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The precise knowledge of the diffraction condition, i.e., the angle of incidence and electron energy, is crucial for the study of surface morphology through spot profile analysis low-energy electron diffraction (LEED). We demonstrate four different procedures to determine the diffraction condition: employing the distortion of the LEED pattern under large angles of incidence, the layer-by-layer growth oscillations during homoepitaxial growth, a G(S) analysis of a rough surface, and the intersection of facet rods with 3D Bragg conditions.
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We show in a combined study of four-point conductance measurement and tunneling microscopy that surface state conductance induced by one monolayer of Pb on Si(557) can be quasi one dimensional with conductivity values close to typical three-dimensional metals. At a critical temperature of Tc = 78 K, associated with an order-disorder phase transition and a tenfold superperiodicity along the Pb chains, the system switches from low to high conductance anisotropy, with a semiconductor-insulator transition in the direction perpendicular to the chain structure, while along the chains conductance with a (1/T + const) temperature dependence was found.
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We have studied, for the first time, the energy and the linewidth dispersion of a plasmon in a dense two-dimensional electron system in a metallic surface-state band on a silicon surface. As expected from the considerably high effective density and long Fermi wavelength of the system, the plasmon energy dispersion exhibited an excellent agreement with the nearly free-electron theory. However, in a small wave number region below the Landau edge, we have observed an anomalous linewidth dispersion which nearly free-electron theories do not predict.
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PURPOSE: a) To assess the age-related incidence of morbid cardiac events including cardiac death (CD), nonfatal myocardial infarction (MI), and angina pectoris (AP) in all patients treated for Hodgkin's disease at a single institution; b) to examine the prevalence of cardiac risk factors and presence of coronary artery disease (CAD) in affected patients. METHODS AND MATERIALS: 475 patients were treated for Hodgkin's disease in our institution between 1954 and 1989. The status of 97% of the cohort was established either by patient visit and examination in 1992-1993, personal telephone contact, or documentation of death. The 326 of these patients who had mantle irradiation (RT) and survived 3 years formed the study population. Patients who experienced AP, MI, or CD secondary to CAD were assessed for the presence of specific cardiac risk factors. Cardiac catheterization and necropsy data were reviewed to determine the presence and degree of coronary artery stenosis. RESULTS: Eighteen of 326 patients (5.5%) have had a morbid cardiac event directly related to CAD. Seven patients had CD. Seven patients experienced nonfatal MI, and four patients had AP. The mean interval from RT to morbid cardiac event was 13.1 years (range: 4.4-27.0), and the mean age at the time of the event was 39.4 years (range: 24-65). Four of these patients had morbid cardiac events between ages 24-29 years. Based on US statistics of CD secondary to MI, the relative risk of CD for the treated group was 2.8 (3.1 for males and 1.8 for females). Remarkably, no difference was found in the risk of experiencing a morbid cardiac endpoint in patients stratified by either decile of age at which RT was given, or by duration of follow-up. Only one patient experiencing an event (AP) had received an anthracycline. The mean RT dose to the central cardiac volume for the affected patients was 44.3 Gy (range: 35-60.4). Autopsy or catheterization data were available on 15 patients and revealed 90-100% stenosis of at least one major vessel in 11 patients (73%), and no single artery was more commonly stenosed. Specifically, the left anterior descending and right coronary arteries were each greater than or equal to 60% stenosed in 10 out of 15 patients (67%), and either the left main or circumflex arteries were greater than or equal to 50% stenosed in 5 out of 15 patients (33%); triple vessel disease was present in seven patients. Risk factor data were available on all patients experiencing morbid cardiac events: 72% smoked, 72% were male, 78% had hypercholesterolemia, 61% were obese, 28% had a positive family history, 33% had hypertension, and 6% (one) had diabetes. The average number of risk factors per patient was 2.9; seven patients had at least four risk factors, and all patients had at least one risk factor. This frequency of risk factors is elevated when compared to the US population. CONCLUSIONS: In our institution, 5.5% of patients treated for Hodgkin's disease experienced a morbid cardiac event following RT to the central cardiac volume. The doses given were greater than commonly used today. Some patients experienced events at a young age, and the likelihood of experiencing CD was increased compared to the general population. This observation is consistent with RT as an additional risk factor in the induction of morbid cardiac events. Appropriate cardiac shielding and radiation doses, careful follow-up, which includes monitoring of cardiac function, and a preventative program of sensible dietary habits, exercise, and nonsmoking may be beneficial in reducing cardiac morbidity in long-term survivors of Hodgkin's disease.
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Doença das Coronárias/epidemiologia , Doença de Hodgkin/radioterapia , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Doença das Coronárias/etiologia , Doença das Coronárias/patologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/etiologia , Dosagem Radioterapêutica , Fatores de Risco , Análise de Sobrevida , Fatores de TempoRESUMO
The treatment of seminoma with radiation therapy risks transient infertility. We have prospectively followed eight patients with stage I seminoma of the testicle. All patients underwent radical orchiectomy of the affected testis. The mean age of the patients was 32.9 years (range 24-40). Each patient was treated with megavoltage radiation with a 10- or 18-MV linear accelerator. The remaining testicle was shielded using a standard lead enclosure, and the mean testicular dose was 44 cGy (range 20.8-78.2). Semen specimens were delivered to the lab within 30 minutes of ejaculation. All specimens were analyzed using a computer-assisted sperm analyzer. Pretreatment parameters were within normal limits for all but one patient; one patient presented with a borderline normal sperm count at 18 and 22 x 10(6)/ml. Following treatment, there was a decrease in sperm count, detected at 3 months, to < 10 x 10(6)/ml (range 4.4- 8.6 x 10(6)) in all patients except one, who presented with an initial pretreatment count of 189 x 10(6)/ml, which decreased to 58 x 10(6)/ml at 3 months, 32 x 10(6)/ml at 6 months, and rose to 325 x 10(6)/ml by 12 months following treatment. Although the sperm count for this patient (D.L.) was within the normal range, the post-radiation sperm count was less than 20% of the pretreatment count. There was no difference in the motility at 3 months, the mean of which was 51.3%. One patient's (F.C.) wife conceived at 9 months following treatment, one at 12 months (J.R.), and one (J.S.) at 14 months, and all have delivered normal infants.(ABSTRACT TRUNCATED AT 250 WORDS)
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Fertilidade/efeitos da radiação , Seminoma/radioterapia , Contagem de Espermatozoides/efeitos da radiação , Neoplasias Testiculares/radioterapia , Testículo/efeitos da radiação , Adulto , Idoso , Relação Dose-Resposta à Radiação , Doença de Hodgkin/complicações , Doença de Hodgkin/patologia , Doença de Hodgkin/radioterapia , Humanos , Infertilidade Masculina/etiologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Orquiectomia , Estudos Prospectivos , Radioterapia Adjuvante , Estudos Retrospectivos , Seminoma/complicações , Seminoma/patologia , Motilidade dos Espermatozoides/fisiologia , Motilidade dos Espermatozoides/efeitos da radiação , Espermatozoides/patologia , Espermatozoides/efeitos da radiação , Neoplasias Testiculares/complicações , Neoplasias Testiculares/patologia , Testículo/patologia , Testículo/fisiologiaRESUMO
A prospective study was designed to evaluate the effect of CT-guided lumbar sympathectomy in PAOD using the following investigations: 1: laser flowmetry, 2. thermography, 3. plethysmography, 4. thallium scintigraphy. A significant improvement of perfusion was shown. The results of thallium scintigraphy disproved the often claimed steal effect of the muscle perfusion in favor of an increased skin perfusion. 80% of the treated patients experienced relief of their pain. Chemical sympathectomy proved to be as effective as the surgical procedure.
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Arteriopatias Oclusivas/cirurgia , Perna (Membro)/irrigação sanguínea , Simpatectomia Química , Tomografia Computadorizada por Raios X , Arteriopatias Oclusivas/fisiopatologia , Velocidade do Fluxo Sanguíneo/fisiologia , Diagnóstico por Imagem , Feminino , Humanos , Masculino , Fluxo Sanguíneo Regional/fisiologiaRESUMO
Radiation therapy has been shown to prevent heterotopic bone formation in high risk patients undergoing total hip replacement. A number of doses have been used without a randomized trial comparing one dose regimen against another. A prospective randomized trial was undertaken comparing 10 Gy in 5 fractions versus 8 Gy in 1 fraction. Forty-seven patients have been randomized at the time of this evaluation with 37 patients eligible for analysis. The pre-operative, immediate post-operative and 2 month post-operative radiographs were graded. At the time of this analysis, 17 patients were randomized to the 8 Gy arm with 20 patients in the 10 Gy arm. Patients were treated with limited fields so as to only cover the area at risk for development of heterotopic bone to prevent adverse effects on biologic fixation of uncemented implants. When comparing the pre-operative, operative, and 2 month post-operative radiographs, only four patients (1 patient in the 8 Gy arm and 3 patients in the 10 Gy arm), had an increase in the score. No patient had an increase in score to a clinically significant level, usually grade 3 or 4. These preliminary results appear to show that 8 Gy in a single fraction can be as effective as 10 Gy in 5 fractions in preventing heterotopic bone in susceptible individuals. Further follow-up of the remaining patients may confirm this.
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Articulação do Quadril/efeitos da radiação , Prótese de Quadril/efeitos adversos , Ossificação Heterotópica/prevenção & controle , Feminino , Articulação do Quadril/diagnóstico por imagem , Humanos , Masculino , Ossificação Heterotópica/etiologia , Radiografia , Dosagem Radioterapêutica , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Radiation has been shown to be effective in the prevention of heterotopic bone. The exact etiology of heterotopic bone is unknown. Total Hip prosthetic devices that do not depend upon bone cement for fixation have become increasingly popular. The mechanism by which the bone forms around the prosthesis is similar to the process by which fractures heal which has been shown to be sensitive to irradiation. Using a rabbit model we have undertaken a study to investigate the effect of irradiation on the bony ingrowth on porous coated implants. Forty-five rabbits had porous coated implants surgically placed in the tibiae bilaterally. Each rabbit had one tibae randomly irradiated with 1,000 cGy in 5 fractions starting on the first post-operative day. Animals were sacrificed weekly starting 2 weeks post-operatively and the tibae were sent for pullout studies. The amount of force necessary to pullout the treated tibae was statistically less than the amount of force necessary to remove the untreated tibae at 2 weeks. From 3 weeks on there was no difference in the force necessary to remove the prosthesis from the untreated or treated tibae. Histologically, the untreated tibae showed bone formation while the treated tibae did not. Because of these results, it is suggested that the treatment of patients at risk for development of heterotopic bone be modified to only include the area between the femur and pelvis avoiding treatment of the prosthetic device.