Estimation of extremely small field radiation dose for brain stereotactic radiotherapy using the Vero4DRT system

The purpose of this study was a dosimetric validation of the Vero4DRT for brain stereotactic radiotherapy (SRT) with extremely small fields calculated by the treatment planning system (TPS) iPlan (Ver.4.5.1; algorithm XVMC). Measured and calculated data (e.g. percentage depth dose [PDD], dose profile, and point dose) were compared for small square fields of 30 × 30, 20 × 20, 10 × 10 and 5 × 5 mm² using ionization chambers of 0.01 or 0.04 cm³ and a diamond detector. Dose verifications were performed using an ionization chamber and radiochromic film (EBT3; the equivalent field sizes used were 8.2, 8.7, 8.9, 9.5, and 12.9 mm²) for five brain SRT cases irradiated with dynamic conformal arcs.The PDDs and dose profiles for the measured and calculated data were in good agreement for fields larger than or equal to 10 × 10 mm² when an appropriate detector was chosen. The dose differences for point doses in fields of 30 × 30, 20 × 20, 10 × 10 and 5 × 5 mm² were +0.48%, +0.56%, −0.52%, and +11.2% respectively. In the dose verifications for the brain SRT plans, the mean dose difference between the calculated and measured doses were −0.35% (range, −0.94% to +0.47%), with the average pass rates for the gamma index under the 3%/2 mm criterion being 96.71%, 93.37%, and 97.58% for coronal, sagittal, and axial planes respectively.The Vero4DRT system provides accurate delivery of radiation dose for small fields larger than or equal to 10 × 10 mm².     

The importance of image guided radiotherapy in small cell lung cancer: Case report and review of literature

AimDescribe the anatomical changes and tumor displacement due to a rapid response of a patient’s small cell lung cancer (SCLC) during definitive chemoradiotherapy (CRT).BackgroundThe treatment for SCLC is based on CRT. If interfractional changes during RT are incorrectly assessed they might compromise adequate coverage of the tumor or increase dose to organs at risk. Image guided RT with cone-beam computed tomography (CBCT) allows to identify daily treatment variations.Material and methodsDescribe a SCLC case with rapid changes in size, shape and location of the primary tumor during RT.Case reportA 62-year-old woman was diagnosed with SCLC with complete obstruction of the anterior and lingular bronchi and incomplete left thorax expansion due to a 12 × 15 cm mass. During CRT (45 Gy in 1.5 Gy per fraction, twice daily) the patient presented rapid tumor response, leading to resolution of bronchi obstruction and hemithorax expansion. Tumor shifted up to 4 cm from its original position. The identification of variations led to two new simulations and planning in a 3-week treatment course.ConclusionsThe complete radiological response was possible due to systematic monitoring of the tumor during CRT. We recommend frequent on-site image verification. Daily CBCT should be considered with pretreatment tumor obstruction, pleural effusion, atelectasis, large volumes or radiosensitive histology that might resolve early and rapidly and could lead to a miss of the tumor or increased toxicity. Further research should be made in replanning effect in coverage of microscopic disease since it increases uncertainty in this scenario.     

Impact of rotational errors of whole pelvis on the dose of prostate-based image-guided radiotherapy to pelvic lymph nodes and small bowel in high-risk prostate cancer

BackgroundThe target volume increases when the prostate and pelvic lymph nodes (PLNs) are combined, and the fiducial markers (FMs) are placed at the edge of the irradiation field. Thus, the position of FMs may be changed by the rotational errors (REs) of “whole pelvis”. The aim of this study was to examine the impact of REs of “whole pelvis” on the dose of FMs-based image-guided radiotherapy to the PLNs and the small bowel in prostate cancer including the PLNs.Materials and methodsWe retrospectively evaluated 10 patients who underwent prostate cancer radiotherapy involving the PLNs. The position of FMs was calculated from the radiographs obtained before and after the 6D correction of pelvic REs. We simulated the delivery dose considering the daily pelvic REs and calculated the difference from the planned dose in the D_98% of the PLN clinical target volume and the D_2cc, and V_45Gy of the small bowel.ResultThe position of FMs strongly correlated with the pelvic REs in the pitch direction (r = 0.7788). However, the mean delivered doses to PLNs for 10 patients were not significantly different from the planned doses (p = 0.625). Although the D_2cc and V_45Gy of the small bowel strongly correlated with the pitch rotation of the pelvis, there was no significant difference between the delivered and planned doses (p = 0.922 and p = 0.232, respectively).ConclusionThe dosimetric effect of pelvic REs on the dose to PLNs and the small bowel was negligible during the treatment course.     

The influence of short-term fasting on the quality of small bowel graft preservation

INTRODUCTION: Donor nutritional status may be a determinant of small bowel (SB) quality following storage. In this study, we investigated the effect of donor nutritional status and a proven nutrient-rich preservation solution on graft quality following cold storage. METHODS: Rats were fasted (12-14 h) or non-fasted. SB (n=6) was flushed vascularly with modified University of Wisconsin (UW) solution and flushed luminally with UW or an amino acid-rich (AA) solution as follows: Fasted. UWV, none; UWL, UW solution; AAL, AA solution. Non-fasted. UWV, none; UWL, UW solution; AAL, AA solution. Energetics, peroxidation (malondialdehyde; MDA), glutathione and histology were assessed over 24 h at 4 degrees C. RESULTS: Energetics (ATP, ATP/ADP, and energy charge) were significantly higher in AAL (fasted and non-fasted) groups than other groups. However, there were no differences in energetics parameters between fasted and non-fasted animals in all groups. MDA was higher in fasted groups than non-fasted tissues; interestingly, AAL values were up to 10-fold lower than other groups. Higher glutathione levels were detected in non-fasted AAL tissues. Mucosal integrity was markedly superior in luminally treated tissues (UWL and AAL) in fasted and non-fasted states. Most noteably, AAL tissues from fasted animals exhibited grade 2 injury (villus clefting), whereas normal mucosa was observed in non-fasted tissues (grade 0). CONCLUSION: Luminal flushing and a nutrient-rich preservation solution improve energetics, oxidative stress, and mucosal integrity during storage. Poorer donor nutritional status does not affect energetics throughout storage, but causes mucosal injury as a result of increased oxidative stress, even after a brief period of donor fasting.     

Prospective evaluation of the setup errors and its impact on safety margin for cervical cancer pelvic conformal radiotherapy

AimThe primary objective was to assess set-up errors (SE) and secondary objective was to determine optimal safety margin (SM)BackgroundTo evaluate the SE and its impact on the SM utilizing electronic portal imaging (EPI) for pelvic conformal radiotherapy.Material and methods20 cervical cancer patients were enrolled in this prospective study. Supine position with ankle and knee rest was used during CT simulation. The contouring was done using consensus guideline for intact uterus. 50 Gy in 25 fractions were delivered at the isocenter with ≥95% PTV coverage. Two orthogonal (Anterior and Lateral) digitally reconstructed radiograph (DRR) was constructed as a reference image. The pair of orthogonal [Anterior-Posterior and Right Lateral] single exposure EPIs during radiation was taken. The reference DRR and EPIs were compared for shifts, and SE was calculated in the X-axis, Y-axis, and Z-axis directions.Results320 images (40 DRRs and 280 EPIs) were assessed. The systematic error in the Z-axis (AP EPI), X-axis (AP EPI), and Y-axis (Lat EPI) ranged from -12.0 to 11.8 mm, -10.3 to 7.5 mm, and -8.50 to 9.70 mm, while the random error ranged from 1.60 to 6.15 mm, 0.59 to 4.93 mm, and 1.02 to –4.35 mm. The SM computed were 7.07, 6.36, and 7.79 mm in the Y-axis, X-axis, and Z-axis by Van Herk’s equation, and 6.0, 5.51, and 6.74 mm by Stroom’s equation.ConclusionThe computed SE helps defining SM, and it may differ between institutions. In our study, the calculated SM was approximately 8 mm in the Z-axis, 7 mm in X and Y axis for pelvic conformal radiotherapy.     

A practical methodology to improve the dosimetric accuracy of MR-based radiotherapy simulation for brain tumors

PurposeTo investigate the dosimetric accuracy of synthetic computed tomography (sCT) images generated by a clinically-ready voxel-based MRI simulation package, and to develop a simple and feasible method to improve the accuracy.Methods20 patients with brain tumor were selected to undergo CT and MRI simulation. sCT images were generated by a clinical MRI simulation package. The discrepancy between planning CT and sCT in CT number and body contour were evaluated. To resolve the discrepancies, an sCT specific CT-relative electron density (RED) calibration curve was used, and a layer of pseudo-skin was created on the sCT. The dosimetric impact of these discrepancies, and the improvement brought about by the modifications, were evaluated by a planning study. Volumetric modulated arc therapy (VMAT) treatment plans for each patient were created and optimized on the planning CT, which were then transferred to the original sCT and the modified-sCT for dose re-calculation. Dosimetric comparisons and gamma analysis between the calculated doses in different images were performed.ResultsThe average gamma passing rate with 1%/1 mm criteria was only 70.8% for the comparison of dose distribution between planning CT and original sCT. The mean dose difference between the planning CT and the original sCT were −1.2% for PTV D₉₅ and −1.7% for PTV D_max, while the mean dose difference was within 0.7 Gy for all relevant OARs. After applying the modifications on the sCT, the average gamma passing rate was increased to 92.2%. Mean dose difference in PTV D₉₅ and D_max were reduced to −0.1% and −0.3% respectively. The mean dose difference was within 0.2 Gy for all OAR structures and no statistically significant difference were found.ConclusionsThe modified-sCT demonstrated improved dosimetric agreement with the planning CT. These results indicated the overall dosimetric accuracy and practicality of this improved MR-based treatment planning method.     

A critical review of the application of white rot fungus to environmental pollution control

Research on white rot fungi for environmental biotechnology has been conducted for more than 20 years. In this article, we have reviewed processes for cell growth and enzyme production including the factors influencing enzyme productivity and the methods for enhancement of enzyme production. Significant progress has been achieved in molecular biology related to white rot fungi, especially related to the extraction of genetic material (RNA and DNA), gene cloning and the construction of genetically engineered microorganisms. The development of biotechnologies using white rot fungi for environmental pollution control has been implemented to treat various refractory wastes and to bioremediate contaminated soils. The current status and future research needs for fundamentals and application are addressed in this review.     

A critical review on use of Agrobacterium rhizogenes and their associated binary vectors for plant transformation

Agrobacterium rhizogenes, along with A. tumefaciens, has been used to affect genetic transformation in plants for many years. Detailed studies conducted in the past have uncovered the basic mechanism of foreign gene transfer and the implication of Ri/Ti plasmids in this process. A number of reviews exist describing the usage of binary vectors with A. tumefaciens, but no comprehensive account of the numerous binary vectors employed with A. rhizogenes and their successful applications has been published till date. In this review, we recollect a brief history of development of Ri-plasmid/Ri-T-DNA based binary vectors systems and their successful implementation with A. rhizogenes for different applications. The modification of native Ri plasmid to introduce foreign genes followed by development of binary vector using Ri plasmid and how it facilitated rapid and feasible genetic manipulation, earlier impossible with native Ri plasmid, have been discussed. An important milestone was the development of inducible plant expressing promoter systems which made expression of toxic genes in plant systems possible. The successful application of binary vectors in conjunction with A. rhizogenes in gene silencing and genome editing studies which are relatively newer developments, demonstrating the amenability and adaptability of hairy roots systems to make possible studying previously intractable research areas have been summarized in the present review.     

A prospective observational study to analyse the influence of bladder and rectal volume changes on prostate radiotherapy using IMRT

AimTo analyse the interfractional bladder and rectal volume changes and the influence on prostate position.BackgroundInterfractional displacement of prostate due to variation in bladder and rectal volume is usual. It is only rational to study the bladder and rectal volume changes and their effects on prostate position during intensity modulated radiotherapy of prostate cancer.Materials and MethodsA prospective study was conducted on twenty patients with localized prostate cancer during the first phase of radiotherapy, where 50 gray in 25 fractions was delivered by the IMRT technique with daily cone beam computed tomography Bladder and rectum volumes were delineated on CBCT images and their volumes were noted. Prostate position was noted on each set of CBCT images with respect to specific reference points defined on the ileum and coccyx, and daily prostate displacement was noted.ResultsMean setup errors in vertical, longitudinal and lateral directions were noted as 1.49, 0.498 and 0.17 cm, respectively. Mean change in bladder and rectal volumes in daily CBCT images with respect to that on the first day CT images was noted as 101.94 and 10.22, respectively. Mean lateral and vertical displacement in prostate position was noted as 0.53 and 0.49 cm respectively. No considerable changes in dosimetric parameters were observed because of bladder and rectal volume changes.ConclusionsDaily CBCT should be done for accurate treatment delivery by the IMRT technique for prostate radiotherapy as prostate shifts physiologically with changes in rectal and bladder volumes.     

A review of algorithms for medical image segmentation and their applications to the female pelvic cavity

This paper aims to make a review on the current segmentation algorithms used for medical images. Algorithms are classified according to their principal methodologies, namely the ones based on thresholds, the ones based on clustering techniques and the ones based on deformable models. The last type is focused on due to the intensive investigations into the deformable models that have been done in the last few decades. Typical algorithms of each type are discussed and the main ideas, application fields, advantages and disadvantages of each type are summarised. Experiments that apply these algorithms to segment the organs and tissues of the female pelvic cavity are presented to further illustrate their distinct characteristics. In the end, the main guidelines that should be considered for designing the segmentation algorithms of the pelvic cavity are proposed.     

A critical review of the use and performance of different function types for modeling temperature-dependent development of arthropod larvae

Temperature-dependent development influences production rates of arthropods, including crustaceans important to fisheries and agricultural pests. Numerous candidate equation types (development functions) exist to describe the effect of temperature on development time, yet most studies use only a single type of equation and there is no consensus as to which, if any model predicts development rates better than the others, nor what the consequences of selecting a potentially incorrect model equation are on predicted development times. In this study, a literature search was performed of studies fitting development functions to development data of arthropod larvae (99 species). The published data of most (79) of these species were then fit with 33 commonly-used development functions. Overall performance of each function type and consequences of using a function other than the best one to model data were assessed. Performance was also related to taxonomy and the range of temperatures examined. The majority (91.1%) of studies were found to not use the best function out of those tested. Using the incorrect model lead to significantly less accurate (e.g., mean difference±SE 85.9±27.4%, range: −1.7 to 1725.5%) predictions of development times than the best function. Overall, more complex functions performed poorly relative to simpler ones. However, performance of some complex functions improved when wide temperature ranges were tested, which tended to be confined to studies of insects or arachnids compared with those of crustaceans. Results indicate the biological significance of choosing the best-fitting model to describe temperature-dependent development time data.     

A historical literature review on the role of posterior axillary boost field in the axillary lymph node coverage and development of lymphedema following regional nodal irradiation in breast cancer

To elucidate whether (1) a posterior axillary boost (PAB) field is an optimal method to target axillary lymph nodes (LNs); and (2) the addition of a PAB increases the incidence of lymphedema, a systematic review was undertaken. A literature search was performed in the PubMed database. A total of 16 studies were evaluated. There were no randomized studies. Seven articles have investigated dosimetric aspects of a PAB. The remaining 9 articles have determined the effect of a PAB field on the risk of lymphedema. Only 2 of 9 articles have prospectively reported the impact of a PAB on the risk of lymphedema development. There are conflicting reports on the necessity of a PAB. The PAB field provides a good coverage of level I/II axillary LNs because these nodes are usually at a greater depth. The main concern regarding a PAB is that it produces a hot spot in the anterior region of the axilla. Planning studies optimized a traditional PAB field. Prospective studies and the vast majority of retrospective studies have reported the use of a PAB field does not result in increasing the risk of lymphedema development over supraclavicular-only field. The controversies in the incidence of lymphedema suggest that field design may be more important than field arrangement. A key factor regarding the use of a PAB is the depth of axillary LNs. The PAB field should not be used unless there is an absolute indication for its application. Clinicians should weigh lymphedema risk in individual patients against the limited benefit of a PAB, in particular after axillary dissection. The testing of the inclusion of upper arm lymphatics in the regional LN irradiation target volume, and universal methodology measuring lymphedema are all areas for possible future studies.     

A review on prebiotics and probiotics for the control of dysbiosis: present status and future perspectives

Dysbiosis or dysbacteriosis is defined as a shift in the intestinal microbiota composition resulting in an imbalance between beneficial and harmful bacteria. Since the ban on the use of growth-promoting antibiotics in animal feed in the EU, dysbiosis has emerged as a major problem in intensive animal production. Prebiotics and probiotics are currently under investigation as possible alternatives to growth-promoting antibiotics, as their mode of action is thought to be based largely on a modulation of the composition and function of the intestinal microbiota. In this review, we analyse the currently available data from both animal and human nutrition that document the potential and limitations of prebiotics and probiotics for the control of dysbiosis. An impressive number of empirical feeding trials have been carried out in healthy animals, yielding sometimes contradictory results. More in-depth studies have revealed the complexity of the interactions taking place in the lower intestinal tract, thus illustrating that pre- and probiotics cannot be a simple replacement for growth-promoting antibiotics. Although there are indications that the strategic use of pre- and probiotics can provide major benefits, there is still a lack of basic knowledge on the delicate interactions between the microbiota, the host and the feed components, which hampers the widespread use of these valuable feed additives.     

A critical evaluation of the 2011 ECHA reports on compliance with the REACH and CLP regulations and on the use of alternatives to testing on animals for compliance with the REACH regulation

On 30 June 2011, the European Chemicals Agency published two reports, one on the functioning of the REACH system, the other on the use of alternatives to animal testing in compliance with that system. The data presented are based on information gained during the first registration period under the REACH system, which included high production volume chemicals and substances of very high concern, which have the most extensive information requirements. A total of 25,460 registration dossiers were received, covering 3,400 existing, so-called 'phase-in', substances, and 900 new, so-called 'non-phase-in', substances. Data sharing and the joint submission of data are reported to have worked successfully. In the registration dossiers for these substances, results from new animal tests were included for less than 1% of all the endpoints; testing proposals (required for 'higher-tier' information requirements) were submitted for 711 in vivo tests involving vertebrate animals. The registrants mainly used old, existing experimental data, or options for the adaptation (waiving) of information requirements, before collecting new information. For predicting substance toxicity, 'read-across' was the second most-used approach, followed by 'weight-of-evidence'. In vitro toxicity tests played a minor role, and were only used when the respective test methods had gained the status of regulatory acceptance. All in all, a successful start to the REACH programme was reported, particularly since, in contrast to most predictions, it did not contribute to a significant increase in toxicity testing in animals.     

A review of the positive and negative effects of cardiovascular drugs on sexual function: a proposed table for use in clinical practice

Several antihypertensive drugs, such as diuretics and β-blockers, can negatively affect sexual function, leading to diminished quality of life and often to noncompliance with the therapy. Other drug classes, however, such as angiotensin II receptor blockers (ARBs) are able to improve patients’ sexual function. Sufficient knowledge about the effects of these widely used antihypertensive drugs will make it possible for cardiologists and general practitioners to spare and even improve patients’ sexual health by switching to different classes of cardiac medication. Nevertheless, previous data (part I) indicate that most cardiologists lack knowledge about the effects cardiovascular agents can have on sexual function and will thus not be able to provide the necessary holistic patient care with regard to prescribing these drugs. To be able to improve healthcare on this point, we aimed to provide a practical overview, for use by cardiologists as well as other healthcare professionals, dealing with sexual dysfunction in their clinical practices. Therefore, a systematic review of the literature was performed. The eight most widely used classes of antihypertensive drugs have been categorised in a clear table, marking whether they have a positive, negative or no effect on sexual function.     

A preliminary study on the use of jenny colostrum to improve quality in extenders for freezing donkey semen

Sperm quality in donkeys (Equus asinus) after freezing thawing is still considered lower than that from other animals, including horses. The aim of this study was to test a new freezing extender supplemented with jenny colostrum on donkey sperm. After thawing, we evaluated sperm motility by means of computer-assisted analysis, viability by SYBR-14 and propidium iodide (PI), membrane functional integrity by HOS-test and acrosome integrity by isothiocyanate conjugated with peanut agglutinin (FITC-PNA) and PI. Ejaculates were collected from five fertile Donkeys. Sperm samples were pooled, diluted and cryopreserved into three experimental extender groups: BotuCrio^®, lactose-extender supplemented with egg yolk (20%) and lactose-extender supplemented with jenny colostrum (20%). The results demonstrated that lactose-jenny colostrum samples displayed significantly higher values in almost all parameters evaluated (p < 0.05) compared with the other two extenders after thawing (BotuCrio^® and lactose-egg yolk based extender, respectively) –Total Motility, Viability, HOS test, VCL, VSL and VAP. Acrosome status, LIN, STR and WOB despite showing lower values, none of them were statistically significant (p > 0.05). In conclusion, the extender containing jenny colostrum can be successfully used for donkey semen crypreservation and could effectively improve donkey sperm qualities after freezing -thawing.     

农业面源氮污染控制措施滞后效应形成机理与评估方法研究进展

推广实施最佳管理措施(BMPs)被认为是防治农业面源污染的有效途径,然而许多流域实施BMPs后通常难以在预测的时间内实现水质改善目标,导致人们对BMPs的有效性提出质疑。受流域内养分遗留效应影响,BMPs实施后的环境质量改善效益可能不会立刻显现(也即“滞后期”),这是由于过去人为活动输入的过量营养物质在流域水文传输和生物地球化学转化过程中的积累所致,当来自外部的污染负荷减少时,这部分营养物质的汇集和释放可能掩盖治理措施对于水质改善的影响。鉴于遗留的营养物质在延迟水质改善方面的关键作用,滞后期的量化评估对于全面分析污染成因,科学配置BMPs,有效治理流域农业面源污染,提升水质改善效率非常重要。以农业面源氮控制措施的滞后效应形成机理和评估方法为主线,概述了流域尺度氮累积和滞后效应产生的主要机理,述评了氮污染滞后效应的量化评估方法,提出目前大多数流域模型尚不能很好的表述滞后效应以及缺乏解决水文和生物地球化学遗留效应的能力,并对未来BMPs优化配置研究提出建议：(1)摸清流域水文传输过程和生物地球化学转化过程对BMPs控氮效益滞后期的影响,分析污染负荷削减的时空响应规律;(2)构建包含土壤、浅...     

A review of white rust (Puccinia horiana Henn.) disease on chrysanthemum and the potential for its biological control with Verticillium lecanii (Zimm.) Viégas

The biology, aetiology and epidemiology of Puccinia horiana, the cause of white rust disease of chrysanthemum (Chrysanthemum spp.) is reviewed in relation to current environmental, cultural and chemical methods for its control. Importantly, basidiospore release, germination and infection can take as little as 5 h at optimum r.h. (96%) and temperature (between 17–24°C). Recent developments using the fungus Verticillium lecanii for the control of insects on glasshouse-grown all-year-round chrysanthemums rely upon the maintenance of r.h. during night periods in excess of 95%, thus predisposing plants to white rust attack. However, V. lecanii is unusual in that it can also parasitise spores and fruiting structures of a range of rust fungi including P. horiana. This mycoparasitic ability is also reviewed, and against this background, the potential for an integrated insect and white rust control programme on all-year-round chrysanthemums is assessed.