Water loss from eggs of domestic fowl and calcium status of hatchlings

Water balance in eggs of domestic fowl was manipulated by drilling holes (each 3 mm in diameter) through the calcareous layer into the air cell on day 10 of incubation. Water loss between days 0 and 18 averaged 6 g for eggs in the control group (no hole) but increased to 8, 12, and 15 g for eggs with 1, 2, or 3 holes, respectively. Hatching success was 79–87% for eggs with 0–2 holes through the eggshell but only 43% for eggs with three holes. Live mass of hatchlings declined as the number of holes drilled in the eggshell increased, but dry mass of carcasses was unaffected by the treatments. The quantity of Ca²⁺, Mg²⁺, and phosphorus in residual yolks and yolk-free carcasses of hatchlings was not influenced by the amount of water lost from eggs. Plasma Ca²⁺ and Mg²⁺ were elevated in hatchlings from eggs with high rates of water loss. The inability to regulate plasma Ca²⁺ may be a negative consequence of excessive water loss and could contribute to increased mortality of embryos.     

Flood mitigation function of rain gardens for management of urban storm runoff in Japan

Urban waterlogging stems from coverage with impervious surfaces and increasing rainfall intensity from climate change and variability, meaning that storm water cannot readily infiltrate the ground and excessive surface runoff leads to urban flooding. To reduce related environmental and safety risks, rainfall and groundwater level research was carried out in Kyoto Prefecture with two rain gardens (RG1 and RG2) to investigate flood mitigation functions using a tank model. During the 134 days of monitoring from July 14, 2017, to November 25, 2017, RG1 had seven overflow events with an average runoff control ratio of 63.94%, and RG2 had one event with a ratio of 95.97%. The RG1 tank model (two stages) showed that initial storage for the first and second depths was 6.912?×?10^?11 and 0 mm, respectively. The heights of the discharge holes were 20.857 and 0.784 mm for the first stage and 0.659 mm for the second stage, and the discharge hole coefficients were 0.529 and 0.002 for the first stage and 0.004 for the second stage. The results showed that RG1 had penetration hole coefficients of 0.138 (first stage) and 0.254 (second stage), with a water balance error of 0.017 (<?0.02) and a Nash–Sutcliffe efficiency coefficient of 0.922, indicating better reliability and quality than RG2 with the one-stage tank model. Peak flow simulation for mitigation showed that RG1 had a high overflow control ratio (mitigation time 2 h for instant rainfall of 100 mm/h), and can therefore be considered appropriate for other urban areas of Japan.

     

CdTe compact gamma camera for coded aperture imaging in radioguided surgery

The aim of this work was to assess the performance of a prototype compact gamma camera (MediPROBE) based on a CdTe semiconductor hybrid pixel detector, for coded aperture imaging. This probe can be adopted for various tasks in nuclear medicine such as preoperative sentinel lymph node localization, breast imaging with ^99mTc radiotracers and thyroid imaging, and in general in radioguided surgery tasks. The hybrid detector is an assembly of a 1-mm thick CdTe semiconductor detector bump-bonded to a photon-counting CMOS readout circuit of the Medipix2 series or energy-sensitive Timepix detector. MediPROBE was equipped with a set of two coded aperture masks with 0.07-mm or 0.08-mm diameter holes. We performed laboratory measurements of field of view, system spatial resolution, and signal-difference-to-noise ratio, by using gamma-emitting radioactive sources (¹⁰⁹Cd, ¹²⁵I, ²⁴¹Am, ^99mTc). The system spatial resolution in the lateral direction was 0.56 mm FWHM (coded aperture mask with holes of 0.08 mm and a 60 keV source) at a source-collimator distance of 50 mm and a field of view of 40 mm by side. Correspondingly, the longitudinal resolution in 3D source localization tasks was about 3 mm. MediPROBE showed a significant improvement in terms of spatial resolution when equipped with the high-resolution coded apertures, with respect to the performance previously reported with 1–2 mm pinhole apertures as well as with respect to adopting a 0.35 mm pinhole aperture.     

Pirfenidone inhibits cryoablation induced local macrophage infiltration along with its associated TGFb1 expression and serum cytokine level in a mouse model

PurposeTo investigate the effects of pirfenidone (PFD) on post-cryoablation inflammation in a mouse model.Materials and methodsIn this IACUC-approved study, eighty Balb/c mice were randomly divided into four groups (20/group): sham + vehicle, sham + PFD, cryoablation + vehicle, and cryoablation + PFD. For cryoablation groups, a 20% freeze rate cryoablation (20 s to less than −100 °C) was used to ablate normal muscle in the right flank. For sham groups, the cryoprobe was advanced into the flank and maintained for 20 s without ablation. PFD or vehicle solution was intraperitoneally injected (5 mg/kg) at days 0, 1, 2, 3, and then every other day until day 13 after cryoablation. Mice were euthanized at days 1, 3, 7, and 14. Blood samples were used for serum IL-6, IL-10, and TGFβ1 analysis using electrochemiluminescence and ELISA assays, respectively. Immunohistochemistry-stained ablated tissues were used to analyze macrophage infiltration and local TGFβ1 expression in the border region surrounding the cryoablation-induced coagulation zone.ResultsCryoablation induced macrophage infiltration and increased TGFβ1 expression in the border of the necrotic zone, and high levels of serum IL-6, peaking at days 7 (70.5 ± 8.46/HPF), 14 (228 ± 18.36/HPF), and 7 (298.67 ± 92.63), respectively. Animals receiving PFD showed reduced macrophage infiltration (35.5 ± 16.93/HPF at day 7, p < 0.01) and cytokine levels (60.2 ± 7.6/HPF at day 14, p < 0.01). PFD also significantly reduced serum IL-6 levels (p < 0.001 vs. all non-PFD groups).ConclusionsPFD mitigates cryoablation induced muscle tissue macrophage infiltration, increased IL-6 levels, and local TGFβ1 expression in a small animal model.     

Simultaneous production of mixed electron–photon beam in a medical LINAC: A feasibility study

PurposeThe electron or photon beams might be used for treatment of tumors. Each beam has its own advantage and disadvantages. Combo beam can increase the advantages. No investigation has been performed for producing simultaneous mixed electron and photon beam. In current study a device has been added to the Medical Linac to produce a mixed photon–electron beam.MethodsFirstly a Varian 2300CD head was simulated by MCNP Monte Carlo Code. Two sets of perforated lead sheets with 1 and 2 mm thickness and 0.2, 0.3, and 0.5 cm punches then placed at the top of the applicator holder tray. This layer produces bremsstrahlung x-ray upon impinging fraction electrons on it. The remaining fraction of electrons passes through the holes. The simulation was performed for 10 × 10, 6 × 6, and 4 × 4 cm² field size.ResultsFor 10 × 10 cm² field size, among the punched targets, the largest penumbra difference between the depth of 1 and 7 cm was 72%. This difference for photon and electron beams were 31% and 325% respectively. A maximum of 39% photon percentage was produced by 2 mm target with 0.2 cm holes diameter layer. The minimum surface dose value was 4% lesser than pure electron beam. For small fields, unlike the pure electron beam, the PDD, penumbra, and flatness variations were negligible.ConclusionsThe advantages of mixing the electron and photon beam is reduction of pure electron's penumbra dependency with the depth, especially for small fields, also decreasing of dramatic changes of PDD curve with irradiation field size.     

Infrared imaging of 2-D temperature distribution during cryogen spray cooling

Cryogen spray cooling (CSC) is used in conjunction with pulsed laser irradiation for treatment of dermatologic indications. The main goal of this study was to determine the radial temperature distribution created by CSC and evaluate the importance of radial temperature gradients upon the subsequent analysis of tissue cooling throughout the skin. Since direct measurement of surface temperatures during CSC are hindered by the formation of a liquid cryogen layer, temperature distributions were estimated using a thin, black aluminum sheet. An infrared focal plane array camera was used to determine the 2-D backside temperature distribution during a cryogen spurt, which preliminary measurements have shown is a good indicator of the front-side temperature distribution. The measured temperature distribution was approximately gaussian in shape. Next, the transient temperature distributions in skin were calculated for two cases: 1) the standard 1-D solution which assumes a uniform cooling temperature distribution, and 2) a 2-D solution using a nonuniform surface cooling temperature distribution based upon the back-side infrared temperature measurements. At the end of a 100-ms cryogen spurt, calculations showed that, for the two cases, large discrepancies in temperatures at the surface and at a 60-micron depth were found at radii greater than 2.5 mm. These results suggest that it is necessary to consider radial temperature gradients during cryogen spray cooling of tissue.     

红火蚁饵剂药瓶瓶盖孔洞设计与出药量的关系

红火蚁Solenopsis invicta Buren是一种对人类健康、生态环境等具有严重危害的重大入侵害虫,毒饵诱杀是防控红火蚁的重要手段.在采用人工撒施方法时,如何避免药剂浪费或不足仍需研究.本文研究了红火蚁饵剂药瓶瓶盖出药量与瓶盖上孔洞直径、孔洞数量和施药方式的关系,为红火蚁饵剂施药装置选择合适的孔洞直径、孔洞数...     

Characterization of yeast and filamentous fungi isolated from cryoconite holes of Svalbard,Arctic

Cryoconite holes have biogeochemical, ecological and biotechnological importance. This communication presents results on culturable psychrophilic yeast and filamentous fungi from cryoconite holes at Midre Lovénbreen glacier. The identification of these microbes was achieved through conventional and DNA sequencing techniques. Effect of temperature, salt and media on growth of the cultures was studied. Measurements on the bioavailability of nutrients and trace metals were made through different methods including ICPMS (Inductively Coupled Plasma Mass Spectrometry). Colony forming unit (CFU) per gram of sediment sample was calculated to be about 7 × 10³–1.4 × 10⁴ and 4 × 10³–1.2 × 10⁴ of yeast and filamentous fungi, respectively. Based on morphology and sequence data, these were identified as Cryptococcus gilvescens, Mrakia sp., Rhodotorula sp., Phialophora alba and Articulospora tetracladia. Amongst these, Phialophora alba, Cryptococcus gilvescens and Mrakia sp. zhenx-1 are reported for the first time from Svalbard Arctic, while Rhodotorula sp. (95% gene similarity) is a new species, yet to be described. Rhodotorula sp. expressed high amylase, while Cryptococcus gilvescens showed high lipase activity. Mrakia sp. showed phosphate solubilization between 4 and 15°C, which is a first record. Chemical analysis revealed the presence of organic carbon, nitrogen and phosphorus in substantial amounts in the sediments. Filamentous fungi and yeast in the cryoconite holes drive the process of organic macromolecule degradation through cold-adapted enzyme secretion, thereby assisting in nutrient cycling in these subglacial environments. Further, these cold-adapted enzymes may provide an opportunity for the prospect of biotechnology in Arctic. This is the first report on mycological investigation into cryoconite holes from Midre Lovénbreen glacier.     

Void development on carbonate coasts: creation of anchialine habitats

Anchialine caves in coastal locations develop in two ways: by pseudokarst processes that form talus caves, sea caves, tafoni, fissure caves and lava tubes, and by karst dissolutional processes that form stream caves, flank margin caves, and blue holes. Pseudokarst caves are of minor importance in anchialine cave habitat development, with some lava tubes being notable exceptions. Dissolution caves provide the most extensive, variable, and long-term environments for anchialine habitats. The Carbonate Island Karst Model (CIKM) allows dissolutional cave development in carbonate coasts to be understood as the interplay between freshwater and marine water mixing, sea-level change, rock maturity, and interaction with adjacent non-carbonate rocks. Glacioeustatic sea-level changes of the Quaternary have moved all coastal anchialine cave environments repeatedly through a vertical range of over 100 m, and modern anchialine environments could not develop at their current elevations until ~4,000 years ago when sea level reached its present position. Blue holes form by a variety of mechanisms, but the most common is upward stoping and collapse from deep dissolutional voids. As a result, they provide vertical connection between different levels of horizontal cave development produced by a variety of earlier sea-level positions. Blue holes are overprinted by successive sea-level fluctuations; each sea-level event adds complexity to the habitats within blue holes and the cave systems they connect. Blue holes can reach depths below the deepest glacioeustatic sea-level lowstand, and thereby provide a refugia for anchialine species when cave passages above are drained by Quaternary sea-level fall. Blue holes represent the most significant anchialine cave environment in the world, and may provide clues to anchialine cave species colonization and speciation events.     

Assessment and clinical validation of margins for adaptive simultaneous integrated boost in neo-adjuvant radiochemotherapy for rectal cancer

PurposeAn adaptive concomitant boost (ACB) for the neo-adjuvant treatment of rectal cancer was clinically implemented. In this study population margins M(90,90) considering rectal deformation were derived for 10 consecutive patients treated at 18 × 2.3 Gy with Helical Tomotherapy (HT) and prospectively validated on 20 additional patients treated with HT, delivering ACB in the last 6 fractions.MethodsSectorial margins M(90,90) of the whole and second treatment parts were assessed for 90% population through a method combining the 90% coverage probability maps of rectal positions (CPC90%) with 3D local distance measurements between the CPC90% and a reference rectal contour. M(90,90) were compared with the margins M(90,90)^95%/99%, ensuring CPC90% coverage with 95%/99% confidence level. M(90,90) of the treatment second part were chosen as ACB margins which were clinically validated for each patient by means of %volume missing of CPC5/6 excluded by the ACB margins.ResultsThe whole treatment M(90,90) ranged between 1.9 mm and 9 mm in the lower-posterior and upper-anterior sectors, respectively. Regarding ACB, M(90,90) were 7 mm in the anterior direction and <5 mm elsewhere. M(90,90)^95%/99% did not significantly differ from M(90,90). The %volume excluded by the ACB margin was<2% for all male and <5% for 9/10 female patients. The dosimetry impact on R_adapt for the patients with the largest residual error was negligible.ConclusionsLocal deformation measurements confirm an anisotropic motion of rectum once set-up error is rigidly corrected. Margins of 7 mm anterior and 5 mm elsewhere are adequate for ACB. Female patients show a slightly larger residual error.     

Water-soluble granules containing <Emphasis Type="Italic">Bacillus megaterium</Emphasis> for biological control of rice sheath blight: formulation,bacterial viability and efficacy testing

Endospores of B. megaterium were formulated in granule formulations with sodium alginate, lactose and polyvinylpyrrolidone (PVP K-30) by the wet granulation technique. The granule formulation exhibited good physical characteristics, such as high-water solubility and optimal viscosity, that would be suitable for spray application. The bacteria remained viable in the dry granule formulation at 10⁹ c.f.u./g after 24 months storage at room temperature. Under laboratory conditions, aqueous solutions of the formulation showed high activity against mycelial growth of R. solani (99.64 ± 0.14% mycelial inhibition). High viability of the bacterial antagonist on leaf sheath and leaf blade at day 7 after spraying with the formulation was observed (approximately 10⁶ c.f.u./g of plant). Application of an equivalent number of un-formulated endospores resulted in much loss of the bacterial endospores even 1 day after application. In a small pilot field study, an aqueous solution of the formulation (3%w/v) applied by spraying at days 1, 5 and 10 after pathogen inoculation of the rice plants was more effective in suppressing rice sheath blight disease than one application of a fungicide (Iprodione) at day 1. Additionally, rice plants sprayed with the aqueous solution of the granule formulation had higher panicle and whole kernel weights than those of fungicide-treated and control (untreated) plants.     

Energetics of tropical hibernation

In this field study, the energetic properties of tropical hibernation were investigated by measuring oxygen consumption and body temperature of the Malagasy primate Cheirogaleus medius in their natural hibernacula. These lemurs use tree holes with extremely varying insulation capacities as hibernacula. In poorly insulated tree holes, tree hole temperature and body temperature fluctuated strongly each day (between 12.8 and 34.4°C). The metabolic rate under these conditions also showed large daily fluctuations between about 29.0 ml O₂/h and 97.9 ml O₂/h in parallel with changes in body temperature. In well insulated tree holes in very large trees on the other hand, tree hole temperature and body temperature remained relatively constant at about 25°C. Lemurs hibernating in these tree holes showed a more constant metabolic rate at an intermediate level, but hibernation was interrupted by repeated arousals with peak metabolic rates up to 350 ml O₂/h. The occurrence of these spontaneous arousals proved that the ability for thermoregulation persists during hibernation. Arousals were energetically costly, but much less so than in temperate and arctic hibernators. Despite the decisive influence of tree hole properties on the pattern of body temperature and metabolic rate during hibernation, the choice of the hibernaculum does not seem to be of energetic importance. The overall energetic savings by tropical hibernation amounted to about 70% as compared to the active season (31.5 vs. 114.3 kJ/d). Therefore, tropical hibernation in C. medius is an effective, well-regulated adaptive response to survive unfavourable seasons.     

Determination of cryothermal injury thresholds in tissues impacted by cardiac cryoablation

Despite widespread clinical use of cryoablation, there remain questions regarding dosing and treatment times which may affect efficacy and collateral injury. Dosing and treatment times are directly related to the degree of cooling necessary for effective lesion formation. Human and swine atrial, ventricular, and lung tissues were ablated using two cryoablation systems with concurrent infrared thermography. Post freeze-thaw samples were cultured and stained to differentiate viable and non-viable tissue. Matlab code correlated viability staining to applied freeze-thaw thermal cycles, to determine injury thresholds. Tissue regions were classified as live, injured, or dead based upon staining intensity at the lesion margin. Injury begins at rates of ∼10 °C/min to 0 °C, with non-viable tissue requiring cooling rates close to 100 °C/min to ∼ −22 °C for swine and significantly greater cooling to −26 °C for human tissue (p = 0.041). At similar rates, lung tissue injury began at 0 °C, with human tissue requiring significantly less cooling, to ∼ −15 °C for complete necrosis and −26 °C for swine (p = 0.024). Data suggest that there are no significant differences between swine and human myocardial response, but there may be differences between swine and human lung cryothermal tolerance.     

Evaluation of an endosulfan tolerant strain of <Emphasis Type="Italic">Trichogramma chilonis</Emphasis> on cotton

The performance of an endosulfan tolerant strain of Trichogramma chilonis Ishii was evaluated against Helicoverpa armigera (Hübner) eggs on cotton plants in a net house. Under pesticide pressure, the tolerant strain could provide significantly higher parasitism in comparison to the susceptible strain. The parasitoid adult emergence was also significantly higher in the treatment with the tolerant strain in comparison to the susceptible strain, when parasitoids were released within 3 days of endosulfan spraying. Release of the tolerant strain of T. chilonis in conjunction with endosulfan spray application resulted in significantly higher pest mortality in comparison to the endosulfan treatment or release of T. chilonis alone. It could be inferred from the results that T. chilonis should be released only 3 days after endosulfan spray application as during the first 3 days after the spraying, endosulfan provided the required protection and adversely affected the performance of the parasitoid.     

Feasibility and safety of cryoablation on the porcine ureter using a new balloon cryoprobe

Cryoablation, as a well-characterized technology, has multifarious clinical applications. But few are reported on ureteral endometriosis. Thus, we examined the feasibility and safety of cryotherapy with a novel balloon cryoprobe on ureter in a live porcine model. During the freezing and thawing cycle, temperature was recorded in different parts of the ureter in real-time. Two-minute cryoablation could induce necrosis within range in 1 cm diameter on serosa layer. The temperature respectively dropped to −136.5 °C, −96.1 °C and −17.5 °C at the cryotherapy center, 1 cm and 1.5 cm from center on serosal side. The ureters were harvested immediately, 2 weeks or 3 months after cryotherapy. No perforation, stricture, adhesions, or hydronephrosis was observed. Histopathologic representations of ureters after cryoablation indicated that full thickness necroses of ureters were seen in all samples. The results demonstrated ureteral cryoablation using a novel balloon probe was feasible, safe, and effective. These findings provided us reference before cryoablation could be applied in clinical practice in treating ureteral endometriosis.     

Validation of annulus formation in sagittal otoliths of three tropical cichlids Oreochromis andersonii (Castelnau, 1861), Oreochromis macrochir (Boulenger, 1912), and Coptodon rendalli (Boulenger, 1896)

The periodicity of growth zone formation in sagittal otoliths of Oreochromis andersonii, Oreochromis macrochir and Coptodon rendalli from the Upper Zambezi region, southern Africa, was validated to test the hypothesis that a single growth zone is deposited annually. Edge analysis was carried out on 754 O. andersonii (54–492 mm TL), 601 O. macrochir (83–438 mm TL) and 622 C. rendalli (45–379 mm TL) caught between August 2010 and August 2011 in Lake Liambezi and the Kavango, Kwando and Upper Zambezi rivers. This was corroborated for O. andersonii (n = 17) and C. rendalli (n = 16) using a fluorochrome marking experiment conducted in a large earthen pond (625 m², 1.5 m deep) adjacent to the Kavango River. Both methods demonstrated that growth zone deposition occurred annually in juvenile and adult fishes. For edge analysis, the highest proportion of otoliths with an opaque margin was observed in summer from October to December. The fluorochrome marking experiment, however, revealed that opaque zone deposition took place in winter between June and September when water temperatures were lowest (17°C), indicating a lag between opaque zone deposition and detection on the otolith edge.     

Diagnosis and treatment of coagulopathy following percutaneous cryoablation of liver tumors: Experience in 372 patients

Coagulopathy after liver cryoablation was first reported many years ago; the cause is local platelet trapping and destruction within the margin of the cryolesion. However, the prognosis and therapeutic effects of coagulopathy remain unclear. This study retrospectively reviewed clinical data from 372 patients (525 sessions) who underwent liver cryoablation in our hospital during the past 4.5 years. Small tumors (major diameter < 6 cm) were treated with a single complete ablation; massive tumors (major diameter 6–10 cm or >10 cm) were divided into two or three parts that were dealt with in turn. Platelet counts decreased to an average of (46.12 ± 68.13) × 10⁹/L after each session of cryoablation. The decline was most evident in patients with high pretreatment platelet counts, while those with low pretreatment counts had the highest risk of coagulopathy. Change in platelet count was not correlated with the diameter of the tumor. Slight coagulopathy (platelet count (70–100) × 10⁹/L) can resolve without treatment within 1 week and administration of recombinant human interleukin-11 can assist recovery from severe coagulopathy (platelet count < 70 × 10⁹/L).     

Evaluation of ferrous benzoic methylthymol-blue gel as a dosimeter via magnetic resonance imaging

PurposeIn previous studies, methylthymol-blue and benzoic acid have been introduced as a diffuser limiter and sensitivity enhancer in the gel dosimeter composition, respectively. This work focused on analyzing a formulation of the Fricke gel dosimeter consisting of methylthymol-blue and benzoic acid through magnetic resonance imaging.MethodsThe gel dosimeter samples were irradiated using 6, 10, and 15 MV photons with different levels of doses and read using a 1.5 T scanner in order to evaluate the dose–response sensitivity and to study the effect of benzoic acid concentration, diffusion coefficient and temperature and to determine the temporal stability of the gel dosimeter.ResultsInspection of radiological properties revealed that this gel dosimeter can be considered as a tissue equivalent medium. Within the dose range 0 to 1000 cGy, the R1 sensitivity and R2 sensitivity of the gel dosimeter equaled 0.058 ± 0.003 and 0.092 ± 0.004 s⁻¹Gy⁻¹, respectively. The diffusion coefficient was less than 0.85 ± 0.02mm²h⁻¹ for doses higher than 200 cGy. In addition, by changing the temperature from 15C to 25, the R1 sensitivity and R2 sensitivity decreased about 5 and 11%, respectively. Further, no significant energy and dose rate dependence were observed over photon energies of 6, 10, and 15 MV and over the range 65 to 525 cGy min⁻¹.ConclusionsBased on our observation, the ferrous benzoic acid methylthymol-blue gel dosimeter can be suggested to measure the dose distribution. Further analysis is required to clarify its performance in clinical situations.     

Determination of optimal planning target volume margins in patients with gynecological cancer

PurposeTo define optimal planning target volume (PTV) margins for intensity modulated radiotherapy (IMRT) ± knee-heel support (KHS) in patients treated with adjuvant radiotherapy.MethodsComputed tomography (CT) scans ± KHS of 10 patients were taken before and at 3rd and 5th week of treatment, fused and compared with initial IMRT plans.ResultsA PTV margin of 15 mm in anteroposterior (AP) and superoinferior (SI) directions and 5 mm in lateral directions were found to be adequate without any difference between ± KHS except for the SI shifts in CTV-primary at the 3rd week. Five mm margin for iliac CTV was found to be inadequate in 10–20% of patients in SI directions however when 7 mm margin was given for iliac PTV, it was found to be adequate. For presacral CTV, it was found that the most striking shift of the target volume was in the direction of AP. KHS caused significantly less volume of rectum and bladder in the treated volume.ConclusionsPTV margin of 15 mm in SI and AP, and 5 mm in lateral directions for CTV-primary were found to be adequate. A minimum of 7 mm PTV margin should be given to iliac CTV. The remarkable shifting in presacral CTV was believed to be due to the unforeseen hip malposition of obese patients. The KHS seems not to provide additional beneficial effect in decreasing the shifts both in CTV-primary and lymphatic, however it may have a beneficial effect of decreasing the OAR volume in PTV margins.