Assessment of Radiation Dosage to the Hippocampi during Treatment of Multiple Brain Metastases Using Gamma Knife Therapy.

Background and Objectives: Brain metastases (BMs) pose significant clinical challenges in systemic cancer patients. They often cause symptoms related to brain compression and are typically managed with multimodal therapies, such as surgery, chemotherapy, whole brain radiotherapy (WBRT), and stereotactic radiosurgery (SRS). With modern oncology treatments prolonging survival, concerns about the neurocognitive side effects of BM treatments are growing. WBRT, though widely used for multiple BMs, has recognized neurocognitive toxicity. SRS, particularly Gamma Knife (GK) therapy, offers a minimally invasive alternative with fewer side effects, suitable for patients with a quantifiable number of metastases and better prognoses. Materials and Methods: A retrospective analysis was conducted on 94 patients with multiple BMs treated exclusively with GK at an academic medical center. Patients with prior WBRT were excluded. This study focused on the mean radiation dose received by the hippocampal area, estimated according to the 'Hippocampal Contouring: A Contouring Atlas for RTOG 0933' guidelines. Results: The precision of GK equipment results in mean doses of radiation that are lower than those suggested by RTOG 0933 and observed in other studies. This precision may help mitigate cognitive dysfunction and other side effects of hippocampal irradiation. Conclusions: GK therapy facilitates the administration of smaller, safer radiation doses to the hippocampi, which is advantageous even for lesions in the temporal lobe. It is feasible to treat multiple metastases, including cases with more than 10, but it is typically reserved for patients with fewer metastases, with an average of 3 in this study. This underlines GK's potential for reducing adverse effects while managing BMs effectively.

In Search of New Therapeutics-Molecular Aspects of the PCOS Pathophysiology: Genetics, Hormones, Metabolism and Beyond.

In a healthy female reproductive system, a subtle hormonal and metabolic dance leads to repetitive cyclic changes in the ovaries and uterus, which make an effective ovulation and potential implantation of an embryo possible. However, that is not so in the case of polycystic ovary syndrome (PCOS), in which case the central mechanism responsible for entraining hormonal and metabolic rhythms during the menstrual cycle is notably disrupted. In this review we provide a detailed description of the possible scenario of PCOS pathogenesis. We begin from the analysis of how a set of genetic disorders related to PCOS leads to particular malfunctions at a molecular level (e.g., increased enzyme activities of cytochrome P450 (CYP) type 17A1 (17α-hydroxylase), 3ß-HSD type II and CYP type 11A1 (side-chain cleavage enzyme) in theca cells, or changes in the expression of aquaporins in granulosa cells) and discuss further cellular- and tissue-level consequences (e.g., anovulation, elevated levels of the advanced glycation end products in ovaries), which in turn lead to the observed subsequent systemic symptoms. Since gene-editing therapy is currently out of reach, herein special emphasis is placed on discussing what kinds of drug targets and which potentially active substances seem promising for an effective medication, acting on the primary causes of PCOS on a molecular level.

Soil pollution indices conditioned by medieval metallurgical activity - A case study from Krakow (Poland).

The studied soil profile under the Main Market Square (MMS) in Krakow was characterised by the influence of medieval metallurgical activity. In the presented soil section lithological discontinuity (LD) was found, which manifests itself in the form of cultural layers (CLs). Moreover, in this paper LD detection methods based on soil texture are presented. For the first time, three different ways to identify the presence of LD in the urban soils are suggested. The presence of LD had an influence on the content and distribution of heavy metals within the soil profile. The content of heavy metals in the CLs under the MMS in Krakow was significantly higher than the content in natural horizons. In addition, there were distinct differences in the content of heavy metals within CLs. Profile variability and differences in the content of heavy metals and phosphorus within the CLs under the MMS were activity indicators of Krakow inhabitants in the past. This paper presents alternative methods for the assessment of the degree of heavy metal contamination in urban soils using selected pollution indices. On the basis of the studied total concentration of heavy metals (Zn, Pb, Cu, Mn, Cr, Cd, Ni, Sn, Ag) and total phosphorus content, the Geoaccumulation Index (Igeo), Enrichment Factor (EF), Sum of Pollution Index (PIsum), Single Pollution Index (PI), Nemerow Pollution Index (PINemerow) and Potential Ecological Risk (RI) were calculated using different local and reference geochemical backgrounds. The use of various geochemical backgrounds is helpful to evaluate the assessment of soil pollution. The individual CLs differed from each other according to the degree of pollution. The different values of pollution indices within the studied soil profile showed that LDS should not be evaluated in terms of contamination as one, homogeneous soil profile but each separate CL should be treated individually.