Flow visualization of mean and coherent flow structures around T-type and L-type groynes

River hydrodynamicsTurbulent open channel flow and transport phenomen

Young athlete with sudden cardiac arrest treated with therapeutic hypothermia

Reported herein is a coronary anomaly that occurred in a young adolescent athlete who presented with cardiopulmonary arrest. The patient was resuscitated and treated with therapeutic hypothermia. The patient had no associated neurological complications at follow up. Enhanced computed tomography of the heart indicated an anomalous left main coronary artery originating from the right coronary sinus and coursing between the aorta and the pulmonary artery. The patient underwent surgical intervention with coronary artery bypass grafting to prevent symptom recurrence.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/100297/1/ped12144.pd

99m-Technetium galactosyl human serum albumin scanning to evaluate liver function after stereotactic body radiotherapy for hepatocellular carcinoma: A case report

The primary choice among treatment options for liver malignancies is surgery. However, if surgery cannot be performed, Stereotactic body radiotherapy (SBRT) may be effective. 99m-technetium galactosyl human serum albumin (GSA) single-photon emission computed tomography (SPECT) imaging is useful for the assessment of liver function before surgery. We report the case of a 77-year-old man who had undergone SBRT for hepatocellular carcinoma of the left lobe of the liver 2 years previously. Follow-up revealed a 15-mm hepatocellular carcinoma at the edge of the right lobe of the liver. 99m-technetium GSA SPECT was performed before SBRT to confirm that there was no accumulation in the left lobe and to ensure that there was good function of the right lobe. Three months after SBRT, the tumor had responded, and decreases in GSA accumulation were observed in line with the radiation beam. Because hepatocellular carcinoma often relapses, it is important to assess the anatomic site of liver dysfunction before and after radiation. This case demonstrates that 99m-technetium GSA SPECT is useful for this purpose

New herpetofaunal records from Gunung Mulu National Park and its surrounding areas in Borneo

Gunung Mulu National Park (GMNP) in northwestern Borneo is marked by high species diversity and diverse environments. We present one new amphibian and ten new reptile records from GMNP and its surrounding area. In the records, Asthenodipsas jamilinaisi and Garthius chaseni were newly recorded in the Sarawak State. We also present the first record of Cyrtodactylus muluensis from outside of GMNP and the second record of Opisthotropis typica from the park. Combined with previous information, a total of 108 amphibians and 104 reptiles are known from GMNP, and their preferred habitat types are diverse. Furthermore, observed male-male combat of Dopasia buettikoferi is the first detailed description of the genus. Two color morphs of D. buettikoferi had an identical ND2 haplotype and appeared to be the same species. The present study provides new information about Bornean amphibians and reptiles, and also emphasizes the importance of continuous monitoring

Comparison of the Motion Accuracy of a Six Degrees of Freedom Radiotherapy Couch with and without Weights

In this study, we compared the motion accuracy of a six degrees of freedom (6D) couch for precision radiotherapy with or without weights attached to the couch. Two digital cameras were focused on the iso-center of a linear accelerator. Images of a needle which had been fixed to the 6D couch were obtained using the cameras when the couch moved in translation and rotation around each axis. The three-dimensional (3D) coordinates of the needle were calculated from coordinate values in the images. A coordinate error of the needle position relative to the theoretical position was calculated. The errors were obtained with or without a 60 kg weight attached to the 6D couch, and these errors were compared with each other. The mean distance of the 3D error vectors for the weighted test was 0.21 ± 0.11 mm, and >0.16 ± 0.09 mm for the non-weighted test (p < 0.05). However, the difference of two values was 0.06 mm which is smaller than the minimum distance the 6D couch system can correctly move. The variance of 0.16 mm for the Y coordinate errors for the weighted test only was larger than that for the non-weighted test, which was 0.06 mm (p < 0.05). We found that a total weight of 60 kg did not affect the accuracy of the 6D couch clinically. However, the variance of the Y coordinate errors was increased. This might suggest that the addition of this weight increased the uncertainty of the motion of the 6D couch

A metric for evaluation of deformable image registration

We propose a new metric, local uncertainty (LU), for the evaluation of deformable image registration (DIR) for dose accumulation in radiotherapy. LU measures the uncertainty of placement of each voxel in an image set after a DIR. The underlying concept of LU is that the distance between a focused voxel and a surrounding voxel on an image feature such as an edge is unchanged locally when the organ that includes these voxels is deformed. A candidate for the focused voxel after DIR can be calculated from three surrounding voxels and their distances. The positions of the candidates of the focused voxel calculated from several groups of any three surrounding voxels would vary. The variation of candidate positions indicates uncertainty of the focused voxel position. Thus, the standard deviation of candidate positions is treated as an LU value. The LU can be calculated in uniform signal regions. Assessment of DIR results in such regions is important for dose accumulation. The LU calculation was applied to a pair of computed tomography (CT) head and neck examinations after DIR. These CT examinations were for the initial radiotherapy planning and re-planning for a treatment course where the tumor underwent shrinkage during treatment. We generated an LU image showing high LU values in the shrinking tumor region and low LU values in undeformable bone. We have proposed the LU as a new metric for DIR

Scores of Child–Pugh Classification Impact Overall Survival After Stereotactic Body Radiation Therapy for Primary and Metastatic Liver Tumors

BackgroundStereotactic body radiotherapy (SBRT) delivers high-dose radiation to tumor tissues in few fractions, thereby reducing radiation damage to at-risk organs. There are more potential effects of SBRT owing to the higher biological equivalent dose delivered. Herein, we retrospectively analyzed its effectiveness and toxicity at our institution.MethodsData from patients with hepatocellular carcinoma (HCC; n = 10) and liver metastases (n = 10) who underwent SBRT (total dose of 30–50 Gy in 5–10 fractions) between 2013 and 2016 were analyzed. Adverse events were recorded at the end of RT, 6 months after treatment, or upon death. Overall survival (OS) was calculated according to the biological effective dose (BED α/β = 10) and liver function (Child–Pugh [CP] classification 5 or 6 vs. 7 or 8) after SBRT, using Kaplan–Meier analyses.ResultsOf the 20 patients, 6 declined the CP classification score after SBRT; grade 3 adverse events were not seen in any patient. A higher OS rate was seen in patients receiving a higher BED and in those with better CP classification after SBRT. Kaplan–Meier survival analysis yielded a median OS of 401 days and 1- and 2-year OS of 45% and 15%, respectively.ConclusionThe higher BED was significantly associated with tumor control, and there were no differences in the tumor control rate between HCC and metastatic tumors. Changes in CP scores after SBRT also affected the survival rate. Good liver function may permit multiple rounds of SBRT