Scattered radiation from dental metallic crowns in head and neck radiotherapy.

We aimed to estimate the scattered radiation from dental metallic crowns during head and neck radiotherapy by irradiating a jaw phantom with external photon beams. The phantom was composed of a dental metallic plate and hydroxyapatite embedded in polymethyl methacrylate. We used radiochromic film measurement and Monte Carlo simulation to calculate the radiation dose and dose distribution inside the phantom. To estimate dose variations in scattered radiation under different clinical situations, we altered the incident energy, field size, plate thickness, plate depth and plate material. The simulation results indicated that the dose at the incident side of the metallic dental plate was approximately 140% of that without the plate. The differences between dose distributions calculated with the radiation treatment-planning system (TPS) algorithms and the data simulation, except around the dental metallic plate, were 3% for a 4 MV photon beam. Therefore, we should carefully consider the dose distribution around dental metallic crowns determined by a TPS.

An experimental attenuation plate to improve the dose distribution in intraoperative electron beam radiotherapy for breast cancer.

Intraoperative electron beam radiotherapy (IOERT) is a technique in which a single-fraction high dose is intraoperatively delivered to subclinical tumour cells using an electron beam after breast-conserving surgery. In IOERT, an attenuation plate consisting of a pair of metal disks is commonly used to protect the normal tissues posterior to the breast. However, the dose in front of the plate is affected by backscatter, resulting in an unpredictable delivered dose to the tumour cells. In this study, an experimental attenuation plate, termed a shielding plate, was designed using Monte Carlo simulation, which significantly diminished the electron beam without introducing any backscatter radiation. The plate's performance was verified by measurements. It was made of two layers, a first layer (source side) of polymethyl methacrylate (PMMA) and a second layer of copper, which was selected from among other metals (aluminium, copper and lead) after testing for shielding capability and the range and magnitude of backscatter. The optimal thicknesses of the PMMA (0.71 cm) and copper (0.3 cm) layers were determined by changing their thicknesses during simulations. On the basis of these results, a shielding plate was prototyped and depth doses with and without the plate were measured by radiophotoluminescence glass dosimeters using a conventional stationary linear accelerator and a mobile linear accelerator dedicated for IOERT. The trial shielding plate functioned as intended, indicating its applicability in clinical practice.

Calculation of 10 MV x-ray spectra emitted by a medical linear accelerator using the BFGS quasi-Newton method.

To calculate photon spectra for a 10 MV x-ray beam emitted by a medical linear accelerator, we performed numerical analysis using the aluminium transmission data obtained along the central axis of the beam under the narrow beam condition corresponding to a 3x3 cm2 field at a 100 cm distance from the source. We used the BFGS quasi-Newton method based on a general nonlinear optimization technique for the numerical analysis. The attenuation coefficients, aluminium thicknesses and measured transmission data are necessary inputs for the numerical analysis. The calculated x-ray spectrum shape was smooth in the lower to higher energy regions without any angular components. The x-ray spectrum acquired by the employed method was evaluated by comparing the measurements along the central axis percentage depth dose in a water phantom and by a Monte Carlo simulation code, the electron gamma shower code. The values of the calculated percentage depth doses for a 10x10 cm2 field at a 100 cm source-to-surface distance in a water phantom were obtained using the same geometry settings as those of the water phantom measurement. The differences in the measured and calculated values were less than +/-1.0% for a broad region from the shallow part near the surface to deep parts of up to 25 cm in the water phantom.

Transfection of antisense p53 tumor suppressor gene oligodeoxynucleotides into rat carotid artery results in abnormal growth of vascular smooth muscle cells.

BACKGROUND: Although loss of activity of an antioncogene, the p53 tumor suppressor gene product, has been postulated in the pathogenesis of human restenosis, little is known about the role of p53 in the regulation of vascular smooth muscle cell (VSMC) growth. In this study, to clarify the role of p53 in the pathogenesis of restenosis, we examined transfection of antisense p53 oligodeoxynucleotides (ODN) into VSMC in vitro and rat carotid artery in vivo. METHODS AND RESULTS: The specificity of antisense p53 ODN was confirmed by a significant decrease in p53 protein. Transfection of antisense p53 ODN into VSMC resulted in a significant increase in DNA synthesis and cell number as compared with sense and scrambled ODN (P<0.01). Importantly, transfection of antisense p53 ODN into rat intact carotid artery resulted in a significant increase in the ratio of neointima to medial area at 2 and 4 weeks after transfection, accompanied by a significant decrease in p53 protein (P<0.01). Moreover, cotransfection of wild-type p53 plasmid completely abolished neointimal formation induced by antisense p53 ODN. The sustained effect of a single antisense ODN administration was confirmed by the kinetics of ODN in the vessel wall with the use of FITC-labeled ODN. CONCLUSIONS: Overall, the present study demonstrated that loss of p53 by antisense p53 ODN resulted in an abnormal VSMC growth in vitro and in vivo. These results demonstrated the potential contribution of p53 to the pathogenesis of restenosis.

Prostaglandin E(2) and stem cell factor can deliver opposing signals to B lymphocyte precursors.

The synthetic prostanoid, 16,16-dimethyl PGE(2), suppressed B lymphopoiesis in mice and proliferation of normal B cell precursors or the F10 pro-B cell line to interleukin 7 in culture. This was not the case with two other prostanoids, PGD(2) and PGF(2alpha), or agonists for PGI(2) agonist and thromboxane A(2) agonist receptors. PGE(2), but not the related prostanoids or agonists, induced apoptosis in F10 cells. The apoptotic response was mediated by the EP2 class of PGE(2) receptors and required an increase in intracellular cyclic adenosine 3',5'-monophosphate, activation of protein kinase A, and protein synthesis. The influence of PGE(2) on F10 cells was diminished in the presence of a cloned stromal cell line or stem cell factor. These findings describe another potential regulatory circuit in bone marrow which might influence B lymphopoiesis under disease or steady-state conditions.

Indirect suppression of IL-7-responsive B cell precursors by vasoactive intestinal peptide.

Bone marrow is supplied with nerves and neuropeptides that influence a variety of cellular responses. This study represents an initial evaluation of vasoactive intestinal peptide (VIP) as a possible regulator of B lineage lymphocyte formation. As little as 10(-10) M concentrations of VIP inhibited the IL-7-driven clonal proliferation of pre-B cells in semisolid agar cultures. The response was blocked by a VIP antagonist and augmented by the ectoenzyme inhibitor, phosphoramidon. Suspensions of highly enriched B lineage precursors were unaffected by VIP unless they were cocultured with macrophage-like cells and conditioned medium from VIP-treated macrophages contained inhibitory activity. Neutralizing Abs were used to determine that IFN-alpha is at least one substance that is elicited by exposure of macrophages to VIP. These findings suggest that a neuropeptide can potentially modulate lymphopoiesis through a regulatory circuit that involves macrophages and IFN-alpha. They also raise the possibility that VIP can participate in antiviral defense.

Human immunoglobulin preparation for intravenous use induces elevation of cellular cyclic adenosine 3':5'-monophosphate levels, resulting in suppression of tumour necrosis factor alpha and interleukin-1 production.

We previously showed that human immunoglobulin preparation for intravenous use (IGIV) suppresses the in vitro production of tumour necrosis factor-alpha (TNF-alpha) and interleukin-1 (IL-1) by rabbit peritoneal exudate cells (PEC) stimulated with lipopolysaccharide (LPS). In this study we investigated the mechanism of the suppression. IGIV treated at pH4 (pH4-G) was used as IGIV. Fc fragments of pH4-G, as well as untreated pH4-G, suppressed TNF-alpha and IL-1 production by rabbit PEC stimulated with LPS. The interaction of pH4-G with PEC also resulted in generation of cyclic adenosine 3':5'-monophosphate (cAMP), known to be an intracellular second messenger. N6, 2'-0-dibutyryl cAMP (BtcAMP), a lipid-soluble derivative of cAMP, and cholera toxin (CT), an adenylate cyclase activating agent, also suppressed the production of TNF-alpha and IL-1. Further N-[2-(methylamino) ethyl]-5-isoquinolinesulphonamide dihydrochloride (H-8), an inhibitor of cAMP-dependent protein kinases, abrogated the suppression by pH4-G of the productions. These results indicate that the binding of IGIV to PEC via Fc gamma receptors (Fc gamma R) induces the elevation of intracellular cAMP levels, resulting in the suppression of LPS-induced TNF-alpha and IL-1 productions.

Suppression of tumor necrosis factor alpha production by a human immunoglobulin preparation for intravenous use.

We investigated the effect of a pH 4-treated human immunoglobulin preparation for intravenous use (pH4-G) on the production of tumor necrosis factor alpha (TNF-alpha) in vivo. The level of TNF-alpha in the sera of rabbits receiving pH4-G before lipopolysaccharide (LPS) injection was lower than that in rabbits receiving only LPS. Similarly, the in vitro production of TNF-alpha was suppressed by pH4-G. Rabbit peritoneal exudate cells stimulated with LPS in the presence of pH4-G produced less TNF-alpha than did those stimulated only with LPS. pH4-G, however, had no effect on various TNF-alpha activities, such as cytotoxicity against tumorigenic murine fibroblasts (L929 cells), induction of interleukin-1 production, or fever induction. These results indicate that pH4-G suppresses TNF-alpha production without affecting TNF-alpha activities. A suppressive effect on the expression of TNF-alpha mRNA was also observed.

Antipyretic activity of a human immunoglobulin preparation for intravenous use in an experimental model of fever in rabbits.

In an effort to elucidate the reason that fever in patients with severe bacterial infections subsided in some cases after the administration of human immunoglobulin preparations for intravenous use (IGIVs), we focused our attention on the antipyretic activity of IGIVs by investigating experimentally produced pyrexia in rabbits with Escherichia coli-derived lipopolysaccharide (LPS). Although little difference in antibody titers against the antigens composing molecules of LPS was found among the IGIVs that were used, IGIVs treated at pH 4 were demonstrated to inhibit a strongly LPS-induced second-phase febrile response, whereas the inhibitory effect of sulfonated and pepsin-treated IGIVs was weak. In vitro experiments on interleukin-1 production by rabbit macrophages stimulated with LPS, silica gel or latex beads and on rosette formation showed that these functions of the cells were also inhibited by IGIVs. The in vivo antipyretic activity and the results of the two in vitro experiments correlated closely. The inhibitory potency decreased in the following order: immunoglobulin G (IgG) treated at pH4, sulfonated IgG, and pepsin-treated IgG. Thus, it is possible that the subsidence of LPS-induced fever by IGIVs was mediated by inhibition of interleukin 1 production by means of binding of IgG to macrophages via an Fc receptor. Results of this study also indicated the importance of the structural integrity of the Fc portion of the IgG contained in the IGIVs to bind with its receptor on the macrophage so as to influence the various functions carried out by the cell.

Hemorrhagic necrosis of pheochromocytoma associated with reversible renal artery stenosis.

An unusual case of pheochromocytoma associated with renal artery stenosis is described. Despite the removal of bilateral adrenal pheochromocytoma, laboratory findings suggested the presence of residual pheochromocytoma and abdominal aortography revealed more pronounced stenosis of the right renal artery. Two months later, the undetected residual pheochromocytoma underwent hemorrhagic necrosis with acute cessation of catecholamine release. Thereafter, the patient's blood pressure decreased to a normal level with marked improvement in hypertensive symptoms. No remaining stenosis was demonstrated on follow up renal angiography. Our case suggests that constant local secretion of catecholamines may be responsible for the development of renal artery stenosis.

Nonfunctioning adrenocortical carcinoma in a young girl.

A 9 year old Japanese girl was admitted complaining of left hypochondrial pain and a large upper left abdominal tumor. There were no clinical or laboratory signs of hormonal abnormality. Intravenous pyelography showed marked compression and deformity of the kidney by a tumor. This tumor was excised together with the left kidney. The pathological diagnosis was adrenocortical carcinoma. Postoperatively, the child was given neither irradiation nor chemotherapy. Twenty-one months after the surgery, there was a hepatic metastasis, and she died 40 months after surgery from a combination of hepatic metastases and local tumor recurrence.

[A case of male breast cancer with special reference to the hormonal environment during chemoendocrine therapy].

Chemoendocrine therapy was performed on a man with advanced breast cancer, and partial response was observed for 11 months. Estrogen receptor in cancer tissue was detected before and after the therapy. Progesterone receptor, however, was not detected after the treatment, whether it had been there or not prior to it. The serum estrone level was continuously high during the treatment, but the serum testosterone level was obviously decreased after that.