Adaptive off-line protocol for prostate external radiotherapy with cone beam computer tomography.

PURPOSE: The goal of this work was to prepare and to evaluate an off-line adaptive protocol for prostate teleradiotherapy with kilovoltage cone beam computer tomography (CBCT). PATIENTS AND METHODS: Ten patients with localized prostate carcinoma treated with external beams underwent image-guided radiotherapy. In total, 162 CBCT images were collected. Position of prostate and pubis symphysis (PS) with respect to the isocenter were measured off-line. Using the CBCT scans obtained in the first three fractions the average position of prostate in relation (AvPosPr) to PB was calculated. On each CBCT scan, the position of prostate with respect to AvPosPr was calculated and cumulative histogram of prostate displacement with respect to AvPosPr was prepared. Using this data, the adaptive protocol was prepared in which (1) based on the CBCT made in the first three fractions the AvPosPr to PS is obtained, (2) in all other fractions two orthogonal images are acquired and if for any direction set-up error exceeds 0.2 cm the patient's position is corrected, and (3) additionally, the patient's position is corrected if the AvPosPr exceeds 0.2 cm in any direction. To evaluate the adaptive protocol for 30 consecutive patients, the CBCT was also made in 10th and 21st fraction. RESULTS: For the first 10 patients, the results revealed that the prostate was displaced in relation to AvPosPr >0.7 cm in the vertical and longitudinal directions only on 4 and 5 images of 162 CBCT images, respectively. For the lateral direction, this displacement was >0.3 cm in one case. For the group of 30 patients, displacement was never >0.7, and 0.3 cm for the vertical and lateral directions. In two cases, displacements were >0.7 cm for the longitudinal direction. CONCLUSION: Implementation of the proposed adaptive procedure based on the on-line set-up error elimination followed by a reduction of systematic internal error enables reducing the CTV-PTV margin to 0.7, 0.7, and 0.4 cm for the vertical, longitudinal, and lateral directions, respectively.

Transition metals induce control of enhanced NLO properties of functionalized organometallic complexes under laser modulations.

The molecular engineering of organometallic complexes has recently attracted renewed interest on account of their potential technological applications for optoelectronics in general and optical data storage. The transition metal which induces control of enhanced nonlinear optical properties of functionalized organometallic complexes versus not only the intensity but also the polarization of the incident laser beam is original and important for all optical switching. This makes organometallic complexes valuable and suitable candidates for nonlinear optical applications. In the present work, we report the synthesis and full characterization of four organometallic complexes consisting of N, N-dibutylamine and azobenzene fragments but differ by auxiliary alkynyl ligands or metal cations. Thus, a ferrocenyl derivative 1 and three ruthenium complexes 2-4 have been prepared. The nonlinear optical properties of the four new azo-based ruthenium and iron organometallic complexes in the solid state, using polymethylmethacrylate as matrix, have been thoroughly studied. This concept is extended to computing the HOMO and LUMO energy levels of the considered complexes, dipole moment, first and second order hyperpolarizabilities using the 6-31 + G(d,p) + LANL2DZ mixed basis set. The second and third nonlinear optical properties of the resulting polymer composites were obtained by measuring SHG and THG response by means of the Maker fringe technique using a laser generating at 1,064 nm with a 30 ps pulse duration. The values of the second and third order NLO susceptibilities of the four organometallic complexes were found to be higher than the common references used. Theoretical calculation shows that the large first and second order hyperpolarizablities are caused by strong intramolecular charge transfer between the transition metal parts and the ligands though a conjugated transmitter. These results indicate that the present organometallic complexes are valuable candidates for optoelectronic and photonic applications.

Cell therapy attenuates deleterious ventricular remodeling and improves cardiac performance after myocardial infarction.

BACKGROUND: Myocardial infarction (MI) promotes deleterious remodeling of the myocardium, resulting in ventricular dilation and pump dysfunction. We examined whether supplementing infarcted myocardium with skeletal myoblasts would (1) result in viable myoblast implants, (2) attenuate deleterious remodeling, and (3) enhance in vivo and ex vivo contractile performance. METHODS AND RESULTS: Experimental MI was induced by 1-hour coronary ligation followed by reperfusion in adult male Lewis rats. One week after MI, 10(6) myoblasts were injected directly into the infarct region. Three groups of animals were studied at 3 and 6 weeks after cell therapy: noninfarcted control (control), MI plus sham injection (MI), and MI plus cell injection (MI+cell). In vivo cardiac function was assessed by maximum exercise capacity testing and ex vivo function was determined by pressure-volume curves obtained from isolated, red cell-perfused, balloon-in-left ventricle (LV) hearts. MI and MI+cell hearts had indistinguishable infarct sizes of approximately 30% of the LV. At 3 and 6 weeks after cell therapy, 92% (13 of 14) of MI+cell hearts showed evidence of myoblast graft survival. MI+cell hearts exhibited attenuation of global ventricular dilation and reduced septum-to-free wall diameter compared with MI hearts not receiving cell therapy. Furthermore, cell therapy improved both post-MI in vivo exercise capacity and ex vivo LV systolic pressures. CONCLUSIONS: Implanted skeletal myoblasts form viable grafts in infarcted myocardium, resulting in enhanced post-MI exercise capacity and contractile function and attenuated ventricular dilation. These data illustrate that syngeneic myoblast implantation after MI improves both in vivo and ex vivo indexes of global ventricular dysfunction and deleterious remodeling and suggests that cellular implantation may be beneficial after MI.

Pilot study of myoblast transfer in the treatment of Becker muscular dystrophy.

We evaluated myoblast implantation therapy in three subjects with Becker muscular dystrophy who received 60 million myoblasts in one tibialis anterior (TA) muscle 2 months after beginning cyclosporine immunosuppression (5 to 10 mg/kg) that continued for 1 year. Strength of the implanted and control TA muscles was measured before and after treatment using a gauge to record TA contraction force. Our protocol controlled for the effects of cyclosporine and myoblast injections. In this pilot study, myoblast implantation did not improve strength of the implanted TA muscles.

Diastereoselective synthesis of 1-benzyltetrahydroisoquinoline derivatives from amino acids via 1,4 chirality transfer. Part 1.

[structure: see text]. L-(-)-phenylalanine, L-(+)-valine, and L-(-)-proline were used in the diastereoselective synthesis of benzyltetrahydroisoquinoline derivatives.

Audit of ambulatory blood pressure monitoring in the diagnosis and management of hypertension in practice.

This study was carried out to ascertain the value of ambulatory blood pressure monitoring (ABPM) in the diagnosis and treatment of hypertension in routine clinical practice. ABPM was performed during the daytime hours in 410 patients believed to be hypertensive after at least three measurements by their physician and one measurement by a nurse in a hypertension clinic. The diagnosis was confirmed in 70% of patients when 90 mm Hg diastolic blood pressure (BP) was used as the upper limit of normal, and 86.3% when 85 mm Hg was used. In 204 patients who were reviewed 5 years later there were 108 on medical treatment. This reduced diastolic pressure from a mean of 100.6 +/- 8.8 to 85.7 +/- 8.8 mm Hg. However, in 30% of patients the diastolic pressure was still above 90 mm Hg. In the 49 patients with isolated clinic hypertension (ICH), who had remained untreated, diastolic pressure increased from 84.0 +/- 4.8 to 88.1 +/- 8.4 mm Hg over the 5 years. In 19 of these the level exceeded 90 mm Hg. ABPM therefore improves diagnostic accuracy and prevents treatment of patients with ICH. This condition, however, requires follow-up since BP tends to rise with time in some patients. The audit also identified patients who had had a suboptimal response to medical treatment.

[The relation between ischemic cerebral stroke and heart diseases]. / Wspólzaleznosc niedokrwiennych udarów mózgu i chorób serca.

The aim of the study was to evaluate the relation between heart diseases and ischemic cerebral stroke. In addition to routine tests, echocardiographic examinations were performed in 70 patients with ischemic cerebral stroke and in 30 persons constituting the control group. It was found that heart diseases occurred in 70% of the patients in the group studied i.e. three times more frequently than in the control group. Heart disease confirmed by echocardiography and electrocardiography occurred more frequently in patients with cerebral infarct than in those with RIND. In the majority of cases cardiac valve diseases and/or atrial fibrillation were noted. It was found that in 14.3% of the patients studied, the results of the echocardiography indicated the need for modification of the treatment applied.

[Reactivity of the bronchi as a function of their initial state in children with asthma]. / Reaktywnosc oskrzeli jako funkcja ich stanu wyjsciowego u dzieci chorych na astme.

The aim of the study was to assess the effect of peripheral bronchial base-line status on the result of the bronchial provocation test. The study was carried out on a group of 65 children with bronchial asthma. Bronchial reactivity was assessed utilizing the carbachol provocation test. Higher reactivity was seen in children with initially lower indices of peripheral bronchial flow (MEF50, MEF25) (PC20 = 3,789 +/- 0.014 mg/ml) in comparison with children with normal indices (PC20 = 74,608 +/- 0,038 mg/ml) (p < 0.001). A linear correlation was found between the results of bronchial provocation (PC) and initial standardized small airway flow values (MEF50 - r = 0.56, p < 0.001; MEF25 - r = 0.49, p < 0.001). The correlation between bronchial provocation and initial FEV1/VC was weaker (r = 0.39 p < 0.01). The authors conclude that demonstration of decreased flow in peripheral, small airways utilizing MEF values enable to predict a positive result of bronchial provocation tests.

Respiratory activity of various parts of the small intestine in fasted and fed animals. Part II. Respiratory activity of the small intestine in guinea pigs.

The aim of this work was to investigate the respiratory activity of three parts of the small intestine: duodenum, jejunum and ileum in guinea pigs, to compare the intensity of oxygen consumption by these parts in hungry and fed animals, and to find possible differences in the intensity of intestinal respiration between guinea pigs and rats. In guinea pigs the intensity of respiration of intestinal homogenates was nearly twice smaller than in rats. similarly, however, as in rats intestinal homogenates of guinea pigs had greater respiration intensity after feeding than while the animals were fasting. The metabolic gradient in the small intestine of guinea pigs was somewhat different, the intensity of respiration was highest in the jejunum, in the duodenum it was slightly lower or equal to that in the ileum it was the lowest. The intensity of mitochondrial respiration was similar in guinea pigs as in rats, and the metabolic gradient in mitochondrial respiration was also similar in three studied parts of the intestine. The effects of fasting and feeding were, however, different than in homogenates. the mitochondria of fed animals consumed less oxygen than those of fasting animals. These changes in respiration were not connected with any changes in the amounts of mitochondrial protein since they were similar in fasting and in fed animals.

The effect of lead acetate on rat liver mitochondria.

The effect of two lead doses (100 and 200 micrograms Pb/kg) on the metabolism of rat liver mitochondria was studied determining the protein content of mitochondria and the activity of mitochondrial ATPase. Structural changes of mitochondria were studied in electron microscopy. Oxygen consumption was measured in mitochondria in two models: in vivo and in vitro. It was found that both doses used caused mitochondrial configuration changes in relation to control animals, reduced the amount of mitochondrial configuration changes in relation to control animals, reduced the amount of mitochondrial protein and the activity of mitochondrial ATPase and raised mitochondrial oxygen consumption in vivo and in vitro. The most powerful action of both lead consumption in vivo and in vitro. The most powerful during the first 30 minutes of lead contact with mitochondria. At the same time a significantly greater stimulation of mitochondrial respiration was observed after the lower dose of lead.

Respiratory activity of different parts of small intestine in starved and fed animals.

Using the manometric method of Warburg the respiratory activity of tissue homogenates of the duodenum, jejunum and ileum was studied in starved and fed rats. The respiratory activity of mitochondria isolated from these parts of the small intestine was determined as well. The intensity of respiration was greatest in duodenal homogenates. The respiratory activity of jejunal homogenates was only slightly lower, while that of ileum homogenates was lowest. Oxygen utilization of intestinal homogenates from fed animals was much higher, particularly in the ileum, than in starved animals. During 50 minutes of incubation theu tilization of oxygen fell most rapidly in the duodenum and slowest in the ileum, and at the end of incubation the values obtained in starved and fed animals differed only slightly. Mitochondria showed similar patterns of oxygen uptake intensity as analogous homogenates, but the effects of starvation and feeding on mitochondrial respiratory activity differed -- in fed animals this activity was lower than in starvation.

Influence of the position of the gain medium on the excess noise factor.

An exact analysis of the excess noise in a two-mirror laser that takes into account the intracavity elements and the position of the active medium is presented. The influence of the active medium's position and length of the laser cavity on the excess noise factor is shown.

Effect of mode nonorthogonality in distributed-feedback lasers.

An analysis of the quantum noise in distributed-feedback lasers based on the Fokker-Planck equation has been developed to take into account the nonorthogonal nature of the laser modes. We have obtained numerical results of the steady-state solution of the single-mode operation that reveal the difference between the standard approach orthogonal laser modes and the realistic model (mode nonorthogonality included) for a distributed-feedback laser with nonvanishing end reflectivity and the complex coupling coefficient.