Coexisting Cardiac and Hematologic Disorders.

Patients with concomitant cardiac and hematologic disorders presenting for noncardiac surgery are challenging. Anemic patients with cardiac disease should be approached in a methodical fashion. Transfusion triggers and target should be based on underlying symptomatology. The approach to anticoagulation management in patients with artificial heart valves, cardiac devices, or severe heart failure in the operative setting must encompass a complete understanding of the rationale of a patient\u27s therapy as well as calculate the risk of changing this regimen. This article focuses common disorders and discusses strategies to optimize care in patients with coexisting cardiac and hematologic disease

Relativistic Cyclotron Radiation Detection of Tritium Decay Electrons as a New Technique for Measuring the Neutrino Mass

The shape of the beta decay energy distribution is sensitive to the mass of the electron neutrino. Attempts to measure the endpoint shape of tritium decay have so far seen no distortion from the zero-mass form, thus placing an upper limit of m_nu_beta < 2.3 eV. Here we show that a new type of electron energy spectroscopy could improve future measurements of this spectrum and therefore of the neutrino mass. We propose to detect the coherent cyclotron radiation emitted by an energetic electron in a magnetic field. For mildly relativistic electrons, like those in tritium decay, the relativistic shift of the cyclotron frequency allows us to extract the electron energy from the emitted radiation. We present calculations for the energy resolution, noise limits, high-rate measurement capability, and systematic errors expected in such an experiment.Comment: 4 pages, 2 figure

Novel Properties of Frustrated Low Dimensional Magnets with Pentagonal Symmetry

In the context of magnetism, frustration arises when a group of spins cannot find a configuration that minimizes all of their pairwise interactions simultaneously. We consider the effects of the geometric frustration that arises in a structure having pentagonal loops. Such five-fold loops can be expected to occur naturally in quasicrystals, as seen for example in a number of experimental studies of surfaces of icosahedral alloys. Our model considers classical vector spins placed on vertices of a subtiling of the two dimensional Penrose tiling, and interacting with nearest neighbors via antiferromagnetic bonds. We give a set of recursion relations for this system, which consists of an infinite set of embedded clusters with sizes that increase as a power of the golden mean. The magnetic ground states of this fractal system are studied analytically, and by Monte Carlo simulation.Comment: 7 pages, 7 figures, contribution to ICQ11 (Sapporo, Japan 2010) conference proceeding

Combined Modality Therapies for High-Risk Prostate Cancer: Narrative Review of Current Understanding and New Directions.

Despite the many prospective randomized trials that have been available in the past decade regarding the optimization of radiation, hormonal, and surgical therapies for high-risk prostate cancer (PCa), many questions remain. There is currently a lack of level I evidence regarding the relative efficacy of radical prostatectomy (RP) followed by adjuvant radiation compared to radiation therapy (RT) combined with androgen deprivation therapy (ADT) for high-risk PCa. Current retrospective series have also described an improvement in biochemical outcomes and PCa-specific mortality through the use of augmented radiation strategies incorporating brachytherapy. The relative efficacy of modern augmented RT compared to RP is still incompletely understood. We present a narrative review regarding recent advances in understanding regarding comparisons of overall and PCa-specific mortality measures among patients with high-risk PCa treated with either an RP/adjuvant RT or an RT/ADT approach. We give special consideration to recent trends toward the assembly of multi-institutional series targeted at providing high-quality data to minimize the effects of residual confounding. We also provide a narrative review of recent studies examining brachytherapy boost and systemic therapies, as well as an overview of currently planned and ongoing studies that will further elucidate strategies for treatment optimization over the next decade

Biodistribution and PET Imaging of pharmacokinetics of manganese in mice using Manganese-52

<div><p>Manganese is essential to life, and humans typically absorb sufficient quantities of this element from a normal healthy diet; however, chronic, elevated ingestion or inhalation of manganese can be neurotoxic, potentially leading to <i>manganism</i>. Although imaging of large amounts of accumulated Mn(II) is possible by MRI, quantitative measurement of the biodistribution of manganese, particularly at the trace level, can be challenging. In this study, we produced the positron-emitting radionuclide ⁵²Mn (<i>t</i>_<i>1/2</i> = 5.6 d) by proton bombardment (<i>E</i>_<i>p</i><15 MeV) of chromium metal, followed by solid-phase isolation by cation-exchange chromatography. An aqueous solution of [⁵²Mn]MnCl₂ was nebulized into a closed chamber with openings through which mice inhaled the aerosol, and a separate cohort of mice received intravenous (IV) injections of [⁵²Mn]MnCl₂. <i>Ex vivo</i> biodistribution was performed at 1 h and 1 d post-injection/inhalation (p.i.). In both trials, we observed uptake in lungs and thyroid at 1 d p.i. Manganese is known to cross the blood-brain barrier, as confirmed in our studies following IV injection (0.86%ID/g, 1 d p.i.) and following inhalation of aerosol, (0.31%ID/g, 1 d p.i.). Uptake in salivary gland and pancreas were observed at 1 d p.i. (0.5 and 0.8%ID/g), but to a much greater degree from IV injection (6.8 and 10%ID/g). In a separate study, mice received IV injection of an imaging dose of [⁵²Mn]MnCl₂, followed by <i>in vivo</i> imaging by positron emission tomography (PET) and <i>ex vivo</i> biodistribution. The results from this study supported many of the results from the biodistribution-only studies. In this work, we have confirmed results in the literature and contributed new results for the biodistribution of inhaled radiomanganese for several organs. Our results could serve as supporting information for environmental and occupational regulations, for designing PET studies utilizing ⁵²Mn, and/or for predicting the biodistribution of manganese-based MR contrast agents.</p></div