Economic valuation of the ecosystem of the high Andean hydrographic basin tributary of the Chumbao River, through multicriteria analysis.

Environmental wealth is the main basis of the social, cultural and economic development of a country, but if there is an absence of the valuation of these natural resources, it can lead to a disproportionate usufruct that causes the deterioration of the ecosystem and even collateral effects of human health. This research aimed to know the total economic value of the ecosystem of the high Andean water basin tributary of the Chumbao River, located between 2000 to 4800 meters above sea level belonging to the province of Andahuaylas, Apurimac region in Perú. The valuation procedure consisted of using the analytical method of multicriteria valuation applying the concept of Total Economic Value, which involved direct and indirect uses related to environmental assets, in which a collective panel of people from different training disciplines (experts) participated, which were made up of researchers, engineers, public officials, farmers and ecologists who had extensive knowledge about the environmental asset. of the geographical area in reference; and once the paired comparison survey was done, the total economic value was quantified up to three amounts, so the respondents were formed into three statistically significant segments (SIG<0.05). The cluster (1): assigned a weighting that quantifies to an economic value of USS 4,359,179,489.46; followed by cluster (2): an intermediate value of USS 4,029,902,444.41 and cluster (3): assigned a lower value to USS 774,163,167.16. Thus, it follows that, on average, 51.78% equals value in use and 48.21% equals value in non-use, respectively. This value expressed as an interval reflects the environmental ethical positions of the groups and makes available as an indicator to government authorities and society in order to exercise actions of environmental sustainability high andean.

Paraparesis as initial manifestation of a Prototheca zopfii infection in a dog.

A case of protothecosis causing non-ambulatory paraparesis in a dog without clinical evidence of disseminated infection is described. A five-year-old female Labrador retriever was referred with a 10-day history of progressive non-ambulatory paraparesis and lumbar pain as the only physical and neurological abnormalities. Lumbar myelography revealed severe extradural spinal cord compression extending from L4 to L7 vertebrae, and a right hemilaminectomy was performed. Surgical findings included an adherent whitish hard ill-defined mass. Cytology and biopsy results disclosed the presence of algae enclosed in a matrix of chronic inflammatory infiltrate. Culture confirmed the presence of Prototheca species. Neurological improvement occurred within a month, and the dog received antifungal treatment without evidence of clinical disseminated disease for 6 months, but died after a generalised tonic-clonic seizure. Post-mortem examination revealed multiple foci of inflammatory granulomatous infiltrate and algae-like structures in the brain, lumbar intumescence and cauda equina. Prototheca zopfii was identified using molecular biology methods.

Comparison of dose calculated by an intensity modulated radiotherapy treatment planning system and an independent monitor unit verification program.

A comparison of isocenter dose calculated by a commercial intensity modulated radiation therapy treatment planning system and independent monitor unit verification calculation (MUVC) software was made. The percent disparity between the treatment plan and MUVC doses were calculated for 507 treatments (head and neck, prostate, abdomen, female pelvis, rectum and anus, and miscellaneous) from 303 patients. The MUVC calculated dose was, on average, 1.4% higher than the treatment planning dose, with a 1.2% standard deviation. The distribution of the disparities appeared to be Gaussian in shape with some variation by treatment site. Based on our analysis, disparities outside the range of +/-3% about the mean value should be checked and resolved prior to treatment delivery.

Initial clinical experience with intensity-modulated whole-pelvis radiation therapy in women with gynecologic malignancies.

OBJECTIVE: Our goal in this article to describe our initial experience with intensity-modulated whole-pelvis radiation therapy (IM-WPRT) in gynecologic malignancies. METHODS: Between February and August 2000, 15 women with cervical (9) or endometrial (6) cancer received IM-WPRT. All patients received a treatment planning computed tomography (CT) scan. On each scan, the target volume (upper vagina, parametrial tissues, presacral region, uterus, and regional lymph nodes) and normal tissues (small bowel, bladder, and rectum) were identified. Using commercially available software, an IM-WPRT plan was generated for each patient. The goal was to provide coverage of the target with the prescription dose (45 Gy) while minimizing the volume of small bowel, bladder, and rectum irradiated. Acute gastrointestinal (GI) and genitourinary (GU) toxic effects in these women were compared with those seen in 25 patients treated with conventional WPRT. RESULTS: IM-WPRT plans provided excellent coverage of the target structures in all patients and were highly conformal, providing considerable sparing of the bladder, rectum, and small bowel. Treatment was well tolerated, with grade 0-1 GI and GU toxicity in 46 and 93% of patients, respectively. IM-WPRT patients had a lower rate of grade 2 GI toxicity (53.4% vs 96%, P = 0.001) than those treated with conventional WPRT. Moreover, the percentage of women requiring no or only infrequent antidiarrheal medications was lower in the IM-WPRT group (73.3% vs 20%, P = 0.001). While grade 2 GU toxicity was also lower in the IM-WPRT patients (6.7% vs 16%), this difference did not reach statistical significance (P = 0.38). CONCLUSION: IM-WPRT provides excellent coverage of the target structures while sparing critical neighboring structures in gynecology patients. Treatment is well tolerated with less acute GI toxicity than conventional WPRT. More patients and longer follow-up are needed to evaluate the full merits of this approach.

Intensity-modulated whole pelvic radiation therapy in patients with gynecologic malignancies.

PURPOSE: To evaluate the ability of intensity-modulated radiation therapy (IMRT) to reduce the volume of small bowel irradiated in women with gynecologic malignancies receiving whole pelvic radiotherapy (WPRT). METHODS AND MATERIALS: Ten women with cervical (5) or endometrial (5) cancer undergoing WPRT were selected for this analysis. A planning CT scan of each patient was obtained following administration of oral, i.v., and rectal contrast. The clinical target volume (CTV) was defined as the proximal vagina, parametrial tissues, uterus (if present), and regional lymph nodes. The CTV was expanded uniformly by 1 cm in all directions to produce a planning target volume (PTV). The bladder, rectum, and small bowel were also delineated in each patient. Two plans were created: a standard "4-field box" with apertures shaped to the PTV in each beam's eye view and an IM-WPRT plan designed to conform to the PTV while minimizing the volume of normal tissues irradiated. Both plans were normalized to deliver 45 Gy to the PTV. Isodose distributions and dose-volume histograms (DVH) were compared. RESULTS: The IM-WPRT plan reduced the volume of small bowel irradiated in all 10 patients at doses above 30 Gy. At the prescription dose, the average volume of small bowel irradiated was reduced by a factor of two (17.4 vs. 33.8%, p = 0.0005). In addition, the average volume of rectum and bladder irradiated at the prescription dose was reduced by 23% in both cases (p = 0.0002 and p = 0.0005, respectively). The average PTV doses delivered by the conventional and IM-WPRT plans were 47.8 Gy and 47.4 Gy, respectively. Corresponding maximum doses were 50.0 Gy and 54.8 Gy, respectively. However, on average, only 3.2% of the PTV received greater than 50.0 Gy in the IM-WPRT plans. CONCLUSION: Our results suggest that IM-WPRT is an effective means of reducing the volume of small bowel irradiated in women with gynecologic malignancies receiving WPRT. This approach potentially offers a method for reducing small bowel complications in patients with gynecologic malignancies.

Quantization of setup uncertainties in 3-D dose calculations.

Random setup errors can lead to erroneous prediction of the dose distribution calculated for a patient using a static computed tomography (CT) model. Multiple recomputations of the dose distribution covering the range of expected patient positions provides a way to estimate a course of treatment. However, due to the statistical nature of the setup uncertainties, many courses of treatment must be simulated to calculate a distribution of average dose values delivered to a patient. Thus, direct simulation methods can be time consuming and may be impractical for routine clinical treatment planning applications. Methods have been proposed to efficiently calculate the distribution of average dose values via a convolution of the dose distribution (calculated on a static CT model) with a probability distribution function (generally Gaussian) that describes the nature of the uncertainty. In this paper, we extend the convolution-based calculation to calculate the standard deviation of potential outcomes sigmaD(x,y,z) about the distribution of average dose values, and we characterize the statistical significance of this quantity using the central limit theorem. For an example treatment plan based on a treatment protocol in use at our institution, we found that there is a 68% probability that the actual dose delivered to any point (x,y,z) will be within 3% of the average dose value at that point. The standard deviation also yields confidence limits on the dose distribution, and these may be used to evaluate treatment plan stability.

A method for incorporating organ motion due to breathing into 3D dose calculations.

A method is proposed that incorporates the effects of intratreatment organ motion due to breathing on the dose calculations for the treatment of liver disease. Our method is based on the convolution of a static dose distribution with a probability distribution function (PDF) which describes the nature of the motion. The organ motion due to breathing is assumed here to be one-dimensional (in the superior-inferior direction), and is modeled using a periodic but asymmetric function (more time spent at exhale versus inhale). The dose distribution calculated using convolution-based methods is compared to the static dose distribution using dose difference displays and the effective volume (Veff) of the uninvolved liver, as per a liver dose escalation protocol in use at our institution. The convolution-based calculation is also compared to direct simulations that model individual fractions of a treatment. Analysis shows that incorporation of the organ motion could lead to changes in the dose prescribed for a treatment based on the Veff of the uninvolved liver. Comparison of convolution-based calculations and direct simulation of various worst-case scenarios indicates that a single convolution-based calculation is sufficient to predict the dose distribution for the example treatment plan given.

Determination of rotations in three dimensions using two-dimensional portal image registration.

The relative relationships among anatomic features visualized on planar radiographic images change due to rotations of the patient out of the imaging plane. These changes can be predicted a priori from a three-dimensional radiographic model of the patient. In this study we assess the feasibility of using that information together with a planar image feature alignment tool to account for out-of-plane rotations in the evaluation of subsequent clinical patient images. A series of digitally reconstructed radiographs (DRRs) with known patient rotations was generated from a computed tomography scan of an anthropomorphic head phantom. Fixed anatomic features were extracted, as seen in the DRRs of rotated anatomy and entered into a database. Alignment of features from test radiographs with those from an entry in this database yielded an estimate of rotation out of plane (database entry that resulted in the best fit via planar transformation) along with the planar components of setup errors in the rotated plane. Tests using DRRs and films show that it is possible to select anatomic features in AP skull radiographs with position and orientation sensitive to out-of-plane rotation.

The Genome Sequence DataBase version 1.0 (GSDB): from low pass sequences to complete genomes.

The Genome Sequence DataBase (GSDB) has completed its conversion to an improved relational database. The new database, GSDB 1.0, is fully operational and publicly available. Data contributions, including both original sequence submissions and community annotation, are being accomplished through the use of a graphical client-server interface tool, the GSDB Annotator, and via GIO (GSDB Input/Output) files. Data retrieval services are being provided through a new Web Query Tool and direct SQL. All methods of data contribution and data retrieval fully support the new data types that have been incorporated into GSDB, including discontiguous sequences, multiple sequence alignments, and community annotation.

The Genome Sequence DataBase (GSDB): meeting the challenge of genomic sequencing.

The genome sequence database (GSDB) is a complete, publicly available relational database of DNA sequences and annotation maintained by the National Center for Genome Resources (NCGR) under a Cooperative Agreement with the US Department of Energy (DOE). GSDB provides direct, client- server access to the database for data contributions, community annotation and SQL queries. The GSDB Annotator, a multi-platform graphic user interface, is freely available. Automatically updated relational replicates of GSDB are also freely available.

Comparison of the sensitivity of different geographical races of Onchocerca volvulus microfilariae to ivermectin: studies in vitro.

This study was designed to provide baseline information on the sensitivity of 4 geographical isolates of Onchocerca volvulus microfilariae (mf) (Ghana forest, Ghana savanna, Cameroon forest and Guatemala) to ivermectin, and to develop an in vitro system with which to examine parasites for the possible development of drug resistance. Drug effects were best visualized in the presence of monkey kidney (LLCMK2) feeder cells in the culture system (MEM medium+20% serum), since mf maintained in the absence of cells declined in condition rapidly. Incubation of Ghana forest mf (+cells) in ivermectin (10(-5)-10(-10) M) caused a decrease in motility index (MI) scores in a concentration-dependent fashion; drug effects could be observed as early as 6 h, but cultures maintained for up to 8 d showed greater differences between control and drug groups with increasing time. All 4 O. volvulus isolates and O. lienalis (bovine) were compared for their response to ivermectin (10(-7) M): O. lienalis mf were significantly more sensitive (78%) reduction in MI scores on day 8) than the O. volvulus isolates (33.4-47.7% reduction). O. volvulus microfilariae ex utero generally displayed lower levels of motility and were slightly less inhibited by ivermectin than were skin mf. The in vitro system described can distinguish between the populations of mf studied on the basis of differing MI responses to ivermectin and, when combined with assays to test the infectivity of mf to blackflies following exposure to drug, will provide methods with which to examine parasites for the possible development of resistance.

Determination of the optimized individual kinetic constants of the aminolysis reaction in basic medium of beta-lactam antibiotics by a numerical computational method.

The individual kinetic constants of the aminolysis reaction in basic medium of several beta-lactam compounds (6-aminopenicillanic acid, carbenicillin, 7-aminocephalosporanic acid, and cephalothin) are determined and improved by application of a computational method KINBETA. The method uses a modified version of the AGDC optimization algorithm adapted to the reaction system. Initial estimates of the constants for this reaction, obtained from the conventional methodology reported in the literature, were used. The computational method applied is self-consistent and affords both a considerable saving in experimental time and more reliable and exact results.

Duplicacion intestinal: informe de dos casos / Intestinal duplication: report of 2 cases

Las duplicaciones intestinales son infrecuentes y resultan de fallos embriológicos en la canalización normal del tubo digestivo. Este trabajo presenta un caso de duplicación intestinal en el ileon y su diagnóstico diferencial con el Divertículo de Meckel. A continuación se presenta un caso de duplicación de recto en un paciente de edad asintomático

Duplicacion intestinal: informe de dos casos / Intestinal duplication: report of 2 cases

Las duplicaciones intestinales son infrecuentes y resultan de fallos embriológicos en la canalización normal del tubo digestivo. Este trabajo presenta un caso de duplicación intestinal en el ileon y su diagnóstico diferencial con el Divertículo de Meckel. A continuación se presenta un caso de duplicación de recto en un paciente de edad asintomático (AU)

[Intestinal duplication. Report of 2 cases]. / Duplicación intestinal. Informe de dos casos.

Intestinal duplications are rare and they result from embryological failures in the canalization of the gastrointestinal tract. This paper presents a case of ileal intestinal duplication and its differential diagnosis from Meckel's diverticulum. Besides, a case of rectal duplication in an asymptomatic elder patient is presented.

Duplicación intestinal. Informe de dos casos. / [Intestinal duplication. Report of 2 cases]

Intestinal duplications are rare and they result from embryological failures in the canalization of the gastrointestinal tract. This paper presents a case of ileal intestinal duplication and its differential diagnosis from Meckels diverticulum. Besides, a case of rectal duplication in an asymptomatic elder patient is presented.

Duplicación intestinal. Informe de dos casos. / [Intestinal duplication. Report of 2 cases]

Intestinal duplications are rare and they result from embryological failures in the canalization of the gastrointestinal tract. This paper presents a case of ileal intestinal duplication and its differential diagnosis from Meckels diverticulum. Besides, a case of rectal duplication in an asymptomatic elder patient is presented.

[Incidence of intrahepatic and subcapsular hematomas after percutaneous needle biopsy]. / Incidencia de hematomas intrahepáticos y subcapsulares post punción biopsia percutánea del hígado.

Intrahepatic and subcapsular hematomas are described as complications of percutaneous liver biopsy. Even though, its incidence is not clearly established. Through this study we try to set which is the real incidence of this complication in our medium. To comply with this, we control our patients by ultrasonography before, after, and even seven days after procedure has been carried out.