30 (32.2% were treated with ECT. The mean ofhospitalization period of the total group was 29.81±15.52days. Patients received ECT had a significantly longerhospitalization period than others. The patients in thegroup had diagnosed as depression (54.8% , manicepisode of bipolar disorder (33.4% and depressive episodeof bipolar disorder (11.8%. The results of the studyshowed that ECT was usually chosen as a treatmentmethod for mood disorders (37.3% of bipolar depression,36.4% of major depression and 22.6 % of manic episode.Conclusions: The findings of this study may provide anevidence for the efficacy of ECT in treatment of mood disordersby documenting the frequency rates of ECT usagein a university clinic.Key words: Mood disorder, electroconvulsive therapy,depression, mania

  5. Potential of para-boronophenylalaninol as a boron carrier in boron neutron capture therapy, referring to that of its enantiomers

    International Nuclear Information System (INIS)

    We evaluated the potential of a newly developed 10B-containing alpha-amino alcohol of para-boronophenylalanine-10B (BPA), para-boronophenylalaninol (BPAol), as a boron carrier in boron neutron capture therapy. C57BL mice bearing EL4 tumors and C3H/He mice bearing SCC VII tumors received 5-bromo-2'-deoxyuridine (BrdU) continuously via implanted mini-osmotic pumps to label all proliferating (P) cells. After oral administration of L-BPA or D-BPA, or intraperitoneal injection of L-BPAol or D-BPAol, the tumors were irradiated with reactor thermal neutron beams. For the combination with mild temperature hyperthermia (MTH) and/or tirapazamine (TPZ), the tumors were heated at 40 degrees centigrade for 30 minutes right before neutron exposure, and/or TPZ was intraperitoneally injected 30 minutes before irradiation. The tumors were then excised, minced and trypsinized. The tumor cell suspensions thus obtained were incubated with cytochalasin-B (a cytokinesis blocker), and the micronucleus (MN) frequency in cells without BrdU labeling ( = quiescent (Q) cells) was determined using immunofluorescence staining for BrdU. Meanwhile, 6 hours after irradiation, tumor cell suspensions obtained in the same manner were used for determining the apoptosis frequency in Q cells. The apoptosis and MN frequency in total (P + Q) tumor cells were determined from the tumors that were not pretreated with BrdU. Without TPZ or MTH, L- and D-BPAol increased both frequencies markedly, especially for total cells. Although not significantly, L-BPA and D-BPAol increased both frequencies slightly more remarkably than D-BPA and L-BPAol, respectively. On combined treatment with both MTH and TPZ, the sensitivity difference between total and Q cells was markedly reduced. MTH increased the 10B uptake of all 10B-carriers into both tumor cells to some degree. Both L- and D-BPAol have potential as 10B-carriers in neutron capture therapy, especially when combined with both MTH and TPZ

  6. Supervised physical therapy in women treated with radiotherapy for breast cancer 1

    Science.gov (United States)

    Leal, Nara Fernanda Braz da Silva; de Oliveira, Harley Francisco; Carrara, Hélio Humberto Angotti

    2016-01-01

    ABSTRACT Objective: to evaluate the effect of physical therapy on the range of motion of the shoulders and perimetry of the upper limbs in women treated with radiotherapy for breast cancer. Methods: a total of 35 participants were randomized into two groups, with 18 in the control group (CG) and 17 in the study group (SG). Both of the groups underwent three evaluations to assess the range of motion of the shoulders and perimetry of the upper limbs, and the study group underwent supervised physical therapy for the upper limbs. Results: the CG had deficits in external rotation in evaluations 1, 2, and 3, whereas the SG had deficits in flexion, abduction, and external rotation in evaluation 1. The deficit in abduction was recovered in evaluation 2, whereas the deficits in all movements were recovered in evaluation 3. No significant differences in perimetry were observed between the groups. Conclusion: the applied supervised physical therapy was effective in recovering the deficit in abduction after radiotherapy, and the deficits in flexion and external rotation were recovered within two months after the end of radiotherapy. Registration number of the clinical trial: NCT02198118. PMID:27533265

  7. Novel personalized therapies for cystic fibrosis: treating the basic defect in all patients.

    Science.gov (United States)

    Amaral, M D

    2015-02-01

    Cystic fibrosis (CF) is the most common genetic life-shortening condition in Caucasians. Despite being a multi-organ disease, CF is classically diagnosed by symptoms of acute/chronic respiratory disease, with persistent pulmonary infections and mucus plugging of the airways and failure to thrive. These multiple symptoms originate from dysfunction of the CF transmembrane conductance regulator (CFTR) protein, a channel that mediates anion transport across epithelia. Indeed, establishment of a definite CF diagnosis requires proof of CFTR dysfunction, commonly through the so-called sweat Cl(-) test. Many drug therapies, including mucolytics and antibiotics, aim to alleviate the symptoms of CF lung disease. However, new therapies to modulate defective CFTR, the basic defect underlying CF, have started to reach the clinic, and several others are in development or in clinical trials. The novelty of these therapies is that, besides targeting the basic defect underlying CF, they are mutation specific. Indeed, even this monogenic disease is influenced by a large number of different genes and biological pathways as well as by environmental factors that are difficult to assess. Accordingly, every person with CF is unique and so functional assessment of patients' tissues ex vivo is key for diagnosing and predicting the severity of this disease. Of note, such assessment will also be crucial to assess drug responses, in order to effectively treat all CF patients. It is not because it is a monogenic disorder that personalized treatment for CF is much easier than for complex disorders. PMID:25266997

  8. Early Toxicity in Patients Treated With Postoperative Proton Therapy for Locally Advanced Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cuaron, John J. [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Chon, Brian; Tsai, Henry; Goenka, Anuj; DeBlois, David [Procure Proton Therapy Center, Somerset, New Jersey (United States); Ho, Alice; Powell, Simon [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Hug, Eugen [Procure Proton Therapy Center, Somerset, New Jersey (United States); Cahlon, Oren, E-mail: cahlono@mskcc.org [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Procure Proton Therapy Center, Somerset, New Jersey (United States)

    2015-06-01

    Purpose: To report dosimetry and early toxicity data in breast cancer patients treated with postoperative proton radiation therapy. Methods and Materials: From March 2013 to April 2014, 30 patients with nonmetastatic breast cancer and no history of prior radiation were treated with proton therapy at a single proton center. Patient characteristics and dosimetry were obtained through chart review. Patients were seen weekly while on treatment, at 1 month after radiation therapy completion, and at 3- to 6-month intervals thereafter. Toxicity was scored using Common Terminology Criteria for Adverse Events version 4.0. Frequencies of toxicities were tabulated. Results: Median dose delivered was 50.4 Gy (relative biological equivalent [RBE]) in 5 weeks. Target volumes included the breast/chest wall and regional lymph nodes including the internal mammary lymph nodes (in 93%). No patients required a treatment break. Among patients with >3 months of follow-up (n=28), grade 2 dermatitis occurred in 20 patients (71.4%), with 8 (28.6%) experiencing moist desquamation. Grade 2 esophagitis occurred in 8 patients (28.6%). Grade 3 reconstructive complications occurred in 1 patient. The median planning target volume V95 was 96.43% (range, 79.39%-99.60%). The median mean heart dose was 0.88 Gy (RBE) [range, 0.01-3.20 Gy (RBE)] for all patients, and 1.00 Gy (RBE) among patients with left-sided tumors. The median V20 of the ipsilateral lung was 16.50% (range, 6.1%-30.3%). The median contralateral lung V5 was 0.34% (range, 0%-5.30%). The median maximal point dose to the esophagus was 45.65 Gy (RBE) [range, 0-65.4 Gy (RBE)]. The median contralateral breast mean dose was 0.29 Gy (RBE) [range, 0.03-3.50 Gy (RBE)]. Conclusions: Postoperative proton therapy is well tolerated, with acceptable rates of skin toxicity. Proton therapy favorably spares normal tissue without compromising target coverage. Further follow-up is necessary to assess for clinical outcomes and cardiopulmonary

  9. [Morita Therapy to Treat Depression: When and How to Encourage Patients to Join Activities].

    Science.gov (United States)

    Nakamura, Kei

    2015-01-01

    The author discusses how Morita therapy is used to treat depression, illustrated with a clinical case, and makes comparisons between Morita therapy and behavioral activation (BA). The author further examines the issue of when and how to encourage patients to join activities in clinical practice in Japan. Both Morita therapy and BA share at least a common view that it is effective to activate patients' constructive behavior at a certain point in depression treatment. However, BA therapists, compared to Morita therapists, seem to pay less attention to the necessity of resting and the appropriate timing for introducing behavioral activation. There may be some contextual differences between depressive patients in Japan and those in North America. In the case of Japanese patients, exhaustion from overwork is often considered a factor triggering the development of depression. At the same time, the Morita-based pathogenic model of depression seems different from BA's model of the same disorder. BA's approach to understanding depression may be considered a psychological (behavioristic) model. In this model, the cause of depression lies in: (a) a lack of positive reinforcement, and (b) negative reinforcement resulting from avoidance of the experience of discomfort. Therefore, the basic strategy of BA is to release depressive patients from an avoidant lifestyle, which serves as a basis for negative reinforcement, and to redirect the patients toward activities which offer the experience of positive reinforcement BA is primarily practiced by clinical psychologists in the U. S. while psychiatrists prescribe medication as a medical service. On the other hand, the clinical practice of treating depression in Japan is based primarily on medical models of depression. This is also true of Morita therapy, but in a broad sense. While those who follow medical models in a narrow sense try to identify the cause of illness and then remove it, Morita therapists pay more attention to the

  10. [Morita Therapy to Treat Depression: When and How to Encourage Patients to Join Activities].

    Science.gov (United States)

    Nakamura, Kei

    2015-01-01

    The author discusses how Morita therapy is used to treat depression, illustrated with a clinical case, and makes comparisons between Morita therapy and behavioral activation (BA). The author further examines the issue of when and how to encourage patients to join activities in clinical practice in Japan. Both Morita therapy and BA share at least a common view that it is effective to activate patients' constructive behavior at a certain point in depression treatment. However, BA therapists, compared to Morita therapists, seem to pay less attention to the necessity of resting and the appropriate timing for introducing behavioral activation. There may be some contextual differences between depressive patients in Japan and those in North America. In the case of Japanese patients, exhaustion from overwork is often considered a factor triggering the development of depression. At the same time, the Morita-based pathogenic model of depression seems different from BA's model of the same disorder. BA's approach to understanding depression may be considered a psychological (behavioristic) model. In this model, the cause of depression lies in: (a) a lack of positive reinforcement, and (b) negative reinforcement resulting from avoidance of the experience of discomfort. Therefore, the basic strategy of BA is to release depressive patients from an avoidant lifestyle, which serves as a basis for negative reinforcement, and to redirect the patients toward activities which offer the experience of positive reinforcement BA is primarily practiced by clinical psychologists in the U. S. while psychiatrists prescribe medication as a medical service. On the other hand, the clinical practice of treating depression in Japan is based primarily on medical models of depression. This is also true of Morita therapy, but in a broad sense. While those who follow medical models in a narrow sense try to identify the cause of illness and then remove it, Morita therapists pay more attention to the

  11. Fifty Cases of Child Restless Syndrome Treated with the Integrated Method of Chinese Herbal Drugs and Auricular-Plaster Therapy

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    @@ Fifty cases of child restless syndrome were treated with oral administration of Chinese traditional herbal drugs plus auricular-plaster therapy from December 1998 to November 2001, and another 47 cases were treated with oral administration of methylphenidate as controls. The result is reported as follows.

  12. THE EFFECTS OF EXTRACORPOREAL SHOCKWAVE THERAPY (ESWT AND CRYOTHERAPY IN TREATING PATELLAR TENDINOPATHIES IN PROFESSIONAL ATHLETES

    Directory of Open Access Journals (Sweden)

    Dobreci Iulian

    2014-03-01

    Full Text Available Aim: this paper tries to optimize the existent classical treatments for patellar tendinopathies that are resistant to classical forms of therapy, in professional athletes. Hypotheses: this research wants to highlight the effectiveness of the ESWT and cryotherapy in treating patellar tendinopathies in professional athletes who previously underwent classical treatments that had no positive results. Material: the research was conducted at the Bacau Spinal Care Rehabilitation Clinic, where the systems BTL 6000 and Cryo 6 Zimmer were used. Method: the study comprised 38 male athletes, of which 12 volleyball players, 13 handball players, 5 badminton players, 5 tennis players, and 3 football players, who were subjected over the course of 3 months (previous to this experiment to steroidal and non-steroidal anti-inflammatory treatment, cortical injections and electrotherapy, without any results. The present treatment span over 3 weeks, with two sessions per week, during which ESWT and cryotherapy (-30°C were applied. The pain was assessed using the Visual Analogue Scale (VAS for Pain. Results and conclusions: at the end of the research, out of the total 38 subjects, 32 recorded very good results both during the study, and during the intermediary assessments, one month, two and three months after the treatment ended; 4 of them, at the 3 months assessment still felt a slight pain during training, while 2 of them did not respond favorably to the treatment, at the end of which they were send to the orthopedist for PRP infiltrations. After analyzing the results, one can say that the ESWT, combined with locally administered cryotherapy of -30°C, has very good results in treating the patellar tendinopathies that are resistant to other forms of therapy. Another positive aspect that can be said after this study is that the positive effects of the applied therapy have maintained also 3 months after its end.

  13. Case Report of Pes Anserine Bursitis patient treated with Bee Venom Acua-Acupuncture Therapy by Using DITI

    Directory of Open Access Journals (Sweden)

    Moon Ja-Young

    2004-02-01

    Full Text Available Objective : The purpose of this study is to report the effect of Bee Venom Acua-Acupuncture Therapy to the patient of Pes Anserine Bursitis by using DITI. Patient & Methods : The patient was 60-year-old woman who complained severe knee pain. She was treated by bee venom acuaacupuncture therapy. To estimate the efficacy of tratment, we used DITI, visual analog scale, knee joint check(ROM. Results : In this case, we treated patient of Pes Anserine Bursitis for 28 days. bee venom acua-acupuncture therapy efficiently relieved patient's pain and improved ROM. DITI and Visual analog scale also showed significantly valuable changes.

  14. Achilles tendon of wistar rats treated with laser therapy and eccentric exercise

    Directory of Open Access Journals (Sweden)

    Maria Verônica de Souza

    2015-10-01

    Full Text Available ABSTRACTIntroduction:Both laser therapy and eccentric exercises are used in tendon injuries. However, the association of these physiotherapeutic modalities is yet little investigated.Objective:To evaluate the effect of low-level laser therapy associated to eccentric exercise (downhill walking on Achilles tendinopathy of Wistar rats.Method:Eighteen Achilles tendon from 15 adult male Wistar rats were used. Tendons were distributed in six groups (laser, eccentric exercise, laser and eccentric exercise, rest, contralateral tendon, and healthy tendon. Unilateral tendinopathy was surgically induced by transversal compression followed by scarification of tendon fibers. The treatments laser therapy (904 nm, 3J/cm² and/or eccentric exercise (downhill walking; 12 m/min; 50 min/day; 15o inclination treadmill began 24 hours after surgery and remained for 20 days. Clinical and biomechanical analyzes were conducted. Achilles tendon was macroscopically evaluated and the transversal diameter measured. Euthanasia was performed 21 days after lesion induction. Tendons of both limbs were collected and frozen at -20°C until biomechanical analysis, on which the characteristic of maximum load (N, stress at ultimate (MPa and maximum extension (mm were analyzed.Results:Swelling was observed within 72 hours postoperative. No fibrous adhesions were observed nor increase in transversal diameter of tendons. Animals with the exercised tendons, but not treated with laser therapy, presented lower (p=0.0000 locomotor capacity. No difference occurred be-tween groups for the biomechanical characteristics maximum load (p=0.4379, stress at ultimate (p=0.4605 and maximum extension (p=0.3820 evaluated, even considering healthy and contralateral tendons.Conclusion:The concomitant use of low-level laser and the eccentric exercise of downhill walking, starting 24 hours after surgically induced tendinopathy, do not result in a tendon with the same biomechanical resistance or elasticity

  15. Chemoprevention gene therapy (CGT): novel combinatorial approach for preventing and treating pancreatic cancer.

    Science.gov (United States)

    Sarkar, S; Azab, B M; Das, S K; Quinn, B A; Shen, X; Dash, R; Emdad, L; Thomas, S; Dasgupta, S; Su, Z-Z; Wang, X-Y; Sarkar, D; Fisher, P B

    2013-08-01

    Pancreatic cancer remains one of the deadliest of all cancers despite aggressive surgical treatment combined with adjuvant radiotherapy and chemotherapy. Chemoresistance and radioresistance are the principal causes of failure of pancreatic cancer patients to respond to therapy. Conditionally replication competent adenovirus (CRCA)-based cancer gene therapy is an innovative strategy for treating cancers displaying inherent resistance to treatment. Limitations of current adenovirus (Ad)-based gene therapies for malignant tumors include lack of cancer-specificity, and effective and targeted delivery. To remedy this situation, CRCAs have been designed that express E1A, necessary for Ad replication, under the control of a cancer-specific progression elevated gene-3 promoter (PEG-Prom) with concomitant expression of an immunomodulatory cytokine, such as mda-7/IL-24 or interferon-γ (IFN-γ), under the control of a ubiquitous and strong cytomegalovirus promoter (CMV-Prom) from the E3 region. These bipartite CRCAs, when armed with a transgene, are called cancer terminator viruses (CTVs), i.e., Ad.PEG-E1A-CMV-mda-7 (CTV-M7) and Ad.PEG-E1A-CMV-IFN-γ (CTV-γ), because of their universal effectiveness in cancer treatment irrespective of p53/pRb/p16 or other genetic alterations in tumor cells. In addition to their selective oncolytic effects in tumor cells, the potent 'bystander antitumor' properties of MDA-7/IL-24 and IFN-γ embody the CTVs with expanded treatment properties for both primary and distant cancers. Pancreatic cancer cells display a "translational block" of mda-7/IL-24 mRNA, limiting production of MDA-7/IL-24 protein and cancer-specific apoptosis. Specific chemopreventive agents abrogate this "translational block" resulting in pancreatic cancer-specific killing. This novel chemoprevention gene therapy (CGT) strategy holds promise for both prevention and treatment of pancreatic cancers where all other strategies have proven ineffective.

  16. Observations on the Efficacy of Auricular-plaster Therapy plus Medicine in Treating Heroin Addiction

    Institute of Scientific and Technical Information of China (English)

    王泽涛; 袁宜勤; 王军; 罗杰坤

    2006-01-01

    Objective:To investigate the curative effect of auricular-plaster therapy on heroin addiction. Methods: Sixty cases of heroin addiction were treated by auricular-plaster therapy in cooperation with methadone and another 60 cases with methadone as a control. The treatment lasted 10 days. Results and conclusion: The results showed that the curative effect of auricular-plaster therapy plus methadone on heroin addiction was significantly better than that of methadone in the control group(P<0.01). The rate of drug relapse was also significantly lower in the former(P<0.01). It is considered that auricular-plaster therapy in cooperation with methadone is now an ideal therapeutic method for drug withdrawal.%目的:观察耳穴贴压治疗海洛因依赖的疗效.方法:耳穴贴压配合西药美沙酮治疗海洛因依赖60例,并与美沙酮治疗60例作对照,临床戒毒观察10 d.结果与结论:结果表明,耳穴贴压配合西药美沙酮戒毒疗效明显优于对照组美沙酮的戒毒疗效(P《0.01),其复吸率也低(P《0.01).认为耳穴贴压配合西药美沙酮戒毒是目前比较理想的戒毒治疗方法.

  17. Stability of high-speed lithium sheet jets for the neutron source in Boron Neutron Capture Therapy (BNCT)

    International Nuclear Information System (INIS)

    The stability of high-speed liquid lithium sheet jets was analytically studied for the neutron source in Boron Neutron Capture Therapy (BNCT), which makes cancers and tumors curable with cell-level selections and hence high QOL. The object of our research is to realize the thin and high-speed plane sheet jets of liquid lithium in a high-vacuum as an accelerator target. Linear analysis approach is made to the stability on thin plane sheet jets of liquid lithium in a high-vacuum, and then our analytical results were compared with the previous experimental ones. We proved that the waves of surface tension on thin lithium sheet jets in a high-vacuum are of supercritical flows and neutral stable under about 17.4 m/s in flow velocity and that the fast non-dispersive anti-symmetric waves are more significant than the very slow dispersive symmetric waves. We also formulated the equation of shrinking angle in isosceles-triangularly or isosceles-trapezoidal shrinking sheet jets corresponding to the Mach angle of supersonic gas flows. This formula states universally the physical meaning of Weber number of sheet jets on the wave of surface tension in supercritical flows. We obtained satisfactory prospects (making choice of larger flow velocity U and larger thickness of sheet a) to materialize a liquid target of accelerator in BNCT. (author)

  18. In-phantom two-dimensional thermal neutron distribution for intraoperative boron neutron capture therapy of brain tumours

    International Nuclear Information System (INIS)

    The aim of this study was to determine the in-phantom thermal neutron distribution derived from neutron beams for intraoperative boron neutron capture therapy (IOBNCT). Gold activation wires arranged in a cylindrical water phantom with (void-in-phantom) or without (standard phantom) a cylinder styrene form placed inside were irradiated by using the epithermal beam (ENB) and the mixed thermal-epithermal beam (TNB-1) at the Japan Research Reactor No 4. With ENB, we observed a flattened distribution of thermal neutron flux and a significantly enhanced thermal flux delivery at a depth compared with the results of using TNB-1. The thermal neutron distribution derived from both the ENB and TNB-1 was significantly improved in the void-in-phantom, and a double high dose area was formed lateral to the void. The flattened distribution in the circumference of the void was observed with the combination of ENB and the void-in-phantom. The measurement data suggest that the ENB may provide a clinical advantage in the form of an enhanced and flattened dose delivery to the marginal tissue of a post-operative cavity in which a residual and/or microscopically infiltrating tumour often occurs. The combination of the epithermal neutron beam and IOBNCT will improve the clinical results of BNCT for brain tumours. (author)

  19. Design and preparation of gadolinium-reservoir microcapsules for neutron-capture therapy by means of the Wurster process.

    Science.gov (United States)

    Miyamoto, M; Ichikawa, H; Fukumori, Y; Akine, Y; Tokuuye, K

    1997-12-01

    Gadolinium (Gd)-containing microcapsules designed for neutron-capture therapy (NCT) were prepared by a spouted bed coating process. Microcapsules were designed as a Gd-reservoir. They were prepared with the following properties: particle size was smaller than 50 microns, Gd-content was as high as possible, and release of Gd was suppressed as long as possible. Calcium carbonate (20-32 microns) was selected as a speed particle. As a Gd-source, gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) or a synthesized water-insoluble Gd-DTPA derivative, Gd-DTPA-distearylamide (Gd-DTPA-SA), was layered onto the seed particles. The release-suppressing layer was composed of aqueous acrylic latex of 9:9:4 poly(ethyl acrylate/methyl methacrylate/2-hydroxyethyl methacrylate). In preliminary studies, Gd-DTPA microcapsules with 41-45 microns (mass median diameter) were prepared; they released Gd with a short lag-time and 3h-prolongation. Complete release suppression was, however, difficult to achieve because of high water-solubility of Gd-DTPA. Hence, a hydrophobic derivative, Gd-DTPA-SA, was next used as a Gd source. Gd-DTPA-SA microcapsules could be prepared with a mass median diameter of 52 microns. Gd-DTPA-SA content of the microcapsules was 38% and release of Gd was suppressed to less than 0.2% over 60 d. PMID:9433776

  20. Synthesis and evaluation of thymidine kinase 1-targeting carboranyl pyrimidine nucleoside analogs for boron neutron capture therapy of cancer.

    Science.gov (United States)

    Agarwal, Hitesh K; Khalil, Ahmed; Ishita, Keisuke; Yang, Weilian; Nakkula, Robin J; Wu, Lai-Chu; Ali, Tehane; Tiwari, Rohit; Byun, Youngjoo; Barth, Rolf F; Tjarks, Werner

    2015-07-15

    A library of sixteen 2nd generation amino- and amido-substituted carboranyl pyrimidine nucleoside analogs, designed as substrates and inhibitors of thymidine kinase 1 (TK1) for potential use in boron neutron capture therapy (BNCT) of cancer, was synthesized and evaluated in enzyme kinetic-, enzyme inhibition-, metabolomic-, and biodistribution studies. One of these 2nd generation carboranyl pyrimidine nucleoside analogs (YB18A [3]), having an amino group directly attached to a meta-carborane cage tethered via ethylene spacer to the 3-position of thymidine, was approximately 3-4 times superior as a substrate and inhibitor of hTK1 than N5-2OH (2), a 1st generation carboranyl pyrimidine nucleoside analog. Both 2 and 3 appeared to be 5'-monophosphorylated in TK1(+) RG2 cells, both in vitro and in vivo. Biodistribution studies in rats bearing intracerebral RG2 glioma resulted in selective tumor uptake of 3 with an intratumoral concentration that was approximately 4 times higher than that of 2. The obtained results significantly advance the understanding of the binding interactions between TK1 and carboranyl pyrimidine nucleoside analogs and will profoundly impact future design strategies for these agents. PMID:26087030

  1. Gamma/neutron dose evaluation using Fricke gel and alanine gel dosimeters to be applied in boron neutron capture therapy

    International Nuclear Information System (INIS)

    Full text: Radiosurgery is a non-invasive surgery carried out by means of directed beams of ionizing radiation. This procedure was developed since there are many diseases for which conventional surgical treatment can not be applied, due to difficult or vital structures being damaged. Neutron radiation from nuclear reactors is used in a kind of radiosurgery called Boron Neutron Capture Therapy (BNCT) for the treatment of brain tumours which depends on the interaction of slow neutrons with 10B isotope injected in the tumour to produce alpha particles. Gel Dosimetry allows three-dimensional (3D) measurement of absorbed dose in tissueequivalent dosimeter phantoms. The measure technique is based on the transformation of ferrous ions (Fe2+) and ferric ions (Fe3+). The ferric ions concentration can be measured by spectrophotometry technique comparing the two wavelengths, 457 nm band that corresponds to ferrous ions concentration and 588 nm band that corresponds to ferric ions concentration. This work aims to study the gamma/neutron reactor dose relationship to be applied in BNCT using gel dosimeters. The Fricke Xylenol Gel (FXG) and Alanine Gel (AG) gel solutions produced at IPEN using gelatine 300 bloom were mixed with Na2B4O7 salt containing 19,9% of 10B isotope. This solutions were used to evaluate thermal and epithermal neutrons and gamma doses at an irradiation cell on BH3 of the IEA-R1 research reactor of IPEN

  2. Experimental verification of improved depth-dose distribution using hyper-thermal neutron incidence in neutron capture therapy.

    Science.gov (United States)

    Sakurai, Y; Kobayashi, T

    2001-01-01

    We have proposed the utilization of 'hyper-thermal neutrons' for neutron capture therapy (NCT) from the viewpoint of the improvement in the dose distribution in a human body. In order to verify the improved depth-dose distribution due to hyper-thermal neutron incidence, two experiments were carried out using a test-type hyper-thermal neutron generator at a thermal neutron irradiation field in Kyoto University Reactor (KUR), which is actually utilized for NCT clinical irradiation. From the free-in-air experiment for the spectrum-shift characteristics, it was confirmed that the hyper-thermal neutrons of approximately 860 K at maximum could be obtained by the generator. From the phantom experiment, the improvement effect and the controllability for the depth-dose distribution were confirmed. For example, it was found that the relative neutron depth-dose distribution was about 1 cm improved with the 860 K hyper-thermal neutron incidence, compared to the normal thermal neutron incidence.

  3. Feasibility of boron neutron capture therapy (BNCT) for malignant pleural mesothelioma from a viewpoint of dose distribution analysis

    International Nuclear Information System (INIS)

    Purpose: To investigate the feasibility of boron neutron capture therapy (BNCT) for malignant pleural mesothelioma (MPM) from a viewpoint of dose distribution analysis using Simulation Environment for Radiotherapy Applications (SERA), a currently available BNCT treatment planning system. Methods and Materials: The BNCT treatment plans were constructed for 3 patients with MPM using the SERA system, with 2 opposed anterior-posterior beams. The 1B concentrations in the tumor and normal lung in this study were assumed to be 84 and 24 ppm, respectively, and were derived from data observed in clinical trials. The maximum, mean, and minimum doses to the tumors and the normal lung were assessed for each plan. The doses delivered to 5% and 95% of the tumor volume, D05 and D95, were adopted as the representative dose for the maximum and minimum dose, respectively. Results: When the D05 to the normal ipsilateral lung was 5 Gy-Eq, the D95 and mean doses delivered to the normal lung were 2.2-3.6 and 3.5-4.2 Gy-Eq, respectively. The mean doses delivered to the tumors were 22.4-27.2 Gy-Eq. The D05 and D95 doses to the tumors were 9.6-15.0 and 31.5-39.5 Gy-Eq, respectively. Conclusions: From a viewpoint of the dose-distribution analysis, BNCT has the possibility to be a promising treatment for MPM patients who are inoperable because of age and other medical illnesses

  4. Predicting Radiation Pneumonitis After Stereotactic Ablative Radiation Therapy in Patients Previously Treated With Conventional Thoracic Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Liu Hui; Zhang Xu [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Vinogradskiy, Yevgeniy Y. [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Swisher, Stephen G. [Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Komaki, Ritsuko [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Chang, Joe Y., E-mail: jychang@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2012-11-15

    Purpose: To determine the incidence of and risk factors for radiation pneumonitis (RP) after stereotactic ablative radiation therapy (SABR) to the lung in patients who had previously undergone conventional thoracic radiation therapy. Methods and Materials: Seventy-two patients who had previously received conventionally fractionated radiation therapy to the thorax were treated with SABR (50 Gy in 4 fractions) for recurrent disease or secondary parenchymal lung cancer (T <4 cm, N0, M0, or Mx). Severe (grade {>=}3) RP and potential predictive factors were analyzed by univariate and multivariate logistic regression analyses. A scoring system was established to predict the risk of RP. Results: At a median follow-up time of 16 months after SABR (range, 4-56 months), 15 patients had severe RP (14 [18.9%] grade 3 and 1 [1.4%] grade 5) and 1 patient (1.4%) had a local recurrence. In univariate analyses, Eastern Cooperative Oncology Group performance status (ECOG PS) before SABR, forced expiratory volume in 1 second (FEV1), and previous planning target volume (PTV) location were associated with the incidence of severe RP. The V{sub 10} and mean lung dose (MLD) of the previous plan and the V{sub 10}-V{sub 40} and MLD of the composite plan were also related to RP. Multivariate analysis revealed that ECOG PS scores of 2-3 before SABR (P=.009), FEV1 {<=}65% before SABR (P=.012), V{sub 20} {>=}30% of the composite plan (P=.021), and an initial PTV in the bilateral mediastinum (P=.025) were all associated with RP. Conclusions: We found that severe RP was relatively common, occurring in 20.8% of patients, and could be predicted by an ECOG PS score of 2-3, an FEV1 {<=}65%, a previous PTV spanning the bilateral mediastinum, and V{sub 20} {>=}30% on composite (previous RT+SABR) plans. Prospective studies are needed to validate these predictors and the scoring system on which they are based.

  5. Capture and Transport of Laser Accelerated Protons by Pulsed Magnetic Fields: Advancements Toward Laser-Based Proton Therapy

    Science.gov (United States)

    Burris-Mog, Trevor J.

    The interaction of intense laser light (I > 10 18 W/cm2) with a thin target foil leads to the Target Normal Sheath Acceleration mechanism (TNSA). TNSA is responsible for the generation of high current, ultra-low emittance proton beams, which may allow for the development of a compact and cost effective proton therapy system for the treatment of cancer. Before this application can be realized, control is needed over the large divergence and the 100% kinetic energy spread that are characteristic of TNSA proton beams. The work presented here demonstrates control over the divergence and energy spread using strong magnetic fields generated by a pulse power solenoid. The solenoidal field results in a parallel proton beam with a kinetic energy spread DeltaE/E = 10%. Assuming that next generation lasers will be able to operate at 10 Hz, the 10% spread in the kinetic energy along with the 23% capture efficiency of the solenoid yield enough protons per laser pulse to, for the first time, consider applications in Radiation Oncology. Current lasers can generate proton beams with kinetic energies up to 67.5 MeV, but for therapy applications, the proton kinetic energy must reach 250 MeV. Since the maximum kinetic energy Emax of the proton scales with laser light intensity as Emax ∝ I0.5, next generation lasers may very well accelerate 250 MeV protons. As the kinetic energy of the protons is increased, the magnetic field strength of the solenoid will need to increase. The scaling of the magnetic field B with the kinetic energy of the protons follows B ∝ E1/2. Therefor, the field strength of the solenoid presented in this work will need to be increased by a factor of 2.4 in order to accommodate 250 MeV protons. This scaling factor seems reasonable, even with present technology. This work not only demonstrates control over beam divergence and energy spread, it also allows for us to now perform feasibility studies to further research what a laser-based proton therapy system

  6. Chronic depression treated successfully with novel taping therapy: a new approach to the treatment of depression

    Directory of Open Access Journals (Sweden)

    Han CH

    2016-06-01

    Full Text Available Chang Hyun Han,1,* Hwa Soo Hwang,2,* Young Joon Lee,3 Sang Nam Lee,4 Jane J Abanes,5 Bong Hyo Lee6 1Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, 2Chims-Saengvit Oriental Medicine Clinic, Seoul, 3Department of Preventive Korean Medicine, 4Department of Qigong, College of Korean Medicine, Daegu Haany University, Gyeongsangbuk-do, South Korea; 5Daniel K Inouye Graduate School of Nursing, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; 6Department of Acupuncture, Moxibustion and Acupoint, College of Korean Medicine, Daegu Haany University, Daegu, South Korea *These authors contributed equally to this work Introduction: Despite improved research in the treatment, depression remains difficult to treat. Till date, successful treatment of depression using taping therapy has not been known yet. We report cases where patients with severe depressive symptoms were successfully treated by taping therapy, a new approach.Methods: In case 1, a patient was taking several psychiatric medications for 10 years and admitted often to the psychiatric hospital with a leaning head, flexible legs, and nearly closed eyes; in case 2, a patient after a hysterectomy complained with heart palpitations, depressive- and anxiety-like behaviors, insomnia, and gastrointestinal problems; and in case 3, a patient with complaints of adverse effects from antidepressant medications had suicidal thoughts frequently. The medical tapes were placed on acupoints, trigger points, and pain points found by finger pressing examination in the chest, sides, and upper back of the patients.Results: In case 1, the patient started weeping immediately after the first treatment. He discontinued psychiatric drugs and returned to baseline functioning after 2 months. In case 2, the patient felt at ease showing decreased palpitation immediately after the first treatment, and after 1 week, she quit medications. In case 3, the patient experienced a

  7. Histomorphometric analysis of the Achilles tendon of Wistar rats treated with laser therapy and eccentric exercise

    Directory of Open Access Journals (Sweden)

    Maria V. de Souza

    2015-12-01

    Full Text Available Abstract: Low-level laser therapy is recommended for the treatment of tendinopathies despite the contradictory results related to the ideal dose of energy, wavelength and time of application. This study aimed to assess the effects of laser therapy and eccentric exercise on tendinopathy of the Achilles tendon of Wistar rats. Forty-eight adult male rats were randomly distributed into four groups (L= laser; E= eccentric exercise; LE = laser and eccentric exercise; and R= rest. Laser therapy (904nm/3J/cm2 and/or eccentric exercise (downhill walking; 15o incline treadmill; 12m/min; 50min/day was started 24h after induction of unilateral tendinopathy and remained for 20 days. At 3, 7, 14 and 21 days after lesion induction, three rats from each group were euthanized and the tendons were collected for histological and morphometric analyses. There was no difference among groups or among times for the characteristics hemorrhage (p=0.4154, fibrinous adhesion formation (p=0.0712, and organization of collagen fibers (p=0.2583 and of the connective tissue (p=0.1046. For these groups, regardless of the time, eccentric exercise led to epitenon thickening (p=0.0204, which was lower in the group treated with laser therapy. Histological analysis revealed differences (p=0.0032 in the number of inflammatory cells over time. They were more numerous in the group that only exercised. This result was confirmed by morphometric analysis, which showed a significant interaction (groups x time for this characteristic. Eccentric exercise increased (p=0.0014 the inflammatory infiltrate over time (3 and 21 days. However, association with laser therapy reduced inflammatory reaction. On the other hand, the combination of the treatments increased angiogenesis in morphometric (p=0.0000 and histological (p=0.0006 analyses compared with the other groups, while the isolated application of low-level laser reduced this characteristic over time. Animals maintained at rest presented the

  8. Localized Ocular Adnexal Mucosa-Associated Lymphoid Tissue Lymphoma Treated With Radiation Therapy: A Long-Term Outcome in 86 Patients With 104 Treated Eyes

    Energy Technology Data Exchange (ETDEWEB)

    Harada, Ken, E-mail: keharada@ncc.go.jp [Department of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan); Murakami, Naoya; Kitaguchi, Mayuka; Sekii, Shuhei; Takahashi, Kana; Yoshio, Kotaro; Inaba, Koji; Morota, Madoka; Ito, Yoshinori; Sumi, Minako [Department of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan); Suzuki, Shigenobu [Department of Ophthalmic Oncology, National Cancer Center Hospital, Tokyo (Japan); Tobinai, Kensei [Department of Hematologic Oncology, National Cancer Center Hospital, Tokyo (Japan); Uno, Takashi [Department of Radiology, Chiba University School of Medicine, Chiba (Japan); Itami, Jun [Department of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan)

    2014-03-01

    Purpose: To evaluate the natural history, behavior of progression, prognostic factors, and treatment-related adverse effects of primary ocular adnexal mucosa-associated lymphoid tissue (MALT) lymphoma (POAML). Methods and Materials: Eighty-six patients with histologically proven stage I POAML treated with radiation therapy at National Cancer Center Hospital, Tokyo between 1990 and 2010 were retrospectively reviewed. The median age was 56 years (range, 18-85 years). The median dose administered was 30 Gy (range, 30-46 Gy). Seventy-seven patients (90%) were treated by radiation therapy alone. Results: The median follow-up duration was 9 years (range, 0.9-22 years). The 5- and 10-year overall survival (OS) rates were 97.6% and 93.5%, respectively, and no patients died of lymphoma. Patients with tumor sizes ≥4 cm showed a greater risk of contralateral relapse (P=.012). Six patients with contralateral relapse were seen and treated by radiation therapy alone, and all the lesions were controlled well, with follow-up times of 3 to 12 years. There was 1 case of local relapse after radiation therapy alone, and 3 cases of relapse occurred in a distant site. Cataracts developed in 36 of the 65 eyes treated without lens shielding and in 12 of the 39 patients with lens shielding (P=.037). Conclusions: The majority of patients with POAML showed behavior consistent with that of localized, indolent diseases. Thirty gray of local irradiation seems to be quite effective. The initial bilateral involvement and contralateral orbital relapses can be also controlled with radiation therapy alone. Lens shielding reduces the risk of cataract.

  9. How I treat patients with inherited bleeding disorders who need anticoagulant therapy.

    Science.gov (United States)

    Martin, Karlyn; Key, Nigel S

    2016-07-14

    Situations that ordinarily necessitate consideration of anticoagulation, such as arterial and venous thrombotic events and prevention of stroke in atrial fibrillation, become challenging in patients with inherited bleeding disorders such as hemophilia A, hemophilia B, and von Willebrand disease. There are no evidence-based guidelines to direct therapy in these patients, and management strategies that incorporate anticoagulation must weigh a treatment that carries a risk of hemorrhage in a patient who is already at heightened risk against the potential consequences of not treating the thrombotic event. In this paper, we review atherothrombotic disease, venous thrombotic disease, and atrial fibrillation in patients with inherited bleeding disorders, and discuss strategies for using anticoagulants in this population using cases to illustrate these considerations. PMID:27106121

  10. The effectiveness of acceptance and commitment therapy in treating a case of obsessive compulsive disorder.

    Directory of Open Access Journals (Sweden)

    Yaghoob Vakili

    2014-06-01

    Full Text Available The aim of this study was to evaluate the effectiveness of acceptance and commitment therapy (ACT in treating obsessive compulsive disorder (OCD.In a single-subject experiment trial, the treatment process was carried out on a 39-year old male subject. The patient satisfied the DSM-IV-TR criteria for OCD and was assessed for pre-duration and post treatment. The scales used in this study included: The Yale-Brown Obsessive Compulsive Scale(Y-BOCS, Beck Depression Inventory-II-second edition (BDI-II, and Beck Anxiety Inventory (BAI. In addition, all scales were again completed by the subject at 1-month, 3-months, and 6-months follow-ups.The treatment led to reductions in symptoms of OCD, depression and anxiety. Gains were maintained at follow-ups.The treatment approach appears to be effective in the treatment of OCD.

  11. Clinical study on acute craniocerebral injury treated with mild hypothermia auxiliary therapy

    Institute of Scientific and Technical Information of China (English)

    Cheng Zhang; Jian-Ming Li; De-Zhang Dou; Jun-Lin Hu

    2016-01-01

    Objective: To study the changes of the rest energy expenditure, intracranial pressure, brain function parameters and serum indexes of acute craniocerebral injury after treated with mild hypothermia auxiliary therapy. Methods: Clinical data of 58 patients received emergency treatment for craniocerebral injury in our hospital from October 2009 to December 2014 were analyzed retrospec-tively. Among them, 27 cases treated with mild hypothermia therapy were included in the experiment group, while 31 cases without the therapy were considered as the control group. Their rest energy expenditure, intracranial pressure, brain function parameters and serum TNF-a, nitric oxide and myelin basic protein contents were determined. Results: The intracranial pressure [(20.3 ± 2.9) vs. (25.8 ± 3.3) mmHg], [(17.8 ± 2.7) vs. (23.1 ± 3.6) mmHg], [(14.2 ± 2.4) vs. (20.6 ± 3.1) mmHg], [(11.3 ± 1.8) vs. (16.3 ± 2.6) mmHg] and rest energy expenditure [(6 861 ± 994) vs. (14 074 ± 2 016) kJ/d], [(5 946 ± 768) vs. (15 525 ± 1 936) kJ/d], [(5 512 ± 873) vs. (5 512 ± 873) kJ/d], [(6 248 ± 906) vs. (14 413 ± 2 166) kJ/d] in patients of experiment group on the 1st, 2nd, 3rd and 4th days after treatment were all significantly lower than those of patients in the control group. After treated for 24 h, PbtO2 [(23.59 ± 4.97) vs. (15.68 ± 3.14) mmHg] and SjvO2 [(61.39 ± 9.79) vs. (46.76 ± 7.28) %] of the experiment group were distinctly higher than those of the control group, while its contents of TNF-a [(1.96 ± 0.29) vs. (3.39 ± 0.72)μg/L] and nitric oxide [(10.39 ± 2.16) vs. (24.42 ± 3.51) mg/L] and myelin basic protein [(2.19 ± 0.52) vs. (4.34 ± 0.78) μg/L] were all lower than those of the control group. Conclusions: After treated with mild hypothermia auxiliary therapy, the metabolic rate and intracranial pressure of patients with craniocerebral injury decreased obviously, their cerebral blood flow perfusion were improved evidently and the release of adverse metabolic

  12. Zoon's balanitis successfully treated with photodynamic therapy: Case report and literature review.

    Science.gov (United States)

    Borgia, Francesco; Vaccaro, Mario; Foti, Antonio; Giuffrida, Roberta; Cannavò, Serafinella P

    2016-03-01

    Zoon's balanitis (ZB) is an idiopathic chronic condition usually presenting as a solitary erythematous plaque on the glans of primarily uncircumcised, middle-aged to older men. The different treatment options for this condition often achieve partial results, with frequent recurrence after treatment withdrawal. Recently, photodynamic therapy (PDT) has been proposed as therapeutic option with discordant results. We treated a thirty-five year-old man affected by Zoon's balanitis, resistant to conventional treatments, with 3 sessions of topical ALA-PDT at two weeks intervals. At the end of the treatment period notable improvement of clinical features was observed, with almost complete clearance at 3 months' follow-up, high safety profile and absence of durable side-effects. PMID:26321748

  13. Treating bulimia with hypnosis and low-level light therapy: a case report

    Science.gov (United States)

    Laser, Eleanor; Sassack, Michael

    2012-03-01

    This case report describes an effort to control bulimia nervosa by combining low-level laser therapy (LLLT)-the application of red and near-infrared light to specific body points-and hypnosis. A 29-year old female with a 14-year history of bulimia received one session of LLLT combined with hypnosis. Two weeks later, following a measurable decrease in bulimic episodes (purging), a session of psychotherapy and hypnosis was administered. Six months post-treatment, the patient has experienced a complete cessation of purging activities without recurrence. LLLT, when used in conjunction with hypnosis and psychotherapy, was effective in managing bulimia and may prove useful in treating other eating disorders.

  14. Work-related thumb disorders in South African physiotherapists treating musculoskeletal conditions using manual therapy techniques

    Directory of Open Access Journals (Sweden)

    Heather Jenkins

    2015-04-01

    Full Text Available Research question: What is the prevalence of and factors associated with work-related thumb problems (WRTP in South African physiotherapists treating musculoskeletal conditions using manual therapy techniques?Design: A cross-sectional, descriptive study design was used and data were collected using two Internet-based questionnaires.Participants: The sample size calculated for the study was 284 using 95% confidence levels and a 5% margin of error. There were 395 participants that were included in the study. Outcome measures: The variables measured included demographic, employment, educational and occupational factors.Results: The lifetime prevalence of WRTP in the physiotherapists was 65.3%. The manual techniques that were significantly associated with WRTP in the respondents who reported thumb problems were all grades of transverse glides applied to the spine as well as grade II–IV unilateral and central posterior-anterior pressures to the spine. The factors that remained significantly associated with WRTP in all 395 respondents after regression analysis were the cervical treatment of up to six patients a day and hyperextension > 30° of the non-dominant interphalangeal (IP joint of the thumb.Conclusion: This study confirms that a high percentage of physiotherapists using manual therapy techniques to treat musculoskeletal conditions are experiencing WRTP.Recommendations: The development of a valid and reliable WRTP screening tool is needed to aid in the identification of physiotherapists at risk and thus in the primary prevention of WRTP. A longitudinal study which follows newly qualified physiotherapists is recommended to investigate a possible cause-effect relationship and preventative strategies for WRTP in physiotherapists.

  15. Current status of boron neutron capture therapy of high grade gliomas and recurrent head and neck cancer.

    Science.gov (United States)

    Barth, Rolf F; Vicente, M Graca H; Harling, Otto K; Kiger, W S; Riley, Kent J; Binns, Peter J; Wagner, Franz M; Suzuki, Minoru; Aihara, Teruhito; Kato, Itsuro; Kawabata, Shinji

    2012-08-29

    Boron neutron capture therapy (BNCT) is a biochemically targeted radiotherapy based on the nuclear capture and fission reactions that occur when non-radioactive boron-10, which is a constituent of natural elemental boron, is irradiated with low energy thermal neutrons to yield high linear energy transfer alpha particles and recoiling lithium-7 nuclei. Clinical interest in BNCT has focused primarily on the treatment of high grade gliomas, recurrent cancers of the head and neck region and either primary or metastatic melanoma. Neutron sources for BNCT currently have been limited to specially modified nuclear reactors, which are or until the recent Japanese natural disaster, were available in Japan, United States, Finland and several other European countries, Argentina and Taiwan. Accelerators producing epithermal neutron beams also could be used for BNCT and these are being developed in several countries. It is anticipated that the first Japanese accelerator will be available for therapeutic use in 2013. The major hurdle for the design and synthesis of boron delivery agents has been the requirement for selective tumor targeting to achieve boron concentrations in the range of 20 μg/g. This would be sufficient to deliver therapeutic doses of radiation with minimal normal tissue toxicity. Two boron drugs have been used clinically, a dihydroxyboryl derivative of phenylalanine, referred to as boronophenylalanine or "BPA", and sodium borocaptate or "BSH" (Na2B12H11SH). In this report we will provide an overview of other boron delivery agents that currently are under evaluation, neutron sources in use or under development for BNCT, clinical dosimetry, treatment planning, and finally a summary of previous and on-going clinical studies for high grade gliomas and recurrent tumors of the head and neck region. Promising results have been obtained with both groups of patients but these outcomes must be more rigorously evaluated in larger, possibly randomized clinical trials

  16. Current status of boron neutron capture therapy of high grade gliomas and recurrent head and neck cancer

    Directory of Open Access Journals (Sweden)

    Barth Rolf F

    2012-08-01

    Full Text Available Abstract Boron neutron capture therapy (BNCT is a biochemically targeted radiotherapy based on the nuclear capture and fission reactions that occur when non-radioactive boron-10, which is a constituent of natural elemental boron, is irradiated with low energy thermal neutrons to yield high linear energy transfer alpha particles and recoiling lithium-7 nuclei. Clinical interest in BNCT has focused primarily on the treatment of high grade gliomas, recurrent cancers of the head and neck region and either primary or metastatic melanoma. Neutron sources for BNCT currently have been limited to specially modified nuclear reactors, which are or until the recent Japanese natural disaster, were available in Japan, United States, Finland and several other European countries, Argentina and Taiwan. Accelerators producing epithermal neutron beams also could be used for BNCT and these are being developed in several countries. It is anticipated that the first Japanese accelerator will be available for therapeutic use in 2013. The major hurdle for the design and synthesis of boron delivery agents has been the requirement for selective tumor targeting to achieve boron concentrations in the range of 20 μg/g. This would be sufficient to deliver therapeutic doses of radiation with minimal normal tissue toxicity. Two boron drugs have been used clinically, a dihydroxyboryl derivative of phenylalanine, referred to as boronophenylalanine or “BPA”, and sodium borocaptate or “BSH” (Na2B12H11SH. In this report we will provide an overview of other boron delivery agents that currently are under evaluation, neutron sources in use or under development for BNCT, clinical dosimetry, treatment planning, and finally a summary of previous and on-going clinical studies for high grade gliomas and recurrent tumors of the head and neck region. Promising results have been obtained with both groups of patients but these outcomes must be more rigorously evaluated in larger

  17. Current status of boron neutron capture therapy of high grade gliomas and recurrent head and neck cancer

    International Nuclear Information System (INIS)

    Boron neutron capture therapy (BNCT) is a biochemically targeted radiotherapy based on the nuclear capture and fission reactions that occur when non-radioactive boron-10, which is a constituent of natural elemental boron, is irradiated with low energy thermal neutrons to yield high linear energy transfer alpha particles and recoiling lithium-7 nuclei. Clinical interest in BNCT has focused primarily on the treatment of high grade gliomas, recurrent cancers of the head and neck region and either primary or metastatic melanoma. Neutron sources for BNCT currently have been limited to specially modified nuclear reactors, which are or until the recent Japanese natural disaster, were available in Japan, the United States, Finland and several other European countries, Argentina and Taiwan. Accelerators producing epithermal neutron beams also could be used for BNCT and these are being developed in several countries. It is anticipated that the first Japanese accelerator will be available for therapeutic use in 2013. The major hurdle for the design and synthesis of boron delivery agents has been the requirement for selective tumor targeting to achieve boron concentrations in the range of 20 μg/g. This would be sufficient to deliver therapeutic doses of radiation with minimal normal tissue toxicity. Two boron drugs have been used clinically, a dihydroxyboryl derivative of phenylalanine, referred to as boronophenylalanine or “BPA”, and sodium borocaptate or “BSH” (Na2B12H11SH). In this report we will provide an overview of other boron delivery agents that currently are under evaluation, neutron sources in use or under development for BNCT, clinical dosimetry, treatment planning, and finally a summary of previous and on-going clinical studies for high grade gliomas and recurrent tumors of the head and neck region. Promising results have been obtained with both groups of patients but these outcomes must be more rigorously evaluated in larger, possibly randomized clinical

  18. Klatskin tumor treated by inter-disciplinary therapies including stereotactic radiotherapy: A case report

    Institute of Scientific and Technical Information of China (English)

    Gerhild Becker; Hubert E. Blum; Felix Momm; Henning Schwacha; Norbert Hodapp; Henning Usadel; Michael Geiβler; Annette Barke; Annette Schmitt-Gr(a)ff; Karl Henne

    2005-01-01

    In view of the poor prognosis of patients with cholangiocarcinoma (CCC), there is a need for new therapeutic strategies. Inter-disciplinary therapy seems to be most promising. Radiotherapy is an effective alternative to surgery for hilar CCC (Klatskin tumors) if an adequate radiation dose can be delivered to the liver hilus. Here,we describe a patient for whom we used a stereotactic radiotherapy technique in the context of an inter-disciplinary treatment concept. We report a 45-year-old patient with a locally advanced Klatskin tumor. Explorative laparotomy showed that the tumor was not resectable. A metallic stent was implanted and the patient was treated by stereotactic radiotherapy using a body frame. A total dose of 48 Gy (3x4 Gy/wk) was administered. Therapy was well tolerated. After 32 mo, local tumor recurrence and a chest wall metastasis developed and were controlled by radio-chemotherapy. After more than 56 mo with a good quality of life, the patient died of advanced neoplastic disease. Stereotactic radiotherapy led to a long-term survival of this patient with a locally advanced Klatskin tumor. In the context of inter-disciplinary treatment concepts, this radiotherapy technique is a promising choice of treatment for patients with hilar CCC.

  19. Treatment outcome of ductal carcinoma in situ patients treated with postoperative radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Yu Jin; Kim, Kyu Bo; Choi, Eui Kyu; Han, Won Shik; Noh, Dong Young; Ha, Sung W. [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2013-12-15

    To evaluate the outcome of ductal carcinoma in situ (DCIS) patients who underwent surgery followed by radiation therapy (RT). We retrospectively reviewed 106 DCIS patients who underwent surgery followed by postoperative RT between 1994 and 2006. Ninety-four patients underwent breast-conserving surgery, and mastectomy was performed in 12 patients due to extensive DCIS. Postoperative RT was delivered to whole breast with 50.4 Gy/28 fx. Tumor bed boost was offered to 7 patients (6.6%). Patients with hormonal receptor-positive tumors were treated with hormonal therapy. The median follow-up duration was 83.4 months (range, 33.4 to 191.5 months) and the median age was 47.8 years. Ten patients (9.4%) had resection margin <1 mm and high-grade and estrogen receptor-negative tumors were observed in 39 (36.8%) and 20 (18.9%) patients, respectively. The 7-year ipsilateral breast tumor recurrence (IBTR)-free survival rate was 95.3%. Resection margin (<1 or ≥1 mm) was the significant prognostic factor for IBTR in univariate and multivariate analyses (p < 0.001 and p = 0.016, respectively). Postoperative RT for DCIS can achieve favorable treatment outcome. Resection margin was the important prognostic factor for IBTR in the DCIS patients who underwent postoperative RT.

  20. Cerebral Embolism Associated with Left Atrial Myxoma That Was Treated with Thrombolytic Therapy

    Directory of Open Access Journals (Sweden)

    Naoto Kohno

    2012-01-01

    Full Text Available We present a case of cerebral embolism associated with a left atrial myxoma that was treated with intravenous thrombolytic therapy. A 79-year-old right-handed man with no history of neurological or psychiatric illnesses was referred to our hospital because of confusion. He had been self-supported in the activity of daily living and could enjoy gardening until just before his admission. He had aphasia, left conjugate deviation, right hemiparesis, and right pathological reflexes. His NIHSS score was 24. Cranial DWI showed hyperintense lesions in the left middle cerebral artery territory, and MRA revealed left middle cerebral artery occlusion. We started treatment with the recombinant tissue plasminogen activator alteplase intravenously 3 h after the onset. However, the therapy was ineffective, and the NIHSS score was 25 on the second day. A transthoracic echocardiogram and heart MRI showed a left atrial myxoma. However, surgery was contraindicated because of the patient’s poor general condition. Although intravenous recombinant tissue plasminogen activator is a reasonable treatment for stroke patients, even with a cardiac myxoma, we cannot always expect good effects, especially if the emboli are parts of the tumor itself. In this case, we could not perform an endovascular mechanical embolectomy; however, we speculate that mechanical embolus retrieval in cerebral ischemia might be effective in such cases.

  1. Comorbidity-Adjusted Survival in Early Stage Lung Cancer Patients Treated with Hypofractionated Proton Therapy

    Directory of Open Access Journals (Sweden)

    Sharon Y. Do

    2010-01-01

    Full Text Available Objective. To determine the influence of comorbidity on survival in early-stage lung cancer patients treated with proton radiotherapy, using the Charlson Comorbidity Index. Study Design and Setting. Fifty-four non-small-cell lung cancer patients, treated prospectively in a phase II clinical trial with hypofractionated proton therapy, were analyzed retrospectively to assess their burden of comorbid disease as expressed by Charlson Comorbidity Index. Using the Charlson Comorbidity Index method, a predicted survival curve based on comorbidity was formulated and compared to the observed mortality from causes other than lung cancer in the study population. Results. The study population had an average age score of 2.8 and an average Charlson Comorbidity Index of 4.7. Predicted survival was calculated to be 67% and 50% at 2 and 4 years, respectively. Actual comorbidity-specific survival at 2 and 4 years was 64% and 45%, respectively. The observed survival fell within the 95% confidence intervals of the predicted survival at all time points up to 5 years. Conclusion. Predicted mortality from concurrent disease, based on Charlson Comorbidity Index, correlated well with observed comorbidity-specific mortality. This helps substantiate the accuracy of the data coding in cause of death and strengthens previously reported disease-specific survival rates.

  2. Pseudoepitheliomatous Hyperplasia Treated by Photodynamic Therapy with Variable Irradiation Dose and Concentration of Photosensitizer

    Science.gov (United States)

    Jiao, Bin; Long, Heather Ann

    2011-01-01

    Abstract Objective: The aim of this study was to test the effectiveness of photodynamic therapy (PDT) in treating pseudoepitheliomatous hyperplasia (PEH) after skin wounding. Background Data: PEH is a difficult-to-treat extreme-degree acanthosis characterized by proliferation of the epithelium. Topical PDT offers an effective and non-invasive treatment for intraepithelial neoplasia and inflammatory dermatosis. These disorders and PEH show the same histological features: epidermal hyperplasia. To our knowledge, there have been no clinical trials published about therapeutic responses of PDT for PEH. Materials and Methods: After application of 10–30% methyl aminolaevulinate (MAL) emulsion, each lesion was irradiated with 633-nm red light at a total dose of 113–339 J/cm2. Therapeutic response was assessed by clinical examination at 3 months. Results: Only 4 of 16 lesions clinically showed a minimal response. No response was observed in 12 of the 16 lesions, either with different cumulative doses or different concentrations of MAL. Conclusion: PEH after skin wounding responds poorly to the topical MAL-PDT. Besides removal of underlying diseases, surgical excision is still the recommended first option. PMID:20969441

  3. Use of fluorine-18-BPA PET images and image registration to enhance radiation treatment planning for boron neutron capture therapy

    Science.gov (United States)

    Khan, Mohammad Khurram

    The Monte-Carlo based simulation environment for radiation therapy (SERA) software is used to simulate the dose administered to a patient undergoing boron neutron capture therapy (BNCT). Point sampling of tumor tissue results in an estimate of a uniform boron concentration scaling factor of 3.5. Under conventional treatment protocols, this factor is used to scale the boron component of the dose linearly and homogenously within the tumor and target volumes. The average dose to the tumor cells by such a method could be improved by better methods of quantifying the in-vivo 10B biodistribution. A better method includes radiolabeling para-Boronophenylalanine (p-BPA) with 18F and imaging the pharmaceutical using positron emission tomography (PET). This biodistribution of 18F-BPA can then be used to better predict the average dose delivered to the tumor regions. This work uses registered 18F-BPA PET images to incorporate the in-vivo boron biodistribution within current treatment planning. The registered 18F-BPA PET images are then coupled in a new computer software, PET2MRI.m, to linearly scale the boron component of the dose. A qualititative and quantitative assessment of the dose contours is presented using the two approaches. Tumor volume, tumor axial extent, and target locations are compared between using MRI or PET images to define the tumor volume. In addition, peak-to-normal brain value at tumor axial center is determined for pre and post surgery patients using 18F-BPA PET images. The differences noted between the registered GBM tumor volumes (range: 34.04--136.36%), tumor axial extent (range: 20--150%), and the beam target location (1.27--4.29 cm) are significantly different. The peak-to-normal brain values are also determined at the tumor axial center using the 18F-BPA PET images. The peak-to-normal brain values using the last frame of the pre-surgery study for the GBM patients ranged from 2.05--3.4. For post surgery time weighted PET data, the peak

  4. Impact of intra-arterial administration of boron compounds on dose-volume histograms in boron neutron capture therapy for recurrent head-and-neck tumors

    International Nuclear Information System (INIS)

    Purpose: To analyze the dose-volume histogram (DVH) of head-and-neck tumors treated with boron neutron capture therapy (BNCT) and to determine the advantage of the intra-arterial (IA) route over the intravenous (IV) route as a drug delivery system for BNCT. Methods and Materials: Fifteen BNCTs for 12 patients with recurrent head-and-neck tumors were included in the present study. Eight irradiations were done after IV administration of boronophenylalanine and seven after IA administration. The maximal, mean, and minimal doses given to the gross tumor volume were assessed using a BNCT planning system. Results: The results are reported as median values with the interquartile range. In the IA group, the maximal, mean, and minimal dose given to the gross tumor volume was 68.7 Gy-Eq (range, 38.8-79.9), 45.0 Gy-Eq (range, 25.1-51.0), and 13.8 Gy-Eq (range, 4.8-25.3), respectively. In the IV group, the maximal, mean, and minimal dose given to the gross tumor volume was 24.2 Gy-Eq (range, 21.5-29.9), 16.4 Gy-Eq (range, 14.5-20.2), and 7.8 Gy-Eq (range, 6.8-9.5), respectively. Within 1-3 months after BNCT, the responses were assessed. Of the 6 patients in the IV group, 2 had a partial response, 3 no change, and 1 had progressive disease. Of 4 patients in the IA group, 1 achieved a complete response and 3 a partial response. Conclusion: Intra-arterial administration of boronophenylalanine is a promising drug delivery system for head-and-neck BNCT

  5. Prognosis for Mammographically Occult, Early-Stage Breast Cancer Patients Treated With Breast-Conservation Therapy

    International Nuclear Information System (INIS)

    Purpose: To compare mammographically occult (MamOcc) and mammographically positive (MamPos) early-stage breast cancer patients treated with breast-conservation therapy (BCT), to analyze differences between the two cohorts. Methods and Materials: Our two cohorts consisted of 214 MamOcc and 2168 MamPos patients treated with BCT. Chart reviews were conducted to assess mammogram reports and method of detection. All clinical-pathologic and outcome parameters were analyzed to detect differences between the two cohorts. Results: Median follow-up was 7 years. There were no differences in final margins, T stage, nodal status, estrogen/progesterone receptor status, or 'triple-negative' status. Significant differences included younger age at diagnosis (p o histology (p < 0.0001). At 10 years, the differences in overall survival, cause-specific survival, and distant relapse between the two groups did not differ significantly. The MamOcc cohort had more breast relapses (15% vs. 8%; p = 0.0357), but on multivariate analysis this difference was not significant (hazard ratio 1.0, 95% confidence interval 0.993-1.007, p = 0.9296). Breast relapses were mammographically occult in 32% of the MamOcc and 12% of the MamPos cohorts (p = 0.0136). Conclusions: Although our study suggests that there are clinical-pathologic variations for the MamOcc cohort vs. MamPos patients that may ultimately affect management, breast relapse after BCT was not significantly different. Breast recurrences were more often mammographically occult in the MamOcc cohort; consideration should be given to closer follow-up and alternative imaging strategies (ultrasound, breast MRI) for routine posttreatment examination. To our knowledge, this represents the largest series addressing the prognostic significance of MamOcc cancers treated with BCT.

  6. NIFTI and DISCOS: New concepts for a compact accelerator neutron source for boron neutron capture therapy applications

    International Nuclear Information System (INIS)

    Two new concepts, NIFTI and DISCOS, are described. These concepts enable the efficient production of epithermal neutrons for BNCT (Boron Neutron Capture Therapy) medical treatment, utilizing a low current, low energy proton beam impacting on a lithium target. The NIFTI concept uses fluoride compounds, such as lead or beryllium fluoride, to efficiently degrade high energy neutrons from the lithium target to the lower energies required for BNCT. The fluoride compounds are in turn encased in an iron layer that strongly impedes the transmission of neutrons with energies above 24 KeV. Lower energy neutrons readily pass through this iron filter, which has a deep window in its scattering cross section at 24 KeV. The DISCOS concept uses a rapidly rotating, high g disc to create a series of thin (∼ 1 micron thickness) liquid lithium targets in the form of continuous films or sheets of discrete droplets--through which the proton beam passes. The average energy lost by a proton as it passes through a single target is small, approximately 10 KeV. Between the targets, the proton beam is re-accelerated by an applied DC electric field. The DISCOS approach enables the accelerator--target facility to operate with a beam energy only slightly above the threshold value for neutron production--resulting in an output beam of low-energy epithermal neutrons--while achieving a high yield of neutrons per milliamp of proton beam current. Parametric trade studies of the NIFTI and DISCOS concepts are described. These include analyses of a broad range of NIFTI designs using the Monte carlo MCNP neutronics code, as well as mechanical and thermal-hydraulic analyses of various DISCOS designs

  7. Characteristics comparison between a cyclotron-based neutron source and KUR-HWNIF for boron neutron capture therapy

    Science.gov (United States)

    Tanaka, H.; Sakurai, Y.; Suzuki, M.; Masunaga, S.; Kinashi, Y.; Kashino, G.; Liu, Y.; Mitsumoto, T.; Yajima, S.; Tsutsui, H.; Maruhashi, A.; Ono, K.

    2009-06-01

    At Kyoto University Research Reactor Institute (KURRI), 275 clinical trials of boron neutron capture therapy (BNCT) have been performed as of March 2006, and the effectiveness of BNCT has been revealed. In order to further develop BNCT, it is desirable to supply accelerator-based epithermal-neutron sources that can be installed near the hospital. We proposed the method of filtering and moderating fast neutrons, which are emitted from the reaction between a beryllium target and 30-MeV protons accelerated by a cyclotron accelerator, using an optimum moderator system composed of iron, lead, aluminum and calcium fluoride. At present, an epithermal-neutron source is under construction from June 2008. This system consists of a cyclotron accelerator, beam transport system, neutron-yielding target, filter, moderator and irradiation bed. In this article, an overview of this system and the properties of the treatment neutron beam optimized by the MCNPX Monte Carlo neutron transport code are presented. The distribution of biological effect weighted dose in a head phantom compared with that of Kyoto University Research Reactor (KUR) is shown. It is confirmed that for the accelerator, the biological effect weighted dose for a deeply situated tumor in the phantom is 18% larger than that for KUR, when the limit dose of the normal brain is 10 Gy-eq. The therapeutic time of the cyclotron-based neutron sources are nearly one-quarter of that of KUR. The cyclotron-based epithermal-neutron source is a promising alternative to reactor-based neutron sources for treatments by BNCT.

  8. Tumor cell killing effect of boronated dipeptide. Boromethylglycylphenylalanine on boron neutron capture therapy for malignant brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Takagaki, Masao; Ono, Koji; Masunaga, Shinichiro; Kinashi, Yuko; Kobayashi, Toru [Kyoto Univ., Kumatori, Osaka (Japan). Research Reactor Inst.; Oda, Yoshifumi; Kikuchi, Haruhiko; Spielvogel, B.F.

    1994-03-01

    The killing effect of Boron Neutron Capture Therapy; BNCT, is dependant on the boron concentration ratio of tumor to normal brain (T/N ratio), and also that of tumor to blood (T/B ratio). The clinical boron carrier of boro-captate (BSH) showed the large T/N ratio of ca. 8, however the T/B ratio was around 1, which indicated nonselective accumulation into tumor. Indeed high boron concentration of blood restrict the neutron irradiation dose in order to circumvent the normal endothelial damage, especially in the case of deeply seated tumor. Phenylalanine analogue of para borono-phenylalanine (BPA) is an effective boron carrier on BNCT for malignant melanoma. For the BNCT on brain tumors, however, BPA concentration in normal brain was reported to be intolerably high. In order to improve the T/N ratio of BPA in brain, therefore, a dipeptide of boromethylglycylphenylalanine (BMGP) was synthesized deriving from trimethylglycine conjugated with BPA. It is expected to be selectively accumulated into tumor with little uptake into normal brain. Because a dipeptide might not pass through the normal blood brain barrier (BBB). Its killing effect on cultured glioma cell, T98G, and its distribution in rat brain bearing 9L glioma have been investigated in this paper. The BNCT effect of BMGP on cultured cells was nearly triple in comparison with DL-BPA. The neutron dose yielding 1% survival ratio were 7x10{sup 12}nvt for BMGP and 2x10{sup 13}nvt for BPA respectively on BNCT after boron loading for 16 hrs in the same B-10 concentration of 20ppm. Quantitative study of boron concentration via the {alpha}-auto radiography and the prompt gamma ray assay on 9L brain tumor rats revealed that T/N ratio and T/B ratio are 12.0 and 3.0 respectively. Those values are excellent for BNCT use. (author).

  9. Demonstration of three-dimensional deterministic radiation transport theory dose distribution analysis for boron neutron capture therapy

    International Nuclear Information System (INIS)

    The Monte Carlo stochastic simulation technique has traditionally been the only well-recognized method for computing three-dimensional radiation dose distributions in connection with boron neutron capture therapy (BNCT) research. A deterministic approach to this problem would offer some advantages over the Monte Carlo method. This paper describes an application of a deterministic method to analytically simulate BNCT treatment of a canine head phantom using the epithermal neutron beam at the Brookhaven medical research reactor (BMRR). Calculations were performed with the TORT code from Oak Ridge National Laboratory (ORNL), an implementation of the discrete ordinates, or Sn method. Calculations were from first principles and used no empirical correction factors. The phantom surface was modeled by flat facets of approximately 1 cm2. The phantom interior was homogeneous. Energy-dependent neutron and photon scalar fluxes were calculated on a 32x16x22 mesh structure with 96 discrete directions in angular phase space. The calculation took 670 min on an Apollo DN10000 workstation. The results were subsequently integrated over energy to obtain full three-dimensional dose distributions. Isodose contours and depth-dose curves were plotted for several separate dose components of interest. Phantom measurements were made by measuring neutron activation (and therefore neutron flux) as a function of depth in copper--gold alloy wires that were inserted through catheters placed in holes drilled in the phantom. Measurements agreed with calculations to within about 15%. The calculations took about an order of magnitude longer than comparable Monte Carlo calculations but provided various conveniences, as well as a useful check

  10. Myofunctional Therapy to Treat Obstructive Sleep Apnea: A Systematic Review and Meta-analysis

    Science.gov (United States)

    Camacho, Macario; Certal, Victor; Abdullatif, Jose; Zaghi, Soroush; Ruoff, Chad M.; Capasso, Robson; Kushida, Clete A.

    2015-01-01

    , Capasso R, Kushida CA. Myofunctional therapy to treat obstructive sleep apnea: a systematic review and meta-analysis. SLEEP 2015;38(5):669–675. PMID:25348130

  11. Comparative adequacy of surgery and radiation therapy in 175 T2 glottic carcinomas: 116 cases treated with surgery and 59 with radiation therapy

    International Nuclear Information System (INIS)

    The results were analyzed of 175 patients with glottic squamous cell carcinomas who were treated with curative purposes (1970-1986). Overall 10-year local control rates were 74% for the surgical series and 69% for the cases treated by radiation therapy. After salvage therapy 10-year survival rates were 83% and 76% respectively. The analysis of the results showed no statistically significant difference. In the group treated by radical surgery 80% local control was observed, versus 66% in the cases treated with conservative surgery. 10-year survival rate was higher in the latter group (89% versus 81%) because of better results of salvage therapy: 7 of 10 recurrences were salvaged with the second treatment. Several prognostic factors were evaluated-i.e., T extent, anterior commissure involvement, subglottic invasion, vocal cord mobility impairment, and ventricular involvement. Anterior commissure involvement was the main factor affecting out-come in the surgical series: in the presence of this factor, 64% 10-year local control was observed versus 85% in the patients without commissure involvement. This factor proved more important in the patients treated with conservative surgery (10-year control: 42 versus 88%) than in those undergoing radical surgery (78% versus 85%). Anterior commissure involvement and the number of involved subsites were found to worsen prognosis in the serial treated by radiation therapy: cases with anterior commissure involvement had 59% 10-year local control versus 83%. The cases with a deeper spread had 60% local control versus 75%. Vocal cord mobility impairment was a less important prognosis factor in both series. Our results suggest radiation therapy as a valuable method in a treatment of the small T2 laryngeal cancers which are not suitable for conservative surgery

  12. Case Report of Pes Anserine Bursitis patient treated with Bee Venom Acua-Acupuncture Therapy by Using DITI

    OpenAIRE

    Moon Ja-Young; Kim Kang; Lim Jin-Kang; Wang Wu-Hao; Jang Hyoung-Seok

    2004-01-01

    Objective : The purpose of this study is to report the effect of Bee Venom Acua-Acupuncture Therapy to the patient of Pes Anserine Bursitis by using DITI. Patient & Methods : The patient was 60-year-old woman who complained severe knee pain. She was treated by bee venom acuaacupuncture therapy. To estimate the efficacy of tratment, we used DITI, visual analog scale, knee joint check(ROM). Results : In this case, we treated patient of Pes Anserine Bursitis for 28 days. bee venom acua-a...

  13. #Hyperbaric oxygen therapy (1.5 ATA in treating sports related TBI/CTE: two case reports

    Directory of Open Access Journals (Sweden)

    Stoller Kenneth P

    2011-07-01

    Full Text Available Abstract Despite adequate evidence, including randomized controlled trials; hyperbaric oxygen is not yet recognized as efficacious for treating various forms of brain injury, specifically traumatic brain injury. Political-economic issues have kept this benign therapy from being widely adopted despite the lack of viable alternatives. Two football players with TBI/CTE are herewith shown to benefit from being treated with hyperbaric oxygen as documented by neurocognitive examinations and functional brain imaging, in one case treatment commenced decades after the brain injury. Perhaps the interest in HBOT by those participating in high-risk sports will help expand this orphan therapy into mainstream medicine.

  14. Carbon capture and biogas enhancement by carbon dioxide enrichment of anaerobic digesters treating sewage sludge or food waste.

    Science.gov (United States)

    Bajón Fernández, Y; Soares, A; Villa, R; Vale, P; Cartmell, E

    2014-05-01

    The increasing concentration of carbon dioxide (CO2) in the atmosphere and the stringent greenhouse gases (GHG) reduction targets, require the development of CO2 sequestration technologies applicable for the waste and wastewater sector. This study addressed the reduction of CO2 emissions and enhancement of biogas production associated with CO2 enrichment of anaerobic digesters (ADs). The benefits of CO2 enrichment were examined by injecting CO2 at 0, 0.3, 0.6 and 0.9 M fractions into batch ADs treating food waste or sewage sludge. Daily specific methane (CH4) production increased 11-16% for food waste and 96-138% for sewage sludge over the first 24h. Potential CO2 reductions of 8-34% for sewage sludge and 3-11% for food waste were estimated. The capacity of ADs to utilise additional CO2 was demonstrated, which could provide a potential solution for onsite sequestration of CO2 streams while enhancing renewable energy production.

  15. Carbon capture and biogas enhancement by carbon dioxide enrichment of anaerobic digesters treating sewage sludge or food waste.

    Science.gov (United States)

    Bajón Fernández, Y; Soares, A; Villa, R; Vale, P; Cartmell, E

    2014-05-01

    The increasing concentration of carbon dioxide (CO2) in the atmosphere and the stringent greenhouse gases (GHG) reduction targets, require the development of CO2 sequestration technologies applicable for the waste and wastewater sector. This study addressed the reduction of CO2 emissions and enhancement of biogas production associated with CO2 enrichment of anaerobic digesters (ADs). The benefits of CO2 enrichment were examined by injecting CO2 at 0, 0.3, 0.6 and 0.9 M fractions into batch ADs treating food waste or sewage sludge. Daily specific methane (CH4) production increased 11-16% for food waste and 96-138% for sewage sludge over the first 24h. Potential CO2 reductions of 8-34% for sewage sludge and 3-11% for food waste were estimated. The capacity of ADs to utilise additional CO2 was demonstrated, which could provide a potential solution for onsite sequestration of CO2 streams while enhancing renewable energy production. PMID:24632434

  16. Refractory vasculitic ulcer of the toe in adolescent suffering from Systemic Lupus Erythematosus treated successfully with hyperbaric oxygen therapy

    Directory of Open Access Journals (Sweden)

    Mauro Angela

    2010-10-01

    Full Text Available Abstract Skin ulcers are a dangerous and uncommon complication of vasculitis. We describe the case of a teenager suffering from Systemic Lupus Erythematosus with digital ulcer resistant to conventional therapy, treated successfully with Hyperbaric Oxygen Therapy. The application of hyperbaric oxygen, which is used for the treatment of ischemic ulcers, is an effective and safe therapeutic option in patients with ischemic vasculitic ulcers in combination with immunosuppressive drugs. Further studies are needed to evaluate its role as primary therapy for this group of patients.

  17. Ultrasound aspects in therapy-naive CIDP compared to long-term treated CIDP.

    Science.gov (United States)

    Grimm, Alexander; Vittore, Debora; Schubert, Victoria; Rasenack, Maria; Décard, Bernhard F; Heiling, Bianka; Hammer, Nadin; Axer, Hubertus

    2016-06-01

    To investigate the use of nerve ultrasound (NUS) along with the European Federation of Neurological Societies (EFNS) guidelines and clinical scores in untreated, recently diagnosed chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) vs. long-lasting treated CIDP. NUS and nerve conduction studies (NCS) of predefined nerves/cervical roots were performed in CIDP on diagnostic onset and "chronic-CIDP" (diagnosis and therapy >6 months), compared to controls. Nerve morphology was quantified using the modified ultrasound pattern sum score mUPSS, which is the sum of 3 ultrasound scores derived at 12 predefined measurement points and the homogeneity score (HS) in ulnar, median, and tibial nerve. 21 onset-CIDP, 21 "chronic-CIDP", and 21 age-matched controls were included. No differences in clinical scores or in the number of electrophysiologically affected nerves existed between the groups. Significantly enlarged cross-sectional areas of the nerves and diameters of the roots ensued already in onset-CIDP; however, with proximal predominance, whilst in chronic-CIDP, nerve enlargement was more prominent and ubiquitous. Increased UPS scores were shown in both patient groups compared to the controls. Significant differences between the patient groups were found particularly in the peripheral nerve score UPSA. Evaluation by means of HS revealed that the nerves in onset-CIDP were mostly regionally enlarged (often sparing distal segments) whereas in chronic-CIDP, nerves were more generalized enlarged. Onset- and chronic-CIDP show enlarged nerves and therefore increased mUPSS, however, nerve enlargement shows a more generalized pattern in chronic-CIDP compared to disease onset and correlates with disease duration and delayed therapy start, but not with disability. PMID:27017343

  18. The TOPSHOCK study: Effectiveness of radial shockwave therapy compared to focused shockwave therapy for treating patellar tendinopath - design of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Diercks Ron L

    2011-10-01

    Full Text Available Abstract Background Patellar tendinopathy is a chronic overuse injury of the patellar tendon that is especially prevalent in people who are involved in jumping activities. Extracorporeal Shockwave Therapy is a relatively new treatment modality for tendinopathies. It seems to be a safe and promising part of the rehabilitation program for patellar tendinopathy. Extracorporeal Shockwave Therapy originally used focused shockwaves. Several years ago a new kind of shockwave therapy was introduced: radial shockwave therapy. Studies that investigate the effectiveness of radial shockwave therapy as treatment for patellar tendinopathy are scarce. Therefore the aim of this study is to compare the effectiveness of focussed shockwave therapy and radial shockwave therapy as treatments for patellar tendinopathy. Methods/design The TOPSHOCK study (Tendinopathy Of Patella SHOCKwave is a two-armed randomised controlled trial in which the effectiveness of focussed shockwave therapy and radial shockwave therapy are directly compared. Outcome assessors and patients are blinded as to which treatment is given. Patients undergo three sessions of either focused shockwave therapy or radial shockwave therapy at 1-week intervals, both in combination with eccentric decline squat training. Follow-up measurements are scheduled just before treatments 2 and 3, and 1, 4, 7 and 12 weeks after the final treatment. The main outcome measure is the Dutch VISA-P questionnaire, which asks for pain, function and sports participation in subjects with patellar tendinopathy. Secondary outcome measures are pain determined with a VAS during ADL, sports and decline squats, rating of subjective improvement and overall satisfaction with the treatment. Patients will also record their sports activities, pain during and after these activities, and concurrent medical treatment on a weekly basis in a web-based diary. Results will be analysed according to the intention-to-treat principle. Discussion

  19. Constitutive STAT5 Activation Correlates With Better Survival in Cervical Cancer Patients Treated With Radiation Therapy

    International Nuclear Information System (INIS)

    Purpose: Constitutively activated signal transducers and activators of transcription (STAT) factors, in particular STAT1, STAT3, and STAT5, have been detected in a wide variety of human primary tumors and have been demonstrated to directly contribute to oncogenesis. However, the expression pattern of these STATs in cervical carcinoma is still unknown, as is whether or not they have prognostic significance. This study investigated the expression patterns of STAT1, STAT3, and STAT5 in cervical cancer and their associations with clinical outcomes in patients treated with radical radiation therapy. Methods and Materials: A total of 165 consecutive patients with International Federation of Gynecology and Obstetrics (FIGO) Stages IB to IVA cervical cancer underwent radical radiation therapy, including external beam and/or high-dose-rate brachytherapy between 1989 and 2002. Immunohistochemical studies of their formalin-fixed, paraffin-embedded tissues were performed. Univariate and multivariate analyses were performed to identify and to evaluate the effects of these factors affecting patient survival. Results: Constitutive activations of STAT1, STAT3, and STAT5 were observed in 11%, 22%, and 61% of the participants, respectively. While STAT5 activation was associated with significantly better metastasis-free survival (p < 0.01) and overall survival (p = 0.04), STAT1 and STAT3 activation were not. Multivariate analyses showed that STAT5 activation, bulky tumor (≥4 cm), advanced stage (FIGO Stages III and IV), and brachytherapy (yes vs. no) were independent prognostic factors for cause-specific overall survival. None of the STATs was associated with local relapse. STAT5 activation (odds ratio = 0.29, 95% confidence interval = 0.13–0.63) and advanced stage (odds ratio = 2.54; 95% confidence interval = 1.03–6.26) were independent predictors of distant metastasis. Conclusions: This is the first report to provide the overall expression patterns and prognostic significance

  20. Constitutive STAT5 Activation Correlates With Better Survival in Cervical Cancer Patients Treated With Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Helen H.W. [Department of Radiation Oncology, National Cheng Kung University, Medical College and Hospital, Tainan, Taiwan (China); Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Chou, Cheng-Yang [Department of Obstetrics and Gynecology, National Cheng Kung University, Medical College and Hospital, Tainan, Taiwan (China); Wu, Yuan-Hua; Hsueh, Wei-Ting; Hsu, Chiung-Hui [Department of Radiation Oncology, National Cheng Kung University, Medical College and Hospital, Tainan, Taiwan (China); Guo, How-Ran [Department of Environmental and Occupational Health, National Cheng Kung University, Medical College and Hospital, Tainan, Taiwan (China); Lee, Wen-Ying, E-mail: 7707@so-net.net.tw [Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan (China) and Department of Pathology, College of Medicine, Taipei Medical University, Taipei, Taiwan (China); Su, Wu-Chou, E-mail: sunnysu@mail.ncku.edu.tw [Department of Internal Medicine, National Cheng Kung University, Medical College and Hospital, Tainan, Taiwan (China)

    2012-02-01

    Purpose: Constitutively activated signal transducers and activators of transcription (STAT) factors, in particular STAT1, STAT3, and STAT5, have been detected in a wide variety of human primary tumors and have been demonstrated to directly contribute to oncogenesis. However, the expression pattern of these STATs in cervical carcinoma is still unknown, as is whether or not they have prognostic significance. This study investigated the expression patterns of STAT1, STAT3, and STAT5 in cervical cancer and their associations with clinical outcomes in patients treated with radical radiation therapy. Methods and Materials: A total of 165 consecutive patients with International Federation of Gynecology and Obstetrics (FIGO) Stages IB to IVA cervical cancer underwent radical radiation therapy, including external beam and/or high-dose-rate brachytherapy between 1989 and 2002. Immunohistochemical studies of their formalin-fixed, paraffin-embedded tissues were performed. Univariate and multivariate analyses were performed to identify and to evaluate the effects of these factors affecting patient survival. Results: Constitutive activations of STAT1, STAT3, and STAT5 were observed in 11%, 22%, and 61% of the participants, respectively. While STAT5 activation was associated with significantly better metastasis-free survival (p < 0.01) and overall survival (p = 0.04), STAT1 and STAT3 activation were not. Multivariate analyses showed that STAT5 activation, bulky tumor ({>=}4 cm), advanced stage (FIGO Stages III and IV), and brachytherapy (yes vs. no) were independent prognostic factors for cause-specific overall survival. None of the STATs was associated with local relapse. STAT5 activation (odds ratio = 0.29, 95% confidence interval = 0.13-0.63) and advanced stage (odds ratio = 2.54; 95% confidence interval = 1.03-6.26) were independent predictors of distant metastasis. Conclusions: This is the first report to provide the overall expression patterns and prognostic significance of

  1. Beneficial effects of combined resveratrol and metformin therapy in treating diet-induced insulin resistance.

    Science.gov (United States)

    Frendo-Cumbo, Scott; MacPherson, Rebecca E K; Wright, David C

    2016-08-01

    The polyphenol compound resveratrol (RSV) has attracted attention due to its reputed beneficial effects on insulin sensitivity. Our lab has previously identified protective effects of RSV against the development of type 2 diabetes in rats. These effects occurred in a manner similar to thiazolidinedione's (TZDs), a class of insulin sensitizing drugs. TZDs are commonly prescribed in combination with metformin (MET) and thus we sought to examine the combined effects of RSV and MET in treating insulin resistance. Male C57BL6 mice were fed a low- (LFD; 10% Kcal from fat) or high-fat diet (HFD; 60% Kcal from fat) for 9 weeks to induce glucose and insulin intolerance. HFD mice were then assigned to control (HFD), MET (231.28 ± 12.24 mg/kg/day), RSV (93.68 ± 3.51 mg/kg/day), or combined (COM; MET 232.01 ± 17.12 mg/kg/day and RSV 92.77 ± 6.92 mg/kg/day) treatment groups. Changes in glucose and insulin tolerance and tissue-specific insulin signaling were measured 4 weeks post-treatment. RSV or MET alone did not have beneficial effects on glucose tolerance, although MET significantly improved insulin tolerance compared to HFD Glucose and insulin tolerance were significantly improved in COM compared to HFD and this was mirrored by enhanced insulin-stimulated AKT phosphorylation in triceps muscle and inguinal subcutaneous adipose tissue in COM compared to HFD mice. Improvements with COM treatment were not explained by differences in body weight, adiposity, or markers of adipose tissue inflammation. In summary, this study provides evidence of beneficial effects of combined RSV and MET therapy in treating impairments in glucose homeostasis. PMID:27482073

  2. Elements of lentiviral vector design toward gene therapy for treating mucopolysaccharidosis I

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    Li Ou

    2016-09-01

    Full Text Available Mucopolysaccharidosis type I (MPS I is a lysosomal disease caused by α-l-iduronidase (IDUA deficiency and accumulation of glycosaminoglycans (GAG. Lentiviral vector encoding correct IDUA cDNA could be used for treating MPS I. To optimize the lentiviral vector design, 9 constructs were designed by combinations of various promoters, enhancers, and codon optimization. After in vitro transfection into 293FT cells, 5 constructs achieved the highest IDUA activities (5613 to 7358 nmol/h/mg protein. These 5 candidate vectors were then tested by injection (1 × 107 TU/g into neonatal MPS I mice. After 30 days, one vector, CCEoIDW, achieved the highest IDUA levels: 2.6% of wildtype levels in the brain, 9.9% in the heart, 200% in the liver and 257% in the spleen. CCEoIDW achieved the most significant GAG reduction: down 49% in the brain, 98% in the heart, 100% in the liver and 95% in the spleen. Further, CCEoIDW had the lowest transgene frequency, especially in the gonads (0.03 ± 0.01 copies/100 cells, reducing the risk of insertional mutagenesis and germ-line transmission. Therefore, CCEoIDW is selected as the optimal lentiviral vector for treating MPS I disease and will be applied in large animal preclinical studies. Further, taken both in vitro and in vivo comparisons together, codon optimization, use of EF-1α promoter and woodchuck hepatitis virus posttranscriptional response element (WPRE could enhance transgene expression. These results provided a better understanding of factors contributing efficient transgene expression in lentiviral gene therapies.

  3. Dosimetric predictors of hypothyroidism in oropharyngeal cancer patients treated with intensity-modulated radiation therapy

    International Nuclear Information System (INIS)

    Radiation to the neck has long been associated with an elevated risk of hypothyroidism development. The goal of the present work is to define dosimetric predictors of hypothyroidism in oropharyngeal cancer (OPC) patients treated with intensity-modulated radiation therapy. Data for 123 patients, with a median follow up of 4.6 years, were retrospectively analyzed. Patients with elevated thyroid-stimulating hormone levels or with a clinical diagnosis were categorized as hypothyroid. Patient demographic parameters, thyroid volume, mean thyroid dose, the percent of thyroid volume receiving minimum specified dose levels (VxxGy), and the absolute thyroid volume spared from specified dose levels (VSxxGy) were analyzed. Normal-tissue complication probability (NTCP) was also calculated using several recently published models. Thyroid volume and many radiation dosimetric parameters were statistically different in the hypothyroid group. For the patients with initial thyroid volumes of 8 cc or greater, several dosimetric parameters were found to define subgroups at statistically significant lower risk of developing hypothyroidism. Patients with VS45 Gy of at least 3 cc, VS50 Gy at least 5 cc, VS50 Gy at least 6 cc, V50 Gy below 45%, V50 Gy below 55%, or mean thyroid dose below 49 Gy had a 28-38% estimated risk of hypothyroidism at 3 years compared to a 55% risk for the entire study group. Patients with a NTCP of less than 0.75 or 0.8, calculated using recently published models, were also observed to have a lower risk of developing hypothyroidism. Based on long-term follow up data for OPC patients treated with IMRT, we recommend plan optimization objectives to reduce the volume of thyroid receiving over 45 Gy to significantly decrease the risk of developing hypothyroidism. The online version of this article (doi:10.1186/s13014-014-0269-4) contains supplementary material, which is available to authorized users

  4. Is neoadjuvant androgen deprivation therapy beneficial in prostate cancer treated with definitive radiotherapy?

    Energy Technology Data Exchange (ETDEWEB)

    Eom, Keun Yong; Ha, Sung W.; Lee, Eun Sik; Kwak, Cheol [Seoul National University College of Medicine, Seoul (Korea, Republic of); Lee, Sang Eun [Dept.of Urology, Seoul National University Bundang Hospital, Seongam (Korea, Republic of)

    2014-12-15

    To determine whether neoadjuvant androgen deprivation therapy (NADT) improves clinical outcomes in patients with prostate cancer treated with definitive radiotherapy. We retrospectively reviewed medical records of 201 patients with prostate cancer treated with radiotherapy between January 1991 and December 2008. Of these, 156 patients with more than 3 years of follow-up were the subjects of this study. The median duration of follow-up was 91.2 months. NADT was given in 103 patients (66%) with median duration of 3.3 months (range, 1.0 to 7.7 months). Radiation dose was escalated gradually from 64 Gy to 81 Gy using intensity-modulated radiotherapy technique. Biochemical relapse-free survival (BCRFS) and overall survival (OS) of all patients were 72.6% and 90.7% at 5 years, respectively. BCRFS and OS of NADT group were 79.5% and 89.8% at 5 years and those of radiotherapy alone group were 58.8% and 92.3% at 5 years, respectively. Risk group (p = 0.010) and radiation dose > or =70 Gy (p = 0.017) affected BCRFS independently. NADT was a significant prognostic factor in univariate analysis, but not in multivariate analysis (p = 0.073). Radiation dose > or =70 Gy was only an independent factor for OS (p = 0.007; hazard ratio, 0.261; 95% confidence interval, 0.071-0.963). NADT prior to definitive radiotherapy did not result in significant benefit in terms of BCRFS and OS. NADT should not be performed routinely in the era of dose-escalated radiotherapy.

  5. Treating depressive symptoms in psychosis : A network meta-analysis on the effects of non-verbal therapies

    NARCIS (Netherlands)

    Steenhuis, Laura A.; Nauta, Maaike H.; Bocking, Claudi L.H.; Pijnenborg, Gerdina H.M.

    2015-01-01

    AIMS: The aim of this study was to examine whether non-verbal therapies are effective in treating depressive symptoms in psychotic disorders. MATERIAL AND METHODS: A systematic literature search was performed in PubMed, Psychinfo, Picarta, Embase and ISI Web of Science, up to January 2015. Randomize

  6. Treating depressive symptoms in psychosis : A Network Meta-Analysis on the Effects of Non-Verbal Therapies

    NARCIS (Netherlands)

    Steenhuis, Laura A.; Nauta, Maaike H.; Bockting, Claudi; Pijnenborg, Gerdina H.M.

    2015-01-01

    AIMS: The aim of this study was to examine whether non-verbal therapies are effective in treating depressive symptoms in psychotic disorders. MATERIAL AND METHODS: A systematic literature search was performed in PubMed, Psychinfo, Picarta, Embase and ISI Web of Science, up to January 2015. Randomize

  7. [Procedure for daylight methyl aminolevulinate photodynamic therapy to treat actinic keratoses].

    Science.gov (United States)

    Girard, C; Adamski, H; Basset-Séguin, N; Beaulieu, P; Dreno, B; Riboulet, J-L; Lacour, J-P

    2016-04-01

    Actinic keratosis (AK), also known as solar keratosis or pre-cancerous keratosis, is frequently observed in areas of skin exposed to sunlight, particularly in light-skinned patients. In France, photodynamic therapy using red light (conventional PDT) and methylamino 5-levulinate (MAL) is indicated in the treatment of thin or non-hyperkeratotic and non-pigmented multiple AK lesions or large zones covered with AK lesions. It is well-known for its efficacy but also for its side effects, especially pain during illumination, which can limit its use. An alternative to PDT using natural daylight has recently been proposed to treat actinic keratosis lesions, and results in greater flexibility as well as significant reduction in pain. The lesions are prepared as for conventional PDT, with MAL cream being applied by the physician or the patient, after which they are exposed to natural daylight for 2hours. The lesions are then gently cleansed and protected from natural light for 24hours. This paper seeks to provide a precise description of the daylight PDT procedure for the treatment of AK. PMID:27016200

  8. Evaluation of oral ulcers appearing in pemphigus patients treated with dexamethasone-cyclophosphamide pulse therapy

    Directory of Open Access Journals (Sweden)

    Pasricha J

    1992-01-01

    Full Text Available Twenty cases of pemphigus with oral ulcers who were being treated with dexamethasone-cyclophosphamide pulse therapy were evaluated for the cause of ulcers. The lesions were first classified into pemphigus ulcers, aphthous ulcers, pyogenic infection and candidiasis on the basis of clinical characteristics. Smears from these ulcers were then stained with Giemsa stain to look for acantholytic cells and bacteria. Another smear was mounted in 10% KOH to look for candida. Seven patients were clinically diagnosed to have pemphigus ulcers, but acantholytic cells were seen in only 2 cases. Both these patients had superadded infection with candida and gram positive bacteria respectively. Of the 9 cases clinically diagnosed to have candidiasis, only 6 revealed candida in 10% KOH smears, while 1 patient revealed acantholytic cells. All the 3 cases clinically considered to have aphthous ulcers, revealed only normal looking epithelial cells. One patient clinically diagnosed to have pyogenic infection revealed pus cells and bacteria on gram stain. It is obvious that oral ulcers in a pemphigus patient may not always be pemphigus ulcers, and some of these may be super-infected with candida, pyogenic or other organisms. A proper evaluation is therefore necessary for appropriate treatment.

  9. Comparison of Hospitalization and Survival Between Patients Treated With Renal Replacement Therapy

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    Murat MERAL

    2011-01-01

    Full Text Available AIM: Renal replacement therapy (RRT prolongs survival in patients with end-stage-renal-disease (ESRD. We compared patient survival, number and duration of hospitalization in patients treated with RRT in this study. MATERIAL and METHODS: Two hundred and eighty seven patients (87 hemodialysis (HD, 97 peritoneal dialysis (PD, 103 renal transplant (RT patients were enrolled in this study. Patients' data were collected retrospectively from hospital records. RESULTS: HD patients were older and had more comorbid diseases compared to PD and RT patients. Mortality rates were not different between the modalitites. The number and duration of hospitalization episodes were significantly lower in the PD group than that of the other two groups. Survival rates of HD patients were 84%, 55% and 30% for the 1st, 5th and 10th years, respectively while these rates were 93%, 81% and 59% for PD and 95%, 81% and 77% for RT patients. CONCLUSION: PD and RT patients were younger than HD patients and had less comorbid diseases. As a result, the number and duration of hospitalization episodes were significantly lower in the PD group when compared to the others. Survival rates in the RT group were better than that of the HD and PD groups.

  10. Synchronous malignant vagal paraganglioma with contralateral carotid body paraganglioma treated by radiation therapy

    Directory of Open Access Journals (Sweden)

    Devlina Chakarvarty

    2010-06-01

    Full Text Available Paragangliomas are rare tumors and very few cases of malignant vagal paraganglioma with synchronous carotid body paraganglioma have been reported. We report a case of a 20-year old male who presented with slow growing bilateral neck masses of eight years duration. He had symptoms of dysphagia to solids, occasional mouth breathing and hoarseness of voice. Fine needle aspiration cytology (FNAC performed where he lived showed a sinus histiocytosis and he was administered anti-tubercular treatment for six months without any improvement in his symptoms. His physical examination revealed pulsatile, soft to firm, non-tender swellings over the anterolateral neck confined to the upper-mid jugulo-diagastric region on both sides. Direct laryngoscopy examination revealed a bulge on the posterior pharyngeal wall and another over the right lateral pharyngeal wall. Magnetic resonance imaging (MRI, 99mTc-labeled octreotide scan and angiography diagnosed the swellings as carotid body paraganglioma, stage III on the right side with left-sided vagal malignant paraganglioma. Surgery was ruled out as a high morbidity with additional risk to life was expected due to the highly vascular nature of the tumor. The patient was treated with radiation therapy by image guided radiation to a dose of 5040cGy in 28 fractions. At a follow-up at 16 months, the tumors have regressed bilaterally and the patient can take solids with ease.

  11. Will symptom-based therapy be effective for treating asthma in children?

    Science.gov (United States)

    Nuijsink, Marianne; De Jongste, Johan C; Pijnenburg, Mariëlle W

    2013-10-01

    Traditionally, symptoms are important patient-oriented outcomes in asthma treatment, and assessment of symptoms is an essential component of assessing asthma control. However, variable airways obstruction, airways hyperresponsiveness and chronic inflammation are key components of the asthma syndrome, and correlations among these hallmarks and symptoms are weak or even absent. Therefore, it might be questioned if symptom-based therapy is effective for treating asthma in (all) children. To date, there is no firm indication that monitoring asthma based on repetitive lung function measurement or markers of airway inflammation is superior to monitoring based on symptoms only. In the majority of patients, symptom-based asthma management may well be sufficient, and in preschool children, symptoms are presently the only feasible outcome. Nevertheless, there is some evidence that selected groups might benefit from an approach that takes into account individual phenotypic characteristics. In patients with poor perception, those with a discordant phenotype and those with persistent severe asthma, considering lung function, airways hyperresponsiveness and inflammatory markers in treatment decisions might improve outcomes.

  12. Refractory acute promyelocytic leukemia successfully treated with combination therapy of arsenic trioxide and tamibarotene: A case report

    Directory of Open Access Journals (Sweden)

    Minoru Kojima

    2016-01-01

    Full Text Available A 40-year-old male developed refractory acute promyelocytic leukemia (APL after various treatments including all-trans retinoic acid, tamibarotene, arsenic trioxide (As2O3, conventional chemotherapy, and autologous peripheral blood stem cell transplantation. We attempted to use both tamibarotene and As2O3 as a combination therapy, and he achieved molecular complete remission. Grade 2 prolongation of the QTc interval on the electrocardiogram was observed during the therapy. The combination therapy of As2O3 and tamibarotene may be effective and tolerable for treating refractory APL cases who have no treatment options, even when they have previously been treated with tamibarotene and As2O3 as a single agent.

  13. Hyperbaric Oxygen Therapy in Treating Long-Term Gastrointestinal Adverse Effects Caused by Radiation Therapy in Patients With Pelvic Cancer

    Science.gov (United States)

    2011-07-14

    Bladder Cancer; Cervical Cancer; Colorectal Cancer; Endometrial Cancer; Gastrointestinal Complications; Long-term Effects Secondary to Cancer Therapy in Adults; Ovarian Cancer; Prostate Cancer; Radiation Toxicity; Sarcoma; Testicular Germ Cell Tumor; Vaginal Cancer

  14. Use of maggot therapy for treating a diabetic foot ulcer colonized by multidrug resistant bacteria in Brazil

    Directory of Open Access Journals (Sweden)

    Marilia A.R.Q. Pinheiro

    2015-01-01

    Full Text Available This study reports the efficacy of maggot therapy in the treatment of diabetic foot ulcer infected with multidrug resistant microorganisms. A 74 year old female patient with diabetes for over 30 years, was treated with maggot therapy using larvae of Chrysomya megacephala. The microbiological samples were collected to evaluate aetiology of the infection. The therapy done for 43 days resulted in a reduction of necrosis and the ulcer′s retraction of 0.7 cm [2] in area. Analysis of the bacteriological swabs revealed the presence of Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. Further studies need to be done to confirm the role of maggot therapy in wound healing using a large sample and a proper study design.

  15. Neuroplastic Sensorimotor Resting State Network Reorganization in Children With Hemiplegic Cerebral Palsy Treated With Constraint-Induced Movement Therapy.

    Science.gov (United States)

    Manning, Kathryn Y; Menon, Ravi S; Gorter, Jan Willem; Mesterman, Ronit; Campbell, Craig; Switzer, Lauren; Fehlings, Darcy

    2016-02-01

    Using resting state functional magnetic resonance imaging (MRI), we aim to understand the neurologic basis of improved function in children with hemiplegic cerebral palsy treated with constraint-induced movement therapy. Eleven children including 4 untreated comparison subjects diagnosed with hemiplegic cerebral palsy were recruited from 3 clinical centers. MRI and clinical data were gathered at baseline and 1 month for both groups, and 6 months later for the case group only. After constraint therapy, the sensorimotor resting state network became more bilateral, with balanced contributions from each hemisphere, which was sustained 6 months later. Sensorimotor resting state network reorganization after therapy was correlated with a change in the Quality of Upper Extremity Skills Test score at 1 month (r = 0.79, P = .06), and Canadian Occupational Performance Measure scores at 6 months (r = 0.82, P = .05). This clinically correlated resting state network reorganization provides further evidence of the neuroplastic mechanisms underlying constraint-induced movement therapy.

  16. Use of maggot therapy for treating a diabetic foot ulcer colonized by multidrug resistant bacteria in Brazil.

    Science.gov (United States)

    Pinheiro, Marilia A R Q; Ferraz, Julianny B; Junior, Miguel A A; Moura, Andrew D; da Costa, Maria E S M; Costa, Fagner J M D; Neto, Valter F A; Neto, Renato M; Gama, Renata A

    2015-03-01

    This study reports the efficacy of maggot therapy in the treatment of diabetic foot ulcer infected with multidrug resistant microorganisms. A 74 year old female patient with diabetes for over 30 years, was treated with maggot therapy using larvae of Chrysomya megacephala. The microbiological samples were collected to evaluate aetiology of the infection. The therapy done for 43 days resulted in a reduction of necrosis and the ulcer's retraction of 0.7 cm [2] in area. Analysis of the bacteriological swabs revealed the presence of Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. Further studies need to be done to confirm the role of maggot therapy in wound healing using a large sample and a proper study design.

  17. Photodynamic therapy and tumor imaging of hypericin-treated squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    Sercarz Joel

    2006-12-01

    Full Text Available Abstract Background Conventional cancer therapy including surgery, radiation, and chemotherapy often are physically debilitating and largely ineffective in previously treated patients with recurrent head and neck squamous cell carcinoma (SCC. A natural photochemical, hypericin, could be a less invasive method for laser photodynamic therapy (PDT of these recurrent head and neck malignancies. Hypericin has powerful photo-oxidizing ability, tumor localization properties, and fluorescent imaging capabilities as well as minimal dark toxicity. The current study defined hypericin PDT in vitro with human SCC cells before the cells were grown as tumor transplants in nude mice and tested as a model for hypericin induced tumor fluorescence and PDT via laser fiberoptics. Methods SNU squamous carcinoma cells were grown in tissue culture, detached from monolayers with trypsin, and incubated with 0.1 μg to 10 μg/ml of hypericin before exposure to laser light at 514, 550, or 593 nm to define optimal dose, time, and wavelength for PDT of tumor cells. The SCC cells also were injected subcutaneously in nude mice and grown for 6–8 weeks to form tumors before hypericin injection and insertion of fiberoptics from a KTP532 surgical laser to assess the feasibility of this operating room instrument in stimulating fluorescence and PDT of tumors. Results In vitro testing revealed a hypericin dose of 0.2–0.5 μg/ml was needed for PDT of the SCC cells with an optimal tumoricidal response seen at the 593 nm light absorption maximum. In vivo tumor retention of injected hypericin was seen for 7 to10 days using KTP532 laser induced fluorescence and biweekly PDT via laser fiberoptics led to regression of SCC tumor transplants under 0.4 cm2 diameter, but resulted in progression of larger size tumors in the nude mice. Conclusion In this preclinical study, hypericin was tested for 514–593 nm dye laser PDT of human SCC cells in vitro and for KTP532 surgical laser targeting

  18. A suicide gene therapy approach to treat epidermolysis bullosa-associated skin cancer

    International Nuclear Information System (INIS)

    Recessive dystrophic epidermolysis bullosa (RDEB) is an inherited disease causing extensive blister formation within the basal membrane zone (BMZ) of the skin and mucous membranes. It is caused by premature STOP mutations in the COL7A1 gene, which is indispensable for proper skin assembling. RDEB is associated with the development of a highly malignant skin cancer (squamous cell carcinoma, SCC) in early adulthood that displays a life threatening complication within this patient group. To date, neither chemo- nor radiotherapies showed successful results and due to the high metastatic potential of RDEB SCC wide surgical excision is still favoured. In this study we could reveal a new promising cancer treatment using spliceosome mediated RNA trans-splicing (SMaRT) using a suicide gene therapy approach. First we identified the tumour marker gene MMP-9 expressed by RDEB SCC cells in cell culture which was used to generate various pre-mRNA trans-splicing molecules (PTM). PTMs are able to facilitate trans-splicing between a tumour target gene and a cell death inducing peptide/toxin, encoded by the PTM. As a consequence the toxin is expressed in cancer cells leading to the induction of cell death. This technique offers high specificity in cancer cell targeting compared to other conventional cDNA expression studies. Various trans-splicing molecules were pre-evaluated in a fluorescence screening model for their best trans-splicing efficiency with the target molecule. Herein we identified two potent PTMs (PTM BD0 and PTM BD6), that were further adapted for endogenous suicide studies by inserting the toxin streptolysin O. In two independent in vitro cell culture assays we were able to confirm that the trans-splicing molecules are able to induce expression of the toxin resulting in cell membrane permeabilization and increased cell death induction. The results indicate that SMaRT technology offers a new platform for a suicide gene therapy approach to treat malignant squamous cell

  19. Treating dyspareunia caused by vaginal atrophy: a review of treatment options using vaginal estrogen therapy

    Directory of Open Access Journals (Sweden)

    SA Kingsberg

    2009-08-01

    Full Text Available SA Kingsberg¹, S Kellogg², M Krychman³1University Hospitals Case Medical Center, Case Western Reserve University Cleveland OH, USA; 2The Pelvic and Sexual Health Institute of Philadelphia, Drexel University College of Medicine, Philadelphia, USA; 3Southern California Center for Sexual Health and Survivorship Medicine, Newport Beach, CA, USAAbstract: Vulvovaginal atrophy (VVA and dryness are common symptoms of the decline in endogenous production of estrogen at menopause and often result in dyspareunia. Yet while 10% to 40% of women experience discomfort due to VVA, it is estimated that only 25% seek medical help. The main goals of treatment for vaginal atrophy are to improve symptoms and to restore vaginal and vulvar anatomic changes. Treatment choices for postmenopausal dyspareunia resulting from vulvovaginal atrophy will depend on the underlying etiology and might include individualized treatment. A number of forms of vaginal estrogen and manner of delivery are currently available to treat moderate to severe dyspareunia caused by VVA. They all have been shown to be effective and are often the preferred treatment due to the targeted efficacy for urogenital tissues while resulting in only minimal systemic absorption. Both healthcare professionals and patients often find it difficult to broach the subject of sexual problems associated with VVA. However, with minimal effort to initiate a conversation about these problems, healthcare providers can provide useful information to their postmenopausal patients in order to help them each choose the optimal treatment for their needs and symptoms.Keywords: dyspareunia, postmenopausal vulvovaginal atrophy, vaginal estrogen therapy

  20. Review of the Interaction Between Body Composition and Clinical Outcomes in Metastatic Renal Cell Cancer Treated With Targeted Therapies

    Directory of Open Access Journals (Sweden)

    Steven M Yip

    2016-03-01

    Full Text Available Treatment of metastatic renal cell cancer (mRCC currently focuses on inhibition of the vascular endothelial growth factor pathway and the mammalian target of rapamycin (mTOR pathway. Obesity confers a higher risk of RCC. However, the influence of obesity on clinical outcomes in mRCC in the era of targeted therapy is less clear. This review focuses on the impact of body composition on targeted therapy outcomes in mRCC. The International Metastatic Renal Cell Carcinoma Database Consortium database has the largest series of patients evaluating the impact of body mass index (BMI on outcomes in mRCC patients treated with targeted therapy. Overall survival was significantly improved in overweight patients (BMI ≥ 25 kg/m2, and this observation was externally validated in patients who participated in Pfizer trials. In contrast, sarcopenia is consistently associated with increased toxicity to inhibitors of angiogenesis and mTOR. Strengthening patients with mRCC and sarcopenia, through a structured exercise program and dietary intervention, may improve outcomes in mRCC treated with targeted therapies. At the same time, the paradox of obesity being a risk factor for RCC while offering a better overall survival in response to targeted therapy needs to be further evaluated.

  1. Comparison of Endoscopic Vacuum Therapy and Endoscopic Stent Implantation With Self-Expandable Metal Stent in Treating Postsurgical Gastroesophageal Leakage.

    Science.gov (United States)

    Hwang, Jae J; Jeong, Yeon S; Park, Young S; Yoon, Hyuk; Shin, Cheol M; Kim, Nayoung; Lee, Dong H

    2016-04-01

    The aim of the present study was to evaluate the more effective therapy for the postsurgical gastroesophageal leakage by a head-to-head comparison of endoscopic vacuum therapy (EVT) and endoscopic stent implantation with self-expandable metal stent (E-SEMS). In this hospital-based, retrospective, observative study, the patients were classified into 2 groups. Those treated with EVT were assigned to the EVT group (n = 7), and those treated with E-SMS were assigned to the E-SEMS group (n = 11). We evaluated the clinical characteristics and treatment outcomes between the 2 groups. All 7 patients (100%) were treated with EVT, but only 7 of 11 patients (63.6%) in the stenting group were treated successfully. The median time to clinical success was 19.5 (5-21) days in the EVT group and 27.0 (3-84) days in the E-SEMS group. The median hospital stay was 37.1 (13-128) days in the EVT group and 87.3 (17-366) days in the E-SEMS group. The complicaion rate was lower in the EVT group (0/7, 0.0%) than that in the E-SEMS group (6/11, 54.5%) with statistically significant difference (P = 0.042). EVT is more effective and has fewer adverse effects than E-SMS therapy as a treatment for postsurgical gastroesophageal leakage. PMID:27100431

  2. Development of a dual phantom technique for measuring the fast neutron component of dose in boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Sakurai, Yoshinori, E-mail: yosakura@rri.kyoto-u.ac.jp; Tanaka, Hiroki; Kondo, Natsuko; Kinashi, Yuko; Suzuki, Minoru; Masunaga, Shinichiro; Ono, Koji; Maruhashi, Akira [Kyoto University Research Reactor Institute, Asashironishi 2-1010, Kumatori-cho, Sennan-gun, Osaka 590-0494 (Japan)

    2015-11-15

    Purpose: Research and development of various accelerator-based irradiation systems for boron neutron capture therapy (BNCT) is underway throughout the world. Many of these systems are nearing or have started clinical trials. Before the start of treatment with BNCT, the relative biological effectiveness (RBE) for the fast neutrons (over 10 keV) incident to the irradiation field must be estimated. Measurements of RBE are typically performed by biological experiments with a phantom. Although the dose deposition due to secondary gamma rays is dominant, the relative contributions of thermal neutrons (below 0.5 eV) and fast neutrons are virtually equivalent under typical irradiation conditions in a water and/or acrylic phantom. Uniform contributions to the dose deposited from thermal and fast neutrons are based in part on relatively inaccurate dose information for fast neutrons. This study sought to improve the accuracy in the dose estimation for fast neutrons by using two phantoms made of different materials in which the dose components can be separated according to differences in the interaction cross sections. The development of a “dual phantom technique” for measuring the fast neutron component of dose is reported. Methods: One phantom was filled with pure water. The other phantom was filled with a water solution of lithium hydroxide (LiOH) capitalizing on the absorbing characteristics of lithium-6 (Li-6) for thermal neutrons. Monte Carlo simulations were used to determine the ideal mixing ratio of Li-6 in LiOH solution. Changes in the depth dose distributions for each respective dose component along the central beam axis were used to assess the LiOH concentration at the 0, 0.001, 0.01, 0.1, 1, and 10 wt. % levels. Simulations were also performed with the phantom filled with 10 wt. % {sup 6}LiOH solution for 95%-enriched Li-6. A phantom was constructed containing 10 wt. % {sup 6}LiOH solution based on the simulation results. Experimental characterization of the

  3. SU-E-J-100: Reconstruction of Prompt Gamma Ray Three Dimensional SPECT Image From Boron Neutron Capture Therapy(BNCT)

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, D; Jung, J; Suh, T [The Catholic University of Korea, College of medicine, Department of biomedical engineering (Korea, Republic of)

    2014-06-01

    Purpose: Purpose of paper is to confirm the feasibility of acquisition of three dimensional single photon emission computed tomography (SPECT) image from boron neutron capture therapy (BNCT) using Monte Carlo simulation. Methods: In case of simulation, the pixelated SPECT detector, collimator and phantom were simulated using Monte Carlo n particle extended (MCNPX) simulation tool. A thermal neutron source (<1 eV) was used to react with the boron uptake region (BUR) in the phantom. Each geometry had a spherical pattern, and three different BURs (A, B and C region, density: 2.08 g/cm3) were located in the middle of the brain phantom. The data from 128 projections for each sorting process were used to achieve image reconstruction. The ordered subset expectation maximization (OSEM) reconstruction algorithm was used to obtain a tomographic image with eight subsets and five iterations. The receiver operating characteristic (ROC) curve analysis was used to evaluate the geometric accuracy of reconstructed image. Results: The OSEM image was compared with the original phantom pattern image. The area under the curve (AUC) was calculated as the gross area under each ROC curve. The three calculated AUC values were 0.738 (A region), 0.623 (B region), and 0.817 (C region). The differences between length of centers of two boron regions and distance of maximum count points were 0.3 cm, 1.6 cm and 1.4 cm. Conclusion: The possibility of extracting a 3D BNCT SPECT image was confirmed using the Monte Carlo simulation and OSEM algorithm. The prospects for obtaining an actual BNCT SPECT image were estimated from the quality of the simulated image and the simulation conditions. When multiple tumor region should be treated using the BNCT, a reasonable model to determine how many useful images can be obtained from the SPECT could be provided to the BNCT facilities. This research was supported by the Leading Foreign Research Institute Recruitment Program through the National Research

  4. Experimental Studies of Boronophenylalanine ({sup 10}BPA) Biodistribution for the Individual Application of Boron Neutron Capture Therapy (BNCT) for Malignant Melanoma Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Carpano, Marina; Perona, Marina; Rodriguez, Carla [Department of Radiobiology, National Atomic Energy Commission, San Martín (Argentina); Nievas, Susana; Olivera, Maria; Santa Cruz, Gustavo A. [Department of Boron Neutron Capture Therapy, National Atomic Energy Commission, San Martín (Argentina); Brandizzi, Daniel; Cabrini, Romulo [Department of Radiobiology, National Atomic Energy Commission, San Martín (Argentina); School of Dentistry, University of Buenos Aires, Buenos Aires (Argentina); Pisarev, Mario [Department of Radiobiology, National Atomic Energy Commission, San Martín (Argentina); National Research Council of Argentina, Buenos Aires (Argentina); Department of Human Biochemistry, School of Medicine, University of Buenos Aires, Buenos Aires (Argentina); Juvenal, Guillermo Juan [Department of Radiobiology, National Atomic Energy Commission, San Martín (Argentina); National Research Council of Argentina, Buenos Aires (Argentina); Dagrosa, Maria Alejandra, E-mail: dagrosa@cnea.gov.ar [Department of Radiobiology, National Atomic Energy Commission, San Martín (Argentina); National Research Council of Argentina, Buenos Aires (Argentina)

    2015-10-01

    Purpose: Patients with the same histopathologic diagnosis of cutaneous melanoma treated with identical protocols of boron neutron capture therapy (BNCT) have shown different clinical outcomes. The objective of the present studies was to evaluate the biodistribution of boronophenilalanina ({sup 10}BPA) for the potential application of BNCT for the treatment of melanoma on an individual basis. Methods and Materials: The boronophenilalanine (BPA) uptake was evaluated in 3 human melanoma cell lines: MEL-J, A375, and M8. NIH nude mice were implanted with 4 10{sup 6} MEL-J cells, and biodistribution studies of BPA (350 mg/kg intraperitoneally) were performed. Static infrared imaging using a specially modified infrared camera adapted to measure the body infrared radiance of small animals was used. Proliferation marker, Ki-67, and endothelial marker, CD31, were analyzed in tumor samples. Results: The in vitro studies demonstrated different patterns of BPA uptake for each analyzed cell line (P<.001 for MEL-J and A375 vs M8 cells). The in vivo studies showed a maximum average boron concentration of 25.9 ± 2.6 μg/g in tumor, with individual values ranging between 11.7 and 52.0 μg/g of {sup 10}B 2 hours after the injection of BPA. Tumor temperature always decreased as the tumors increased in size, with values ranging between 37°C and 23°C. A significant correlation between tumor temperature and tumor-to-blood boron concentration ratio was found (R{sup 2} = 0.7, rational function fit). The immunohistochemical studies revealed, in tumors with extensive areas of viability, a high number of positive cells for Ki-67, blood vessels of large diameter evidenced by the marker CD31, and a direct logistic correlation between proliferative status and boron concentration difference between tumor and blood (R{sup 2} = 0.81, logistic function fit). Conclusion: We propose that these methods could be suitable for designing new screening protocols applied before melanoma BNCT

  5. Experimental Studies of Boronophenylalanine (10BPA) Biodistribution for the Individual Application of Boron Neutron Capture Therapy (BNCT) for Malignant Melanoma Treatment

    International Nuclear Information System (INIS)

    Purpose: Patients with the same histopathologic diagnosis of cutaneous melanoma treated with identical protocols of boron neutron capture therapy (BNCT) have shown different clinical outcomes. The objective of the present studies was to evaluate the biodistribution of boronophenilalanina (10BPA) for the potential application of BNCT for the treatment of melanoma on an individual basis. Methods and Materials: The boronophenilalanine (BPA) uptake was evaluated in 3 human melanoma cell lines: MEL-J, A375, and M8. NIH nude mice were implanted with 4 106 MEL-J cells, and biodistribution studies of BPA (350 mg/kg intraperitoneally) were performed. Static infrared imaging using a specially modified infrared camera adapted to measure the body infrared radiance of small animals was used. Proliferation marker, Ki-67, and endothelial marker, CD31, were analyzed in tumor samples. Results: The in vitro studies demonstrated different patterns of BPA uptake for each analyzed cell line (P<.001 for MEL-J and A375 vs M8 cells). The in vivo studies showed a maximum average boron concentration of 25.9 ± 2.6 μg/g in tumor, with individual values ranging between 11.7 and 52.0 μg/g of 10B 2 hours after the injection of BPA. Tumor temperature always decreased as the tumors increased in size, with values ranging between 37°C and 23°C. A significant correlation between tumor temperature and tumor-to-blood boron concentration ratio was found (R2 = 0.7, rational function fit). The immunohistochemical studies revealed, in tumors with extensive areas of viability, a high number of positive cells for Ki-67, blood vessels of large diameter evidenced by the marker CD31, and a direct logistic correlation between proliferative status and boron concentration difference between tumor and blood (R2 = 0.81, logistic function fit). Conclusion: We propose that these methods could be suitable for designing new screening protocols applied before melanoma BNCT treatment for each individual

  6. SU-E-J-100: Reconstruction of Prompt Gamma Ray Three Dimensional SPECT Image From Boron Neutron Capture Therapy(BNCT)

    International Nuclear Information System (INIS)

    Purpose: Purpose of paper is to confirm the feasibility of acquisition of three dimensional single photon emission computed tomography (SPECT) image from boron neutron capture therapy (BNCT) using Monte Carlo simulation. Methods: In case of simulation, the pixelated SPECT detector, collimator and phantom were simulated using Monte Carlo n particle extended (MCNPX) simulation tool. A thermal neutron source (<1 eV) was used to react with the boron uptake region (BUR) in the phantom. Each geometry had a spherical pattern, and three different BURs (A, B and C region, density: 2.08 g/cm3) were located in the middle of the brain phantom. The data from 128 projections for each sorting process were used to achieve image reconstruction. The ordered subset expectation maximization (OSEM) reconstruction algorithm was used to obtain a tomographic image with eight subsets and five iterations. The receiver operating characteristic (ROC) curve analysis was used to evaluate the geometric accuracy of reconstructed image. Results: The OSEM image was compared with the original phantom pattern image. The area under the curve (AUC) was calculated as the gross area under each ROC curve. The three calculated AUC values were 0.738 (A region), 0.623 (B region), and 0.817 (C region). The differences between length of centers of two boron regions and distance of maximum count points were 0.3 cm, 1.6 cm and 1.4 cm. Conclusion: The possibility of extracting a 3D BNCT SPECT image was confirmed using the Monte Carlo simulation and OSEM algorithm. The prospects for obtaining an actual BNCT SPECT image were estimated from the quality of the simulated image and the simulation conditions. When multiple tumor region should be treated using the BNCT, a reasonable model to determine how many useful images can be obtained from the SPECT could be provided to the BNCT facilities. This research was supported by the Leading Foreign Research Institute Recruitment Program through the National Research

  7. Treating Depressive Symptoms in Psychosis: A Network Meta-Analysis on the Effects of Non-Verbal Therapies.

    Directory of Open Access Journals (Sweden)

    Laura A Steenhuis

    Full Text Available The aim of this study was to examine whether non-verbal therapies are effective in treating depressive symptoms in psychotic disorders.A systematic literature search was performed in PubMed, Psychinfo, Picarta, Embase and ISI Web of Science, up to January 2015. Randomized controlled trials (RCTs comparing a non-verbal intervention to a control condition in patients with psychotic disorders, whilst measuring depressive symptoms as a primary or secondary outcome, were included. The quality of studies was assessed using the 'Clinical Trials Assessment Measure for psychological treatments' (CTAM scale. Cohen's d was calculated as a measure of effect size. Using a Network Meta-analysis, both direct and indirect evidence was investigated.10 RCTs were included, of which three were of high quality according to the CTAM. The direct evidence demonstrated a significant effect on the reduction in depressive symptoms relative to treatment as usual (TAU, in favor of overall non-verbal therapy (ES: -0.66, 95% C.I. = -0.88, -0.44 and music therapy (ES: -0.59, 95% C.I. = -0.85, -0.33. Combining both direct and indirect evidence, yoga therapy (ES: -0.79, 95% C.I. = -1.24, -0.35 had a significant effect on depressive symptoms, and occupational therapy (ES: 1.81, 95% C.I. = 0.81, 2.81 was less effective, relative to TAU. Exercise therapy did not show a significant effect on depressive symptoms in comparison to TAU (ES: -0.02 95% C.I. = -0.67, 0.62. Due to inconsistency of study evidence, the indirect effects should be interpreted cautiously.Non-verbal therapies appear to be effective in reducing depressive symptomatology in psychotic disorders, in particular music therapy and yoga therapy.

  8. The changes in complete blood count in thyroid cancer patients treated with radioactive iodine ablation therapy

    OpenAIRE

    Bircan Sönmez; İsmail Doğan; Canan Yavruoğlu; Gamze Can; Mehmet Sönmez

    2010-01-01

    Objective: The aim of this study was to evaluate the effect of radioactive iodine (RAI) ablation therapy on the complete blood count (CBC) in thyroid cancer patients. Materials and Methods: One hundred sixty four patients undergoing RAI ablation therapy after total thyroidectomy were included. CBC results were available from the patients’ medical records at the time of ablation and at the 1st, 6th, and 12th months after RAI therapy.Results: Hemoglobin (Hb), white blood cell (WBC) and platelet...

  9. Tumor development in field-cancerized tissue is inhibited by a double application of Boron neutron capture therapy (BNCT) without exceeding radio-tolerance

    International Nuclear Information System (INIS)

    Introduction: BNCT is based on the capture reaction between boron, selectively targeted to tumor tissue, and thermal neutrons which gives rise to lethal, short-range high linear energy transfer particles that selectively damage tumor tissue, sparing normal tissue. We previously evidenced a remarkable therapeutic success of a 'single' application of boron neutron capture therapy (BNCT) mediated by boronophenylalanine (BPA), GB-1(Na210B10H10) or (GB-10+BPA) to treat hamster cheek pouch tumors with no normal tissue radiotoxicity. Based on these results, we developed a model of precancerous tissue in the hamster cheek pouch for long-term studies. Employing this model we evaluated the long-term potential inhibitory effect on the development of second primary tumors from precancerous tissue and eventual radiotoxicity of a single application of BNCT mediated by BPA, GB-10 or (GB-10+BPA), in the RA-6. The clinical rationale of this study was to search for a BNCT protocol that is therapeutic for tumor, not radio-toxic for the normal tissue that lies in the neutron beam path, and exerts the desired inhibitory effect on the development of second primary tumors, without exceeding the radio-tolerance of precancerous tissue, the dose limiting tissue in this case. Second primary tumors that arise in precancerous tissue (also called locoregional recurrences) are a frequent cause of therapeutic failure in head and neck tumors. Aim: Evaluate the radiotoxicity and inhibitory effect of a 'double' application of the same BNCT protocols that were proved therapeutically successful for tumor and precancerous tissue, with a long term follow up (8 months). A 'double' application of BNCT is a potentially useful strategy for the treatment of tumors, in particular the larger ones, but the cost in terms of side-effects in dose-limiting tissues might preclude its application and requires cautious evaluation. Materials and methods: We performed a double application of 1) BPA-BNCT; 2) (GB- 10+BPA

  10. Preparation and characterization of Boron carbide nanoparticles for use as a novel agent in T cell-guided boron neutron capture therapy.

    Science.gov (United States)

    Mortensen, M W; Sørensen, P G; Björkdahl, O; Jensen, M R; Gundersen, H J G; Bjørnholm, T

    2006-03-01

    Boron carbide nanoparticles are proposed as a system for T cell-guided boron neutron capture therapy. Nanoparticles were produced by ball milling in various atmospheres of commercially available boron carbide. The physical and chemical properties of the particles were investigated using transmission electron microscopy, photon correlation spectroscopy, X-ray photoelectron spectroscopy, X-ray diffraction, vibrational spectroscopy, gel electrophoresis and chemical assays and reveal profound changes in surface chemistry and structural characteristics. In vitro thermal neutron irradiation of B16 melanoma cells incubated with sub-100 nm nanoparticles (381.5 microg/g (10)B) induces complete cell death. The nanoparticles alone induce no toxicity.

  11. Development of high intensity ion sources for a Tandem-Electrostatic-Quadrupole facility for Accelerator-Based Boron Neutron Capture Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Bergueiro, J. [Gerencia de Investigacion y Aplicaciones, Comision Nacional de Energia Atomica (Argentina)] [CONICET, Buenos Aires (Argentina); Igarzabal, M.; Suarez Sandin, J.C. [Gerencia de Investigacion y Aplicaciones, Comision Nacional de Energia Atomica (Argentina); Somacal, H.R. [Gerencia de Investigacion y Aplicaciones, Comision Nacional de Energia Atomica (Argentina)] [Escuela de Ciencia y Tecnologia, Universidad Nacional de San Martin (Argentina); Thatar Vento, V. [Gerencia de Investigacion y Aplicaciones, Comision Nacional de Energia Atomica (Argentina)] [CONICET, Buenos Aires (Argentina); Huck, H.; Valda, A.A. [Gerencia de Investigacion y Aplicaciones, Comision Nacional de Energia Atomica (Argentina)] [Escuela de Ciencia y Tecnologia, Universidad Nacional de San Martin (Argentina); Repetto, M. [Gerencia de Investigacion y Aplicaciones, Comision Nacional de Energia Atomica (Argentina)

    2011-12-15

    Several ion sources have been developed and an ion source test stand has been mounted for the first stage of a Tandem-Electrostatic-Quadrupole facility For Accelerator-Based Boron Neutron Capture Therapy. A first source, designed, fabricated and tested is a dual chamber, filament driven and magnetically compressed volume plasma proton ion source. A 4 mA beam has been accelerated and transported into the suppressed Faraday cup. Extensive simulations of the sources have been performed using both 2D and 3D self-consistent codes.

  12. Boron neutron capture therapy for clear cell sarcoma (CCS): Biodistribution study of p-borono-L-phenylalanine in CCS-bearing animal models

    Energy Technology Data Exchange (ETDEWEB)

    Andoh, T. [Laboratory of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences and Cooperative Research Center of Life Sciences, Kobe Gakuin University, Kobe 650-8586 (Japan); Fujimoto, T. [Department of Orthopaedic Surgery, Hyogo Cancer Center, Akashi 673-0021 (Japan); Sudo, T. [Section of Translational Research, Hyogo Cancer Center, Akashi 673-0021 (Japan); Fujita, I.; Imabori, M. [Department of Orthopaedic Surgery, Hyogo Cancer Center, Akashi 673-0021 (Japan); Moritake, H. [Department of Pediatrics, Miyazaki University, Kiyotake 889-1692 (Japan); Sugimoto, T. [Department of Pediatrics, Saiseikai Shigaken Hospital, Ritto 520-3046 (Japan); Sakuma, Y. [Department of Pathology, Hyogo Cancer Center, Akashi 673-0021 (Japan); Takeuchi, T. [Department of Pathology, Kochi University, Nangoku 783-8505 (Japan); Kawabata, S. [Department of Neurosurgery, Osaka Medical College, Osaka 569-8686 (Japan); Kirihata, M. [Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Sakai 599-8531 (Japan); Akisue, T. [Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017 (Japan); Yayama, K. [Laboratory of Cardiovascular Pharmacology, Faculty of Pharmaceutical Sciences and Cooperative Research Center of Life Sciences, Kobe Gakuin University, Kobe 650-8586 (Japan); Kurosaka, M. [Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017 (Japan); Miyatake, S. [Department of Neurosurgery, Osaka Medical College, Osaka 569-8686 (Japan); Fukumori, Y. [Laboratory of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences and Cooperative Research Center of Life Sciences, Kobe Gakuin University, Kobe 650-8586 (Japan); Ichikawa, H., E-mail: ichikawa@pharm.kobegakuin.ac.jp [Laboratory of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences and Cooperative Research Center of Life Sciences, Kobe Gakuin University, Kobe 650-8586 (Japan)

    2011-12-15

    Clear cell sarcoma (CCS) is a rare melanocytic malignant tumor with a poor prognosis. Our previous study demonstrated that in vitro cultured CCS cells have the ability to highly uptake L-BPA and thus boron neutron capture therapy could be a new option for CCS treatment. This paper proved that a remarkably high accumulation of {sup 10}B (45-74 ppm) in tumor was obtained even in a CCS-bearing animal with a well-controlled biodistribution followed by intravenous administration of L-BPA-fructose complex (500 mg BPA/kg).

  13. A Case of Stage IV Non-Small Cell Lung Cancer Treated with Korean Medicine Therapy Alone

    Directory of Open Access Journals (Sweden)

    Dong-hyun Lee

    2013-11-01

    Full Text Available This report presents a case that shows a significant anticancer effect of Korean medicine therapy (KMT. A 79-year-old man, who was diagnosed as stage Ⅳ non-small cell lung cancer (NSCLC in December 2012, was treated with KMT including intravenous pharmacopunctures and oral herbal medicine from February 22, 2013, until September 2013 without any surgical intervention, chemotherapy or radiotherapy. The intravenous pharmacopunctures were the wild ginseng pharmacopuncture, Cordyceps sinensis pharmacopuncture and Trichosanthes kirilowii pharmacopuncture. The oral herbal medicine used was soramdan, made of cultivated wild ginseng. The effectiveness of this therapy was evaluated with computed tomography and the Eastern Cooperative Oncology Group (ECOG performance scale. The size of the tumor mass was markedly decreased and the ECOG performance scale was also improved. These results suggest that KMT alone can be an effective method to treat NSCLC.

  14. Capturing Thoughts, Capturing Minds?

    DEFF Research Database (Denmark)

    Nielsen, Janni

    2004-01-01

    Think Aloud is cost effective, promises access to the user's mind and is the applied usability technique. But 'keep talking' is difficult, besides, the multimodal interface is visual not verbal. Eye-tracking seems to get around the verbalisation problem. It captures the visual focus of attention...

  15. Interstitial implantation as a radiation boost for high risk patients treated with breast conservation therapy

    International Nuclear Information System (INIS)

    Purpose: As part of a prospective institutional protocol for breast conservation treatment which employed aggressive therapy to the tumor-bearing quadrant, interstitial implantation was the preferred method of boost after 50.4 Gy whole breast irradiation for 'high risk' patients with tumor margins ≤ 2 mm. An analysis of clinical outcomes with respect to local tumor control and breast cosmesis was performed. Patients and Methods: From 1982-1994, 128 patients received an implant boost and a comparison data base was drawn from a total experience of 501 treated breasts. The median age of the implanted patients was 51 yrs and the median follow-up was 75 mos (range 10-150 mos). The implant target volume was determined by clinical assessment of post-operative induration and pre- and post-excisional mammograms. All implants were constructed in accordance with a pre-planning algorithm designed to maximize dose homogeniety within a prescription isodose goal of 50 cGy/hr. Local control and cosmetic outcome were evaluated with respect to extent of tumor, histopathology, margin status, extent of surgery, and systemic adjuvant therapy. Implant quality was assessed using four calculated parameters: strand separation product (SSP), planar separation product (PSP), global separation product (GSP), and dose homogeneity index (DHI). The mean implant volume was 47.9 ± 20.2 cc, the mean prescribed dose rate was 46.2 ± 8.5 cGy/hr and the mean total implant dose was 1993.8 ± 151.0 cGy. The final excision margin was positive, >0<1 mm, 1-2 mm, and indeterminate in 50%, 19%, 21%, and 15%, respectively. Results: Cosmetic outcome was good/excellent in 91% of patients which was not statistically different from non-implant patients. Logistic regression analysis revealed that re-excision, elevated SSP, and decreased DHI were associated with adverse cosmesis. There were 10 local failures in the implanted patients (4 within the prescribed isodose volume, 5 at the periphery and 1 elsewhere in

  16. Clinical observation on common peroneal nerve palsy treated with comprehensive therapy

    Institute of Scientific and Technical Information of China (English)

    杨丽娟

    2014-01-01

    Objective To compare the difference of the clinical efficacy on common peroneal nerve palsy between the comprehensive therapy of electroacupuncture,moxibustion and moving cupping method and western medication.Methods Ninety cases of common peroneal nerve palsy were randomized into a comprehensive therapy group and a western medication group,45 cases in each

  17. Cellular signaling in sinecatechins-treated external genital and perianal warts: unraveling the mechanism of action of a botanical therapy

    Institute of Scientific and Technical Information of China (English)

    Harrison; P; Nguyen; Hung; Q; Doan; Peter; Rady; Stephen; K; Tyring

    2015-01-01

    <正>Dear Editor,Derived from green tea leaves,sinecatechins(Veregen)ointment,15%is a topical therapy that is FDA-approved to treat human papillomavirus(HPV)-induced external genital and perianal warts(EGW)in immunocompetent patients aged 18 years and older.In two phase 3 trials enrolling over 1,000 participants with EGW,a 16-week treatment regimen with sinecatechins ointment resulted in higher rates of complete clearance of all warts—both

  18. Occurrence and morphological characteristics of cataracts in patients treated with general steroid therapy at the Cantonal Hospital Zenica

    OpenAIRE

    Jasmin Zvorničanin; Edita Zvorničanin

    2015-01-01

    Dear Editor, We read with interest the article by Čerim et al. regarding the occurrence and morphological characteristics of cataracts in patients treated with general steroid therapy (1). Similar to the results of previous studies, the authors found that the use of corticosteroids is associated with a higher incidence of cataract development and posterior subcapsular (PSC) cataract as most prevalent morphological type (2). Older age and heredity are the most important risk factors as...

  19. [A case report of claustrophobia with panic attack due to an MRI, treated by cognitive-behavioral therapy].

    Science.gov (United States)

    Montel, S

    2009-07-01

    Claustrophobia, this fear of being locked up without being able to escape, affects about 4 to 5% of subjects in the general population. For some years, studies tackle this trouble in the context of medical exam and treatments (MRI, radiotherapy, etc.). Studies show that cognitive-behavioral therapies (CBT) obtain satisfying results for treating such patients. Here, we present a case report of a CBT intervention for a patient suffering from a cancer and whose claustrophobia impeded her treatment. PMID:18433940

  20. Experience of emplying extracorporal shock-wave therapy for treating limb enthesopathies in patients with articular hypermobility syndrome

    OpenAIRE

    VOROTNIKOV ALEXANDER; SANEYEVA GALINA; TSYMBAL ANDREY

    2014-01-01

    Purpose: to study the efficiency of extracorporal shock-wave therapy and the affected area orthopedic relief for treating pain syndrome associated with enthesopathies in patients with articular hypermobility syndrome.75 patients with enthesopathies of various localizations and diagnosed articular hypermobility were observed in 2008-2011, their age varying from 35 to 55 years (median age: 37.5±0.4 years). The treatment mode was out-patient, with a shockwave device PIEZOSON-100 (manufacturer: R...

  1. Primary Injuries and Secondary Organ Failures in Trauma Patients with Acute Kidney Injury Treated with Continuous Renal Replacement Therapy

    OpenAIRE

    Sigrid Beitland; Ingrid Os; Kjetil Sunde

    2014-01-01

    Background. Acute kidney injury (AKI) treated with continuous renal replacement therapy (CRRT) is a severe complication in trauma patients. The aim of the study was to assess primary traumatic injuries and secondary organ failures in severe posttraumatic AKI. Methods. Retrospective review of adult trauma patients admitted to the trauma centre at Oslo University Hospital Ullevål. Injury severity score (ISS) was used to assess the severity of primary injuries, and sequential organ failure asses...

  2. Cognitive behaviour therapy in medication-treated adults with ADHD and persistent Symptoms: A randomized controlled trial

    OpenAIRE

    Einarsson Emil; Baldursson Gisli; Sigurdsson Jon F; Gudjonsson Gisli; Emilsson Brynjar; Olafsdottir Halldora; Young Susan

    2011-01-01

    Abstract Background Attention deficit hyperactivity disorder (ADHD) in adulthood is not fully treated by psychopharmacological treatment alone. The main aim of the current study was to evaluate a newly developed cognitive behaviour therapy (CBT) based group programme, the Reasoning and Rehabilitation for ADHD Youths and Adults (R&R2ADHD), using a randomized controlled trial. Methods 54 adults with ADHD already receiving psychopharmacological treatment were randomly allocated to an experimenta...

  3. The Effectiveness of Eye Movement Desensitization and Reprocessing Therapy to Treat Symptoms Following Trauma in Timor Leste.

    Science.gov (United States)

    Schubert, Sarah J; Lee, Christopher W; de Araujo, Guilhermina; Butler, Susan R; Taylor, Graham; Drummond, Peter D

    2016-04-01

    The effectiveness of eye movement desensitization and reprocessing (EMDR) therapy for treating trauma symptoms was examined in a postwar/conflict, developing nation, Timor Leste. Participants were 21 Timorese adults with symptoms of posttraumatic stress disorder (PTSD), assessed as those who scored ≥2 on the Harvard Trauma Questionnaire (HTQ). Participants were treated with EMDR therapy. Depression and anxiety symptoms were assessed using the Hopkins Symptom Checklist. Symptom changes post-EMDR treatment were compared to a stabilization control intervention period in which participants served as their own waitlist control. Sessions were 60-90 mins. The average number of sessions was 4.15 (SD = 2.06). Despite difficulties providing treatment cross-culturally (i.e., language barriers), EMDR therapy was followed by significant and large reductions in trauma symptoms (Cohen's d = 2.48), depression (d = 2.09), and anxiety (d = 1.77). At posttreatment, 20 (95.2%) participants scored below the HTQ PTSD cutoff of 2. Reliable reductions in trauma symptoms were reported by 18 participants (85.7%) posttreatment and 16 (76.2%) at 3-month follow-up. Symptoms did not improve during the control period. Findings support the use of EMDR therapy for treatment of adults with PTSD in a cross-cultural, postwar/conflict setting, and suggest that structured trauma treatments can be applied in Timor Leste. PMID:26934487

  4. Healthcare seeking behaviour for Buruli ulcer in Benin : a model to capture therapy choice of patients and healthy community members

    NARCIS (Netherlands)

    Mulder, Annelies A.; Boerma, Roelien P.; Barogui, Yves; Zinsou, Claude; Johnson, R. Christian; Gbovi, Jules; van der Werf, Tjip S.; Stienstra, Ymkje

    2008-01-01

    Buruli ulcer is a devastating condition emerging in West Africa. We investigated why patients often report late to the hospital. Health seeking behaviour determinants and stigma were studied by in-depth interviews in patients treated in hospital (n = 107), patients treated traditionally (n = 46) of

  5. Electrophysiological Monitoring in Patients With Tumors of the Skull Base Treated by Carbon-12 Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Carozzo, Simone [Department of Neuroscience, Ophthalmology, and Genetics, University of Genova, Genova (Italy); Schardt, Dieter [Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt (Germany); Narici, Livio [Department of Physics, University of Rome Tor Vergata, Rome (Italy); Combs, Stephanie E.; Debus, Jürgen [Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany); Sannita, Walter G., E-mail: wgs@dism.unige.it [Department of Neuroscience, Ophthalmology, and Genetics, University of Genova, Genova (Italy); Department of Psychiatry, State University of New York, Stony Brook, New York (United States)

    2013-03-15

    Purpose: To report the results of short-term electrophysiologic monitoring of patients undergoing {sup 12}C therapy for the treatment of skull chordomas and chondrosarcomas unsuitable for radical surgery. Methods and Materials: Conventional electroencephalogram (EEG) and retinal and cortical electrophysiologic responses to contrast stimuli were recorded from 30 patients undergoing carbon ion radiation therapy, within a few hours before the first treatment and after completion of therapy. Methodologies and procedures were compliant with the guidelines of the International Federation for Clinical Neurophysiology and International Society for Clinical Electrophysiology of Vision. Results: At baseline, clinical signs were reported in 56.6% of subjects. Electrophysiologic test results were abnormal in 76.7% (EEG), 78.6% (cortical evoked potentials), and 92.8% (electroretinogram) of cases, without correlation with neurologic signs, tumor location, or therapy plan. Results on EEG, but not electroretinograms and cortical responses, were more often abnormal in patients with reported clinical signs. Abnormal EEG results and retinal/cortical responses improved after therapy in 40% (EEG), 62.5% (cortical potentials), and 70% (electroretinogram) of cases. Results on EEG worsened after therapy in one-third of patients whose recordings were normal at baseline. Conclusions: The percentages of subjects whose EEG results improved or worsened after therapy and the improvement of retinal/cortical responses in the majority of patients are indicative of a limited or negligible (and possibly transient) acute central nervous system toxicity of carbon ion therapy, with a significant beneficial effect on the visual pathways. Research on large samples would validate electrophysiologic procedures as a possible independent test for central nervous system toxicity and allow investigation of the correlation with clinical signs; repeated testing over time after therapy would demonstrate, and may

  6. Internet-Delivered Cognitive Behavioral Therapy to Treat Insomnia: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Michael Seyffert

    Full Text Available Insomnia is of major public health importance. While cognitive behavioral therapy is beneficial, in-person treatment is often unavailable. We assessed the effectiveness of internet-delivered cognitive behavioral therapy for insomnia.The primary objectives were to determine whether online cognitive behavioral therapy for insomnia could improve sleep efficiency and reduce the severity of insomnia in adults. Secondary outcomes included sleep quality, total sleep time, time in bed, sleep onset latency, wake time after sleep onset, and number of nocturnal awakenings.We searched PubMed/MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, PsycInfo, Cochrane Library, Embase, and the Web of Science for randomized trials.Studies were eligible if they were randomized controlled trials in adults that reported application of cognitive behavioral therapy for insomnia via internet delivery. Mean differences in improvement in sleep measures were calculated using the Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis.We found 15 trials, all utilizing a pretest-posttest randomized control group design. Sleep efficiency was 72% at baseline and improved by 7.2% (95% CI: 5.1%, 9.3%; p<0.001 with internet-delivered cognitive behavioral therapy versus control. Internet-delivered cognitive behavioral therapy resulted in a decrease in the insomnia severity index by 4.3 points (95% CI: -7.1, -1.5; p = 0.017 compared to control. Total sleep time averaged 5.7 hours at baseline and increased by 20 minutes with internet-delivered therapy versus control (95% CI: 9, 31; p = 0.004. The severity of depression decreased by 2.3 points (95% CI: -2.9, -1.7; p = 0.013 in individuals who received internet-delivered cognitive behavioral therapy compared to control. Improvements in sleep efficiency, the insomnia severity index and depression scores with internet-delivered cognitive behavioral therapy were maintained from 4 to 48 weeks after post

  7. Study of the interaction of boron-containing amino acids for the neutron capture therapy with biologically interesting compounds by using 'three-spot zone electrophoresis'

    International Nuclear Information System (INIS)

    As the boron carriers for boron neutron capture therapy, p-borono phenylalanine (BPA) is the boron compound which has been clinically used together with sodium borocaptate. It was found by the electrophoresis behavior that the BPA interacted with organic carboxylic acids in its dissolved state. In this paper, the electrophoresis behavior of general amino acids as seen in three-spot zone electrophoresis and the peculiar interaction of the amino acids having dihydroxyboryl radical are described. Zone electrophoresis has been developed as separation means, and three-spot process excludes the errors due to accidental factors as far as possible. The behaviors of zone electrophoresis of ordinary neutral amino acids, orthoboric acid and p-BPA are reported. For utilizing the features of boron neutron capture therapy, it is necessary to develop the carrier which is singularly taken into cancer cells. There is not a good method for discriminating normal cells and cancer cells. As for the administration of BPA to patients, its solubility is insufficient, therefore, its fructose complex has been used. The research on the biochemical peculiarity of boron is important. (K.I.)

  8. Is Yangxue Qingnao Granule Combined with Antihypertensive Drugs, a New Integrative Medicine Therapy, More Effective Than Antihypertensive Therapy Alone in Treating Essential Hypertension?

    Directory of Open Access Journals (Sweden)

    Jie Wang

    2013-01-01

    Full Text Available Background. Yangxue Qingnao granule (YQG combined with antihypertensive drugs, a new integrative medicine therapy, has been widely used for essential hypertension (EH in China. This study aims to assess the current clinical evidence of YQG combined with antihypertensive drugs for EH. Methods. Randomized controlled trials(RCTs published between 1996 and 2012 on YQG combined with antihypertensive drugs versus antihypertensive drugs in treating EH were retrieved from six major electronic databases, including The Cochrane Library, PubMed, Chinese National Knowledge Infrastructure, Chinese Scientific Journal Database, Chinese Biomedical Literature Database, and Wanfang Data. Meta-analysis was performed on the overall effects on blood pressure. Results. Twelve randomized trials were included. Methodological quality of the trials was evaluated as generally low. Meta-analysis showed that YQG combined with antihypertensive drugs demonstrated potential effect for lowing either SBP (MD: −7.31 [−11.75, −2.87]; P=0.001 or DBP (MD: −5.21 [−8.19, −2.24]; P=0.0006 compared to antihypertensive drugs alone. Conclusions. It indicated that YQG combined with antihypertensive drugs is more effective than antihypertensive drugs alone in treating EH. However, more RCTs of larger scale, multicentre/country, longer follow-up periods, and higher quality are required to verify the efficacy of integrative medicine therapy over all antihypertensive therapies.

  9. Sphincter preservation in patients with low rectal cancer treated with radiation therapy with or without local excision or fulguration

    International Nuclear Information System (INIS)

    Twenty-six patients with small cancers limited to the lower two-thirds of the rectum were treated with conservative surgery and radiation therapy (XRT). In patients treated with local excision or fulguration followed by XRT, there was a 6% local failure rate (one in 17); in 16 of 17 patients receiving radiation doses above 4500 cGy, the local control was complete for follow-up periods of 6 months to 7 years. In nine patients treated with XRT for residual tumor, local failure occurred in five (56%). Serious late complications occurred only if total doses were greater than 6300 cGy. Local excision combined with XRT proved to be a safe alternative to radical surgery in selected patients and resulted in excellent local control while allowing preservation of anal sphincter function

  10. Is Androgen Deprivation Therapy Necessary in All Intermediate-Risk Prostate Cancer Patients Treated in the Dose Escalation Era?

    Energy Technology Data Exchange (ETDEWEB)

    Castle, Katherine O., E-mail: kocastle@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hoffman, Karen E.; Levy, Lawrence B.; Lee, Andrew K.; Choi, Seungtaek; Nguyen, Quynh N.; Frank, Steven J.; Pugh, Thomas J.; McGuire, Sean E.; Kuban, Deborah A. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2013-03-01

    Purpose: The benefit of adding androgen deprivation therapy (ADT) to dose-escalated radiation therapy (RT) for men with intermediate-risk prostate cancer is unclear; therefore, we assessed the impact of adding ADT to dose-escalated RT on freedom from failure (FFF). Methods: Three groups of men treated with intensity modulated RT or 3-dimensional conformal RT (75.6-78 Gy) from 1993-2008 for prostate cancer were categorized as (1) 326 intermediate-risk patients treated with RT alone, (2) 218 intermediate-risk patients treated with RT and ≤6 months of ADT, and (3) 274 low-risk patients treated with definitive RT. Median follow-up was 58 months. Recursive partitioning analysis based on FFF using Gleason score (GS), T stage, and pretreatment PSA concentration was applied to the intermediate-risk patients treated with RT alone. The Kaplan-Meier method was used to estimate 5-year FFF. Results: Based on recursive partitioning analysis, intermediate-risk patients treated with RT alone were divided into 3 prognostic groups: (1) 188 favorable patients: GS 6, ≤T2b or GS 3+4, ≤T1c; (2) 71 marginal patients: GS 3+4, T2a-b; and (3) 68 unfavorable patients: GS 4+3 or T2c disease. Hazard ratios (HR) for recurrence in each group were 1.0, 2.1, and 4.6, respectively. When intermediate-risk patients treated with RT alone were compared to intermediate-risk patients treated with RT and ADT, the greatest benefit from ADT was seen for the unfavorable intermediate-risk patients (FFF, 74% vs 94%, respectively; P=.005). Favorable intermediate-risk patients had no significant benefit from the addition of ADT to RT (FFF, 94% vs 95%, respectively; P=.85), and FFF for favorable intermediate-risk patients treated with RT alone approached that of low-risk patients treated with RT alone (98%). Conclusions: Patients with favorable intermediate-risk prostate cancer did not benefit from the addition of ADT to dose-escalated RT, and their FFF was nearly as good as patients with low-risk disease

  11. Evaluation of Pain in Single and Multi Rooted Teeth Treated in Single Visit Endodontic Therapy

    OpenAIRE

    Raju, T B V G; Seshadri, Abitha; Vamsipavani, B; Abhilash, K; Subhash, A V; Kumari, K.V Halini

    2014-01-01

    Background: The incidence of post-operative pain was compared following single-visit canal treatment in single- and multi-rooted teeth, with and without periapical radiolucency. The article also reviews the issues of postoperative pain and healing, following single-visit and multi-visit endodontic therapy. Single-visit endodontic therapy (SVE) was performed in 50 single-rooted teeth and 60 multiple-rooted teeth.

  12. Plasma exchange successfully treats central pontine myelinolysis after acute hypernatremia from intravenous sodium bicarbonate therapy

    OpenAIRE

    Chang, Kyung Yoon; Lee, In-Hee; Kim, Gi Jun; Cho, Kangwon; Park, Hoon Suk; Kim, Hyung Wook

    2014-01-01

    Background Osmotic demyelination syndrome (ODS) primarily occurs after rapid correction of severe hyponatremia. There are no proven effective therapies for ODS, but we describe the first case showing the successful treatment of central pontine myelinolysis (CPM) by plasma exchange, which occurred after rapid development of hypernatremia from intravenous sodium bicarbonate therapy. Case presentation A 40-year-old woman presented with general weakness, hypokalemia, and metabolic acidosis. The p...

  13. Treating Traumatized Offenders and Veterans by Means of Narrative Exposure Therapy

    OpenAIRE

    Tobias eHecker; Katharin eHermenau; Anselm eCrombach; Thomas eElbert

    2015-01-01

    Violent offenders and soldiers are at high risk of developing appetitive aggression and trauma-related disorders, which reduce successful integration into societies. Narrative Exposure Therapy for Forensic Offender Rehabilitation (FORNET) aims at reducing symptoms of traumatic stress (e.g. posttraumatic stress disorder) and controlling readiness for aggressive behavior. It follows the logic of the evidence-based trauma-focused Narrative Exposure Therapy (NET) with special emphasis on violent ...

  14. Effect of long-term music therapy intervention on autonomic function in anthracycline-treated breast cancer patients.

    Science.gov (United States)

    Chuang, Chih-Yuan; Han, Wei-Ru; Li, Pei-Chun; Song, Mi-Yun; Young, Shuenn-Tsong

    2011-12-01

    Anthracyclines are potent antineoplastic agents associated with cardiotoxicity, which may lead to congestive heart failure, causing impairment of autonomic cardiovascular function as assessed by heart rate variability (HRV). This decreases survival rates. This study aimed to determine whether music therapy intervention improves autonomic function in anthracycline-treated breast cancer patients, and if so, whether such improvements persist after cessation of the intervention. Participants were 12 women with breast cancer who had undergone mastectomy or breast-conserving treatment and adjuvant chemotherapy; they attended 8 weekly music therapy sessions, each lasting 2 hours. Electrocardiogram traces (5 minutes) for HRV analysis were recorded 4 times: prior to the first music session, T1; after the fourth music session, T2; after the eighth music session, T3; and 4 weeks after the completion of music therapy, T4. HRV parameters were subjected to a nonparametric Friedman test on the differences between T1 and T2, T3, and T4. The standard deviation of normal intervals and the total power of HRV parameters, related to global autonomic function, were significantly higher at T3 than at T1. The root-mean-square differences of successive normal R-R intervals and high-frequency (HF) HRV parameters, related to parasympathetic activity, were significantly increased, but no change was seen in the LF/HF ratio of HRV parameters (which is related to sympathetic activity) during the music therapy. Global autonomic function and parasympathetic activity had not changed significantly at T4 relative to T1. The authors provide preliminary evidence of the benefits of music therapy for anthracycline-treated breast cancer survivors. PMID:21382955

  15. Regional Lymphotropic Therapy in Combination with Low Level Laser Therapy for Treating Multi-Drug-Resistant Tuberculosis

    Directory of Open Access Journals (Sweden)

    Oksana Dogorova

    2016-03-01

    Full Text Available With the growing incidence of Multi-Drug-Resistant Tuberculosis (MDR-TB in newly identified patients, novel multimodality treatment methods are needed, aimed at reducing the time to sputum conversion and cavity healing, which would be applicable in MDR cases. Our experimental treatment consisted of the following: 1 chemotherapy based on the drug sensitivity profile, 2 local laser irradiation therapy for 25 days, and lymphotropic administration of isoniazid (to subcutaneous tissue in alternating locations: underarm area; fifth intercostal space along the sterna border; subclavian area where the first rib meets the sternum in a daily dose of 10mg/kg 5 times a week. This treatment was significantly more effective in newly detected destructive MDR-TB versus the standard Category IV regimen for MDR-TB in terms of reduced time for sputum culture conversion and cavity healing, estimated to be 6 months after initiation of treatment.

  16. Safety and immunogenicity of therapeutic DNA vaccination in individuals treated with antiretroviral therapy during acute/early HIV-1 infection.

    Directory of Open Access Journals (Sweden)

    Eric S Rosenberg

    Full Text Available BACKGROUND: An effective therapeutic vaccine that could augment immune control of HIV-1 replication may abrogate or delay the need for antiretroviral therapy. AIDS Clinical Trials Group (ACTG A5187 was a phase I/II, randomized, placebo-controlled, double-blinded trial to evaluate the safety and immunogenicity of an HIV-1 DNA vaccine (VRC-HVDNA 009-00-VP in subjects treated with antiretroviral therapy during acute/early HIV-1 infection. (clinicaltrials.gov NCT00125099 METHODS: Twenty healthy HIV-1 infected subjects who were treated with antiretroviral therapy during acute/early HIV-1 infection and had HIV-1 RNA<50 copies/mL were randomized to receive either vaccine or placebo. The objectives of this study were to evaluate the safety and immunogenicity of the vaccine. Following vaccination, subjects interrupted antiretroviral treatment, and set-point HIV-1 viral loads and CD4 T cell counts were determined 17-23 weeks after treatment discontinuation. RESULTS: Twenty subjects received all scheduled vaccinations and discontinued antiretroviral therapy at week 30. No subject met a primary safety endpoint. No evidence of differences in immunogenicity were detected in subjects receiving vaccine versus placebo. There were also no significant differences in set-point HIV-1 viral loads or CD4 T cell counts following treatment discontinuation. Median set-point HIV-1 viral loads after treatment discontinuation in vaccine and placebo recipients were 3.5 and 3.7 log(10 HIV-1 RNA copies/mL, respectively. CONCLUSIONS: The HIV-1 DNA vaccine (VRC-HIVDNA 009-00-VP was safe but poorly immunogenic in subjects treated with antiretroviral therapy during acute/early HIV-1 infection. Viral set-points were similar between vaccine and placebo recipients following treatment interruption. However, median viral load set-points in both groups were lower than in historical controls, suggesting a possible role for antiretroviral therapy in persons with acute or early HIV-1

  17. PHYSICAL THERAPY AS A SUPPORT FOR PSYCHOTHERAPY IN TREATING BODY DYSMORPHIC DISORDER (BDD - CASE STUDY

    Directory of Open Access Journals (Sweden)

    Mârza-Dănilă Doina

    2015-10-01

    Full Text Available The treatment for Body Dysmorphic Disorder (or dysmorphophobia includes antidepressant medication, cognitive-behavioral psychotherapy, psychoanalytical psychotherapy, hypnosis and others [2].Cognitive-behavioral psychotherapy was used for a patient with Body Dysmorphic Disorder, without any remarkable results, because even if the patient could bring himself to imagine the anxiogenic scenes, he could not manage to confront his fears. The psychotherapist called upon the services of physical therapy and over the course of three months, the patient's phobia regressed almost completely from his daily life. In conclusion, physical therapy can be considered, in Body Dysmorphic Disorder cases that are hard to manage through behavioral and cognitive therapies, as a support for psychotherapy.

  18. Laser-Based Strategies to Treat Diabetic Macular Edema: History and New Promising Therapies

    Directory of Open Access Journals (Sweden)

    Young Gun Park

    2014-01-01

    Full Text Available Diabetic macular edema (DME is the main cause of visual impairment in diabetic patients. The management of DME is complex and often various treatment approaches are needed. At the present time, despite the enthusiasm for evaluating several new treatments for DME, including the intravitreal pharmacologic therapies (e.g., corticosteroids and anti-VEGF drugs, laser photocoagulation still remains the current standard in DME. The purpose of this review is to update our knowledge on laser photocoagulation for DME and describe the developments in laser systems. And we will also discuss the new laser techniques and review the latest results including benefits of combined therapy. In this paper, we briefly summarize the major laser therapeutics for the treatment of diabetic macular edema and allude to some future promising laser therapies.

  19. [Retrospective analysis for 104 cases of early-stage Hodgkin's Lymphoma treated with different modality therapies].

    Science.gov (United States)

    Du, Ting-Ting; Xiao, Xiu-Bin; Su, Hang; Da, Yong; Chen, Xin-Lin; Zhong, Kai-Li; Zhao, Shi-Hua; Lu, Yun; Wang, Shuang; Zhang, Wei-Jing

    2012-04-01

    This paper explored the curative effect of combined modality therapy and extended field radiotherapy for early-stage Hodgkin's Lymphoma. 104 cases of early-stage Hodgkin's Lymphoma from Jan 1987 to Dec 2010 in PLA Hospital 307 were retrospectively analyzed, including 76 cases in combined modality therapy group and 28 cases in extended field radiotherapy group, and the long-term efficacy and toxicity of two therapy modalities were evaluated. The results showed that the median survival time of 104 cases was 85.42 months, the complete remission rates of combined modality therapy and extended field radiotherapy groups were 72.4 and 71.4 respectively (P = 0.924); the overall response rates of combined modality therapy and extended field radiotherapy groups were 97.4 and 96.4 respectively (P = 0.779); the 5-year overall survival (OS) rates in the 2 groups were 89.5 and 89.1 respectively, and the 8-year OS rates of the 2 groups were 81.3 and 70.6. No statistical difference was found in above-mentioned 2 groups. Moreover, the 5-year progression free survival (PFS) rates of these 2 groups were 84.2 and 69.0 (P = 0.04), and 8-year PFS rates of these 2 groups were 80.0 and 55.5 (P = 0.04) respectively, the 5-year relapse rates of these 2 groups were 28.1 and 45.6 (P = 0.023) respectively. It is concluded that the combined modality therapy can raise the PFS rate and reduce the relapse rate as compared with extended field radiotherapy for early-stage Hodgkin's Lymphoma, but there is no difference in the overall survival rate between the 2 groups.

  20. Effect of Cardiac Resynchronization Therapy in Patients With Insulin-Treated Diabetes Mellitus

    DEFF Research Database (Denmark)

    Szepietowska, Barbara; Kutyifa, Valentina; Ruwald, Martin H;

    2015-01-01

    branch block in the Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy trial. Treatment with CRT-D versus implantable cardioverter defibrillator was associated with 76% risk reduction in all-cause mortality (hazard ratio 0.24; 95% confidence interval 0.08 to 0...... by the presence of insulin treatment. We determined whether cardiac resynchronization therapy with defibrillator (CRT-D) versus implantable cardioverter defibrillator improves clinical outcomes in these 3 subgroups. Cox proportional hazards regression models were used to analyze 1,278 patients with left bundle...

  1. Children peripheral facial palsy treated with three therapies of strong stimulation: a randomized controlled trial

    Institute of Scientific and Technical Information of China (English)

    曹文忠

    2013-01-01

    Objective To evaluate the clinical efficacy and safety of the three therapies of strong stimulation for children peripheral facial palsy so as to deal with the problem on the inactive acceptance of acupuncture in children.Methods Eighty cases of children peripheral facial palsy were randomized into a moxa stick group (group A) and a group with three therapies of strong stimulation (group B) .Baihui (GV 20) ,Sibai (ST 2) ,Dicang (ST 4) ,Jiache (ST 6) and the other acupoints were selected in the two groups and stimulated with half-needling technique.

  2. [How I treat...Recommendations for controlling and optimizing a pharmacological therapy].

    Science.gov (United States)

    Scheen, A J

    2014-11-01

    Any pharmacological treatment should ideally be effective and safe. The supervision of an ongoing therapy should control that individualized goals are reached while tolerance and safety are present. In case of not reaching the predefined objectives, the causes of failure should first be screened (for instance, exclusion of poor patient compliance), and the treatment should be then optimized: dose adjustment, add-on of another drug (if possible synergistic combination) and/or shift to a more effective pharmacological therapy. In some cases, therapeutic monitoring may be useful or even mandatory in order to better adjust drug dosing and thus guarantee both efficacy and safety.

  3. Clinical Study on Therapy of Clearing Hallow Viscera in Treating Critical Patients with Gastro-enteric Function Disorder

    Institute of Scientific and Technical Information of China (English)

    YANG Sheng-lan; LI Dao-ben

    2006-01-01

    Objective: To explore the clinical effect of therapy of clearing hallow viscera in treating critical patients with gastro-enteric function disorder (GEFD). Methods: Retrospective analysis was carried out The recovery rate, recovery time of gastro-enteric function, incidence rate and fatality rate of multiple organdysfunction syndrome (MODS), as well as the level of plasma endotoxin (ET) before and after treatment between the two groups were compared. Results: Comparison between the two groups in gastro-enteric function recovery rate (81.3% vs 45.8%), functional disorder sustaining time in patients who got recovered (1.2 ±0.3 daysvs4.0±1.1 days), incidence rate (29. 17% vs52.08%) and fatality rate (28.57% vs56.00%)of MODS all showed significant difference ( P<0.05 or P<0.01 ). The plasma level of ET after treatment in the treated group was significantly lower than that in the control group (P<0.05). Conclusion: Therapy of clearing hallow viscera has a good effect in treating critical patients with gastro-enteric function disorder, and could reduce the incidence and fatality of MODS.

  4. The changes in complete blood count in thyroid cancer patients treated with radioactive iodine ablation therapy

    Directory of Open Access Journals (Sweden)

    Bircan Sönmez

    2010-12-01

    Full Text Available Objective: The aim of this study was to evaluate the effect of radioactive iodine (RAI ablation therapy on the complete blood count (CBC in thyroid cancer patients. Materials and Methods: One hundred sixty four patients undergoing RAI ablation therapy after total thyroidectomy were included. CBC results were available from the patients’ medical records at the time of ablation and at the 1st, 6th, and 12th months after RAI therapy.Results: Hemoglobin (Hb, white blood cell (WBC and platelet (Plt values were significantly lower than baseline at 1 month after treatment (p<0.0001. Hb and WBC values were increased at the 6th month and at the 1st year. Plt values increased at the 6th month but had decreased again at the 1st year. The values were usually in normal ranges except in the patients with low pretreatment Hb and WBC values.Conclusion: RAI ablation therapy in thyroid cancer patients is a safe treatment modality without any serious or persistent hematological side effects.

  5. The Additive Benefit of Hypnosis and Cognitive-Behavioral Therapy in Treating Acute Stress Disorder

    Science.gov (United States)

    Bryant, Richard A.; Moulds, Michelle L.; Guthrie, Rachel M.; Nixon, Reginald D. V.

    2005-01-01

    This research represents the first controlled treatment study of hypnosis and cognitive- behavioral therapy (CBT) of acute stress disorder (ASD). Civilian trauma survivors (N = 87) who met criteria for ASD were randomly allocated to 6 sessions of CBT, CBT combined with hypnosis (CBT-hypnosis), or supportive counseling (SC). CBT comprised exposure,…

  6. Detection of lipoatrophy in human immunodeficiency virus-1-infected children treated with highly active antiretroviral therapy.

    NARCIS (Netherlands)

    Hartman, K.; Verweel, G.; Groot, R. de; Hartwig, N.G.

    2006-01-01

    BACKGROUND: Highly active antiretroviral therapy has been associated with lipodystrophy in adults. Much is unknown about its characteristics, especially in children. OBJECTIVE: To obtain an objective case definition of the lipodystrophy syndrome. METHODS: This was a cross-sectional study. One invest

  7. Psychopathy as predictor and moderator of Multisystemic Therapy outcomes among adolescents treated for antisocial behavior

    NARCIS (Netherlands)

    W.A. Manders; M. Deković; J.J. Asscher; P.H. van der Laan; P.J.M. Prins

    2013-01-01

    Objective: The aim of the present study was to determine whether psychopathic traits act as a predictor and/or moderator of the effectiveness of Multisystemic Therapy (MST). Method: The sample included N = 256 adolescents (188 boys and 68 girls) referred for conduct problems, randomized to MST or Tr

  8. Treating Inpatients with Comorbid Depression and Alcohol Use Disorders: A Comparison of Acceptance and Commitment Therapy

    Science.gov (United States)

    Petersen, Connie L.; Zettle, Robert D.

    2009-01-01

    Inpatients involuntarily committed to a chemical dependency unit and exhibiting a co-occurring depressive disorder received either individual sessions of acceptance and commitment therapy (ACT) or treatment as usual (TAU) within the context of an ongoing 12-step program. Results indicated significant, but equivalent, reductions in levels of…

  9. [Post-pneumonectomy Empyema Successfully Treated with Negative Pressure Wound Therapy].

    Science.gov (United States)

    Hayashi, Satoshi; Takahashi, Nana; Yasuda, Shunsuke; Ishibashi, Kei; Kitada, Masahiro

    2016-03-01

    A 61-year-old man underwent right pneumonectomy for primary lung cancer. Four weeks later, he was referred to our hospital for empyema. After 2 months of irrigation with saline, vacuum-assited closure therapy followed by the open thoracotomy was started. After cleaning thoracic cavity bacteriologically, the thoracoplasty and muscle flap transposition was performed, and the empyema completely disappeared.

  10. An augmented cognitive behavioural therapy for treating post-stroke depression: description of a treatment protocol

    NARCIS (Netherlands)

    Kootker, J.A.; Rasquin, S.M.; Smits, P; Geurts, A.C.H.; Heugten, C.M. van; Fasotti, L.

    2015-01-01

    AIM: Currently, no evidence-based treatment is available for mood problems after stroke. We present a new psychological intervention designed to reduce depressive complaints after stroke. METHOD OF PROTOCOL DEVELOPMENT: This intervention was based on cognitive behavioural therapy principles and was

  11. An augmented cognitive behavioural therapy for treating post-stroke depression: Description of a treatment protocol

    NARCIS (Netherlands)

    Kootker, J.A.; Rasquin, S.M.C.; Smits, P.; Geurts, A.C.H.; Heugten, C.M. van; Fasotti, L.

    2015-01-01

    Aim Currently, no evidence-based treatment is available for mood problems after stroke. We present a new psychological intervention designed to reduce depressive complaints after stroke. Method of protocol development This intervention was based on cognitive behavioural therapy principles and was sh

  12. Comparative Study of Multimodal and Pharmacological Therapy in Treating School Aged Children with ADHD

    Directory of Open Access Journals (Sweden)

    Susana Bogdana MILEA

    2012-09-01

    Full Text Available The attention deficit hyperactivity disorder (ADHD, one of the most commonly diagnosed psychiatric disorders among school aged children, continues to create disputes between specialists, upon the best treatment to be used. The herby study aims to bring forward some differences that may exist between the efficacy of the multimodal treatment compared to the drug treatment of ADHD. The novelty component of this study, unfolded February 2010-July 2012, is that the children, their parents and also their teachers were included in the multimodality treatment. The children included in this research (n=63, aged 6-14 and ADHD diagnosed, were randomly assigned in two groups. In the medication (Med group (n=32 the children only received the specific pharmacological treatment (Atomoxetine or Methylphenidate, and for the multimodality (MM group (n=31 the therapy included psychosocial interventions besides the drug therapy. All children were evaluated, both pre and post intervention, with the Achenbach System of Empirically Based Assessment – ASEBA, for the 6-18 aged category. We have compared the influence of therapy on the core symptoms, on the adaptive functionality and academic performance and on the competences and social functioning of the children in the two groups. The multimodal intervention proved to be more effective (p<0.05 than medication alone, firstly in ameliorating the child’s social behavior in both family and school environment, than in what concerns the main ADHD symptoms. The children’s academic performance was little impacted by either of the two therapies.

  13. Association between adjuvant regional radiotherapy and cognitive function in breast cancer patients treated with conservation therapy

    International Nuclear Information System (INIS)

    Although protracted cognitive impairment has been reported to occur after radiotherapy even when such therapy is not directed to brain areas, the mechanism remains unclear. This study investigated whether breast cancer patients exposed to local radiotherapy showed lower cognitive function mediated by higher plasma interleukin (IL)-6 levels than those unexposed. We performed the Wechsler Memory Scale-Revised (WMS-R) and measured plasma IL-6 levels for 105 breast cancer surgical patients within 1 year after the initial therapy. The group differences in each of the indices of WMS-R were investigated between cancer patients exposed to adjuvant regional radiotherapy (n = 51) and those unexposed (n = 54) using analysis of covariance. We further investigated a mediation effect by plasma IL-6 levels on the relationship between radiotherapy and the indices of WMS-R using the bootstrapping method. The radiotherapy group showed significantly lower Immediate Verbal Memory Index and Delayed Recall Index (P = 0.001, P = 0.008, respectively). Radiotherapy exerted an indirect effect on the lower Delayed Recall Index of WMS-R through elevation of plasma IL-6 levels (bootstrap 95% confidence interval = −2.6626 to −0.0402). This study showed that breast cancer patients exposed to adjuvant regional radiotherapy in conservation therapy might have cognitive impairment even several months after their treatment. The relationship between the therapy and the cognitive impairment could be partially mediated by elevation of plasma IL-6 levels

  14. Clenched fist injury complicated by septic arthritis and osteomyelitis treated with negative pressure wound therapy: One case report

    Institute of Scientific and Technical Information of China (English)

    Miroslav Kilian

    2016-01-01

    We reported a 30 years old man who suffered a bite wound of the right hand in a fight.Two days after the injury,he was admitted in emergency because of stab wound above the head of the third metacarpal bone.He presented the swelling,redness,pain and fever.Primary revision confirmed only partial lesion of the extensor apparatus.During the following days,we recorded a deterioration of local findings and magnetic resonance imaging revealed osteomyelitis and septic arthritis of the third metacarpophalangeal joint.The wound was then revised several times using negative pressure wound therapy in combination with intravenous antibiotics.After resolution of clinical and laboratory findings,the wound was finally closed by delayed primary suture.Clenched fist injury is a medical emergency that requires immediate surgical revision.We treated clenched fist injury with the development of septic arthritis and osteomyelitis with negative pressure wound therapy and obtained good outcomes.

  15. Proton Radiation Therapy for Pediatric Medulloblastoma and Supratentorial Primitive Neuroectodermal Tumors: Outcomes for Very Young Children Treated With Upfront Chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Jimenez, Rachel B., E-mail: rbjimenez@partners.org [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Sethi, Roshan [Harvard Medical School, Boston, Massachusetts (United States); Depauw, Nicolas [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Pulsifer, Margaret B. [Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts (United States); Adams, Judith [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); McBride, Sean M. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Ebb, David [Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts (United States); Fullerton, Barbara C.; Tarbell, Nancy J.; Yock, Torunn I.; MacDonald, Shannon M. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2013-09-01

    Purpose: To report the early outcomes for very young children with medulloblastoma or supratentorial primitive neuroectodermal tumor (SPNET) treated with upfront chemotherapy followed by 3-dimensional proton radiation therapy (3D-CPT). Methods and Materials: All patients aged <60 months with medulloblastoma or SPNET treated with chemotherapy before 3D-CPT from 2002 to 2010 at our institution were included. All patients underwent maximal surgical resection, chemotherapy, and adjuvant 3D-CPT with either craniospinal irradiation followed by involved-field radiation therapy or involved-field radiation therapy alone. Results: Fifteen patients (median age at diagnosis, 35 months) were treated with high-dose chemotherapy and 3D-CPT. Twelve of 15 patients had medulloblastoma; 3 of 15 patients had SPNET. Median time from surgery to initiation of radiation was 219 days. Median craniospinal irradiation dose was 21.6 Gy (relative biologic effectiveness); median boost dose was 54.0 Gy (relative biologic effectiveness). At a median of 39 months from completion of radiation, 1 of 15 was deceased after a local failure, 1 of 15 had died from a non-disease-related cause, and the remaining 13 of 15 patients were alive without evidence of disease recurrence. Ototoxicity and endocrinopathies were the most common long-term toxicities, with 2 of 15 children requiring hearing aids and 3 of 15 requiring exogenous hormones. Conclusions: Proton radiation after chemotherapy resulted in good disease outcomes for a small cohort of very young patients with medulloblastoma and SPNET. Longer follow-up and larger numbers of patients are needed to assess long-term outcomes and late toxicity.

  16. Boron neutron capture therapy of glioblastoma multiforme using the p- boronophenylalanine-fructose complex and epithermal neutrons

    International Nuclear Information System (INIS)

    The amino acid analogue p-boronophenylalanine (BPA) is under investigation as a neutron capture agent for BNCT of glioblastoma multiforme. A series of patients undergoing surgical removal of tumor received BPA orally as the free amino acid. Favorable tumor/blood boron concentration ratios were obtained but the absolute amount of boron in the tumor would have been insufficient for BNCT. BPA can be solubilized at neutral pH by complexation with fructose (BPA-F). Studies with rats suggest that intraperitoneal injection of BPA-F complex produces a much higher tumor boron concentration to rat intracerebral 9L gliosarcoma that were possible with oral BPA. Higher boron concentrations have allowed higher tumor radiation doses to be delivered while maintaining the dose to the normal brain vascular endothelium below the threshold of tolerance. The experience to date of the administration of BPA-F to one patient is provided in this report

  17. Generation and Feasibility Assessment of a New Vehicle for Cell-Based Therapy for Treating Corneal Endothelial Dysfunction.

    Directory of Open Access Journals (Sweden)

    Naoki Okumura

    Full Text Available The corneal endothelium maintains corneal transparency by its pump and barrier functions; consequently, its decompensation due to any pathological reason causes severe vision loss due to corneal haziness. Corneal transplantation is the only therapeutic choice for treating corneal endothelial dysfunction, but associated problems, such as a shortages of donor corneas, the difficulty of the surgical procedure, and graft failure, still need to be resolved. Regenerative medicine is attractive to researchers as a means of providing innovative therapies for corneal endothelial dysfunction, as it now does for other diseases. We previously demonstrated the successful regeneration of corneal endothelium in animal models by injecting cultured corneal endothelial cells (CECs in combination with a Rho kinase (ROCK inhibitor. The purpose of the present study was to optimize the vehicle for clinical use in cell-based therapy. Our screening of cell culture media revealed that RELAR medium promoted CEC adhesion. We then modified RELAR medium by removing hormones, growth factors, and potentially toxic materials to generate a cell therapy vehicle (CTV composed of amino acid, salts, glucose, and vitamins. Injection of CECs in CTV enabled efficient engraftment and regeneration of the corneal endothelium in the rabbit corneal endothelial dysfunction model, with restoration of a transparent cornea. The CECs retained >85% viability after a 24 hour preservation as a cell suspension in CTV at 4°C and maintained their potency to regenerate the corneal endothelium in vivo. The vehicle developed here is clinically applicable for cell-based therapy aimed at treating the corneal endothelium. Our strategy involves the generation of vehicle from a culture medium appropriate for a given cell type by removing materials that are not favorable for clinical use.

  18. The Modern Role of Radiation Therapy in Treating Advanced-Stage Retinoblastoma: Long-Term Outcomes and Racial Differences

    International Nuclear Information System (INIS)

    Purpose/Objective(s): To evaluate the effects of various patient characteristics and radiation therapy treatment variables on outcomes in advanced-stage retinoblastoma. Methods and Materials: This was a retrospective review of 41 eyes of 30 patients treated with external beam radiation therapy between June 1, 1992, and March 31, 2012, with a median follow-up time of 133 months (11 years). Outcome measures included overall survival, progression-free survival, local control, eye preservation rate, and toxicity. Results: Over 90% of the eyes were stage V. Definitive external beam radiation therapy (EBRT) was delivered in 43.9% of eyes, adjuvant EBRT in 22% of eyes, and second-line/salvage EBRT in 34.1% of eyes. A relative lens sparing (RLS) technique was used in 68.3% of eyes and modified lens sparing (MLS) in 24.4% of eyes. Three eyes were treated with other techniques. Doses ≥45 Gy were used in 68.3% of eyes. Chemotherapy was a component of treatment in 53.7% of eyes. The 10-year overall survival was 87.7%, progression-free survival was 80.5%, and local control was 87.8%. White patients had significantly better overall survival than did African-American patients in univariate analysis (hazard ratio 0.09; 95% confidence interval 0.01-0.84; P=.035). Toxicity was seen in 68.3% of eyes, including 24.3% with isolated acute dermatitis. Conclusions: External beam radiation therapy continues to be an effective treatment modality for advanced retinoblastoma, achieving excellent long-term local control and survival with low rates of treatment-related toxicity and secondary malignancy

  19. The Modern Role of Radiation Therapy in Treating Advanced-Stage Retinoblastoma: Long-Term Outcomes and Racial Differences

    Energy Technology Data Exchange (ETDEWEB)

    Orman, Amber [Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, Florida (United States); Koru-Sengul, Tulay [Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida (United States); Miao, Feng [Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida (United States); Markoe, Arnold [Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, Florida (United States); Panoff, Joseph E., E-mail: jpanoff@med.miami.edu [Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, Florida (United States)

    2014-12-01

    Purpose/Objective(s): To evaluate the effects of various patient characteristics and radiation therapy treatment variables on outcomes in advanced-stage retinoblastoma. Methods and Materials: This was a retrospective review of 41 eyes of 30 patients treated with external beam radiation therapy between June 1, 1992, and March 31, 2012, with a median follow-up time of 133 months (11 years). Outcome measures included overall survival, progression-free survival, local control, eye preservation rate, and toxicity. Results: Over 90% of the eyes were stage V. Definitive external beam radiation therapy (EBRT) was delivered in 43.9% of eyes, adjuvant EBRT in 22% of eyes, and second-line/salvage EBRT in 34.1% of eyes. A relative lens sparing (RLS) technique was used in 68.3% of eyes and modified lens sparing (MLS) in 24.4% of eyes. Three eyes were treated with other techniques. Doses ≥45 Gy were used in 68.3% of eyes. Chemotherapy was a component of treatment in 53.7% of eyes. The 10-year overall survival was 87.7%, progression-free survival was 80.5%, and local control was 87.8%. White patients had significantly better overall survival than did African-American patients in univariate analysis (hazard ratio 0.09; 95% confidence interval 0.01-0.84; P=.035). Toxicity was seen in 68.3% of eyes, including 24.3% with isolated acute dermatitis. Conclusions: External beam radiation therapy continues to be an effective treatment modality for advanced retinoblastoma, achieving excellent long-term local control and survival with low rates of treatment-related toxicity and secondary malignancy.

  20. Generation and Feasibility Assessment of a New Vehicle for Cell-Based Therapy for Treating Corneal Endothelial Dysfunction.

    Science.gov (United States)

    Okumura, Naoki; Kakutani, Kazuya; Inoue, Ryota; Matsumoto, Daiki; Shimada, Tomoki; Nakahara, Makiko; Kiyanagi, Yumiko; Itoh, Takehiro; Koizumi, Noriko

    2016-01-01

    The corneal endothelium maintains corneal transparency by its pump and barrier functions; consequently, its decompensation due to any pathological reason causes severe vision loss due to corneal haziness. Corneal transplantation is the only therapeutic choice for treating corneal endothelial dysfunction, but associated problems, such as a shortages of donor corneas, the difficulty of the surgical procedure, and graft failure, still need to be resolved. Regenerative medicine is attractive to researchers as a means of providing innovative therapies for corneal endothelial dysfunction, as it now does for other diseases. We previously demonstrated the successful regeneration of corneal endothelium in animal models by injecting cultured corneal endothelial cells (CECs) in combination with a Rho kinase (ROCK) inhibitor. The purpose of the present study was to optimize the vehicle for clinical use in cell-based therapy. Our screening of cell culture media revealed that RELAR medium promoted CEC adhesion. We then modified RELAR medium by removing hormones, growth factors, and potentially toxic materials to generate a cell therapy vehicle (CTV) composed of amino acid, salts, glucose, and vitamins. Injection of CECs in CTV enabled efficient engraftment and regeneration of the corneal endothelium in the rabbit corneal endothelial dysfunction model, with restoration of a transparent cornea. The CECs retained >85% viability after a 24 hour preservation as a cell suspension in CTV at 4°C and maintained their potency to regenerate the corneal endothelium in vivo. The vehicle developed here is clinically applicable for cell-based therapy aimed at treating the corneal endothelium. Our strategy involves the generation of vehicle from a culture medium appropriate for a given cell type by removing materials that are not favorable for clinical use. PMID:27355373

  1. Unproved tuberculous lesion of penis: A rare cause of saxophone penis treated by a therapeutic trial of anti-tubercular therapy

    Directory of Open Access Journals (Sweden)

    Srinivasan Narayanaswamy

    2011-01-01

    We report a case of a 25 year old male patient who came with multiple discharging sinuses and an urethrocutaneous fistula over the penis treated by a therapeutic trial of Anti-tubercular therapy (ATT.

  2. Elevation of serum KL-6 in patients with psoriasis treated with anti-tumour necrosis factor-α therapy.

    Science.gov (United States)

    Higashi, Y; Tada, K; Shimokawa, M; Kawai, K; Kanekura, T

    2016-01-01

    We report three patients with psoriasis whose serum level of Krebs Von Den Lungen (KL)-6 increased during therapy with anti-tumour necrosis factor (TNF)-α. A diagnosis of early-phase or subclinical interstitial pneumonia was made in two patients, and their KL-6 level decreased after anti-TNF-α discontinuation. The rise in KL-6 in the other patient was attributed to methotrexate. We propose that serum KL-6 should be monitored routinely in patients treated with anti-TNF agents. PMID:25557847

  3. A case of Scalp Rosacea treated with low dose doxycycline and probiotic therapy and literature review on therapeutic options.

    Science.gov (United States)

    Fortuna, M C; Garelli, V; Pranteda, G; Romaniello, F; Cardone, M; Carlesimo, M; Rossi, A

    2016-07-01

    Rosacea is a common chronic inflammatory disorder showing a wide range of clinical features such as telangiectasia, erythema, papules, and pustules primarily involving the central part of face (forehead, cheeks and nose) although extra facial manifestation have been described. We describe a case of rosacea with predominant scalp involvement successfully treated with a 8-week-course of doxycycline 40 mg once a day and probiotic therapy twice a day (Bifidobacterium breve BR03, Lactobacillus salivarius LS01 1 × 10(9) UFC/dose). PMID:27087407

  4. Endurance training improves insulin sensitivity and body composition in prostate cancer patients treated with androgen deprivation therapy

    DEFF Research Database (Denmark)

    Hvid, Thine; Winding, Kamilla; Rinnov, Anders;

    2013-01-01

    Insulin resistance and changes in body composition are side effects of androgen deprivation therapy (ADT) given to prostate cancer patients. The present study investigated whether endurance training improves insulin sensitivity and body composition in ADT-treated prostate cancer patients. Nine me...... and magnetic resonance imaging). The secondary endpoint was systemic inflammation. Statistical analysis was carried out using two-way ANOVA. Endurance training increased VO2max (ml(O2)/min per kg) by 11 and 13% in the patients and controls respectively (P...

  5. Conceptual design project: Accelerator complex for nuclear physics studies and boron neutron capture therapy application at the Yerevan Physics Institute (YerPhI) Yerevan, Armenia

    Energy Technology Data Exchange (ETDEWEB)

    Avagyan, R.H.; Kerobyan, I.A.

    2015-07-15

    The final goal of the proposed project is the creation of a Complex of Accelerator Facilities at the Yerevan Physics Institute (CAF YerPhI) for nuclear physics basic researches, as well as for applied programs including boron neutron capture therapy (BNCT). The CAF will include the following facilities: Cyclotron C70, heavy material (uranium) target/ion source, mass-separator, LINAC1 (0.15–1.5 MeV/u) and LINAC2 (1.5–10 MeV/u). The delivered by C70 proton beams with energy 70 MeV will be used for investigations in the field of basic nuclear physics and with energy 30 MeV for use in applications.

  6. Synthesis and characterization of gadolinium nanostructured materials with potential applications in magnetic resonance imaging, neutron-capture therapy and targeted drug delivery

    Energy Technology Data Exchange (ETDEWEB)

    Stefanakis, Dimitrios; Ghanotakis, Demetrios F., E-mail: ghanotakis@chemistry.uoc.g [University of Crete, Department of Chemistry (Greece)

    2010-05-15

    Two Gadolinium nanostructured materials, Gd{sub 2}(OH){sub 5}NO{sub 3} nanoparticles and Gd(OH){sub 3} nanorods, were synthesized and extensively characterized by various techniques. In addition to the potential use of Gd{sub 2}(OH){sub 5}NO{sub 3} in magnetic resonance imaging (MRI) and Neutron-capture therapy (NCT) application, it could also be used in targeted drug delivery. An antibiotic (nalidixic acid), two amino acids (aspartic and glutamic acid), a fatty acid and a surfactant (SDS) were intercalated in the nanoparticles. The surface of the nanoparticles was modified with folic acid in order to be capable of targeted delivery to folate receptor expressing sites, such as tumor human cells.

  7. Biodistribution of nanoparticles of hydrophobic gadopentetic-acid derivative prepared with a planetary ball mill for neutron-capture therapy of cancer

    International Nuclear Information System (INIS)

    Nanoparticles of hydrophobic gadopentetic-acid derivatives (Gd-nanoGR) were prepared with a wet ball-milling process for gadolinium neutron-capture therapy. Ball-milling of solid mass of gadopentetic acid distearylamide with soybean lecithin as a dispersant in the presence of water and subsequent sonication at 70degC resulted in the Gd-nanoGR with the particle size of 63 nm. Biodistribution study using melanoma-bearing hamsters demonstrated that the i.v. injection of the Gd-nanoGR made a higher gadolinium accumulation in tumor (109 μg Gd/g wet tumor at 6h after administration), when compared with the gadolinium-loaded micellar-like nanoparticles previously reported. (author)

  8. Controllability of depth dose distribution for neutron capture therapy at the Heavy Water Neutron Irradiation Facility of Kyoto University Research Reactor.

    Science.gov (United States)

    Sakurai, Yoshinori; Kobayashi, Tooru

    2002-10-01

    The updating construction of the Heavy Water Neutron Irradiation Facility of the Kyoto University Research Reactor has been performed from November 1995 to March 1996 mainly for the improvement in neutron capture therapy. On the performance, the neutron irradiation modes with the variable energy spectra from almost pure thermal to epi-thermal neutrons became available by the control of the heavy-water thickness in the spectrum shifter and by the open-and-close of the cadmium and boral thermal neutron filters. The depth distributions of thermal, epi-thermal and fast neutron fluxes were measured by activation method using gold and indium, and the depth distributions of gamma-ray absorbed dose rate were measured using thermo-luminescent dosimeter of beryllium oxide for the several irradiation modes. From these measured data, the controllability of the depth dose distribution using the spectrum shifter and the thermal neutron filters was confirmed.

  9. Combination of nitric oxide therapy, anti-oxidative therapy, low level laser therapy, plasma rich platelet therapy and stem cell therapy as a novel therapeutic application to manage the pain and treat many clinical conditions

    Science.gov (United States)

    Halasa, Salaheldin; Dickinson, Eva

    2014-02-01

    From hypertension to diabetes, cancer to HIV, stroke to memory loss and learning disorders to septic shock, male impotence to tuberculosis, there is probably no pathological condition where nitric oxide does not play an important role. Nitric oxide is an analgesic, immune-modulator, vasodilator, anti-apoptotic, growth modulator, angiogenetic, anti-thrombotic, anti-inflammatory and neuro-modulator. Because of the above actions of nitric oxide, many clinical conditions associated with abnormal Nitric oxide (NO) production and bioavailability. Our novel therapeutic approach is to restore the homeostasis of nitric oxide and replace the lost cells by combining nitric oxide therapy, anti-oxidative therapy, low level laser therapy, plasma rich platelet therapy and stem cell therapy.

  10. Incidence, Causative Mechanisms, and Anatomic Localization of Stroke in Pituitary Adenoma Patients Treated With Postoperative Radiation Therapy Versus Surgery Alone

    Energy Technology Data Exchange (ETDEWEB)

    Sattler, Margriet G.A., E-mail: g.a.sattler@umcg.nl [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON (Canada); Vroomen, Patrick C. [Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Sluiter, Wim J. [Department of Endocrinology and Metabolic Diseases, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Schers, Henk J. [Department of Primary and Community Care, Radboud University Nijmegen Medical Centre (Netherlands); Berg, Gerrit van den [Department of Endocrinology and Metabolic Diseases, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Langendijk, Johannes A. [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Wolffenbuttel, Bruce H.R. [Department of Endocrinology and Metabolic Diseases, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Bergh, Alphons C.M. van den [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Beek, André P. van [Department of Endocrinology and Metabolic Diseases, University of Groningen, University Medical Center Groningen, Groningen (Netherlands)

    2013-09-01

    Purpose: To assess and compare the incidence of stroke and stroke subtype in pituitary adenoma patients treated with postoperative radiation therapy (RT) and surgery alone. Methods and Materials: A cohort of 462 pituitary adenoma patients treated between 1959 and 2008 at the University Medical Center Groningen in The Netherlands was studied. Radiation therapy was administered in 236 patients. The TOAST (Trial of ORG 10172 in Acute Stroke Treatment) and the Oxfordshire Community Stroke Project classification methods were used to determine causative mechanism and anatomic localization of stroke. Stroke incidences in patients treated with RT were compared with that observed after surgery alone. Risk factors for stroke incidence were studied by log–rank test, without and with stratification for other significant risk factors. In addition, the stroke incidence was compared with the incidence rate in the general Dutch population. Results: Thirteen RT patients were diagnosed with stroke, compared with 12 surgery-alone patients. The relative risk (RR) for stroke in patients treated with postoperative RT was not significantly different compared with surgery-alone patients (univariate RR 0.62, 95% confidence interval [CI] 0.28-1.35, P=.23). Stroke risk factors were coronary or peripheral artery disease (univariate and multivariate RR 10.4, 95% CI 4.7-22.8, P<.001) and hypertension (univariate RR 3.9, 95% CI 1.6-9.8, P=.002). There was no difference in TOAST and Oxfordshire classification of stroke. In this pituitary adenoma cohort 25 strokes were observed, compared with 16.91 expected (standard incidence ratio 1.48, 95% CI 1.00-1.96, P=.049). Conclusions: In pituitary adenoma patients, an increased incidence of stroke was observed compared with the general population. However, postoperative RT was not associated with an increased incidence of stroke or differences in causative mechanism or anatomic localization of stroke compared with surgery alone. The primary stroke risk

  11. Incidence, Causative Mechanisms, and Anatomic Localization of Stroke in Pituitary Adenoma Patients Treated With Postoperative Radiation Therapy Versus Surgery Alone

    International Nuclear Information System (INIS)

    Purpose: To assess and compare the incidence of stroke and stroke subtype in pituitary adenoma patients treated with postoperative radiation therapy (RT) and surgery alone. Methods and Materials: A cohort of 462 pituitary adenoma patients treated between 1959 and 2008 at the University Medical Center Groningen in The Netherlands was studied. Radiation therapy was administered in 236 patients. The TOAST (Trial of ORG 10172 in Acute Stroke Treatment) and the Oxfordshire Community Stroke Project classification methods were used to determine causative mechanism and anatomic localization of stroke. Stroke incidences in patients treated with RT were compared with that observed after surgery alone. Risk factors for stroke incidence were studied by log–rank test, without and with stratification for other significant risk factors. In addition, the stroke incidence was compared with the incidence rate in the general Dutch population. Results: Thirteen RT patients were diagnosed with stroke, compared with 12 surgery-alone patients. The relative risk (RR) for stroke in patients treated with postoperative RT was not significantly different compared with surgery-alone patients (univariate RR 0.62, 95% confidence interval [CI] 0.28-1.35, P=.23). Stroke risk factors were coronary or peripheral artery disease (univariate and multivariate RR 10.4, 95% CI 4.7-22.8, P<.001) and hypertension (univariate RR 3.9, 95% CI 1.6-9.8, P=.002). There was no difference in TOAST and Oxfordshire classification of stroke. In this pituitary adenoma cohort 25 strokes were observed, compared with 16.91 expected (standard incidence ratio 1.48, 95% CI 1.00-1.96, P=.049). Conclusions: In pituitary adenoma patients, an increased incidence of stroke was observed compared with the general population. However, postoperative RT was not associated with an increased incidence of stroke or differences in causative mechanism or anatomic localization of stroke compared with surgery alone. The primary stroke risk

  12. Transferrin-loaded nido-carborane liposomes. Synthesis and intracellular targeting to solid tumors for boron neutron capture therapy

    International Nuclear Information System (INIS)

    The boron ion cluster lipids, as a double-tailed boron lipid synthesized from heptadecanol, formed stable liposomes at 25% molar ratio toward DSPC with cholesterol. Transferrin was able to be introduced on the surface of boron liposomes (Tf-PEG-CL liposomes) by the coupling of transferrin to the PEG-CO2H moieties of PEG-CL liposomes. The biodistribution of Tf-PEG-CL liposomes showed that Tf-PEG-CL liposomes accumulated in tumor tissues and stayed there for a sufficiently long time to increase tumor:blood concentration ratio. A 10B concentration of 22 ppm in tumor tissues was achieved by the injection of Tf-PEG-CL liposome at 7.2 mg/kg body weight 10B in tumor-bearing mice. After neutron irradiation, the average survival rate of mice not treated with Tf-PEG-CL liposomes was 21 days, whereas that of the treated mice was 31 days. Longer survival rates were observed in the mice treated with Tf-PEG-CL liposomes; one of them even survived for 52 days after BNCT. (author)

  13. Pharmaco-thermodynamics of deuterium-induced oedema in living rat brain via 1H2O MRI: implications for boron neutron capture therapy of malignant brain tumours

    International Nuclear Information System (INIS)

    In addition to its common usage as a tracer in metabolic and physiological studies, deuterium possesses anti-tumoural activity and confers protection against γ-irradiation. A more recent interest in deuterium emanates from the search for alternatives capable of improving neutron penetrance whilst reducing healthy tissue radiation dose deposition in boron neutron capture therapy of malignant brain tumours. Despite this potential clinical application, deuterium induces brain oedema, which is detrimental to neutron capture therapy. In this study, five adult male rats were titrated with deuterated drinking water while brain oedema was monitored via water proton magnetic resonance imaging. This report concludes that deuterium, as well as deuterium-induced brain oedema, possesses a uniform brain bio-distribution. At a steady-state blood fluid deuteration value of 16%, when the deuterium isotope fraction in drinking water was 25%, a mean oedematous volume change of 9 ± 2% (p-value <0.001) was observed in the rat brain-this may account for neurological and behavioural abnormalities found in mammals drinking highly deuterated water. In addition to characterizing the pharmaco-thermodynamics of deuterium-induced oedema, this report also estimates the impact of oedema on thermal neutron enhancement and effective dose reduction factors using simple linear transport calculations. While body fluid deuteration enhances thermal neutron flux penetrance and reduces dose deposition, oedema has the opposite effect because it increases the volume of interest, e.g., the brain volume. Thermal neutron enhancement and effective dose reduction factors could be reduced by as much as ∼10% in the presence of a 9% water volume increase (oedema)

  14. Computed Tomography as an Objective Measurement Tool for Secondary Lymphedema Treated With Extracorporeal Shock Wave Therapy

    OpenAIRE

    Kim, So-Yeon; Bae, Hasuk; Ji, Hye Min

    2015-01-01

    Two patients with stage three secondary lymphedema of the upper extremities underwent treatment for breast cancer, including surgery, chemotherapy, and radiotherapy. They were examined with computed tomography (CT) before and after extracorporeal shock wave therapy (ESWT). We used a manual tracing method using PiViewSTAR software to calculate the volume of the upper extremities. There was a decrease in the volume of the subcutaneous compartment measured by CT before and after ESWT. CT may be ...

  15. Advances in immune-modulating therapies to treat atherosclerotic cardiovascular diseases

    OpenAIRE

    Chyu, Kuang-Yuh; Prediman K Shah

    2014-01-01

    In addition to hypercholesterolemia, innate and adaptive immune mechanisms play a critical role in atherogenesis, thus making immune-modulation therapy a potentially attractive way of managing atherosclerotic cardiovascular disease. These immune-modulation strategies include both active and passive immunization and confer beneficial reduction in atherosclerosis. Preclinical studies have demonstrated promising results and we review current knowledge on the complex role of the immune system and...

  16. Phenytoin mouthwash to treat cancer therapy-induced oral mucositis: A pilot study

    Directory of Open Access Journals (Sweden)

    M Baharvand

    2015-01-01

    Full Text Available Background: Oral mucositis is one of the most common side effects of cancer therapy with no definite treatment. Phenytoin has positive effects on healing of mucosal and dermal wounds. In this study efficacy of 1% phenytoin mouthwash on severity of mucositis (on the basis of WHO scale, pain relief (based on Visual Analogue Scale, and improvement of patients' quality of life (on the basis of EORTC-QLQ-H and N35 questionnaire was evaluated. Materials And Methods: In a pilot -double-blind randomized clinical trial, eight patients in study group were given 1% phenytoin mouthwash while eight patients in control group used normal saline. Data analysis was performed by Mann-Whitney and Repeated Measured ANOVA tests. Results: Reduction of mucositis severity was observed, but the difference was not significant. On the other hand, patients on phenytoin therapy had better pain relief (VAS# 6.75 ± 1.58 at the beginning of the study reached to # 3.75 ± 1.16 after 3 weeks in phenytoin group and improvement in quality of life (score of QOL was 70.63 ± 5.5 that reached to 63.61 ± 6.39 in phenytoin group than normal saline group significantly (P < 0.05. Conclusion: One percent phenytoin mouthwash caused pain relief and improvement of life quality significantly in patients with mucositis due to cancer therapy, but it did not reduce the severity of mucositis in a statistically significant scale.

  17. Effect of oxandrolone therapy on adult height in Turner syndrome patients treated with growth hormone: a meta-analysis.

    Science.gov (United States)

    Sheanon, Nicole M; Backeljauw, Philippe F

    2015-01-01

    Turner syndrome is a chromosomal abnormality in which there is complete or partial absence of the X chromosome. Turner syndrome effects 1 in every 2000 live births. Short stature is a cardinal feature of Turner Syndrome and the standard treatment is recombinant human growth hormone. When growth hormone is started at an early age a normal adult height can be achieved. With delayed diagnosis young women with Turner Syndrome may not reach a normal height. Adjuvant therapy with oxandrolone is used but there is no consensus on the optimal timing of treatment, the duration of treatment and the long term adverse effects of treatment. The objective of this review and meta-analysis is to examine the effect of oxandrolone on adult height in growth hormone treated Turner syndrome patients. Eligible trials were identified by a literature search using the terms: Turner syndrome, oxandrolone. The search was limited to English language randomized-controlled trials after 1980. Twenty-six articles were reviewed and four were included in the meta-analysis. A random effects model was used to calculate an effect size and confidence interval. The pooled effect size of 2.0759 (95 % CI 0.0988 to 4.0529) indicates that oxandrolone has a positive effect on adult height in Turner syndrome when combined with growth hormone therapy. In conclusion, the addition of oxandrolone to growth hormone therapy for treatment of short stature in Turner syndrome improves adult height. Further studies are warranted to investigate if there is a subset of Turner syndrome patients that would benefit most from growth hormone plus oxandrolone therapy, and to determine the optimal timing and duration of such therapy. PMID:26322078

  18. Increased Ribavirin Bioavailability Associated With Telaprevir Use in Hepatitis C Patients Treated With PEGylated -Interferon/Ribavirin/Telaprevir Triple Therapy

    Directory of Open Access Journals (Sweden)

    Pradat

    2015-09-01

    Full Text Available Background Anemia is more frequent in patients receiving telaprevir with PEGylated interferon/ribavirin (PEG-IFN/RBV than in those receiving PEG-IFN/RBV alone. Objectives The objective was to measure the impact of telaprevir on RBV bioavailability and to assess the concomitant renal function. Materials and Methods Thirty-seven hepatitis C virus (HCV patients non-responders to a previous course of PEG-IFN/RBV therapy and re-treated with triple therapy combining PEG-IFN/RBV and telaprevir were analyzed. RBV bioavailability was measured before the triple therapy initiation, during telaprevir treatment at week (W 4 and W8, and after telaprevir cessation (post W16. The renal function was assessed by estimating the glomerular filtration rate (eGFR. Results At W4, RBV bioavailability, expressed as mg/L/daily dose/kg body weight, was significantly increased (median increase = 0.06 mg/L/dose/kg; P < 0.001. In parallel, the renal function was impaired with a mean eGFR decrease of -6.8 mL/minutes/1.73 m² (P = 0.109. Between W4 and W8, RBV bioavailability continued to increase (P < 0.001 but subsequently decreased slightly after telaprevir discontinuation with a concomitant restoration of the renal function (eGFR increase of 6.34 mL/minutes/1.73 m². Conclusions Our results indicated a reversible increase in RBV bioavailability after telaprevir exposure, which might be linked to the impairment of the GFR. This also suggests a RBV-telaprevir pharmacological interaction, a possible source of severe anemia observed under triple therapy. These results suggest that RBV pharmacological monitoring may be clinically relevant, especially in the context of first-generation HCV protease inhibitor-based therapy.

  19. Effect of oxandrolone therapy on adult height in Turner syndrome patients treated with growth hormone: a meta-analysis.

    Science.gov (United States)

    Sheanon, Nicole M; Backeljauw, Philippe F

    2015-01-01

    Turner syndrome is a chromosomal abnormality in which there is complete or partial absence of the X chromosome. Turner syndrome effects 1 in every 2000 live births. Short stature is a cardinal feature of Turner Syndrome and the standard treatment is recombinant human growth hormone. When growth hormone is started at an early age a normal adult height can be achieved. With delayed diagnosis young women with Turner Syndrome may not reach a normal height. Adjuvant therapy with oxandrolone is used but there is no consensus on the optimal timing of treatment, the duration of treatment and the long term adverse effects of treatment. The objective of this review and meta-analysis is to examine the effect of oxandrolone on adult height in growth hormone treated Turner syndrome patients. Eligible trials were identified by a literature search using the terms: Turner syndrome, oxandrolone. The search was limited to English language randomized-controlled trials after 1980. Twenty-six articles were reviewed and four were included in the meta-analysis. A random effects model was used to calculate an effect size and confidence interval. The pooled effect size of 2.0759 (95 % CI 0.0988 to 4.0529) indicates that oxandrolone has a positive effect on adult height in Turner syndrome when combined with growth hormone therapy. In conclusion, the addition of oxandrolone to growth hormone therapy for treatment of short stature in Turner syndrome improves adult height. Further studies are warranted to investigate if there is a subset of Turner syndrome patients that would benefit most from growth hormone plus oxandrolone therapy, and to determine the optimal timing and duration of such therapy.

  20. NIH researchers use gene therapy to treat a soft tissue tumor

    Science.gov (United States)

    Results of an intermediate stage clinical trial of several dozen people provides evidence that a method that has worked for treating patients with metastatic melanoma can also work for patients with metastatic synovial cell sarcoma, one of the most common soft tissue tumors in adolescents and young adults.

  1. Apoptotic cell infusion treats ongoing collagen-induced arthritis, even in the presence of methotrexate, and is synergic with anti-TNF therapy

    OpenAIRE

    Bonnefoy, Francis; Daoui, Anna; Valmary-Degano, Séverine; Toussirot, Eric; Saas, Philippe; Perruche, Sylvain

    2016-01-01

    Background Apoptotic cell-based therapies have been proposed to treat chronic inflammatory diseases. The aim of this study was to investigate the effect of intravenous (i.v.) apoptotic cell infusion in ongoing collagen-induced arthritis (CIA) and the interaction of this therapy with other treatments used in rheumatoid arthritis (RA), including methotrexate (MTX) or anti-TNF therapy. Methods The effects of i.v. apoptotic cell infusion were evaluated in a CIA mouse model in DBA/1 mice immunized...

  2. Computerized axial tomographic and magnetic resonance imaging scan follow-up of two patients after boron neutron capture therapy for Glioblastoma Multiforme

    Energy Technology Data Exchange (ETDEWEB)

    Marano, S.R.; Spickard, J.H.; Griebenow, M.L.

    1988-01-01

    Using computer tomography (CT) and magnetic resonance imaging (MRI), we are following a 30-year old, white female and a 64-year old, white female and a 64-year old, white male, both with biopsy-proven Glioblastoma Multiforme, from their preoperative through post-operative stages and pre- and post-BNCT treatment. The images visually demonstrate the evolving changes in the tumor and surrounding cortex. These patients were treated by Hiroshi Hatanaka of Teikyo University, at the Musashi Institute of Technology (MIT) reactor which is a 100 kW Triga-II facility that has been used by Hatanaka for many years for BNCT therapy. 10 figs.

  3. Computerized axial tomographic and magnetic resonance imaging scan follow-up of two patients after boron neutron capture therapy for Glioblastoma Multiforme

    Energy Technology Data Exchange (ETDEWEB)

    Marano, S.R.; Spickard, J.H.; Griebenow, M.L.

    1988-01-01

    Using computed tomography (CT) and magnetic resonance imaging (MRI), we are following a 30-year old, white female and a 64-year old, white female and a 64-year old, white male, both with biopsy-proven Glioblastoma Multiforme, from their preoperative through post-operative stages and pre- and post-BNCT treatment. The images visually demonstrate the evolving changes in the tumor and surrounding cortex. These patients were treated by Hiroshi Hatanaka of Teikyo University, at the Musashi Institute of Technology (MIT) reactor is a 100 kW Triga-II facility that has been used by Hatanaka for many years for BNCT therapy. 7 figs.

  4. Acute and late toxicity in prostate cancer patients treated by dose escalated intensity modulated radiation therapy and organ tracking

    Directory of Open Access Journals (Sweden)

    Behrensmeier Frank

    2008-10-01

    Full Text Available Abstract Background To report acute and late toxicity in prostate cancer patients treated by dose escalated intensity-modulated radiation therapy (IMRT and organ tracking. Methods From 06/2004 to 12/2005 39 men were treated by 80 Gy IMRT along with organ tracking. Median age was 69 years, risk of recurrence was low 18%, intermediate 21% and high in 61% patients. Hormone therapy (HT was received by 74% of patients. Toxicity was scored according to the CTC scale version 3.0. Median follow-up (FU was 29 months. Results Acute and maximal late grade 2 gastrointestinal (GI toxicity was 3% and 8%, late grade 2 GI toxicity dropped to 0% at the end of FU. No acute or late grade 3 GI toxicity was observed. Grade 2 and 3 pre-treatment genitourinary (GU morbidity (PGUM was 20% and 5%. Acute and maximal late grade 2 GU toxicity was 56% and 28% and late grade 2 GU toxicity decreased to 15% of patients at the end of FU. Acute and maximal late grade 3 GU toxicity was 8% and 3%, respectively. Decreased late ≥ grade 2 GU toxicity free survival was associated with higher age (P = .025, absence of HT (P = .016 and higher PGUM (P Discussion GI toxicity rates after IMRT and organ tracking are excellent, GU toxicity rates are strongly related to PGUM.

  5. Predictors of Severe Acute and Late Toxicities in Patients With Localized Head-and-Neck Cancer Treated With Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, Francois, E-mail: francois.meyer@chuq.qc.ca [Laval University Cancer Research Center, Centre hospitalier universitaire de Quebec - L' Hotel-Dieu de Quebec, Quebec (Canada); Fortin, Andre; Wang, Chang Shu [Radiation Therapy Department, Centre hospitalier universitaire de Quebec - L' Hotel-Dieu de Quebec, Quebec (Canada); Liu, Geoffrey [Applied Molecular Oncology, Ontario Cancer Institute/Princess Margaret Hospital, Toronto (Canada); Bairati, Isabelle [Laval University Cancer Research Center, Centre hospitalier universitaire de Quebec - L' Hotel-Dieu de Quebec, Quebec (Canada)

    2012-03-15

    Purpose: Radiation therapy (RT) causes acute and late toxicities that affect various organs and functions. In a large cohort of patients treated with RT for localized head and neck cancer (HNC), we prospectively assessed the occurrence of RT-induced acute and late toxicities and identified characteristics that predicted these toxicities. Methods and Materials: We conducted a randomized trial among 540 patients treated with RT for localized HNC to assess whether vitamin E supplementation could improve disease outcomes. Adverse effects of RT were assessed using the Radiation Therapy Oncology Group Acute Radiation Morbidity Criteria during RT and one month after RT, and the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer Late Radiation Morbidity Scoring Scheme at six and 12 months after RT. The most severe adverse effect among the organs/tissues was selected as an overall measure of either acute or late toxicity. Grade 3 and 4 toxicities were considered as severe. Stepwise multivariate logistic regression models were used to identify all independent predictors (p < 0.05) of acute or late toxicity and to estimate odds ratios (OR) for severe toxicity with their 95% confidence intervals (CI). Results: Grade 3 or 4 toxicity was observed in 23% and 4% of patients, respectively, for acute and late toxicity. Four independent predictors of severe acute toxicity were identified: sex (female vs. male: OR = 1.72, 95% confidence interval [CI]: 1.06-2.80), Karnofsky Performance Status (OR = 0.67 for a 10-point increment, 95% CI: 0.52-0.88), body mass index (above 25 vs. below: OR = 1.88, 95% CI: 1.22-2.90), TNM stage (Stage II vs. I: OR = 1.91, 95% CI: 1.25-2.92). Two independent predictors were found for severe late toxicity: female sex (OR = 3.96, 95% CI: 1.41-11.08) and weight loss during RT (OR = 1.26 for a 1 kg increment, 95% CI: 1.12-1.41). Conclusions: Knowledge of these predictors easily collected in a clinical setting could help

  6. Predictors of Severe Acute and Late Toxicities in Patients With Localized Head-and-Neck Cancer Treated With Radiation Therapy

    International Nuclear Information System (INIS)

    Purpose: Radiation therapy (RT) causes acute and late toxicities that affect various organs and functions. In a large cohort of patients treated with RT for localized head and neck cancer (HNC), we prospectively assessed the occurrence of RT-induced acute and late toxicities and identified characteristics that predicted these toxicities. Methods and Materials: We conducted a randomized trial among 540 patients treated with RT for localized HNC to assess whether vitamin E supplementation could improve disease outcomes. Adverse effects of RT were assessed using the Radiation Therapy Oncology Group Acute Radiation Morbidity Criteria during RT and one month after RT, and the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer Late Radiation Morbidity Scoring Scheme at six and 12 months after RT. The most severe adverse effect among the organs/tissues was selected as an overall measure of either acute or late toxicity. Grade 3 and 4 toxicities were considered as severe. Stepwise multivariate logistic regression models were used to identify all independent predictors (p < 0.05) of acute or late toxicity and to estimate odds ratios (OR) for severe toxicity with their 95% confidence intervals (CI). Results: Grade 3 or 4 toxicity was observed in 23% and 4% of patients, respectively, for acute and late toxicity. Four independent predictors of severe acute toxicity were identified: sex (female vs. male: OR = 1.72, 95% confidence interval [CI]: 1.06–2.80), Karnofsky Performance Status (OR = 0.67 for a 10-point increment, 95% CI: 0.52–0.88), body mass index (above 25 vs. below: OR = 1.88, 95% CI: 1.22–2.90), TNM stage (Stage II vs. I: OR = 1.91, 95% CI: 1.25–2.92). Two independent predictors were found for severe late toxicity: female sex (OR = 3.96, 95% CI: 1.41–11.08) and weight loss during RT (OR = 1.26 for a 1 kg increment, 95% CI: 1.12–1.41). Conclusions: Knowledge of these predictors easily collected in a clinical

  7. Acute Spinal Cord Ischemia during Aortography Treated with Intravenous Thrombolytic Therapy

    OpenAIRE

    Restrepo, Lucas; Guttin, Jorge F.

    2006-01-01

    Acute anterior spinal cord ischemia is a rare but disastrous complication of endovascular aortic procedures. Although intravenous thrombolysis with recombinant tissue plasminogen activator is an effective treatment for acute brain ischemia, its use for the treatment of spinal cord ischemia has not previously been reported. We report the case of a patient who developed anterior spinal cord ischemia during diagnostic aortography. He was treated with intravenous recombinant tissue plasminogen ac...

  8. Low incidence of radionecrosis in children treated with conventional radiation therapy and intrathecal radioimmunotherapy.

    Science.gov (United States)

    Kramer, Kim; Pandit-Taskar, Neeta; Zanzonico, Pat; Wolden, Suzanne L; Humm, John L; DeSelm, Carl; Souweidane, Mark M; Lewis, Jason S; Cheung, Nai-Kong V

    2015-06-01

    Radionecrosis is a potentially devastating complication of external beam radiotherapy (XRT). Intraventricular compartmental radioimmunotherapy (cRIT) using (131)I-3F8 or (131)I-8H9 can eradicate malignant cells in the CSF. The incidence of radionecrosis using cRIT (131)I based intraventricular radioimmunotherapy, when used alone or in combination with conventional craniospinal CSI-XRT is unknown. We retrospectively analyzed the incidence of radionecrosis in two cohorts of pediatric patients treated with both CSI-XRT and cRIT at MSKCC since 2003: patients with metastatic CNS neuroblastoma (NB) and medulloblastoma (MB). 94 patients received both CSI-XRT and cRIT, two received cRIT alone, median follow up 41.5 months (6.5-124.8 months). Mean CSI-XRT dose was 28 Gy (boost to the primary tumor site up to 54 Gy) in the MB cohort, and CSI XRT dose 18-21 Gy (boost to 30 Gy for focal parenchymal mass) in the NB cohort. For MB patients, 20 % had focal re-irradiation for a second or more subsequent relapse, mean repeat-XRT dose was 27.5 Gy; seven patients with NB had additional focal XRT. Median CSF cRIT dose was 18.6 Gy in the MB cohort and 32.1 in the NB cohort. One asymptomatic patient underwent resection of 0.6-cm hemorrhagic periventricular white-matter lesion confirmed to be necrosis and granulation tissue, 2.5 years after XRT. The risk of radionecrosis in children treated with XRT and cRIT appears minimal (~1 %). No neurologic deficits secondary to radionecrosis have been observed in long-term survivors treated with both modalities, including patients who underwent re-XRT. Administration of cRIT may safely proceed in patients treated with conventional radiotherapy without appearing to increase the risk of radionecrosis. PMID:25944385

  9. Antidepressant therapy in epilepsy: can treating the comorbidities affect the underlying disorder?

    OpenAIRE

    Cardamone, L.; Salzberg, MR; O'Brien, TJ; Jones, NC

    2013-01-01

    There is a high incidence of psychiatric comorbidity in people with epilepsy (PWE), particularly depression. The manifold adverse consequences of comorbid depression have been more clearly mapped in recent years. Accordingly, considerable efforts have been made to improve detection and diagnosis, with the result that many PWE are treated with antidepressant drugs, medications with the potential to influence both epilepsy and depression. Exposure to older generations of antidepressants (notabl...

  10. Intensity-Modulated Radiation Therapy in Treating Younger Patients With Lung Metastases

    Science.gov (United States)

    2013-09-23

    Adult Rhabdomyosarcoma; Lung Metastases; Metastatic Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor; Previously Treated Childhood Rhabdomyosarcoma; Recurrent Adult Soft Tissue Sarcoma; Recurrent Childhood Rhabdomyosarcoma; Recurrent Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor; Recurrent Wilms Tumor and Other Childhood Kidney Tumors; Stage IV Adult Soft Tissue Sarcoma; Stage IV Wilms Tumor; Stage V Wilms Tumor; Unspecified Adult Solid Tumor, Protocol Specific; Unspecified Childhood Solid Tumor, Protocol Specific

  11. Prophylaxis and therapy of viral infections in pediatric patients treated for malignancy

    Directory of Open Access Journals (Sweden)

    Anna Pegoraro

    2011-02-01

    Full Text Available Infections are still an important cause of mortality and morbidity in pediatric cancer patients. Most of the febrile episodes in immunocompromised patients are classified as a fever of unknown origin (FUO while bacteria are the more frequent causes of documented infections. Viral infections are also feared during chemotherapy but less data are available on their incidence and morbidity. We reviewed the literature on incidence, morbidity, and mortality of viral infections in children undergoing chemotherapy and discussed the evidence concerning the prophylaxis and the therapy.

  12. MAGGOT DEBRIDEMENT THERAPY (MDT): IT IS SAFE AND ECONOMIC FOR TREATING A DIABETIC FOOT ULCER.

    Science.gov (United States)

    El-Tawdy, Ahmed Hassan Fawzi; Ibrahim, Eissa Abdel Hamed; Abdallah, Eman Shokry; Al Sakhawy, Eman Mahmoud Aly; Morsy, Tosson A

    2016-04-01

    Diabetic foot ulcer (DFU) is the major global and devastating complication of diabetes mellitus that affects at least 20% of diabetic patients during their lifetime. This article presents an overview of the research evidence on maggot debridement therapy that serves as a guide to health professionals who may be users of this form of treatment now and in the future. It is a time to apply this sample and safe worldwide approved method for diabetic foot ulcer to save money and avoid surgical intervention.

  13. Antiviral therapy for "difficult-to-treat" hepatitis C virus-infected patients

    Institute of Scientific and Technical Information of China (English)

    Tatsuo Kanda; Osamu Yokosuka; Masao Omata

    2013-01-01

    Objective To review the updated research on direct antiviral agents (DAAs)-including regimens for hepatitis C virus (HCV),and focus on "difficult-to-treat" HCV-infected patients.Data sources The literature concerning DAAs and hepatitis C cited in this review was collected from PubMed and Google Scholar databases published in English up to July 2013.Study selection Data from published articles regarding HCV and DAAs in clinical trials and in clinical use were identified and reviewed.Results It was recognized that some "difficult-to-treat" patients would still exist,even though stronger treatments using such as DAAs,including telaprevir and boceprevir,which lead to higher sustained virological response rates,are available.Such patients include those with advanced fibrosis/cirrhosis,elderly persons,children,HCV-human immunodeficiency virus co-infected patients,HCV-infected recipients,and so on.Conclusions Certain "difficult-to-treat" patients would still exist,even though stronger treatment is available.Although evidence from clinical trials is still lacking,interferon-sparing regimens could have stronger effects for eradicating HCV in such cases.

  14. To treat or not to treat with testosterone replacement therapy: a contemporary review of management of late-onset hypogonadism and critical issues related to prostate cancer.

    Science.gov (United States)

    Kava, Bruce R

    2014-07-01

    Over the last 10 years there has been a dramatic increase in the number of patients identified and treated with testosterone replacement therapy (TRT) for late-onset hypogonadism (LOH). By virtue of age, race, and family history, many of these patients are concurrently at risk for harboring indolent prostate cancer. Other men are at increased risk for prostate cancer as a result of an elevated serum PSA level or having had a prior prostate biopsy showing prostatic intraepithelial neoplasia (PIN) or atypical small acinar proliferation (ASAP). The clinician is often challenged with the decision whether to initiate TRT in these patients. This review presents a contemporary overview of the rationale for TRT, as well as the relationship between testosterone (endogenous and exogenous) and premalignant and malignant lesions of the prostate. We will discuss preliminary data from several recent series demonstrating that TRT may be safely administered in select patients with certain premalignant and bona fide malignant tumors of the prostate. In the absence of a large randomized clinical trial with long-term outcome data evaluating TRT, we hope that this overview will provide clinicians with an evidence-based approach to managing these anxiety-provoking - and often frustrating - clinical scenarios.

  15. Arterial hypertension and dyslipidemia in a HIV-positive patient treated with antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Alessandro Maloberti

    2012-03-01

    Full Text Available The introduction of antiretroviral therapy (ART has substantially modified the clinical history and epidemiology of HIV infection with an important decline in infective causes of death and an increase in non-infective comorbidities particularly in cardiovascular complications. HIV infection has been related to an increased cardiovascular risk due to the presence of three factors: classic cardiovascular risk factors (shared with the general population, HIV infection itself (indirectly due to the inflammation and directly due to viral molecule and ART-related chronic metabolic alterations. We describe a peculiar case of metabolic alteration in an HIV infected patient on ART with particular attention to the diagnosis and therapeutic aspects. Giving the higher cardiovascular risk of this specific population it is advisable that the clinician performs a frequent re-assessment of risk factors and cardiovascular organ damage. An early detection of metabolic alteration must lead to an aggressive specific therapy; this must be done by taking care of the HIV-infected subject fragility and the interactions with ART.

  16. Domestic dengue infection with hemophagocytic lymphohistiocytosis successfully treated by early steroid therapy.

    Science.gov (United States)

    Yoshifuji, Kota; Oshina, Takahiro; Sonokawa, Saeko; Noguchi, Yuma; Suzuki, Sayaka; Tanaka, Keisuke; Kumagai, Takashi

    2016-07-01

    A 34-year-old man, working at a park in Tokyo, Japan, was repeatedly bitten by mosquitoes while cutting grass. He was hospitalized with sudden fever, fatigue, and weakness. He was eventually diagnosed with dengue virus infection, detected using reverse transcription polymerase chain reaction for the genome and by the presence of nonstructural protein 1 in his peripheral blood. Symptomatic treatments such as acetaminophen for the fever were not effective. Moreover, peripheral blood examination showed drastically decreased white blood cells and platelets, as well as marked elevations of ferritin and soluble interleukin 2 receptor. Furthermore, bone marrow examination revealed increased macrophages with hemophagocytosis. Dengue infection with hemophagocytic lymphohistiocytosis (HLH) was ultimately diagnosed. Half-dose steroid pulse therapy for three days dramatically reduced his temperature, thereby ameliorating physical symptoms and restoring normal peripheral blood data. He was discharged 12 days after admission. Dengue infection with HLH is rare and this is the first report, to our knowledge, of domestic dengue infection with HLH in Japan. Early steroid therapy may be effective in such cases. PMID:27498730

  17. Outcomes of Low-Risk Ductal Carcinoma In Situ in Southeast Asian Women Treated With Breast Conservation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Wong, Fuh Yong, E-mail: fuhyong@yahoo.com [Department of Radiation Oncology, National Cancer Centre Singapore (Singapore); Wang, Fuqiang [Department of Radiation Oncology, National Cancer Centre Singapore (Singapore); Chen, John Ju [Department of Cancer Informatics, National Cancer Centre Singapore (Singapore); Tan, Chiew Har [Department of Radiation Oncology, National Cancer Centre Singapore (Singapore); Tan, Puay Hoon [Department of Pathology, Singapore General Hospital (Singapore)

    2014-04-01

    Purpose: To examine the outcomes of Southeast Asian (SEA) women with low-risk ductal carcinoma in situ (DCIS) treated with breast-conserving surgery (BCS) and adjuvant radiation therapy. Methods and Materials: Retrospective chart reviews of patients treated with BCS for DCIS from 1995 to 2011 were performed. Patients meeting the selection criteria from Eastern Cooperative Oncology Group 5194 were included. Most patients received adjuvant radiation therapy (RT) consisting of whole-breast RT delivered to 50 Gy followed by a 10-Gy boost to the tumor bed. Results: Of 744 patients with pathologic diagnosis of pure DCIS identified, 273 met the selection criteria: low-intermediate grade (LIG), n=219; high grade (HG), n=54. Median follow-up for these patients was 60 months. There were 8 ipsilateral breast tumor recurrences (IBTRs) in total, 7 of which were DCIS. The estimated actuarial IBTR rates at 5 and 10 years for the entire cohort are 1.8% and 4.3%, respectively. Of the 219 patients with LIG DCIS, 210 received RT and 9 did not. There were 7 IBTRs in LIG DCIS, 2 among the 9 patients who did not receive RT. The IBTR rates in LIG DCIS at 5 and 10 years are 2.3% and 4.2%, respectively. All patients with HG DCIS received RT. There was only 1 IBTR occurring beyond 5 years, giving an estimated IBTR rate of 4.5% at 10 years. Conclusions: SEA women with screen-detected DCIS have exceedingly low rates of IBTR after BCS, comparable to that observed in reports of similar patients with low-risk DCIS treated with adjuvant radiation.

  18. Folate receptor-mediated boron-10 containing carbon nanoparticles as potential delivery vehicles for boron neutron capture therapy of nonfunctional pituitary adenomas.

    Science.gov (United States)

    Dai, Congxin; Cai, Feng; Hwang, Kuo Chu; Zhou, Yongmao; Zhang, Zizhu; Liu, Xiaohai; Ma, Sihai; Yang, Yakun; Yao, Yong; Feng, Ming; Bao, Xinjie; Li, Guilin; Wei, Junji; Jiao, Yonghui; Wei, Zhenqing; Ma, Wenbin; Wang, Renzhi

    2013-02-01

    Invasive nonfunctional pituitary adenomas (NFPAs) are difficult to completely resect and often develop tumor recurrence after initial surgery. Currently, no medications are clinically effective in the control of NFPA. Although radiation therapy and radiosurgery are useful to prevent tumor regrowth, they are frequently withheld because of severe complications. Boron neutron capture therapy (BNCT) is a binary radiotherapy that selectively and maximally damages tumor cells without harming the surrounding normal tissue. Folate receptor (FR)-targeted boron-10 containing carbon nanoparticles is a novel boron delivery agent that can be selectively taken up by FR-expressing cells via FR-mediated endocytosis. In this study, FR-targeted boron-10 containing carbon nanoparticles were selectively taken up by NFPAs cells expressing FR but not other types of non-FR expressing pituitary adenomas. After incubation with boron-10 containing carbon nanoparticles and following irradiation with thermal neutrons, the cell viability of NFPAs was significantly decreased, while apoptotic cells were simultaneously increased. However, cells administered the same dose of FR-targeted boron-10 containing carbon nanoparticles without neutron irradiation or received the same neutron irradiation alone did not show significant decrease in cell viability or increase in apoptotic cells. The expression of Bcl-2 was down-regulated and the expression of Bax was up-regulated in NFPAs after treatment with FR-mediated BNCT. In conclusion, FR-targeted boron-10 containing carbon nanoparticles may be an ideal delivery system of boron to NFPAs cells for BNCT. Furthermore, our study also provides a novel insight into therapeutic strategies for invasive NFPA refractory to conventional therapy, while exploring these new applications of BNCT for tumors, especially benign tumors.

  19. Genomic and Proteomic Evaluation of Tissue Quality of Porcine Wounds Treated With Negative Pressure Wound Therapy in Continuous, Noncontinuous, and Instillation Modes

    OpenAIRE

    Derrick, Kathleen L.; Lessing, M. Christian

    2014-01-01

    Objective: Negative pressure wound therapy with instillation (NPWTi-d) combines NPWT with automated delivery and removal of topical wound treatment solutions. This porcine study compared genomic and proteomic responses of wounds treated with NPWTi-d with saline to wounds treated with NPWT in continuous and noncontinuous modes. Methods: Full-thickness porcine dorsal excisional wounds were treated with continuous NPWT, intermittent NPWT, dynamic NPWT, or NPWTi-d with saline (n = 10 wounds per g...

  20. Assessment of doses due to secondary neutrons received by patient treated by proton therapy

    International Nuclear Information System (INIS)

    Proton therapy is a specific technique of radiotherapy which aims at destroying cancerous cells by irradiating them with a proton beam. Nuclear reactions in the device and in the patient himself induce secondary radiations involving mainly neutrons which contribute to an additional dose for the patient. The author reports a study aimed at the assessment of these doses due to secondary neutrons in the case of ophthalmological and intra-cranial treatments. He presents a Monte Carlo simulation of the room and of the apparatus, reports the experimental validation of the model (dose deposited by protons in a water phantom, ambient dose equivalent due to neutrons in the treatment room, absorbed dose due to secondary particles in an anthropomorphic phantom), and the assessment with a mathematical phantom of doses dues to secondary neutrons received by organs during an ophthalmological treatment. He finally evokes current works of calculation of doses due to secondary neutrons in the case of intra-cranial treatments

  1. Mortality from infections and malignancies in patients treated with renal replacement therapy

    DEFF Research Database (Denmark)

    Vogelzang, Judith L; van Stralen, Karlijn J; Noordzij, Marlies;

    2015-01-01

    BACKGROUND: Infections and malignancies are the most common non-cardiovascular causes of death in patients on chronic renal replacement therapy (RRT). Here, we aimed to quantify the mortality risk attributed to infections and malignancies in dialysis patients and kidney transplant recipients when...... compared with the general population by age group and sex. METHODS: We followed 168 156 patients included in the ERA-EDTA registry who started RRT in 1993-2007 until 1 January 2012. Age- and cause-specific mortality rates per 1000 person-years (py) and mortality rate ratios (MRRs) compared...... in dialysis and kidney transplant patients, while the risk of malignancy-related death is moderately increased. Young women on dialysis may deserve special attention because of their high excess risk of infection-related mortality. Further research into the mechanisms, prevention and optimal treatment...

  2. Moving Past Anti-VEGF: Novel Therapies for Treating Diabetic Retinopathy

    Science.gov (United States)

    Bolinger, Mark T.; Antonetti, David A.

    2016-01-01

    Diabetic retinopathy is the leading cause of blindness in working age adults, and is projected to be a significant future health concern due to the rising incidence of diabetes. The recent advent of anti-vascular endothelial growth factor (VEGF) antibodies has revolutionized the treatment of diabetic retinopathy but a significant subset of patients fail to respond to treatment. Accumulating evidence indicates that inflammatory cytokines and chemokines other than VEGF may contribute to the disease process. The current review examines the presence of non-VEGF cytokines in the eyes of patients with diabetic retinopathy and highlights mechanistic pathways in relevant animal models. Finally, novel drug targets including components of the kinin–kallikrein system and emerging treatments such as anti-HPTP (human protein tyrosine phosphatase) β antibodies are discussed. Recognition of non-VEGF contributions to disease pathogenesis may lead to novel therapeutics to enhance existing treatments for patients who do not respond to anti-VEGF therapies. PMID:27618014

  3. Moving Past Anti-VEGF: Novel Therapies for Treating Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    Mark T. Bolinger

    2016-09-01

    Full Text Available Diabetic retinopathy is the leading cause of blindness in working age adults, and is projected to be a significant future health concern due to the rising incidence of diabetes. The recent advent of anti-vascular endothelial growth factor (VEGF antibodies has revolutionized the treatment of diabetic retinopathy but a significant subset of patients fail to respond to treatment. Accumulating evidence indicates that inflammatory cytokines and chemokines other than VEGF may contribute to the disease process. The current review examines the presence of non-VEGF cytokines in the eyes of patients with diabetic retinopathy and highlights mechanistic pathways in relevant animal models. Finally, novel drug targets including components of the kinin–kallikrein system and emerging treatments such as anti-HPTP (human protein tyrosine phosphatase β antibodies are discussed. Recognition of non-VEGF contributions to disease pathogenesis may lead to novel therapeutics to enhance existing treatments for patients who do not respond to anti-VEGF therapies.

  4. A case of lupus vulgaris successfully treated with antituberculous therapy despite negative PCR and culture.

    Science.gov (United States)

    Akoglu, Gulsen; Karaduman, Aysen; Boztepe, Gonca; Ozkaya, Ozay; Sahin, Sedef; Erkin, Gul; Kolemen, Fikret

    2005-01-01

    A 14-year-old boy presented with a pink firm plaque with well-defined borders in the right infra-orbital skin area. On diascopy, the infiltrate exhibited a typical apple-jelly appearance. No acid-fast bacilli could be demonstrated. A polymerase chain reaction (PCR) assay did not reveal the presence of mycobacteria in a lesional biopsy sample. Culture of biopsied tissue on Loewenstein-Jensen medium was negative. Although the tuberculosis culture and PCR did not confirm tuberculosis, a diagnosis of lupus vulgaris was made considering the clinical and histopathological findings. After a 9-month antituberculous therapy, the lesion disappeared. We believe that a diagnosis of lupus vulgaris still depends more on clinical and histopathological findings than on tuberculosis culture or PCR.

  5. [Clinical characteristics of patients treated with electroconvulsive therapy in a public hospital in Peru].

    Science.gov (United States)

    Cortez-Vergara, Carla; Cruzado, Lizardo; Rojas-Rojas, Ira Galia; Sánchez-Fernández, Miguel; Ladd-Huarachi, Guillermo

    2016-03-01

    With the purpose of describe the profile of use of electroconvulsive therapy (ECT) on hospitalized patients at "Honorio Delgado - Hideyo Noguchi" National Institute of Mental Health in Lima, Peru, the medical records of patients receiving ECT between 2001 and 2011 were reviewed. The main findings were: four hundred and nineteen ECT courses were applied to 372 patients, with a total of 5439 applications the most common diagnosis was paranoid schizophrenia (70.7%), the most common indication was resistance to treatment (80.7%), also the clinical response to ECT was good in 70.1% of cases while side effects were generally transient and mild. The use of ECT decreased over the period of the study but it was tolerable and safe, especially in the modified version, and it had a high response rate so remains as a first-line psychiatric treatment. PMID:27384628

  6. “To Treat or Not To Treat?”: An Exploratory Study of Medical Practitioners' Perspective on Clinical Ethics in Stem Cell Therapies

    OpenAIRE

    Shariat, Sadaf

    2011-01-01

    This study investigates the practitioners‘ perception toward an ethical Stem Cell therapy. Reviewing literature, it is revealed that studies on Stem Cell therapies are predominately focus on ethical aspects of Stem Cell researches, commercialization, and concept of ethic support in clinical practice; whereas the notion of clinical ethics in Stem Cell therapies and particularly medical practitioners‘ perspective is noticeably absent from contemporary clinical ethics and Stem Cell therapy discu...

  7. Examination of resectable and borderline pancreatic cancer treated with neoadjuvant chemoradiation therapy

    International Nuclear Information System (INIS)

    The purpose of this study was to determine the effect of neoadjuvant chemotherapy (NAC) and chemoradiation therapy (NAC-RT) for the treatment of potentially resectable (PR) and borderline resectable (BR) pancreatic cancer. Patients with PR (n=14) and BR (n=13) pancreatic cancer who received NAC (n=15) or NAC-RT (n=12) were enrolled in our study. NAC comprised 2 cycles of S-1 or S-1 plus gemcitabine, and NAC-RT comprised hyperaccelerated radiation therapy and S-1 chemotherapy. According to the Response Evaluation Criteria in Solid Tumors (RECIST), partial response was observed in 10 patients (37%); stable disease (SD), in 11 patients (41%); and progressive disease (PD), in 6 patients (22%). The rates of curative surgery in patients with PR and BR pancreatic cancer were 57% and 38%, respectively. Curative surgery was performed in 8 patients with PR pancreatic cancer. Downstaging was observed in 3 patients and upstaging was observed in 1 patient. During the postoperative course, peritoneal dissemination was detected in 2 patients at 4 months after surgery. One patient survived for more than 3 years. Curative surgery was performed in 5 patients with BR pancreatic cancer. Downstaging was observed in 4 patients, and upstaging was observed in 1 patient. During the postoperative course, recurrence was detected in 3 patients and the remaining 2 patients survived with a recurrence-free status. The results of the present study indicate that NAC-RT may be useful for the treatment of patients with PR or BR pancreatic cancer. However, this protocol has disadvantages in that the possibility of resectability might be compromised and early recurrence might occur, Thus, this protocol warrants further evaluation. (author)

  8. Accelerated resolution therapy: an innovative mental health intervention to treat post-traumatic stress disorder.

    Science.gov (United States)

    Finnegan, Alan; Kip, K; Hernandez, D; McGhee, S; Rosenzweig, L; Hynes, C; Thomas, M

    2016-04-01

    Post-traumatic stress disorder (PTSD) is a disabling trauma and stress-related disorder that may occur after a person experiences a traumatic event, and evokes a combination of intrusion and avoidance symptoms, negative alterations in cognitions and mood, and alterations in arousal and reactivity. Accelerated resolution therapy (ART) is an emerging psychotherapy that provides fast and lasting resolution for mental health problems such as PTSD. ART has been shown to achieve a positive result in one to five sessions, typically over a 2-week period, and requires no homework, skills practice or repeated exposure to targeted events. Initial research, including one randomised control trial, has demonstrated that ART interventions can significantly reduce symptoms of psychological trauma in both civilians and US service members and veterans. These results suggest that ART be considered as either a primary treatment option or for refractory PTSD in those with a suboptimal response to endorsed first-line therapies. Conservative estimates indicate substantial potential cost savings in PTSD treatment. Despite the need for more definitive clinical trials, there is increasing interest in ART in the USA, including in the US Army. The growing positive empirical evidence is compelling, and there appears to be sufficient evidence to warrant UK researchers undertaking ART research. The armed forces offer the potential for comparative international trials. However, equally important are veterans, emergency services personnel and those subjected to violence. ART appears to also have application in other conditions, including depression, anxiety disorders, and alcohol or drug misuse. ART can potentially help personnel traumatised by the unique challenges of war and conflict zones by providing brief psychotherapy in a readily accessible and culturally competent manner. ART facilitates the provision of interventions and resolutions in theatre, thus enhancing forces' fighting capability.

  9. Accelerated resolution therapy: an innovative mental health intervention to treat post-traumatic stress disorder.

    Science.gov (United States)

    Finnegan, Alan; Kip, K; Hernandez, D; McGhee, S; Rosenzweig, L; Hynes, C; Thomas, M

    2016-04-01

    Post-traumatic stress disorder (PTSD) is a disabling trauma and stress-related disorder that may occur after a person experiences a traumatic event, and evokes a combination of intrusion and avoidance symptoms, negative alterations in cognitions and mood, and alterations in arousal and reactivity. Accelerated resolution therapy (ART) is an emerging psychotherapy that provides fast and lasting resolution for mental health problems such as PTSD. ART has been shown to achieve a positive result in one to five sessions, typically over a 2-week period, and requires no homework, skills practice or repeated exposure to targeted events. Initial research, including one randomised control trial, has demonstrated that ART interventions can significantly reduce symptoms of psychological trauma in both civilians and US service members and veterans. These results suggest that ART be considered as either a primary treatment option or for refractory PTSD in those with a suboptimal response to endorsed first-line therapies. Conservative estimates indicate substantial potential cost savings in PTSD treatment. Despite the need for more definitive clinical trials, there is increasing interest in ART in the USA, including in the US Army. The growing positive empirical evidence is compelling, and there appears to be sufficient evidence to warrant UK researchers undertaking ART research. The armed forces offer the potential for comparative international trials. However, equally important are veterans, emergency services personnel and those subjected to violence. ART appears to also have application in other conditions, including depression, anxiety disorders, and alcohol or drug misuse. ART can potentially help personnel traumatised by the unique challenges of war and conflict zones by providing brief psychotherapy in a readily accessible and culturally competent manner. ART facilitates the provision of interventions and resolutions in theatre, thus enhancing forces' fighting capability

  10. A successful case on traditional Chinese fumigation-soaking therapy in treating diabetic peripheral neuropathy

    Institute of Scientific and Technical Information of China (English)

    Hongfang Liu; Huayang Wu; Lizhong Zhang; Jinxi Zhao

    2006-01-01

    AIM: To investigate the scheme of inducing the diabetic peripheral neuropathy (DNP) symptoms by combine Chinese traditional medicine with modern medicine. METHODS: Patient hospitalized on April 1, 2005. Main symptoms in hospitalization: His bilateral fingers and toe tips felt stabbing pain, numb, cold, assuming a type of sock set which alleviated after he had a rest and aggravated after exercise. He had also got the symptom of dizziness, asthenia, eating little food, very thin bowel and body pain which had influence on his sleeping. Physical examination in hospital: The bilateral lower limbs which got a hyperpathia did not swell. The bilateral dorsum pedis artery pulsation was atlenuarive. The skin temperature was not high. Other nerve system examination had been discovered abnormal. Diagnosis: Traditional Chinese medical diagnosis: Xiaokebing (blood stasis for insufficiency of qi, blockage of meridian and collaterals). Modern medical diagnosis: Diabetes type 2, DNP, diabetic lower limbs artery obliteration, diabetic foot (0 level), diabetic retinopathy, coronary atherosclerotic heart disease, hypertension, chronic bronchitis, chronic obstructive pulmonary emphysema. Carried on the former therapy plan that continued to use insulin to control blood glucose, depressed blood pressure and total plasma lipoprotein etc. Meanwhile used the therapy of bilateral feet medicinal bath (Sanling 30 g, Ezhu 30 g, Ruxiang 30 g, Moyao 30 g, Zhichuanwu 30 g, Zhicaowu 30 g, Weilingxian 30 g, Mugua 30 g, Sangzhi 30 g), boiled in water, 1 dose everyday, soak feet twice a day, 20-30 minutes once, < 37 ℃. RESULTS: Seven days later, the pain of bilateral feet alleviated obviously, and the bilateral dorsum pedis artery pulsation enhanced. Blood glucose and total plasma lipoprotein had no changes. CONCLUSION: The symptoms of DNP such as pain, coldness, numbness of the lower limbs can be induced by combining feet medicinal bath (fumigation-soaking) treatment with modern medicine.

  11. Kidney failure during HIV disease treated with tenofovir, multiple concurrent diseases and drug therapies

    Directory of Open Access Journals (Sweden)

    Roberto Manfredi

    2012-04-01

    Full Text Available A significant case report of a HIV infected patient in his fifties who experienced an excellent virological and immunological response to antiretroviral therapy (which has been modified just to prevent or avoid some adverse events, but developed a severe, sudden acute kidney failure while under a polypharmacy due to some underlying and overwhelming disorders (i.e. arterial hypertension, non-insulin-dependent diabetes mellitus, a recent acute heart infarction with remarkable remnants, and finally an anecdotal muscle-joint pain with self-prescription of non-steroideal anti-inflammatory drugs, represents the key point for a debate around the increasing frequency of “polypharmacy” in the field of HIV infection, even when HIV resistance to antiretroviral is not a concern. The continuing increase of mean age of HIV-infected population, plus the existing, sometimes unmodifiable risk factors for cardiovascular, dysmetabolic, and renal disorders, plus the adjunct of anecdotal illnesses prompting the resort to different drugs and medications, either prescribed for HIV infection itself, or taken for concurrent or subsequent diseases, or self-prescribed occasionally due to an intercurrent, trivial disorders per se, may prompt a complicated scenario culminating with a life-threatening acute renal failure of tubular origin. Our report gives us the opportunity to revise and discuss the expected interactions between antiretroviral therapy and the even growing exposure to multiple different drug and drug classes, which may be responsible for relevant drug interactions and direct or adjunctive end-organ impairment, up to life-threatening conditions, which may be avoided or prevented by considering carefully all comorbidites and co-treatments potentially administered to HIV infected patients, thirty years after the discovery of AIDS.

  12. A commentary on TREAT: The trial of early aggressive drug therapy in juvenile idiopathic arthritis

    Directory of Open Access Journals (Sweden)

    Baildam Eileen

    2012-06-01

    Full Text Available Abstract Polyarticular juvenile idiopathic arthritis (JIA is a category of JIA where multiple joints are affected by chronic inflammation, and where serious and lasting damage to joints is the expected natural history in untreated disease. There is evidence of response to disease-modifying antirheumatic and biologic drugs, but little evidence of permanent remission from any of the existing therapeutic trials. The TREAT trial by Wallace et al., recently published in Arthritis and Rheumatism, used a collaborative multicenter approach to studying early aggressive treatment of polyarticular JIA in an attempt to achieve full clinical inactive disease after 6 months of treatment. The study's main finding that the earlier in the disease course that treatment is started, the better the chance of disease control, has provided evidence that there is a 'window of opportunity' for treating JIA as there is in adult rheumatoid arthritis (RA. The study provides both a platform and an impetus for concentrating future treatment trials on early rather than established disease and investigating a standard of starting treatment within 10 to 12 weeks.

  13. Impact of ribavirin dosage in chronic hepatitis C patients treated with simeprevir, pegylated interferon plus ribavirin combination therapy.

    Science.gov (United States)

    Tahata, Yuki; Hiramatsu, Naoki; Oze, Tsugiko; Urabe, Ayako; Morishita, Naoki; Yamada, Ryoko; Yakushijin, Takayuki; Hosui, Atsushi; Oshita, Masahide; Kaneko, Akira; Hagiwara, Hideki; Mita, Eiji; Ito, Toshifumi; Yamada, Yukinori; Inada, Masami; Katayama, Kazuhiro; Tamura, Shinji; Imai, Yasuharu; Hikita, Hayato; Sakamori, Ryotaro; Yoshida, Yuichi; Tatsumi, Tomohide; Hayashi, Norio; Takehara, Tetsuo

    2016-10-01

    The factors associated with sustained virologic response (SVR) in chronic hepatitis C (CH-C) genotype 1 patients treated with simeprevir (SMV), pegylated interferon (Peg-IFN) plus ribavirin (RBV) triple therapy have not been fully investigated. Two hundred and twenty-nine treatment-naïve CH-C patients treated with SMV triple therapy were enrolled in this study. The overall SVR rate was 87% in per-protocol analysis. In multivariate analysis, the interleukin (IL) 28B genotype (rs8099917, TT vs. non-TT, odds ratio [OR]: 0.044, P = 0.001) and RBV dose (< 10/10-12/ ≥ 12 mg/kg/day, OR: 4.513, P = 0.041) were significant factors associated with SVR. In patients with the IL28B non-TT genotype, RBV dose affected SVR dose-dependently in stratified analysis of RBV dose (P = 0.015); it was 44% (8/18) for patients administered <10 mg/kg/day of RBV, 78% (14/18) for those administered 10-12 mg/kg/day of RBV, and 100% (3/3) for those administered ≥12 mg/kg/day of RBV, whereas in patients with the IL28B TT genotype, a significant correlation between SVR and RBV dose was not observed (P = 0.229). Regarding RBV dose reduction of less than 10 mg/kg/day, the inosine triphosphate pyrophosphatase (ITPA) genotype (rs1127354, CC vs. non-CC, OR: 0.239, P = 0.003) and age (by 1 y.o., OR: 1.084, P = 0.002) were significant independent factors. RBV dosage affected SVR dose-dependently in patients with the IL28B non-TT genotype treated with SMV triple therapy. Special attention to anemia progression and RBV dosage should be paid to aged patients with the ITPA CC genotype. J. Med. Virol. 88:1776-1784, 2016. © 2016 Wiley Periodicals, Inc. PMID:26991414

  14. Changes in lipids over twelve months after initiating protease inhibitor therapy among persons treated for HIV/AIDS

    Directory of Open Access Journals (Sweden)

    Hogg Robert S

    2005-02-01

    Full Text Available Abstract Background Protease inhibitors are known to alter the lipid profiles in subjects treated for HIV/AIDS. However, the magnitude of this effect on plasma lipoproteins and lipids has not been adequately quantified. Objective To estimate the changes in plasma lipoproteins and triglycerides occurring within 12 months of initiating PI-based antiretroviral therapy among HIV/AIDS afflicted subjects. Methods We included all antiretroviral naïve HIV-infected persons treated at St-Paul's Hospital, British Columbia, Canada, who initiated therapy with protease inhibitor antiretroviral (ARV drugs between August 1996 and January 2002 and who had at least one plasma lipid measurement. Longitudinal associations between medication use and plasma lipids were estimated using mixed effects models that accounted for repeated measures on the same subjects and were adjusted for age, sex, time dependent CD4+ T-cell count, and time dependent cumulative use of non-nucleoside reverse transcriptase inhibitors and adherence. The cumulative number of prescriptions filled for PIs was considered time dependent. We estimated the changes in the 12 months following any initiation of a PI based regimen. Results A total of 679 eligible subjects were dispensed nucleoside analogues and PI at the initiation of therapy. Over a median 47 months of follow-up (interquartile range (IQR: 29–62, subjects had a median of 3 (IQR: 1–6 blood lipid measurements. Twelve months after treatment initiation of PI use, there was an estimated 20% (95% confidence interval: 17% – 24% increase in total cholesterol and 22% (12% – 33% increase in triglycerides. Conclusions Twelve months after treatment initiation with PIs, statistically significant increases in total cholesterol and triglycerides levels were observed in HIV-infected patients under conditions of standard treatment. Our results contribute to the growing body of evidence implicating PIs in the development of blood lipid

  15. Symptomatic therapy in multiple sclerosis: the role of cannabinoids in treating spasticity.

    Science.gov (United States)

    Leussink, Verena Isabell; Husseini, Leila; Warnke, Clemens; Broussalis, Erasmia; Hartung, Hans-Peter; Kieseier, Bernd C

    2012-09-01

    A large proportion of patients with multiple sclerosis (MS) have spasticity, which has a marked impact on their quality of life. Anecdotal evidence suggests a beneficial effect of cannabis on spasticity as well as pain. Recently, randomized, double-blind, placebo-controlled studies have confirmed the clinical efficacy of cannabinoids for the treatment of spasticity in patients with MS. Based on these data, nabiximols (Sativex), a 1:1 mix of Δ-9-tetrahydrocannabinol and cannabidiol extracted from cloned Cannabis sativa chemovars, received approval for treating MS-related spasticity in various countries around the globe. In this article we review the current understanding of cannabinoid biology and the value of cannabinoids as a symptomatic treatment option addressing spasticity in patients with MS. PMID:22973422

  16. Forty-seven Cases of Gonitis Treated by A Combined Therapy of Chinese Drugs and Acupuncture

    Institute of Scientific and Technical Information of China (English)

    杨文鹤

    2001-01-01

    @@Osteoarthritis, a nonspecific inflammatory lesion, is a commonly seen joint disease. Clinically, it is mainly characterized by arthralgia, swelling, and motor impairment. Since the knee joint is the load-bearing joint of the human body, and is susceptible to trauma, gonitis tends to have the highest morbidity in the four limbs, which manifests itself arthritis of patella and femur at the early stage; narrowness or disappearance of the medial joint space at the mid stage; and damage of the cartilage accompanied with flexion deformity at the late stage. In recent years, based on the experience of Prof. Cao Yiming, the author has treated 47 cases of gonitis by combined use of Chinese drugs and acupuncture, and obtained satisfactory therapeutic results as reported in the following.

  17. Negative Pressure Wound Therapy (NPWT) to Treat Complex Defect of the Leg after Electrical Burn.

    Science.gov (United States)

    Tevanov, Iulia; Enescu, Dan M; Bălănescu, Radu; Sterian, G; Ulici, Alexandru

    2016-01-01

    Negative pressure wound therapy is a non-invasive treatment that uses under atmospheric pressure to increase blood supply to the wound, stimulating the formation of granulation tissue, angiogenesis, proliferation of fibroblasts and endothelial cells. Negative pressure therapy has also the ability to decrease the bacterial load, reduce swelling and decrease exudate while maintaining a moist environment that facilitates healing. Our patient, a 17 year old male, suffered major third and fourth-degree high voltage electrical burns on 60% of the body surface, in November 2011. After the excision of the necrotic tissue (muscles and tendons), the lower extremity of the right leg- the tibial bone, the fibula, external and internal malleoli became exposed circularly. The soft-tissue defect was partially covered by using an internal twin muscle flap and free split skin. Then, a cross leg flap technique has been used, partially covering the defect with a contralateral thigh flap. Surface swab cultures were positive for Pseudomonas aeruginosa. In October 2013 the patient was transferred to our department. The clinical examination of the right leg showed that the tibial bone had been exposed on an area of 15/3 cm in the lower half. The peroneal malleolus had also been exposed. The resection of the devitalized, exposed tibia and the avivement of the wound edges were performed. Then the NPWT was started and performed by intermittent suction. Local cleansing, soft-tissue avivement and dressing changes were performed twice a week for 6 weeks. After six weeks of NPWT and eleven dressing changes under general anaesthesia, the wounds were ready for skin grafting. Granulation tissue was formed, covering the entire surface of both the tibia bone and the peroneal malleolus. Both receptor beds were covered with free skin graft harvested from the ipsilateral thigh. The mechanical suture of the skin grafts was performed and the grafts were covered with damp dressing. By using the NPWT it

  18. Effect of interfractional shoulder motion on low neck nodal targets for patients treated using volume modulated arc therapy (VMAT

    Directory of Open Access Journals (Sweden)

    Kevin Casey

    2014-03-01

    Full Text Available Purpose: To quantify the dosimetric impact of interfractional shoulder motion on targets in the low neck for head and neck patients treated with volume modulated arc therapy (VMAT.Methods: Three patients with head and neck cancer were selected. All three required treatment to nodal regions in the low neck in addition to the primary tumor site. The patients were immobilized during simulation and treatment with a custom thermoplastic mask covering the head and shoulders. One VMAT plan was created for each patient utilizing two full 360° arcs and a second plan was created consisting of two superior VMAT arcs matched to an inferior static AP supraclavicular field. A CT-on-rails alignment verification was performed weekly during each patient’s treatment course. The weekly CT images were registered to the simulation CT and the target contours were deformed and applied to the weekly CT. The two VMAT plans were copied to the weekly CT datasets and recalculated to obtain the dose to the deformed low neck contours.Results: The average observed shoulder position shift in any single dimension relative to simulation was 2.5 mm. The maximum shoulder shift observed in a single dimension was 25.7 mm. Low neck target mean doses, normalized to simulation and averaged across all weekly recalculations were 0.996, 0.991, and 1.033 (Full VMAT plan and 0.986, 0.995, and 0.990 (Half-Beam VMAT plan for the three patients, respectively. The maximum observed deviation in target mean dose for any individual weekly recalculation was 6.5%, occurring with the Full VMAT plan for Patient 3.Conclusion: Interfractional variation in dose to low neck nodal regions was quantified for three head and neck patients treated with VMAT. Mean dose was 3.3% higher than planned for one patient using a Full VMAT plan. A Half-Beam technique is likely a safer choice when treating the supraclavicular region with VMAT.-------------------------------------------Cite this article as: Casey K

  19. Importance of concomitant topical therapy in moderate-to-severe atopic dermatitis treated with cyclosporine.

    Science.gov (United States)

    Kim, Jeong Eun; Shin, Jae Min; Ko, Joo Yeon; Ro, Young Suck

    2016-01-01

    Cyclosporine (CS) is widely used in patients with refractory atopic dermatitis (AD). During CS treatment, many patients have a tendency to decrease their adherence to topical agents as their disease improves. Our aim was to compare the efficacy and relapse rate of CS treatment combined with topical therapy and CS monotherapy. This prospective, randomized, 6 month study involved 60 patients with moderate-to-severe AD who were randomly assigned to two groups, one receiving CS and topical agents and the other, CS only. Clinical outcomes were based on investigators' global assessment (IGA) scores, eczema areas and severity index scores, and trans-epidermal water loss. If a patient achieved treatment success (IGA score ≤2) during the study period, CS was stopped. Relapse rate and time to relapse were evaluated during the 3 months after discontinuation of CS. The treatment success rate was significantly higher in the combination group (p = 0.028). The combination group had a shorter median time to response (p = 0.040), a lower cumulative dose (p = 0.041), and a longer time to relapse (p topical agents should be used concomitantly.

  20. Factors influencing the outcome of idiopathic sudden sensorineural hearing loss treated with hyperbaric oxygen therapy.

    Science.gov (United States)

    Körpinar, Sefika; Alkan, Zeynep; Yiğit, Ozgür; Gör, Ayşe Pelin; Toklu, Akin Savaş; Cakir, Burak; Soyuyüce, Ozlem Gedik; Ozkul, Haluk

    2011-01-01

    Idiopathic sudden sensorineural hearing loss (ISSNHL) is an otologic emergency with an incidence of about 5-20 per 100,000 of the population per year. There is no universally accepted standard protocol for the treatment of patients with ISSNHL. Hyperbaric oxygen therapy (HBOT), was first reported to improve the outcome following acute inner ear disorders during the late 1960s by both French and German authors. The increase in perilymph oxygenation produced by HBOT provides logical basis for the use of this treatment modality in ISSNHL. We reviewed the records of 97 cases that received HBOT for SSNHL to identify the factors that may affect the treatment outcomes. The effects of age, gender, affected ear, status of the contralateral ear, symptoms associated with hearing loss, presence of a cardiovascular disease, dyslipidemia, history of diabetes mellitus, seasonal factor, smoking, degree of hearing loss, audiogram type, medical treatments provided prior to HBOT, onset time, and number of HBOT sessions were evaluated. The mean hearing gain in all cases after the HBOT was 29.5 dB. The gains were statistically significant in the following cases: early onset of HBOT (p = 0.016), higher number of HBOT sessions (p hearing loss (p = 0.011). The success rate was significantly lower in cases with high frequency-descending audiogram configuration (p hearing loss.