Chest wall moulages for radiotherapy of resected breast cancer with fast electrons: comparative tests of different materials

Irradiation of the thoracic wall with high-speed electrons is one of the standard methods of prophylaxis and therapy of local recurrences and cutaneous metastases of an operated mammary carcinoma. The surface dose, however, is only 85% of the maximum dose, due to the depth dose curve of the electron beams with the preponderantly applied energy of 7MeV. This is a poor value, since most of all recurrences appear near to the surface and so the risk of giving an insufficient dose is involved. The dose distribution could be essentially improved by the use of moulages on the chest. These moulages were made of different materials which were tested and compared with respect to their suitability for radiotherapeutic purposes. The best materials proved to be "Urgo-Plastan" (manufacturer: Holphar, Sulzbach) and "Orthoplast" (manufacturer: Johnson & Johnson, Düsseldorf). Both materials are synthetic substances which after heating can easily be adapted to the body shape and which offer a good stability, little inconvenience for the patient and a relative easy handling. With these moulage materials, the surface dose is increased to 98% ("Urgo-Plastan") and 99% ("Orthoplast") of the maximum dose.     

Face masks for radiotherapy of head and neck tumors: comparative tests of different materials

A most precise immobilisation of the patient's head is indispensable in order to reach a high degree of exactness and reproducibility in radiotherapy of malignant head and neck tumors. Face masks made of different synthetic materials have proved to be a simple and economical solution for this problem. Based on our own experiences with "Baycast Longuettes" (manufacturing firm: Johnson & Johnson, Düsseldorf), eleven substances have been tested in the phantom (compound of plaster and synthetic resin, thermoplast, polyurethane foam, compounds of cotton and synthetic resin, and fibre glass compounds). An appropriate material was "Hexcelite" (manufacturing firm: Medimex, Hamburg), a reticulated thermoplast which after warming up can be easily adapted to the patient's face and which guarantees a very good fixation of the head. As compared to solid masks, there is only a slight superposition of the depth dose of Co-60 gamma radiation by secondary electrons from the mask material, so that an increased rate of radiogenic dermatitides is not to be expected.     

癌组织中p16基因甲基化分析

目的探讨抑癌基因p16在胃癌组织中是否存在甲基化异常及其与胃癌发生发展的关系.方法对20例胃癌组织及相应正常胃粘膜组织应用甲基敏感酶(HpaII)和甲基非敏感酶(MspI)酶切,结合PCR扩增技术,对p16基因外显子1、外显子2的二核苷酸胞嘧啶特定序列5'-CCGG-3'位点甲基化进行检测.结果20例胃癌组织中,p16基因外显子1、2异常甲基化分别为5例(25%)和9例(45%),正常组织未发现甲基化异常;14例高甲基化标本中,中分化胃癌4例,低分化7例,高分化1例;有2例存在外显子1、2同时甲基化异常,二者均为低分化胃癌,进展期胃癌(Ⅲa、Ⅳ期各1例)中1例呈现泳动易位;外显子2甲基化异常多发生于晚期肿瘤患者(P<0.05).结论p16基因甲基化异常可能会造成基因功能丧失,从而失去对细胞增殖的负性调控作用,导致胃癌发生与进展;外显子2高甲基化与临床进展有关,可能为晚期事件.     

投影遗传算法

针对一般遗传算法在求解优化问题的多个优化解时的局限性,结合曲面投影与遗传算法的基本思想,提出了一种基于曲面投影的投影遗传算法用于解决此类问题,数值验证的结果表明了本算法的有效性和实用性。     

胰腺癌侵犯胰周结构的CT评价

目的探讨胰腺癌的CT诊断价值.方法对76例胰腺癌的CT表现进行分析并与手术病理结果对照.结果①胰腺癌在CT上表现为低密度的肿块,不强化或强化不明显,肿块边缘不规则强化;②胰头癌可引起胆总管、胰管的扩张;③胰腺癌多伴邻近血管及脏器受侵.结论 CT能正确评价胰腺癌及胰周浸润,是判断胰腺癌能否手术切除的重要检查手段.     

A COMPARATIVE STUDY OF TENIDAP, A CYTOKINE-MODULATING ANTI-RHEUMATIC DRUG, AND DICLOFENAC IN RHEUMATOID ARTHRITIS: A 24-WEEK ANALYSIS OF A 1-YEAR CLINICAL TRIAL

Tenidap is a novel anti-rheumatic drug that combines cytokinemodulation with cyclo-oxygenase inhibition. This 24-week, multicentre,double-blind, randomized study compared the clinical efficacy,biochemical effects and safety of tenidap 120 mg/day (once daily)with diclofenac 150 mg/day (50 mg t.i.d.) in the treatment of384 patients with active rheumatoid arthritis. After 24 weeks,improvement with tenidap was significantly greater than withdiclofenac for all five primary efficacy parameters, two ofthe four secondary efficacy parameters and 11 of the 13 ArthritisImpact Measurement Scales assessments. The superior efficacyof tenidap was apparent after 4 weeks of treatment with furtherimprovements observed by 24 weeks. The probability of discontinuationdue to lack of efficacy was significantly greater in the diclofenacgroup. Tenidap but not diclofenac was associated with significant,rapid and sustained reductions in C-reactive protein and serumamyloid A levels and with a significant reduction in plasmainterleukin-6. The nature and frequency of side-effects weresimilar in the two groups as was the discontinuation rate fortreatment-related safety reasons. Tenidap was associated withan equal incidence of elevated transaminases, but a higher incidenceof mild (     

Anthropometric Characteristics of Mohawk Children Aged 6 to 11 Years: A Population Perspective

OBJECTIVE: Recent studies have concluded that Native North American children have higher proportions of overweight and obesity than children from the general North American population. This study presents anthropometric data on a representative sample of children from the Mohawk Nation that can be used for comparison with other Native American populations. DESIGN: This is a cross-sectional study comparing distributions of anthropometric characteristics of Mohawk children to the corresponding age and gender data from the Second National Health and Nutrition Examination Survey (NHANES II). Weight, height, triceps and subscapular skinfold thickness, and waist and hip circumferences were measured in 527 children. SUBJECTS/SETTING: All children in grades 1 to 6 (aged 6 to 11 years) in the 3 elementary schools of 2 Mohawk communities in Canada, for whom parental consent was obtained, were enrolled in the present study. There were no exclusion criteria. With a participation rate of 83%, the 527 children enrolled in this study represent an unbiased sample of the population from 2 Mohawk territories. RESULTS: Compared with children studied in NHANES II, Mohawk children were similar in height and triceps skinfolds but were generally heavier, had thicker subscapular skinfolds, and had greater waist and hip circumferences. These differences were greater in older children. Mohawk children who had extreme-high weight values compared with their population means were heavier than their NHANES II counterparts. APPLICATIONS/CONCLUSIONS: Results indicated that, on average, Mohawk children seem to be slightly heavier than children in NHANES II. Except for those with extreme overweight values, Mohawk children show less variation of weight and body mass index than children in NHANES II. Finally, overweight Mohawk children seem to be more likely to carry their excess body fat truncally, compared with overweight children from NHANES II. Health practitioners working with Native American populations should be careful when assessing childhood obesity. Simple comparisons of weight or body mass index with NHANES standards may lead to inappropriate risk assessments.     

Current concepts and practice in postoperative pain management: need for a change?

Despite a growing trend in acute pain management, many deficiencies still account for the high incidence of moderate to severe postoperative pain to date. Patients nowadays continue to receive inadequate doses of analgesics, but additionally the identification and treatment of those patients with pain still remains a significant health care problem. Advanced techniques are available including epidural or intrathecal administration of local anaesthetics and opioids, various opioid administration techniques such as patient-controlled analgesia and infusions via sublingual, oral-transmucosal, nasal, intra-articular and rectal routes. Nonopioid analgesics such as nonsteroidal anti-inflammatory drugs and newer nonopioid drugs such as alpha2-adrenergic agonists, calcium channel antagonists and various combinations of the above are possible. However, the solution to the problem of inadequate pain relief lies not so much in the development of new drugs and new techniques, but in the effective strategy of delivering these to patients through the introduction of acute pain management services on surgical wards.