Radiotherapy-specific interprofessional learning through simulation

IntroductionInterprofessional learning (IPL) is a vital aspect of training in radiation oncology professions, yet is rarely delivered to those professionals who work most closely together in clinical practice. Scenario-based learning using simulation facilities provides a unique opportunity to facilitate this learning and this project aimed to determine the impact and value of this initiative.MethodsSmall groups comprising post-graduate diploma pre-registration therapeutic radiographers, medical physics trainees and radiation oncology registrars were challenged with 4 plausible and challenging radiotherapy scenarios within an academic simulation centre. Pre- and post-event completion of the “Readiness for Interprofessional Learning Scale” measured impact and a Likert-style survey gathered feedback from participants.ResultsThe session increased participants' teamwork and collaboration skills as well as strengthening professional identities. Participants reported high levels of enjoyment related to collaborative working, communication and observing other professionals deploying their technical skills and specialist knowledge.ConclusionAlthough beneficial, simulated scenarios offering equal opportunities for engagement across the professions are challenging to plan and timetabling issues between the 3 groups present significant difficulties. The safe environment and unique opportunity for these groups to learn together was particularly well received and future oncology-specific simulated scenario sessions are planned with larger cohorts.Implications for practiceSimulated scenario training can be used to improve team working across the radiotherapy interprofessional team and may have wider use in other specialist interdisciplinary team development.     

强脉冲光治疗浅表(皮肤)血管瘤临床观察

目的：观察强脉冲光（IPL）治疗浅表（皮肤）血管瘤的疗效。方法：选择60例浅表（皮肤）血管瘤患者,随机分为治疗组和对照组,治疗组用535nm、580nm强脉冲光治疗皮损,每三周治疗一次,三次为一个疗程;对照组采用波长为532nm的Q开关Nd：YAG激光治疗,每两周治疗一次,三次为一个疗程。观察两组皮损的治愈率、并发症等情况,并行统计学处理。结果：治疗组皮损三次治愈率明显高于对照组（P〈0.01）,患处瘢痕形成及炎症性色素沉着发生率均低于对照组。结论：强脉冲光（IPLTM）治疗浅表（皮肤）血管瘤效果满意。     

光-电一体化技术在美容医学领域的兴起与发展

目的介绍光-电一体化技术的机理、适应证的选择、疗效、及并发症和注意事项。方法经文献复习，此项技术的产品有两种类型：①射频与强脉冲光；②射频与激光联合。两种技术发出的能量，分别作用于真皮深层和浅层以及筋膜层，使真皮胶原增厚，以达到皮肤年轻化，并可用于治疗色素沉着、血管病灶、脱毛和痤疮等。电能（RF）40～100J／cm^3，光能15～50J／cm^2。结果根据Fzpatrick皮肤分类和Glogau皱纹分类，选用不同的参数，才能取得好的结果。Bitter和Mulholland报道的Aurora SR设备，皮肤年轻化效果达92％～98％，仅有2％～8％不满意；脱毛效果达80％～85％，20％轻度红斑，24h消失，有8％暂时性色素沉着；下肢静脉扩张最后一次治疗1～6个月，约77％治疗区中有75％～100％扩张血管消失，对桔皮症也取得了较好的效果。结论此项技术的疗效是肯定的，并发症和不良反应少而轻，无不可治愈的不良反应。不同肤色和皱纹选用恰当的治疗参数，是取得满意疗效的保证。     

In vivo requirements for rDNA chromosome condensation reveal two cell-cycle-regulated pathways for mitotic chromosome folding

Chromosome condensation plays an essential role in the maintenance of genetic integrity. Using genetic, cell biological, and biochemical approaches, we distinguish two cell-cycle-regulated pathways for chromosome condensation in budding yeast. From G(2) to metaphase, we show that the condensation of the approximately 1-Mb rDNA array is a multistep process, and describe condensin-dependent clustering, alignment, and resolution steps in chromosome folding. We functionally define a further postmetaphase chromosome assembly maturation step that is required for the maintenance of chromosome structural integrity during segregation. This late step in condensation requires the conserved mitotic kinase Ipl1/aurora in addition to condensin, but is independent of cohesin. Consistent with this, the late condensation pathway is initiated during the metaphase-to-anaphase transition, supports de novo condensation in cohesin mutants, and correlates with the Ipl1/aurora-dependent phosphorylation of condensin. These data provide insight into the molecular mechanisms of higher-order chromosome folding and suggest that two distinct condensation pathways, one involving cohesins and the other Ipl1/aurora, are required to modulate chromosome structure during mitosis.     

Immunohistochemical evidence for epinephrine-containing retinal amacrine cells

The enzyme for the synthesis of epinephrine, phenylethanolamine-N-methyltransferase, has been localized, by an indirect immunofluorescent staining method, to a subpopulation of amacrine cells in the rat retina. The immunoreactive cells are located primarily in the inner nuclear layer and send a single process to the inner plexiform layer. Most of the immunoreactivity is found in the center of the inner plexiform layer. A small percentage of immunoreactive cell bodies were found in the inner plexiform layer and occasionally cells were observed in the ganglion cell layer. These epinephrine-containing amacrine cells are morphologically distinct from the dopamine-containing amacrine cells previously described by formaldehyde fluorescence and we speculate from reports in the literature that epinephrine-containing amacrine cells may play a role in modulating the activity of dopamine-containing amacrine cells.     

Lateral actions at the inner plexiform layer of the carp retina: effects of turning windmill pattern stimulus

Lateral action from amacrine to ganglion cells was studied in the isolated carp retina by using a truncated windmill pattern (TWP). About 25% of ganglion cells of both "on" and "off" center types were suppressed or enhanced in firing activity in response to TWP turning. The suppressed cells were more sensitive to slow turning velocities of TWP than the enhanced cells. In the "on-off" type amacrine cells, a steady depolarizing or hyperpolarizing component (less than several mV) was maintained by stationary TWP, while the cells were exclusively depolarized by turning TWP at a wide range of velocities. These results suggest that individual responses of ganglion cells induced by both stationary and turning TWP are depending on a balance between two factors: the polarizing direction of steady components of the "on-off" amacrine cells and the polarizing direction of ganglion cells synaptically produced by the amacrine cells.     

Therapeutic efficacy of intense pulsed light in patients with refractory meibomian gland dysfunction

Purpose

To evaluate the efficacy and safety of intense pulsed light (IPL) combined with meibomian gland expression (MGX) for treatment of refractory meibomian gland dysfunction (MGD).

How many forms of perseveration? Evidence from cancellation tasks in right hemisphere patients

Neglect patients' performance during cancellation tasks is characterized by left sided omissions and, in many cases, by the production of inappropriate material of various kinds in the ipsilesional space, e.g. additional marks over already cancelled targets, marks drawn away from targets, scribbles, irrelevant drawings. It is unclear whether these behaviours, which have collectively been called perseverative, are functionally and anatomically connected and whether they correlate with the severity of neglect. Here we report a retrospective study on 33 right brain damaged patients with neglect after right hemisphere lesions in whom we measured the intensity of perseveration of the three following kinds: (1) ‘additional marks' (AM) perseveration where patients cancelled a target with two or more well separated marks; (2) ‘scribble’ perseveration, where patients, instead of cancelling the target with a single pen stroke as required by the task, performed multiple pen strokes without breaking the pen-to-paper contact, with the final product being a scribble; (3) ‘flying marks’ (FM) perseveration where patients produced cancellation marks well away from the targets. We found that AM and FM perseveration correlated with neglect severity, while ‘scribble’ perseveration did not. The lesion-symptom mapping showed three separate anatomical areas in the right hemisphere: ‘scribble’ perseveration was associated with lesions of the orbitofrontal cortex and caudate nucleus; AM perseveration was associated with damage to the rolandic operculum, superior temporal gyrus and inferior frontal gyrus; FM perseveration was associated with damage to the dorsal premotor cortex and the temporal pole. Neglect severity followed damage to a region which grossly corresponds to the sum of the regions associated with AM and FM perseveration respectively. This complex behavioural and anatomical pattern is interpreted in terms of a three-factor model, in which AM perseveration is caused by a deficit of disengagement of attention from the right side (also causing omissions), FM perseveration is caused by directional hypokinesia (also causing left-side omissions), and ‘scribble’ perseveration is the consequence of a failure to inhibit an initiated motor act, which is completely separate (both anatomically and functionally) from the disorder inducing omissions.     

Photorejuvenation – An Overview

Classical, ablative laser resurfacing has proven to be very effective for skin rejuvenation, but ablative treatments are associated with significant side effects and down-time. The introduction of newer non-ablative optical methods has generated much interest during the last few years due to very few side effects and low post-operative morbidity.

Non-ablative skin rejuvenation is a series of different optical treatment modalities, which operate through different biological pathways to achieve the following objectives: 1) reduction of visible vessels, 2) reduction of uneven pigmentation, and 3) increased synthesis rate and remodeling of collagen in the upper dermis leading to reduced wrinkling of the skin surface.

This paper describes different non-ablative laser-, intense pulsed light and LED technologies for non-ablative treatments of photo-aged skin.