CyberKnife Boost for Patients with Cervical Cancer Unable to Undergo Brachytherapy

Standard radiation therapy for patients undergoing primary chemosensitized radiation for carcinomas of the cervix usually consists of external beam radiation followed by an intracavitary brachytherapy boost. On occasion, the brachytherapy boost cannot be performed due to unfavorable anatomy or because of coexisting medical conditions. We examined the safety and efficacy of using CyberKnife stereotactic body radiotherapy (SBRT) as a boost to the cervix after external beam radiation in those patients unable to have brachytherapy to give a more effective dose to the cervix than with conventional external beam radiation alone. Six consecutive patients with anatomic or medical conditions precluding a tandem and ovoid boost were treated with combined external beam radiation and CyberKnife boost to the cervix. Five patients received 45 Gy to the pelvis with serial intensity-modulated radiation therapy boost to the uterus and cervix to a dose of 61.2 Gy. These five patients received an SBRT boost to the cervix to a dose of 20 Gy in five fractions of 4 Gy each. One patient was treated to the pelvis to a dose of 45 Gy with an external beam boost to the uterus and cervix to a dose of 50.4 Gy. This patient received an SBRT boost to the cervix to a dose of 19.5 Gy in three fractions of 6.5 Gy. Five percent volumes of the bladder and rectum were kept to ≤75 Gy in all patients (i.e., V75 Gy ≤ 5%). All of the patients remain locally controlled with no evidence of disease following treatment. Grade 1 diarrhea occurred in 4/6 patients during the conventional external beam radiation. There has been no grade 3 or 4 rectal or bladder toxicity. There were no toxicities observed following SBRT boost. At a median follow-up of 14 months, CyberKnife radiosurgical boost is well tolerated and efficacious in providing a boost to patients with cervix cancer who are unable to undergo brachytherapy boost. Further follow-up is required to see if these results remain durable

Long-term clinical performance of experimental glass-ionomer cement with the bi-functional fluid

Introduction. Glass-ionomers have the ability to chemically bond to enamel and dentin, and are characterized by longterm fluoride release and absorption of fluoride from surrounding sources. Objective. The aim of the presented long-term clinical trial was to evaluate and compare the three-year clinical performance of the experimental glass-ionomer cement ‘SJZ/W’ with the bi-functional fluid placed in carious and non-carious cavities. Material and methods. Seventy restorations were made in adult patients of both genders. Clinical evaluation was performed at baseline and yearly intervals after placement using Ryge’s scale, considering the surface structure, anatomical form of the restoration and marginal integrity. Results. Immediately after placement, 70 restorations were assessed, 65 of which were subject to clinical evaluation after a year, 63 subject to clinical evaluation after 2 years, and 3-year evaluation was made for 55 restorations. The material showed minor changes in evaluated parameters and no differences were detected between their performance at baseline, and after three years only in anatomical shape. No post-operative sensitivity was recorded. Conclusion. The examined glass-ionomer ‘SJZ/W’ provided an acceptable clinical performance over a three-year period

The effect of herbal materials on the p-glycoprotein activity and function

P-glycoprotein (P-gp) encoded by the MDR1 (multidrug resistance 1) gene is ATP-dependent transporting protein which is localizated in the cell membrane. P-gp is expressed Review Article 130 A. Bogacz, D. Deka-Pawlik, J. Bartkowiak-Wieczorek, M. Karasiewicz, R. Kujawski, A. Kowalska, A. Chałas, B. Czerny, E. Grześkowiak, P. M. Mrozikiewicz mainly in organs with the secretory functions and its physiological role concerns tissue protection against xenobiotics. P-glycoprotein is involved in the permeability barriers of the blood-brain, blood-placenta directly protecting these organs. It participates in the transport of many drugs and other xenobiotics affecting their absorption, distribution, metabolism and excretion. The high P-gp activity in the cell membranes of cancer tissue is a major cause of lack of effectiveness of chemotherapy. Hence, the methods which could increase the sensibility of these pathological cells to cytostatics are still being searched. In the experimental studies it was shown that natural plant substances may have an effect on the expression level and activity of P-glycoprotein. Hypericum perforatum, Ginkgo biloba and Camellia sinensis increase P-gp activity while curcumin from Curcuma longa, piperine and silymarin inhibit this protein. Taking into account a wide substrate spectrum of P-gp, application of our knowledge on interactions of herbals and synthetic drugs should be considered in order to improve drug impact on different tissues.Glikoproteina P (P-gp) kodowana przez gen oporności wielolekowej MDR1 to ATP-zależne białko transportowe zlokalizowane w błonach komórkowych. P-gp ulega ekspresji głównie w obrębie narządów pełniących funkcje wydzielnicze, a jej fizjologiczna rola polega na ochronie tkanek przed ksenobiotykami. Glikoproteina P bierze udział w barierach przepuszczalności krew-mózg, krew-łożysko, chroniąc bezpośrednio te organy. Uczestniczy w transporcie leków i innych ksenobiotyków, wpływając na ich absorpcję, dystrybucję, metabolizm i wydalanie. Wysoka aktywność P-gp w błonach komórek nowotworowych jest główną przyczyną braku skuteczności chemioterapii. Poszukiwane są więc sposoby zwiększenia wrażliwości tych patologicznych komórek na cytostatyki. Badane są w tym kierunku naturalne substancje roślinne, ponieważ zaobserwowano ich wpływ na stopień ekspresji oraz aktywność glikoproteiny P. Hypericum perforatum, Ginkgo biloba i Camellia sinensis to surowce zwiększające aktywność P-gp, natomiast kurkumina z korzenia ostryża długiego, piperyna oraz sylimaryna hamują działanie tego białka. Ze względu na tak wielokierunkowe oddziaływanie fitoterapii oraz szerokie spektrum substratowe P-gp, stosując wiedzę na temat interakcji surowców roślinnych z lekami syntetycznymi należy zawsze mieć na uwadze zwiększenie biodostępności stosowanych leków

Wpływ surowców roślinnych an aktywność i funkcje glikoproteiny P

P-glycoprotein (P-gp) encoded by the MDR1 (multidrug resistance 1) gene is ATP-dependent transporting protein which is localizated in the cell membrane. P-gp is expressed Review Article 130 A. Bogacz, D. Deka-Pawlik, J. Bartkowiak-Wieczorek, M. Karasiewicz, R. Kujawski, A. Kowalska, A. Chałas, B. Czerny, E. Grześkowiak, P. M. Mrozikiewicz mainly in organs with the secretory functions and its physiological role concerns tissue protection against xenobiotics. P-glycoprotein is involved in the permeability barriers of the blood-brain, blood-placenta directly protecting these organs. It participates in the transport of many drugs and other xenobiotics affecting their absorption, distribution, metabolism and excretion. The high P-gp activity in the cell membranes of cancer tissue is a major cause of lack of effectiveness of chemotherapy. Hence, the methods which could increase the sensibility of these pathological cells to cytostatics are still being searched. In the experimental studies it was shown that natural plant substances may have an effect on the expression level and activity of P-glycoprotein. Hypericum perforatum, Ginkgo biloba and Camellia sinensis increase P-gp activity while curcumin from Curcuma longa, piperine and silymarin inhibit this protein. Taking into account a wide substrate spectrum of P-gp, application of our knowledge on interactions of herbals and synthetic drugs should be considered in order to improve drug impact on different tissues.Glikoproteina P (P-gp) kodowana przez gen oporności wielolekowej MDR1 to ATP-zależne białko transportowe zlokalizowane w błonach komórkowych. P-gp ulega ekspresji głównie w obrębie narządów pełniących funkcje wydzielnicze, a jej fizjologiczna rola polega na ochronie tkanek przed ksenobiotykami. Glikoproteina P bierze udział w barierach przepuszczalności krew-mózg, krew-łożysko, chroniąc bezpośrednio te organy. Uczestniczy w transporcie leków i innych ksenobiotyków, wpływając na ich absorpcję, dystrybucję, metabolizm i wydalanie. Wysoka aktywność P-gp w błonach komórek nowotworowych jest główną przyczyną braku skuteczności chemioterapii. Poszukiwane są więc sposoby zwiększenia wrażliwości tych patologicznych komórek na cytostatyki. Badane są w tym kierunku naturalne substancje roślinne, ponieważ zaobserwowano ich wpływ na stopień ekspresji oraz aktywność glikoproteiny P. Hypericum perforatum, Ginkgo biloba i Camellia sinensis to surowce zwiększające aktywność P-gp, natomiast kurkumina z korzenia ostryża długiego, piperyna oraz sylimaryna hamują działanie tego białka. Ze względu na tak wielokierunkowe oddziaływanie fitoterapii oraz szerokie spektrum substratowe P-gp, stosując wiedzę na temat interakcji surowców roślinnych z lekami syntetycznymi należy zawsze mieć na uwadze zwiększenie biodostępności stosowanych leków

Rythmes événementiels et aménagement des espaces publics à Paris, Montréal, Bruxelles

National audienc