Magnetic resonance thermometry: methodology, pitfalls and practical solutions

Clinically established thermal therapies such as thermoablative approaches or adjuvant hyperthermia treatment rely on accurate thermal dose information for the evaluation and adaptation of the thermal therapy. Intratumoural temperature measurements have been correlated successfully with clinical end points. Magnetic resonance imaging is the most suitable technique for non-invasive thermometry avoiding complications related to invasive temperature measurements. Since the advent of MR thermometry two decades ago, numerous MR thermometry techniques have been developed, continuously increasing accuracy and robustness for in vivo applications. While this progress was primarily focused on relative temperature mapping, current and future efforts will likely close the gap towards quantitative temperature readings. These efforts are essential to benchmark thermal therapy efficiency, to understand temperature-related biophysical and physiological processes and to use these insights to set new landmarks for diagnostic and therapeutic applications. With that in mind, this review summarises and discusses advances in MR thermometry, providing practical considerations, pitfalls and technical obstacles constraining temperature measurement accuracy, spatial and temporal resolution in vivo. Established approaches and current trends in thermal therapy hardware are surveyed with respect to potential benefits for MR thermometry

Evolution of extensional basins and basin and range topography west of Death Valley, California

This is the published version. Copyright 2010 American Geophysical Union. All Rights Reserved.Neogene extension in the Death Valley region, SE California, has produced a variety of sedimentary basins. Diachronous movements on an array of strike-slip and normal fault systems have resulted in the uplift and preservation of older basins in modern ranges. One of the best exposed of these is the Nova basin on the western flank of the Panamint Mountains. The Nova basin includes over 2000 m of sedimentary and volcanic rocks deposited during denudation of the Panamint Mountains metamorphic core complex in late Miocene (?) – early Pliocene time. The principal growth structure for the basin was the Emigrant detachment, which initiated and moved at a low angle. Modern Panamint Valley, west of the range, developed as a consequence of Late Pliocene - Recent, kinematically linked movement on the right-slip, high-angle Hunter Mountain fault zone and the low-angle Panamint Valley detachment. Detailed mapping of the intersection between the Emigrant and Panamint Valley detachments demonstrates that segments of the earlier system remained active during development of Panamint Valley and, thus, during development of modern Basin and Range topography as well. These results indicate that large-scale extension in the Death Valley region, accommodated by movement on low- to moderate-angle normal fault systems and high-angle strike-slip fault systems, is a continuing process. Basin and Range topography in the Panamint Valley - Death Valley area was generated at least in part by displacements on low-angle detachments rather than high-angle normal faults

Thermal magnetic resonance: physics considerations and electromagnetic field simulations up to 23.5 Tesla (1GHz)

Background: Glioblastoma multiforme is the most common and most aggressive malign brain tumor. The 5-year survival rate after tumor resection and adjuvant chemoradiation is only 10 %, with almost all recurrences occurring in the initially treated site. Attempts to improve local control using a higher radiation dose were not successful so that alternative additive treatments are urgently needed. Given the strong rationale for hyperthermia as part of a multimodal treatment for patients with glioblastoma, non-invasive radio frequency (RF) hyperthermia might significantly improve treatment results. Methods: A non-invasive applicator was constructed utilizing the magnetic resonance (MR) spin excitation frequency for controlled RF hyperthermia and MR imaging in an integrated system, which we refer to as thermal MR. Applicator designs at RF frequencies 300 MHz, 500 MHz and 1GHz were investigated and examined for absolute applicable thermal dose and temperature hotspot size. Electromagnetic field (EMF) and temperature simulations were performed in human voxel models. RF heating experiments were conducted at 300 MHz and 500 MHz to characterize the applicator performance and validate the simulations. Results: The feasibility of thermal MR was demonstrated at 7.0 T. The temperature could be increased by ~11 °C in 3 min in the center of a head sized phantom. Modification of the RF phases allowed steering of a temperature hotspot to a deliberately selected location. RF heating was monitored using the integrated system for MR thermometry and high spatial resolution MRI. EMF and thermal simulations demonstrated that local RF hyperthermia using the integrated system is feasible to reach a maximum temperature in the center of the human brain of 46.8 °C after 3 min of RF heating while surface temperatures stayed below 41 °C. Using higher RF frequencies reduces the size of the temperature hotspot significantly. Conclusion: The opportunities and capabilities of thermal magnetic resonance for RF hyperthermia interventions of intracranial lesions are intriguing. Employing such systems as an alternative additive treatment for glioblastoma multiforme might be able to improve local control by "fighting fire with fire". Interventions are not limited to the human brain and might include temperature driven targeted drug and MR contrast agent delivery and help to understand temperature dependent bio- and physiological processes in-vivo

Kaon Condensation in the Bound-State Approach to the Skyrme Model

We explore kaon condensation using the bound-state approach to the Skyrme model on a 3-sphere. The condensation occurs when the energy required to produce a $K^-$ falls below the electron fermi level. This happens at the baryon number density on the order of 3--4 times nuclear density.Comment: LaTeX format, 15 pages. 3 Postscript figures, compressed and uuencode

Chiral quark-soliton model in the Wigner-Seitz approximation

In this paper we study the modification of the properties of the nucleon in the nucleus within the quark-soliton model. This is a covariant, dynamical model, which provides a non-linear representation of the spontaneously broken SU(2)_L X SU(2)_R symmetry of QCD. The effects of the nuclear medium are accounted for by using the Wigner-Seitz approximation and therefore reducing the complex many-body problem to a simpler single-particle problem. We find a minimum in the binding energy at finite density, a change in the isoscalar nucleon radius and a reduction of the in-medium pion decay constant. The latter is consistent with a partial restoration of chiral symmetry at finite density, which is predicted by other models.Comment: 30 pages, 13 figures; uses REVTeX and epsfi

Satisfaction of Older Patients With Emergency Department Care: Psychometric Properties and Construct Validity of the Consumer Emergency Care Satisfaction Scale.

BACKGROUND: Patient satisfaction is an important indicator of quality of care, but its measurement remains challenging. The Consumer Emergency Care Satisfaction Scale (CECSS) was developed to measure patient satisfaction in the emergency department (ED). Although this is a valid and reliable tool, several aspects of the CECSS need to be improved, including the definition, dimension, and scoring of scales. PURPOSE: The purpose of this study was to examine the construct validity of the CECSS and make suggestions on how to improve the tool to measure overall satisfaction with ED care. METHODS: We administered 2 surveys to older adults who presented with a fall to the ED and used electronic health record data to examine construct validity of the CECSS and ceiling effects. RESULTS: Using several criteria, we improved construct validity of the CECSS, reduced ceiling effects, and standardized scoring. CONCLUSION: We addressed several methodological issues with the CECSS and provided recommendations for improvement

A non-randomised, single-centre comparison of induction chemotherapy followed by radiochemotherapy versus concomitant chemotherapy with hyperfractionated radiotherapy in inoperable head and neck carcinomas

BACKGROUND: The application of induction chemotherapy failed to provide a consistent benefit for local control in primary treatment of advanced head and neck (H&N) cancers. The aim of this study was to compare the results of concomitant application of radiochemotherapy for treating locally advanced head-and-neck carcinoma in comparison with the former standard of sequential radiochemotherapy. METHODS: Between 1987 and 1995 we treated 122 patients with unresectable (stage IV head and neck) cancer by two different protocols. The sequential protocol (SEQ; 1987–1992) started with two courses of neoadjuvant chemotherapy (cisplatin [CDDP] + 120-h continuous infusions (c.i.) of folinic acid [FA] and 5-fluorouracil [5-FU]), followed by a course of radiochemotherapy using conventional fractionation up to 70 Gy. The concomitant protocol (CON; since 1993) combined two courses of FA/5-FU c.i. plus mitomycin (MMC) concomitantly with a course of radiotherapy up to 30 Gy in conventional fractionation, followed by a hyperfractionated course up to 72 Gy. Results from the two groups were compared. RESULTS: Patient and tumor characteristics were balanced (SEQ = 70, CON = 52 pts.). Mean radiation dose achieved (65.3 Gy vs. 71.6 Gy, p = 0.00), response rates (67 vs. 90 % for primary, p = 0.02), and local control (LC; 17.6% vs. 41%, p = 0.03), were significantly lower in the SEQ group, revealing a trend towards lower disease-specific (DSS; 19.8% vs. 31.4%, p = 0.08) and overall (14.7% vs. 23.7%, p = 0.11) survival rates after 5 years. Mucositis grades III and IV prevailed in the CON group (54% versus 44%). Late toxicity was similar in both groups. CONCLUSION: Concurrent chemotherapy seemed more effective in treating head and neck tumors than induction chemotherapy followed by chemoradiation, resulting in better local control and a trend towards improved survival

Targeted therapy against Bcl-2-related proteins in breast cancer cells

INTRODUCTION: Bcl-2 and Bcl-xL confer resistance to apoptosis, thereby reducing the effectiveness of chemotherapy. We examined the relationship between the expression of Bcl-2 and Bcl-xL and chemosensitivity of breast cancer cells, with the aim of developing specific targeted therapy. METHODS: Four human breast cancer cell lines were examined, and the effects of antisense (AS) Bcl-2 and AS Bcl-xL phosphorothioate oligodeoxynucleotides (ODNs) on chemosensitivity were tested in vitro and in vivo. Chemosensitivity was evaluated by the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide) assay, and the antitumor effect was assessed in vivo by the success of xenograft transplantation into athymic mice. RESULTS: Treatment with AS Bcl-2 and Bcl-xL ODNs resulted in a sequence-specific decrease in protein expression, compared with controls. Treatment of BT-474, ZR-75-1, and MDA-MB-231 cells with AS Bcl-2 increased chemosensitivity to doxorubicin (DOX), mitomycin C (MMC), paclitaxel (TXL), and docetaxel (TXT). Transfection of the Bcl-2 gene into MDA-MB-453 cells decreased sensitivity to DOX and MMC. Treatment of MDA-MB-231, BT-474, and ZR-75-1 cells with AS Bcl-xL increased chemosensitivity to DOX, MMC and taxanes to a smaller extent than AS Bcl-2. This occurred in the setting of increased Bax and cleaved poly(ADP-ribose) polymerase, as well as decreased Bcl-2 and pAkt. AS Bcl-2 ODNs induced splenomegaly in association with increased serum IL-12, which was attenuated by methylation of the CpG motifs of AS Bcl-2; however, methylated CpG failed to negate the increased antitumor effect of AS Bcl-2. Bcl-2 and Bcl-xL, to a smaller extent, are major determinants of chemosensitivity in breast cancer cells. CONCLUSION: Targeted therapy against Bcl-2 protein with the use of AS ODNs might enhance the effects of chemotherapy in patients with breast cancer

A FUNÇÃO SOCIAL DOS GÊNEROS DISCURSIVOS NO ENSINO DE LÍNGUA PORTUGUESA

Os gêneros discursivos são manifestações da língua, moldadas por características formais habituais e relacionadas a diferentes atividades sociais, sendo que a escrita também se justapõe em gêneros, uma forma convencional da linguagem à qual atribuímos algum papel social, algum valor ou alguma função. No que tange a perspectiva do ensino de Língua Portuguesa a partir dos gêneros do discurso, entende-se que a vivência das mais diversas situações comunicativas, possibilita o contato do sujeito com uma maior diversidade de gêneros. Partindo dessa perspectiva, propôs-se aos alunos do segundo ano, do curso técnico integrado ao ensino médio, do IFC – Instituto Federal Catarinense do campus Blumenau, a produção de uma campanha de conscientização em prol das pessoas com deficiência, em parceria com o Napne – Núcleo de apoio às pessoas com necessidades específicas, do IFC - campus Blumenau. Após compreender a estrutura textual do gênero publicitário, os alunos elaboraram a campanha de conscientização, produzindo textos do gênero com o tema: “a inclusão da pessoa com deficiência na perspectiva dos alunos do segundo ano”. Esses textos, anúncios publicitários, serão expostos e compartilhados com os participantes da mostra. Por saber que os gêneros possuem um propósito comunicativo e uma relação ativa com os seus interlocutores e, além disso, são constituídos nas práticas sociais e culturais da vida cotidiana, os alunos proporcionarão também, uma atividade de integração, a qual dar-se-á por um trajeto, acompanhado, percorrido pelos visitantes da mostra, que assim o desejarem, aos arredores do campus. As pessoas que desejarem participar dessa proposta deverão realizar o trajeto em uma cadeira de rodas ou de olhos vendados. A intenção será proporcionar uma experimentação de locomoção na vivência de uma pessoa com deficiência e, desta maneira, instigar uma visão mais ampla no que se refere à conscientização com relação às barreiras físicas e atitudinais enfrentadas pelas pessoas com deficiência na sociedade atual. Percebe-se a importância da participação dos alunos, como sujeitos ativos, na produção desse trabalho, pois o processo de aprendizagem passa a ser interacional, participativo, dinâmico, e desempenha uma função social, como proposto na perspectiva dos gêneros do discurso.  Palavras-chave: Gêneros discursivos. Gêneros textuais. A pessoa com deficiência. Relação do ensino de Língua Portuguesa com os PCN