SRS淋巴瘤株癌基因表达筛选研究

研究ＳＲＳ鼠白血病／淋巴瘤克隆株（包括ＳＲＳ─８２亲系和ＳＡＣ─ⅡＢ２、ＳＡＣ─ⅡＣ３克隆株）癌基因和癌基因蛋白的表达，筛选此克隆株的癌基因表达谱型，为ＳＲＳ淋巴瘤株的实验性反义核酸治疗提供目标。用ＡＢＣ免疫组织化学方法筛选ＳＲＳ─８２亲系和ＳＡＣ─ⅡＢ２、ＳＡＣ─ⅡＣ３克隆株癌基因表达诺型。在ＳＲＳ克隆株中呈强表达的有ｃ─ｆｏｓ和ｃ─ｍｙｃ。ｃ─ｊｕｎ、ｒａｓ─ｐ２１和ｃ─ｅｒｂＢ─２呈中度表达，Ｐ５３和ｂｃｌ─２则不表达。同时用ＣＤ４和ＣＤ８细胞表面标记进研究，发现ＳＲＳ克隆株属于原始干细胞。结果提示：癌基因谱型的建立对ＳＲＳ淋巴瘤克隆株的实验性反义核酸治疗具有相当重要的作用，ｃ─ｆｏｓ和ｃ─ｍｙｃ可能是反义核酸治疗最好的癌基因靶。     

Norian-SRS-Augmentation bei Revision der Hüfttotalendoprothesen-Pfannenkomponente

Zusammenfassung Vorgestellt wird eine Technik zum primär belastungsstabilen Pfannenaufbau im Rahmen der Revisionshüftendoprothetik. In 6 Fällen wurden knöcherne Defektbereiche – gegebenenfalls nach Durchführung einer Spongiosaplastik – mit dem Knochenzement Norian SRS aufgefüllt. Anschließend folgte die zementierte Implantation eines azetabulären Rekonstruktionsrings bzw. Pfannenkorbs mit Inlay. Die Patienten wurden gemäß der Scores von Harris und Merle dAubigné nachuntersucht. Die Patientenzufriedenheit wurde ermittelt und bei Einverständnis Röntgenaufnahmen angefertigt. Vier von 5 in die Auswertung einbezogenen Patienten erreichten ein gutes oder sehr gutes Ergebnis.     

A rapid microarray based whole genome analysis for detection of uniparental disomy

To date, uniparental disomy (UPD) with phenotypic relevance is described for different chromosomes and it is likely that additional as yet unidentified UPD phenotypes exist. Due to technical difficulties and limitations of time and resources, molecular analyses for UPD using microsatellite markers are only performed in cases with specific phenotypic features. In this study, we carried out a whole genome UPD screening based on a microarray genotyping technique. Six patients with the diagnosis of both complete or segmental UPD including Prader-Willi syndrome (PWS; matUPD15), Angelman syndrome (AS; patUPD15), Silver-Russell syndrome (SRS; matUPD7), Beckwith-Wiedemann syndrome (BWS; patUPD11p), pseudohypoparathyroidism (PHP; patUPD20q) and a rare chromosomal rearrangement (patUPD2p, matUPD2q), were genotyped using the GeneChip Human Mapping 10K Array. Our results demonstrate the presence of UPD in the patients with high efficiency and reveal clues about the mechanisms of UPD formation. We thus conclude that array based SNP genotyping is a fast, cost-effective, and reliable approach for whole genome UPD screening.     

Clinical implementation of radiosurgery using the Helical TomoTherapy unit

The American Society of Radiation Oncology has recently recommended the use of radiosurgery to manage brain metastases. For such a recommendation to be implemented in a widespread manner, radiosurgery must be accessible at community radiation therapy facilities. The work presented here describes our clinical experience in the implementation of radiosurgery using a Helical TomoTherapy unit. Helical TomoTherapy is a unique dose-delivery system designed to perform intensity-modulated radiation therapy (IMRT). The system built on the ring-based gantry has the tight machine tolerances required for radiosurgery. A frameless system consisting of a thermoplastic mask and a noninvasive “stereotactic radiosurgery (SRS)-stereotactic radiotherapy (SRT)” fixation device is used for patient immobilization. Treatment planning is performed using the TomoHD treatment planning system designed for IMRT. The image-guidance system on the Helical TomoTherapy is used for patient localization. Our clinical experience demonstrated that the radiosurgery procedure can be streamlined as we do for IMRT patients. The treatment time of about 10 minutes is comparable with that for IMRT patients. The same patient-specific quality assurance for IMRT is used for radiosurgery. As demonstrated, SRS using Helical TomoTherapy is not a whole-day event, unlike SRS using other dose-delivery systems or SRS performed in the past.     

Monaco treatment planning system tools and optimization processes

The Monaco treatment planning system combines Monte Carlo dose calculation accuracy with robust optimization tools to provide high-quality radiotherapy treatment plans for three-dimensional conformal radiotherapy (3D CRT), intensity modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), stereotactic radiosurgery (SRS), and stereotactic body radiotherapy (SBRT). Recent technology advances have allowed for fast calculation speeds, which allow clinicians and patients to benefit from the accuracy of the Monte Carlo algorithm while reducing overall planning time. A collection of biological and physical dose-based planning tools and templates simplify the planning process and allow for consistent results across organizations. At the same time, multicriteria optimization (MCO) ensures critical organs are spared to the greatest possible degree while maintaining target coverage. Monaco encompasses a full suite of treatment modalities, including conventional radiotherapy and particle therapy, and is paving the way for real-time adaptive treatments with developments in magnetic resonance (MR)-guided radiation therapy.     

Neurological deficit following stereotactic radiosurgery for trigeminal neuralgia

We report a unique case of neurological deficit from late onset multiple sclerosis (MS), in a 65-year-old woman, after stereotactic radiosurgery (SRS) for trigeminal neuralgia (TN). At 3.5 months post-SRS for TN, the patient developed ataxia and left leg paraesthesiae and brain MRI showed altered signal and enhancement in the vicinity of the right trigeminal root entry zone (REZ). The symptoms remitted following treatment with intravenous methylprednisolone, however, 10 months post-SRS, the patient developed gait ataxia and left lower limb weakness. MRI showed persistent T2 changes at the REZ and multiple new non-enhancing white matter lesions in the cerebrum and spinal cord; and oligoclonal bands were present in the cerebrospinal fluid but not serum. A diagnosis of multiple sclerosis (MS) was made. This report raises the issue of whether the risk of radiation-induced toxicity is increased in patients with MS treated with SRS. We hypothesise that breakdown in the blood brain barrier secondary to the radiosurgery may have triggered a vigorous local inflammatory response.     

Nesidioblastosis as a cause of focal pancreatic 111In-pentetreotide uptake in a patient with putative VIPoma: another differential diagnosis

In adults, nesidioblastosis is a very infrequent condition and a rare cause of symptomatic presentations. The diagnosis of nesidioblastosis may be difficult with functional and anatomical imaging modalities. “Slight focal” pancreatic abnormalities using ¹¹¹In-pentetreotide imaging has been reported in patients with hyperinsulinaemic hypoglycaemia, confirmed histologically as nesidioblastosis. We describe a 60-year-old man who presented with a 1-year history of intermittent faecal urgency and refractory diarrhoea, non-specific laboratory results, negative imaging results (CT, MRI and EUS), a FNA biopsy that was inconclusive, but suggested an endocrine cell neoplasm, and a ¹¹¹In-pentetreotide scan that showed a moderately intense focal uptake clearly localised to the pancreatic head on a low-dose fusion CT. The histopathology of the specimen confirmed the diagnosis of nesidioblastosis.