Second primary cancers after radiation for prostate cancer: a review of data from planning studies

A review of planning studies was undertaken to evaluate estimated risks of radiation induced second primary cancers (RISPC) associated with different prostate radiotherapy techniques for localised prostate cancer. A total of 83 publications were identified which employed a variety of methods to estimate RISPC risk. Of these, the 16 planning studies which specifically addressed absolute or relative second cancer risk using dose–response models were selected for inclusion within this review. There are uncertainties and limitations related to all the different methods for estimating RISPC risk. Whether or not dose models include the effects of the primary radiation beam, as well as out-of-field regions, influences estimated risks. Regarding the impact of IMRT compared to 3D-CRT, at equivalent energies, several studies suggest an increase in risk related to increased leakage contributing to out-of-field RISPC risk, although in absolute terms this increase in risk may be very small. IMRT also results in increased low dose normal tissue irradiation, but the extent to which this has been estimated to contribute to RISPC risk is variable, and may also be very small. IMRT is often delivered using 6MV photons while conventional radiotherapy often requires higher energies to achieve adequate tissue penetration, and so comparisons between IMRT and older techniques should not be restricted to equivalent energies. Proton and brachytherapy planning studies suggest very low RISPC risks associated with these techniques. Until there is sufficient clinical evidence regarding RISPC risks associated with modern irradiation techniques, the data produced from planning studies is relevant when considering which patients to irradiate, and which technique to employ

A Role for Thrombospondin-1 Deficits in Astrocyte-Mediated Spine and Synaptic Pathology in Down's Syndrome

Down's syndrome (DS) is the most common genetic cause of mental retardation. Reduced number and aberrant architecture of dendritic spines are common features of DS neuropathology. However, the mechanisms involved in DS spine alterations are not known. In addition to a relevant role in synapse formation and maintenance, astrocytes can regulate spine dynamics by releasing soluble factors or by physical contact with neurons. We have previously shown impaired mitochondrial function in DS astrocytes leading to metabolic alterations in protein processing and secretion. In this study, we investigated whether deficits in astrocyte function contribute to DS spine pathology.Using a human astrocyte/rat hippocampal neuron coculture, we found that DS astrocytes are directly involved in the development of spine malformations and reduced synaptic density. We also show that thrombospondin 1 (TSP-1), an astrocyte-secreted protein, possesses a potent modulatory effect on spine number and morphology, and that both DS brains and DS astrocytes exhibit marked deficits in TSP-1 protein expression. Depletion of TSP-1 from normal astrocytes resulted in dramatic changes in spine morphology, while restoration of TSP-1 levels prevented DS astrocyte-mediated spine and synaptic alterations. Astrocyte cultures derived from TSP-1 KO mice exhibited similar deficits to support spine formation and structure than DS astrocytes.These results indicate that human astrocytes promote spine and synapse formation, identify astrocyte dysfunction as a significant factor of spine and synaptic pathology in the DS brain, and provide a mechanistic rationale for the exploration of TSP-1-based therapies to treat spine and synaptic pathology in DS and other neurological conditions

Survival, mortality and morbidity outcomes after oesophagogastric cancer surgery in New South Wales, 2001-2008

Objectives: To examine the relationship between hospital volume and patient outcomes for New South Wales hospitals performing oesophagectomy and gastrectomy for oesophagogastric cancer. Design, setting and patients: A retrospective, population-based cohort study of NSW residents diagnosed with a new case of invasive oesophageal or gastric cancer who underwent oesophagectomy or gastrectomy between 2001 and 2008 in NSW hospitals using linked de-identified data from the NSW Central Cancer Registry, the National Death Index and the NSW Admitted Patient Data Collection. A higher-volume hospital was defined as one performing > 6 relevant procedures per year. Main outcome measures: Odds ratios for > 21-day length of stay, 28-day unplanned readmission, 30-day mortality and 90-day mortality, and hazard ratios (HRs) for 5-year absolute and conditional survival. Results: Oesophagectomy (908 patients) and gastrectomy (1621 patients) were undertaken in 42 and 84 hospitals, respectively, between 2001 and 2008. Median annual hospital volume ranged from 2 to 4 for oesophagectomies and ranged from 2 to 3 for gastrectomies. Controlling for known confounders, no associations between hospital volume and > 21-day length of stay and 28-day unplanned readmission were found. Overall 30-day mortality was 4.1% and 4.4% for oesophagectomy and gastrectomy, respectively. Five-year absolute survival was significantly better for patients who underwent oesophagectomy in higher-volume hospitals (adjusted HR for lower-volume hospitals, 1.28 [95% CI, 1.10-1.49]; P= 0.002) and for those with localised gastric cancer who underwent gastrectomy in higher-volume hospitals (adjusted HR for lowervolume hospitals, 1.83 [95% CI, 1.28-2.61]; P= 0.001). Conclusions: These data support initial surgery for oesophagogastric cancer in higher-volume hospitals

PROSIDING SEMINAR NASIONAL : "STONE, STEEL AND STRAW"

Arkeoloog menemukan runtuhan dinding neolitik di Yeriko, Tepi Barat, yang diperkirakan dibangun 7.000 tahun S.M. Sejauh ini, dinding itu dianggap sebagai bangunan pertama. Jika nenek moyang manusia modern mulai hadir 200.000 tahun lalu, maka kita hanya dapat membayangkan bahwa hingga 7.000 tahun S.M. nenek moyang kita mungkin tinggal di gua-gua atau pepohonan yang dirangkai. “Arsitek” pertama, barangkali, adalah Imhotep yang merancang Piramida Bertingkat di Saqqara (makam Raja Zoser) 2.639 tahun S.M. Dalam kurun 9.000 tahun, arsitek dan arsitektur telah melibatkan perkembangan dan pemakaian bahan bangunan yang lebih beragam. Batu (stone) masih tetap dipakai. Bahan-bahan alami organik seperti jerami (straw) juga masih banyak dipakai. Baja (steel) mewakili bahan bangunan modern yang berkembang pesat sejak revolusi industri. Saat ini, 2013, kita menyaksikan perkembangan amat pesat bahan-bahan bangunan dalam beberapa tahun terakhir. Ini sejalan dengan perkembangan pesat di dunia kalkulasi digital yang mendorong ditemukannya zat-zat baru. Bahan berteknologi nano, bahan “anti-gravitasi”, dinding hologram, selubung bangunan penuai energi, hanyalah sedikit contoh dari bahan-bahan yang akan mewarnai arsitektur di masa depan. Seminar SCAN#4 bertema “STONE, STEEL and STRAW” yang menjadi salah satu tema dari 10 tema yang telah disiapkan dari SCAN#1 hingga SCAN#10 (tahun 2020). Kali ini kita berkumpul untuk memumpunkan perhatian kita pada bahan bangunan dan membahasnya sesuai dengan latar belakang kita masing-masing, mulai dari sisi budaya, psikologi, rekayasa hingga ekonomi. Kita dapat belajar dari masa lalu dan menggagas masa depan demi keberlanjutan budaya, arsitektur dan lingkungan (Sustainable Culture, Architecture and Nature). Namun, jika pada tahun 0 Masehi bumi baru dihuni sekitar 250 juta manusia dan saat ini telah menjadi 7.000 juta (7 milyar) manusia maka kita, arsitek, perlu waspada bahwa bumi yang tak bertambah luas ini sedang menghadapi kesulitan besar. Semoga, di seminar SCAN#4 ini kita dapat melihat gagasan-gagasan baru tentang bahan-bahan bangunan di masa depan yang mendukung Sustainable Culture, Architecture and Nature demi bumi yang nyaman dan sejahtera bagi seluruh makhluk penghuninya