Improvement of the hybrid approach between Monte Carlo simulation and analytical function for calculating microdosimetric probability densities in macroscopic matter.

Objective. Estimation of the probability density of the microdosimetric quantities in macroscopic matter is indispensable for applying the concept of microdosimetry to medical physics and radiological protection. The Particle and Heavy Ion Transport code System (PHITS) enables estimating the microdosimetric probability densities due to its unique hybrid modality between the Monte Carlo and analytical approaches called the microdosimetric function. It can convert the deposition energies calculated by the macroscopic Monte Carlo radiation transport simulation to microdosimetric probability densities in water using an analytical function based on the track-structure simulations.Approach. In this study, we improved this function using the latest track-structure simulation codes implemented in PHITS. The improved function is capable of calculating the probability densities of not only the conventional microdosimetric quantities such as lineal energy but also the number of ionization events occurring in a target site, the so-called ionization cluster size distribution, for arbitrary site diameters from 3 nm to 1µm.Main results. The accuracy of the improved function was well verified by comparing the microdosimetric probability densities measured by tissue-equivalent proportional counters with the corresponding data calculated in this study. Test calculations for clonogenic cell survival using the improved function coupled with the modified microdosimetric kinetic model suggested a slight increase of its relative biological effectiveness compared with our previous estimations. As a new application of the improved function, we calculated the relative biological effectiveness of the single-strand break and double-strand break yields for proton irradiations using the updated PHITS coupled with the simplified DNA damage estimation model, and confirmed its equivalence in accuracy and its superiority in computational time compared to our previously proposed method based on the track-structure simulation.Significance. From these features, we concluded that the improved function could expand the application fields of PHITS by bridging the gap between microdosimetry and macrodosimetry.

A rare case of fulminant sepsis secondary to postpartum pyomyoma caused by Prevotella bivia: a case report.

Pyomyoma is rare but can cause life-threatening sepsis from uterine leiomyoma infection. Curative radical surgery to completely remove all infectious foci is preferable if conservative treatment fails, but for patients with fertility concerns, alternatives to uterine removal should be considered. The author reports a case of postpartum pyomyoma to remind clinicians of this rare disease and the need for rapid intervention to preserve patient fertility. Case presentation: A postpartum female with a fever of unknown origin was admitted to a public hospital. The patient's general condition rapidly worsened, and surgical removal of the pyomyoma was assumed to be necessary for controlling the infection source. The patient initially refused surgery, as she had fertility concerns; however, she developed septic shock and acute respiratory distress syndrome. Subsequently, surgical intervention was considered imperative, and the patient consented to surgery. Normal uterus was carefully differentiated from degenerated intramural pyomyoma, and the endometrium remained intact. In the pyomyoma specimen, Prevotella bivia, an endogenous anaerobic bacterium that can colonize the lower genital tract, was detected. Clinical discussion: For patients with postpartum sepsis and leiomyoma, pyomyoma should be considered, even if the patient is immunocompetent and has no risk factors. Pyomyoma can be exacerbated into a fulminant and fatal course after subacute, insidious progression. Conclusion: Comprehensive treatment strategies, including source control of infection and uterine preservation, are required for future fertility. Strict vigilance and appropriate and prompt surgical intervention when conservative treatments fail are crucial to save the patient and preserve fertility.

Virtual photon approach of cathodoluminescence and ion-beam induced luminescence of solids.

A novel analysis of cathodoluminescence (CL) and ion-beam induced luminescence (IBIL) is presented on the basis of virtual photon spectra (VPS) produced by charged particles (electrons or ions) passing by luminescent species such as defects or impurities, in wide band-gap ionic-covalent solids. A discussion is provided for irradiations in a wide range of charged particle kinetic energy by using the Weizsäcker-Williams theory. The computed VPS are found to decay rapidly as a function of virtual photon (VP) energy regardless of particle energy, for close or distant collisions. The electron-energy dependence of experimental CL spectra of sapphire (α-Al2O3) is discussed in relation to the computed VPS for the primary and secondary electrons. The experimental IBIL spectra ofα-Al2O3are also analyzed in this framework for protons and helium ions in the MeV energy range. The variations of stopping power are consistent with the variation of the number of emitted VPs. The decay of IBIL yield versus ion stopping power is discussed on the basis of the variation of the computed VPS, and ionization and excitation induced by primary ions and secondary electrons. This decay is accounted for by a decrease of the yield of low-energy secondary electrons with the subsequent VP emission.

Track-structure modes in particle and heavy ion transport code system (PHITS): application to radiobiological research.

PURPOSE: In radiation physics, Monte Carlo radiation transport simulations are powerful tools to evaluate the cellular responses after irradiation. When investigating such radiation-induced biological effects, it is essential to perform track structure simulations by explicitly considering each atomic interaction in liquid water at the sub-cellular and DNA scales. The Particle and Heavy-Ion Transport code System (PHITS) is a Monte Carlo code which enables to calculate track structure at DNA scale by employing the track-structure modes for electrons, protons and carbon ions. In this paper, we review the recent development status and future prospects of the track-structure modes in the PHITS code. CONCLUSIONS: To date, the physical features of these modes have been verified using the available experimental data and Monte Carlo simulation results reported in literature. These track-structure modes can be used for calculating microdosimetric distributions to estimate cell survival and for estimating initial DNA damage yields. The use of PHITS track-structure mode is expected not only to clarify the underlying mechanisms of radiation effects but also to predict curative effects in radiation therapy. The results of PHITS simulations coupled with biophysical models will contribute to the radiobiological studies by precisely predicting radiation-induced biological effects based on the Monte Carlo approach.

Development and validation of proton track-structure model applicable to arbitrary materials.

A novel transport algorithm performing proton track-structure calculations in arbitrary materials was developed. Unlike conventional algorithms, which are based on the dielectric function of the target material, our algorithm uses a total stopping power formula and single-differential cross sections of secondary electron production. The former was used to simulate energy dissipation of incident protons and the latter was used to consider secondary electron production. In this algorithm, the incident proton was transmitted freely in matter until the proton produced a secondary electron. The corresponding ionising energy loss was calculated as the sum of the ionisation energy and the kinetic energy of the secondary electron whereas the non-ionising energy loss was obtained by subtracting the ionising energy loss from the total stopping power. The most remarkable attribute of this model is its applicability to arbitrary materials, i.e. the model utilises the total stopping power and the single-differential cross sections for secondary electron production rather than the material-specific dielectric functions. Benchmarking of the stopping range, radial dose distribution, secondary electron energy spectra in liquid water, and lineal energy in tissue-equivalent gas, against the experimental data taken from literature agreed well. This indicated the accuracy of the present model even for materials other than liquid water. Regarding microscopic energy deposition, this model will be a robust tool for analysing the irradiation effects of cells, semiconductors and detectors.

Analysis of scintillation light intensity by microscopic radiation transport calculation and Förster quenching model.

The scintillation light yield of plastic scintillator considering the quenching effect is reproduced by a calculation model based on a track-structure simulation code and the Förster effect. Energy deposition and its nm-scale spatial arrangement in the irradiation by electrons, protons, and heavy ions (4He to 81Br) in an NE-102A scintillator were simulated by a track-structure simulation code. The spatial arrangements of the excited molecules emitting scintillation light and those dissipating the excitation energy were then obtained to calculate the strength of the quenching effect. Light emission from the excited molecules was integrated to finally obtain the observable light yield. The calculated light yields are in good agreement with the earlier measurement data. Moreover, in the case of low-LET particle incidence, a statistical micro-dosimetric model can substitute the track-structure simulation code for reproducing the light yield.

Complete resection of a rectus abdominis muscle invaded by desmoid tumors and subsequent management with an abdominal binder: a case report.

BACKGROUND: Desmoid-type fibromatosis is characterized by desmoid tumors, which are benign soft tissue tumors that can be locally aggressive but typically do not metastasize. Desmoid tumors can manifest anywhere in the body, and those in the abdominal cavity account for approximately 30 to 50% of all such tumors. Complete resection with free margins has been the standard treatment, but non-surgical therapies have been implemented recently. However, if tumors are strongly invasive and/or persistently recur, radical surgical resection with free margins remains the primary treatment. Unfortunately, radical resection may cause large abdominal defects and hinder reconstruction. Several reports and recommendations have addressed this issue; however, to the best of our knowledge, few reports have described complete resection and the subsequent reconstruction of the rectus abdominis muscle. CASE PRESENTATION: A 35-year-old Asian woman presented at our hospital with a chief complaint of abdominal pain. She had abdominal desmoid tumors that required complete resection of her rectus abdominis muscle. Due to necrosis in her own reconstructed tissue, we failed to cover her anterior abdominal wall; thus, we used an abdominal binder as a substitute material to avoid exacerbating the incisional hernia and help her generate intra-abdominal pressure. CONCLUSIONS: This case report may be informative and helpful for the treatment of patients with desmoid tumors, as managing desmoid-type fibromatosis is difficult.

Cold agglutinins in a patient undergoing normothermic cardiac operation with warm cardioplegia.

Cold agglutinins are autoantibodies that agglutinate red blood cells at low temperatures, leading to haemagglutination and haemolysis. They are generally of no clinical significance. However, when people with cold agglutinins undergo cardiac operation with hypothermia and cold cardioplegia, they can experience complications. Thus, different perioperative management is required for such patients. We describe a 74-year-old man with cold agglutinins incidentally detected on the preoperative screening test. He had never experienced any complications or developed a haematological disease. Since cold agglutinins were incidentally detected on the preoperative test, a special strategy was used to manage the temperature of cardiopulmonary bypass (CPB) and cardioplegia. He successfully underwent normothermic cardiac operation with warm cardioplegia. A continuous retrograde hyperkalaemic infusion and intermittent antegrade infusion of warm cardioplegia with normothermic CPB is one of the best methods to avoid hypothermia and excessive activity and metabolism of the heart, and to provide a suitable operative field.

[Features of PHITS and its application to medical physics].

PHITS is a general purpose Monte Carlo particle transport simulation code to analyze the transport in three-dimensional phase space and collisions of nearly all particles, including heavy ions, over wide energy range up to 100 GeV/u. Various quantities, such as particle fluence and deposition energies in materials, can be deduced using estimator functions "tally". Recently, a microdosimetric tally function was also developed to apply PHITS to medical physics. Owing to these features, PHITS has been used for medical applications, such as radiation therapy and protection.

Benchmarking of activation reaction distribution in an intermediate energy neutron field.

Neutron-induced reaction rate depth profiles inside concrete shield irradiated by intermediate energy neutron were calculated using a Monte-Carlo code and compared with an experiment. An irradiation field of intermediate neutron produced in the forward direction from a thick (stopping length) target bombarded by 400 MeV nucleon(-1) carbon ions was arranged at the heavy ion medical accelerator in Chiba. Ordinary concrete shield of 90 cm thickness was installed 50 cm downstream the iron target. Activation detectors of aluminum, gold and gold covered with cadmium were inserted at various depths. Irradiated samples were extracted after exposure and gamma-ray spectrometry was performed for each sample. Comparison of experimental and calculated shows good agreement for both low- and high-energy neutron-induced reaction except for (27)Al(n,X)(24)Na reaction at the surface.