Brachytherapy: An emblematic example of extreme hypofractionated regimen

In order to provide more convenient irradiation regimens for patient comfort, radiation facility organization and health expenses, new hypofractionated protocols have been evaluated. Moderately (dose/fraction: 2.3 to 3 Gy), then ultra (dose/fraction: 5.2 to 6.1 Gy) hypofractionated irradiations were first validated. The current question is: is it possible to go forward using extreme hypofractionated regimens (EHR) based on 1 to 3 fractions. Different irradiation techniques are under investigation. However, brachytherapy remains the smartest way to deliver a high dose in a small volume. We report prospective and retrospective study results which evaluated EHR for breast and prostate brachytherapy. While oncological outcome and toxicity profile appear extremely encouraging for low-risk breast cancer after a 1 to 4 fractions (6.25 to 20 Gy/fraction), the use of a single fraction of 19 to 23 Gy appears debatable for prostate cancer. Brachytherapy represents an emblematic example of EHR but longer follow-up and more mature results are awaited in order to specify the right indications and refine the EQD2 calculation method including new biological and technical factors.     

皮肤阻抗等效电路及经络低阻抗原因探讨

将矩形波电压通过两点电极加到人体皮肤表面，得到的电流波形是一些尖脉冲。经络线上的电流波形与非经络线上的波形有差别，表现为低电阻，高电容现象。产生高电容现象的机理目前尚不清楚。本文提出了一个等效电路并探讨了产生高电容现象的原因。     

Source Localization of P300 from Oddball, Single Stimulus, and Omitted-Stimulus Paradigms

Three different auditory stimulus paradigms were used to elicit P300 potentials. Normal subjects were tested on the classical rare target stimulus, single-stimulus and omitted-stimulus conditions. Noninvasive identification of the cerebral sources of the event-related potentials (ERPs) was performed using spatio-temporal multiple dipole modeling (BESA software) with individually sized spherical head models. The grand average data of each condition was first independently modeled and these models were used as starting values for modeling each individual subject's data. Models for the rare-stimulus condition and single-stimulus condition both consisted of 6 dipoles. Models for the omitted-stimulus condition consisted of 2 dipoles. The dipole locations of the final individual 6-dipole models for the rare and single-stimulus conditions did not differ significantly from each other or from one previous result obtained from a another group of subjects (Tarkka et al. 1995). Super-imposition of the dipole coordinates on the sterotaxic brain atlas suggests that bilateral deep medial temporal lobe structures are the major contributors to rare and single-stimulus P300s. Because both the wave form morphology and the source model of the P300 elicited by single stimulus were close to those of the rare-stimulus P300 it may be that the underlying neural mechanisms eliciting these P300 potentials are essentially the same.     

Classifying cases of fetal wolff-parkinson-white syndrome by estimating the accessory pathway from fetal magnetocardiograms

The paper presents an evaluation of the possibility of using fetal magnetocardiogram (FMCG) signals to estimate and classify the accessory pathway in fetal Wolff-Parkinson-White (WPW) syndrome. The FMCG signals of two fetuses with WPW syndrome (type A) were detected using a 64-channel superconducting quantum-interference device system. An average across the cycles of these signals was taken to obtain clear WPW signals. To determine the direction and position of the accessory pathway in a fetal heart accurately, the accessory pathway and activated pathway at the peak of the QRS complex thus obtained were estimated for each fetus, using a single-dipole model. The phase angle (about 90^o) between the equivalent current dipoles (ECDs) was the same for both fetuses. This angle suggested that the accessory pathway is in the left side of the heart, i.e. that the pathway exists in the position of the accessory pathway in a fetus with WPW syndrome from the angle between the ECD of the accessory pathway and the ECD of the peak in the QRS complex was thus demonstrated.     

Frequency domain models of the EEG

The structure of the normal resting EEG crosspectrum SVV(omega) is analyzed using complex multivariate statistics. Exploratory data analysis with Principal Component Analysis (PCA) is followed by hypothesis testing and computer simulations related to possible neural generators. The SVV(omega) of 211 normal individuals (ages 5 to 97) may be decomposed into two types of processes: the xi process with spatial isotropicity reflecting diffuse, correlated cortical generators with radial symmetry, and processes that seem to be generated by more spatially concentrated, correlated sources. The latter are reflected as spectral peaks such as the process. The eigenvectors of the xi process are the Spherical Harmonic Functions which explains the recurring pattern of maps characteristic of the spatial PCA of qEEG data. A new method for estimating sources in the frequency domain which fits dipoles to the whole crosspectrum is applied to explain the characteristics of the localized sources.     

Simulation of cardiovascular physiology: the diastolic function(s) of the heart

The cardiovascular system was simulated by using an equivalent electronic circuit. Four sets of simulations were performed. The basic variables investigated were cardiac output and stroke volume. They were studied as functions (i) of right ventricular capacitance and negative intrathoracic pressure; (ii) of left ventricular relaxation and of heart rate; and (iii) of left ventricle failure. It seems that a satisfactory simulation of systolic and diastolic functions of the heart is possible. Presented simulations improve our understanding of the role of the capacitance of both ventricles and of the diastolic relaxation in cardiovascular physiology.     

基于真实头模型的EEG参考电极标准化技术

目的 :研究基于真实头模型的参考电极标准化技术并验证它的有效性。方法 :基于真实头模型的等效源技术 ,建立了由以头表某点或平均电位为参考点的实际记录近似得到以无穷远点为参考的记录的方法。由于无穷远点的电位可假设为常数零 ,因此可称该方法为真实头模型的参考电极标准化技术 (REST)。对真实头模型全空间内任意位置的源的实际头表记录进行REST处理 ,然后计算经REST处理后的近似记录与以无穷远点为参考的记录之间的相对误差 ,以此检验该技术的有效性。结果 :对于真实头模型REST是有效的 ,尤其对重要的表层皮质区域更为有效 ,它的应用可以降低因非零的参考电位而引入头表记录的干扰。结论 :采用参考电极标准化技术能得到更真实的脑电 (EEG)记录 ,从而可能对脑电的应用产生重要的影响。     

两种噪声强度测定法用于噪声作业岗位卫生学评价的比较

目的　探讨两种不同方法对工作场所的噪声强度进行测定的效果 ,为噪声作业岗位的卫生学评价提供科学依据。方法　选择有噪声作业的 3个场所 ,且噪声是不连续、非稳态噪声 ,分别用瞬时测定方法和等效连续A声级测定方法对噪声强度进行测定。结果　用瞬时测定方法测得 3个工作场所A、B、C的噪声强度分别是 89 6dB(A)、95 3dB(A)和 92 7dB(A) ,3个工作场所的噪声强度都超过国家职业卫生标准。用等效连续A声级方法测得 3个工作场所的噪声强度分别是 83 8dB(A)、92 5dB(A)和 88 7dB(A) ,根据国家职业卫生标准 ,工作场所A噪声强度未超标 ,工作场所B、C噪声强度超标。结论　对于不连续、非稳态噪声 ,用等效连续A声级方法测定噪声强度比瞬时测定方法更科学合理 ,更客观反映劳动者接触噪声的实际情况     

Mathematical models of passive motion at the human ankle joint by equivalent spatial parallel mechanisms

The paper presents a theoretical model of the ankle joint, i.e. tibio-talar articulation, which shows how the articular surfaces and the ligaments, acting together as a mechanism, can control the passive kinematics of the joint. The authors had previously shown that, in virtually unloaded conditions, the ankle behaves as a single degree-of-freedom system, and that two ligament fibres remain nearly isometric throughout the flexion arc. Two different equivalent spatial parallel mechanisms together with corresponding kinematic models were formulated. These assumed isometricity of fibres within the calcaneal-fibular and tibio-calcaneal ligaments and rigidity of the articulating surfaces, taken as three sphere-plane contacts in one model, and as a single spherical pair in the other. Geometry parameters for the models were obtained from three specimens. Motion predictions compare quite well with the measured motion of the specimens. The differences are accounted for by the simplifications adopted to represent the complex anatomical structures, and might be reduced by future more realistic representations of the natural articular surfaces.     

骨显像患者饮水时间对其周围剂量当量率影响的研究

目的 探讨骨显像受检者饮水开始时间对周围剂量当量率的影响,以采取相应措施减少对公众的影响。方法 将60例住院骨显像患者随机分为试验组和对照组,前者于注射骨显像剂前1 h开始饮水1 000 ml,后者予注射骨显像剂后2 h饮水1 000 ml,均1 h内饮完。采用辐射剂量仪分别测量注射显像剂后0.5 h、1 h、2 h、3 h、6 h、12 h、24 h的7个时间点,距受检者正面0.5 m、1 m、2 m、3 m处4个距离点的周围剂量当量率;比较2组周围剂量当量率降为2.5 μSv/h时所需时间及距离。 结果 两组在注射显像剂后0.5 h、1 h、2 h、3 h、6 h的5个时间点、距受检者0.5 m、1 m、2 m、3 m处,试验组的周围剂量当量率低于对照组,差异有统计学意义（P<0.05）。试验组与对照组相比,减少了周围剂量当量率降低为2.5 μSv/h所需的时间和距离。两组图像质量均比较满意,达到诊断标准。 结论 骨显像受检者在注射前1 h饮水1 000 ml可以在保证显像质量的前提下,加快显像剂的排泄,降低注射后6 h内的周围剂量当量率。护理人员可利用测量结果来指导患者、家属及公众的放射防护。