To evaluate the dosimetric impact of respiratory breast motion and daily setup error on whole breast irradiation (WBI) using three irradiation techniques; conventional wedge (CW), field-in-field (FIF) and irregular surface compensator (ISC). WBI was planned for 16 breast cancer patients. The dose indices for evaluated clinical target volume (CTVevl), lung, and body were evaluated. For the anterior-posterior (AP) respiratory motion and setup error of a single fraction, the isocenter was moved according to a sine function, and the dose indices were averaged over one period. Furthermore, the dose indices were weighted according to setup error frequencies that have a normal distribution to model systematic and random setup error for the entire treatment course. In all irradiation techniques, AP movement has a significant impact on dose distribution. CTVevlD95 (the minimum relative dose that covers 95 % volume) and V95 (the relative volume receiving 95 % of the prescribed dose) were observed to significantly decrease from the original ISC plan when simulated for the entire treatment course. In contrast, the D95, V95 and dose homogeneity index did not significantly differ from those of the original plans for FIF and CW. With regard to lung dose, the effect of motion was very similar among all three techniques. The dosimetric impact of AP respiratory breast motion and setup error was largest for the ISC technique, and the second greatest effect was observed with the FIF technique. However, these variations are relatively small. 相似文献
The aim was to develop clinical guidelines for multidetector computed tomography urography (CTU) by a group of experts from
the European Society of Urogenital Radiology (ESUR). Peer-reviewed papers and reviews were systematically scrutinized. A summary
document was produced and discussed at the ESUR 2006 and ECR 2007 meetings with the goal to reach consensus. True evidence-based
guidelines could not be formulated, but expert guidelines on indications and CTU examination technique were produced. CTU
is justified as a first-line test for patients with macroscopic haematuria, at high-risk for urothelial cancer. Otherwise,
CTU may be used as a problem-solving examination. A differential approach using a one-, two- or three-phase protocol is proposed,
whereby the clinical indication and the patient population will determine which CTU protocol is employed. Either a combined
nephrographic-excretory phase following a split-bolus intravenous injection of contrast medium, or separate nephrographic
and excretory phases following a single-bolus injection can be used. Lower dose (CTDIvol 5–6 mGy) is used for benign conditions
and normal dose (CTDIvol 9–12 mGy) for potential malignant disease. A low-dose (CTDIvol 2–3 mGy) unenhanced series can be
added on indication. The expert-based CTU guidelines provide recommendations to optimize techniques and to unify the radiologist’s
approach to CTU.
Electronic Supplementary Material The online version of this article (doi:) contains supplementary material, which is available to authorized users.
ESUR: 相似文献
There have been numerous articles published on surgical correction of the constricted ear where the auricular defect was described in detail or classified in addition to their suggested surgical treatment methods or techniques. As for the surgical method introduced by Stephenson and modified by Musgrave it is worthy to note that the technique for the expansion and reinforcement of the auricular cartilage is useful, especially for corrective surgery for cryptotia cases. All articles concerned with surgery involving with the auricle are of importance to young surgeons who seek to pursue a clinical practice involving corrective and reconstructive surgery of the auricle. One must consider not only the selection of the surgical method or technique but also the importance in planning the surgery to correct the defect and in the selection of the material required to correct the defect or to reconstruct the auricle. The ultimate goal is to attain consistent, satisfactory, and favorable results, the appearance of a normal auricle. 相似文献
Background: Vascular smooth muscle tone is regulated by changes in intracellular free Ca2+ concentration ([Ca2+]i) and myofilament Ca2+ sensitivity. These cellular mechanisms could serve as targets for anesthetic agents that alter vasomotor tone. This study tested the hypothesis that propofol increases myofilament Ca2+ sensitivity in pulmonary artery smooth muscle (PASM) via the protein kinase C (PKC) signaling pathway.
Methods: Canine PASM strips were denuded of endothelium, loaded with fura-2/AM, and suspended in modified Krebs- Ringer's buffer at 37[degrees]C for simultaneous measurement of isometric tension and [Ca2+]i.
Results: The KCl (30 mm) induced monotonic increases in [Ca2+]i and tension. Verapamil, an L-type Ca2+ channel blocker, attenuated KCl-induced increases in [Ca2+]i and tension to an equal extent. In contrast, propofol attenuated KCl-induced increases in [Ca2+]i to a greater extent than concomitant changes in tension and caused an upward shift in the peak tension-[Ca2+]i relation. Increasing extracellular Ca2+ in the presence of 30 mm KCl resulted in similar increases in [Ca2+]i in control and propofol-pretreated strips, whereas concomitant increases in tension were greater during propofol administration. The Ca2+ ionophore, ionomycin (0.1 [mu]m), increased [Ca2+]i to approximately 50% of the value induced by 60 mm KCl. Under these conditions, propofol (10, 100 [mu]m) caused increases in tension equivalent to 11 +/- 2 and 28 +/- 3% of the increases in tension in response to 60 mm KCl, whereas [Ca2+]i was slightly decreased. Similar effects were observed in response to the PKC activator, phorbol 12-myristate 13-acetate (PMA, 1 [mu]m). Specific inhibition of PKC with bisindolylmaleimide I before ionomycin administration decreased the propofol- and PMA-induced increases in tension and abolished the propofol- and PMA-induced decreases in [Ca2+]i. Selective inhibition of Ca2+-dependent PKC isoforms with Go 6976 also attenuated propofol-induced increases in tension. 相似文献
In contrast to malignant lymphomas or skin cancer, smooth muscle tumors including leiomyosarcoma are rarely associated with
transplant recipients. We herein present a 33-year-old woman with end-stage renal disease who received a transplant at 27
years of age. Four years after the transplantation, at age 31, she underwent a mastectomy because of primary right breast
cancer, which was found to be a 5-mm-sized mucinous carcinoma with no regional lymph node metastasis. Six years after the
transplantation, a liver tumor was unexpectedly discovered. An explorative laparotomy revealed a well-encapsulated tumor occupying
the posterior portion of the right lobe of the liver. The patient underwent a posterior segmentectomy. Histologically, the
tumor possessed intermingling fascicles of spindle cells with eosinophilic cytoplasm and elongated nuclei. Based on an immunohistochemical
examination, the tumor cells were positive for the muscle-associated antibody. In addition, RNA probes for Epstein-Barr virus
were negative based on in situ hybridization. The histologic, immunohistochemical findings were considered to be diagnostic
for leiomyosarcoma, which is a low-grade malignancy. Two years after surgery, the patient is doing well with no recurrence
of liver tumors or breast cancer.
Received: April 16, 2001 / Accepted: September 11, 2001 相似文献
Background Many studies have shown that angiogenesis plays an important role in the process of cancer development and progression. Vascular
endothelial growth factor (VEGF) has a potent angiogenic activity, and cyclooxygenase-2 (COX-2) supports angiogenesis by regulated
production of angiogenic factors, including VEGF. The purpose of this study was to examine the expression of VEGF in combination
with COX-2 and CD34, their correlation with various clinicopathological factors, and their prognostic significance in human
gastric carcinoma.
Methods Specimens from 169 patients with different grade and stage gastric carcinoma were investigated by immunohistochemistry for
COX-2 and VEGF expression. Tumor microvessel density was assessed with CD34 immunostaining. Correlations between the expression
of VEGF, COX-2, CD34, and various clinicopathological factors were studied. The effect of these proteins on patient survival
was determined.
Results COX-2 and VEGF were positively expressed in 36.7% and 50.3% of the patients, respectively. Positive correlation was found
between VEGF and COX-2 and between VEGF and CD34. VEGF expression was correlated with depth of invasion; metastatic lymph
nodes; lymphatic and venous invasion; and tumor, node, metastasis system stage. Patients with positive staining for VEGF showed
far lower disease-free (64.9% vs. 81.3%) and overall (58.3% vs. 76.9%) survival rates than VEGF-negative patients. In multivariate
analysis, only tumor location, depth of invasion, and lymph node metastasis were shown to be independent prognostic factors.
Conclusions VEGF expression correlates with angiogenesis and tumor progression and is a valuable prognostic factor in patients with gastric
carcinoma. 相似文献
A 68-year-old Japanese woman complaining of general fatigue and intermittent high fever was admitted to our hospital. Abdominal
ultrasonography showed two tumors in the lateral segment of the liver, with soft tissue in the left hepatic vein that was
considered to be a tumor embolus. A diagnosis of cholangiocarcinoma was made based on various radiological and laboratory
examinations and therefore a surgical resection was performed. Microscopically, the tumor consisted of inflammatory cells,
which had aggressively invaded the hepatic vein and Arantius' duct. The pathological diagnosis was inflammatory pseudotumor
(IPT) that had invaded the hepatic vein. Although many cases of hepatic IPT have been previously reported, cases of hepatic
IPT massively invading the hepatic vein are very rare as far as we could determine, based on a literature search. We herein
report this case and discuss the diagnosis and treatment regarding hepatic IPT with massive venous invasion. 相似文献