Dosimetric validation of a magnetic resonance image gated radiotherapy system using a motion phantom and radiochromic film.

PurposeMagnetic resonance image (MRI) guided radiotherapy enables gating directly on the target position. We present an evaluation of an MRI-guided radiotherapy system's gating performance using an MRI-compatible respiratory motion phantom and radiochromic film. Our evaluation is geared toward validation of our institution's clinical gating protocol which involves planning to a target volume formed by expanding 5 mm about the gross tumor volume (GTV) and gating based on a 3 mm window about the GTV.MethodsThe motion phantom consisted of a target rod containing high-contrast target inserts which moved in the superior-inferior direction inside a body structure containing background contrast material. The target rod was equipped with a radiochromic film insert. Treatment plans were generated for a 3 cm diameter spherical planning target volume, and delivered to the phantom at rest and in motion with and without gating. Both sinusoidal trajectories and tumor trajectories measured during MRI-guided treatments were used. Similarity of the gated dose distribution to the planned, motion-frozen, distribution was quantified using the gamma technique.ResultsWithout gating, gamma pass rates using 4%/3 mm criteria were 22-59% depending on motion trajectory. Using our clinical standard of repeated breath holds and a gating window of 3 mm with 10% target allowed outside the gating boundary, the gamma pass rate was 97.8% with 3%/3 mm gamma criteria. Using a 3 mm window and 10% allowed excursion, all of the patient tumor motion trajectories at actual speed resulting in at least 95% gamma pass rate at 4%/3 mm.ConclusionsOur results suggest that the device can be used to compensate respiratory motion using a 3 mm gating margin and 10% allowed excursion results in conjunction with repeated breath holds. Full clinical validation requires a comprehensive evaluation of tracking performance in actual patient images, outside the scope of this study

Serum concentration levels of 25(OH)D and injury reports in NCAA Division I football players

textVitamin D deficiency has been linked with many health problems. Early research demonstrated the importance of vitamin D for bone health, but it may also play a larger role than first reported in muscle health and function. Specifically, low vitamin D may hinder athletic performance, as such evaluation of serum vitamin D levels in high volume training athletes has merit. The purpose of this study was to evaluate serum levels of 25(OH)D in college athletes to determine how many had levels below the recommended values. Data from student-athletes who were attending a large university in the south included: serum vitamin D levels, demographics information, and injury reports. Mean serum vitamin D level for the group was 34.17 ng/mL ± 0.88. Average injury for the group was 1.3± 0.14. The mean value of serum vitamin D for Caucasian players was 38.3 ng/mL ± 1.33 with a range of 23-59 ng/mL. The mean value of serum vitamin D for African American players was 31.16 ng/mL ± 1.08 with a range of 16-52 ng/mL. African American players had significantly lower serum vitamin D levels (p32 ng/ml). Players with one or more musculoskeletal injury or fracture had significantly lower serum vitamin D levels (p<0.05) compared to players that had zero injuries. African American players had significantly lower serum vitamin D levels (p<0.01) compared to Caucasian players. It is important for athletes to monitor serum vitamin D levels and adhere to a supplementation protocol when levels are insufficient.Kinesiology and Health Educatio

Evaluation of staff performance and interpretation of the screening program for prevention of thalassemia

IntroductionThalassemia screening program has been implemented for years in Southeast Asia, but no external quality assessment program has been established. We have developed and initiated the proficiency testing (PT) program for the first time in Thailand with the aim to assess the screening performance of laboratory staff and their competency in interpretation of the screening results. Materials and methodsThree PT cycles per year were organized. From the first to the third cycle of the PT scheme, a total number of participant laboratories increased from 59 to 67. In each cycle, 2 PT items (assigned as blood samples of the couple) were provided. Performance evaluation was based on the accuracy of screening results, i.e. mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and the dichlorophenolindophenol (DCIP) test for haemoglobin E, including the competency in interpretation of screening results and assessment of foetal risk. Performance was assessed by comparing the participants’ result against the assigned value. ResultsOf all 3 cycles, most laboratories reported acceptable MCV and MCH values. From the first to the third cycle, incorrect DCIP test and misinterpretation rates were decreased while incorrect risk assessment varied by cycle to cycle. Combining the accuracy of thalassemia screening and the competency in interpretation and risk assessment, approximately half of participants showed excellent performance. ConclusionImproved performance observed in many laboratories reflects the achievement and benefit of the PT program which should be regularly provided

Effects of a program of pulmonary rehabilitacion in severe epoc

Se describe el caso de un varón de 59 años,con diagnóstico de enfermedad pulmonar obstructiva crónica (EPOC) severa, producto del consumo de cigarrillo. En la evaluación, presenta deficiencias en la capacidad aeróbica, en el desempeño muscular, en la ventilación e intercambio gaseoso, con alteración de sus volúmenes pulmonares, las cuales le ocasionaron limitación funcional y restricción en la realización de las actividades de la vida diaria. Se inició un plan de cuidado y acondicionamiento físico, consistente en incrementar la fuerza y resistencia de miembros inferiores y superiores, entrenamiento de músculos respiratorios y un plan de educación individual y grupal acerca del conocimiento y manejo de la enfermedad, además se le brindó soporte psicoterapéutico. Los resultados del programa mostraron efectos positivos en su condición de salud, en general, y en la disminución de su limitación funcional.We report the case of a 59 year old male with severe chronic obstructive pulmonary disease (COPD) due to cigarette smoking. At the clinical evaluation he presented deficit in his aerobic capabilities, in his muscular performance, in ventilation and gas exchange with variation in lung volume causing functional limitation and restriction in his daily activities. It was designed a therapeutic plan of physical training in order to increase strength and endurance in extremities, training of respiratory muscles and also Individual education and grupal program regarding knowledge and management of his illness along with psychological support. The results of this program showed improvement in his health condition and lessening his functional limitations

Semen evaluation in river terrapin (Batagur affinis).

The Batagur affinis or the southern river terrapin is one of the rarest chelonians in the world, found in the rivers of Malaysia. Over years the population of this species has decreased dramatically. Currently there are no data on the reproductive parameters and performance, to include semen collection and evaluation method, for these species. Therefore, this study documented the first-ever semen collection and evaluation in the freshwater turtle, the Batagur affinis. This study was conducted in December 2010 on 15 male river terrapins. Before electroejaculation, the Batagur affinis were sedated with Ketamine (5 mg/kg) IM and then restrained on a wooden stool. An electrical rectal probe was inserted into the cloaca and stimulated with 1-4 volts electrical stimuli in 5-6 cycles followed by manual stimulation. Semen samples were collected immediately after electrical stimuli and/or after manual stimulation. The results of semen evaluation showed that the average semen volume was 3.3 mL (range 0.85-7.45 mL). The seminal fluid was watery, clear, viscous and slimy to touch. An average sperm motility of 4% (range 0-24%) and average concentration of 2.3 million/mL were observed. The sperms had slightly curved narrow heads and the live sperm percentage was 59%. This study forms the basis for the development of a protocol for semen cryopreservation and artificial insemination in chelonians. The method should contribute to preservation of one of the world’s most critically endangered chelonians

Dimedone Derivative {2-[(4-Hydroxy-phenylamino)- methylene]-5,5-dimethyl-cyclohexane-1,3-dione} Plays an Important Role in Breast Cancer Treatment

Purpose: To investigate the effect of 2-[(4-hydroxy-phenylamino)-methylene]-5,5-dimethyl-cyclohex (HPDH) on mammary carcinogenesis induced by 7,12-dimethylbenz(a)anthracene in female Sprague Dawley rats.Methods: Among three groups of rats (50 each) used in the study, the control group was fed standard diet alone, ibuprofen group received standard diet containing 1200 mg/kg ibuprofen while HPDH group was administered standard diet containing 1200 mg/kg HPDH. The treatment was for 10 days for all the groups. All the animals received 20 mg of DMBA intragastrically by gavage. Clinical parameters for the rats were recorded weekly. Micrometer caliper was used to measure the diameter of all the tumors at the end of the experiment and tumor volume calculated. Histological evaluation was performed using  hematoxylin and eosin (H&amp;E) staining. High performance liquid chromatography (HPLC) was used to determine the level of HPDH and ibuprofen in the serum of the animals.Results: The data revealed a significant decrease in the number of rats with mammary tumor, number of tumors/rat and tumor volume by 54, 72 and 75 %, respectively, in HPDH group compared to control group. The ibuprofen- treated rats also showed significant decrease in the number of rats with tumor, number of tumors/rat and tumor volume by 43, 55, and 59 %, respectively. Treatment of rats with HPDH increased the latency period of tumor induction significantly (p &lt; 0.005). Median detection period (50 % of tumors) was 92, 83 and 56 days, respectively, in HPDH, ibuprofen and control groups, respectively, after DMBA induction.Conclusion: These results demonstrate that HPDH possesses strong chemopreventive activity against mammary carcinogenesis.Keywords: Carcinogenesis, Mammary tumor, Median detection period, Tumor, Latency period, Chemopreventive activity, Ibuprofe

Initial validation of a virtual-reality learning environment for prostate biopsies: realism matters!

: Introduction-objectives: A virtual-reality learning environment dedicated to prostate biopsies was designed to overcome the limitations of current classical teaching methods. The aim of this study was to validate reliability, face, content and construct of the simulator. Materials and methods: The simulator is composed of a) a laptop computer, b) a haptic device with a stylus that mimics the ultrasound probe, c) a clinical case database including three dimensional (3D) ultrasound volumes and patient data and d) a learning environment with a set of progressive exercises including a randomized 12-core biopsy procedure. Both visual (3D biopsy mapping) and numerical (score) feedback are given to the user. The simulator evaluation was conducted in an academic urology department on 7 experts and 14 novices who each performed a virtual biopsy procedure and completed a face and content validity questionnaire. Results: The overall realism of the biopsy procedure was rated at a median of 9/10 by non-experts (7.1-9.8). Experts rated the usefulness of the simulator for the initial training of urologists at 8.2/10 (7.9-8.3), but reported the range of motion and force feedback as significantly less realistic than novices (p=0.01 and 0.03 respectively). Pearson's r correlation coefficient between correctly placed biopsies on the right and left side of the prostate for each user was 0.79 (p<0.001). The 7 experts had a median score of 64% (59-73), and the 14 novices a median score of 52% (43-67), without reaching statistical significance (p=0,19). Conclusion: The newly designed virtual reality learning environment proved its versatility and its reliability, face and content were validated. Demonstrating the construct validity will require improvements to the realism and scoring system used