Impact of body-mass factors on setup displacement in patients with head and neck cancer treated with radiotherapy using daily on-line image guidance

BACKGROUND: To determine the impact of body-mass factors (BMF) before radiotherapy and changes during radiotherapy on the magnitude of setup displacement in patients with head and neck cancer (HNC). METHODS: The clinical data of 30 patients with HNC was analyzed using the alignment data from daily on-line on-board imaging from image-guided radiotherapy. BMFs included body weight, body height, and the circumference and bilateral thickness of the neck. Changes in the BMFs during treatment were retrieved from cone beam computed tomography at the 10th and 20th fractions. Setup errors for each patient were assessed by systematic error (SE) and random error (RE) through the superior-inferior (SI), anterior-posterior (AP), and medial-lateral (ML) directions, and couch rotation (CR). Using the median values of the BMFs as a cutoff, the impact of the factors on the magnitude of displacement was assessed by the Mann–Whitney U test. RESULTS: A higher body weight before radiotherapy correlated with a greater AP-SE (p = 0.045), SI-RE (p = 0.023), and CR-SE (p = 0.033). A longer body height was associated with a greater SI-RE (p = 0.002). A performance status score of 1 or 2 was related to a greater AP-SE (p = 0.043), AP-RE (p = 0.015), and SI-RE (p = 0.043). Among the ratios of the BMFs during radiotherapy, the values at the level of mastoid tip at the 20(th) fraction were associated with greater setup errors. CONCLUSIONS: To reduce setup errors in patients with HNC receiving RT, the use of on-line image-guided radiotherapy is recommended for patients with a large body weight or height, and a performance status score of 1–2. In addition, adaptive planning should be considered for those who have a large reduction ratio in the circumference (<1) and thickness (<0.94) over the level of the mastoid tip during the 20(th) fraction of treatment

Reconstruction for Mandibular Implant Failure

Mandibular defects may result from tumor ablations, trauma, or radiation necrosis. Significant segmental mandibular loss or hemimandibular loss may sometimes be replaced with mandibular implants by ENT surgeons/oral surgeons/head and neck surgeons. However, this may bring about mandibular implant failure in long-term follow-up. Mandibular implant failures usually manifest as: soft tissue atrophy, mandibular implant extrusion, infection, facial nerve involvement, facial asymmetry, derangement of occlusion and mastication, orocutaneous fistula, etc. Over 30 years, the authors have treated 102 patients with mandibular implant failure. Reconstruction may involve removal of the mandibular implant and immediate replacement of the mandibular defect with a piece of vascularized bone flap, not only to compensate for bone loss but also to replace neighboring soft tissue and possible skin defects. Frequently used flaps have been vascularized iliac bone (89/102) or vascularized fibula grafts (13/102). During follow-up, iliac bone flap reconstruction has yielded more favorable results due to its ample bone bulk and adequate soft tissue coverage. Fibula flaps with osteotomies have been associated with an increasing incidence of malunion/nonunion and subsequent easy deformation

HSP90 Inhibitors, Geldanamycin and Radicicol, Enhance Fisetin-Induced Cytotoxicity via Induction of Apoptosis in Human Colonic Cancer Cells

We revealed the cytotoxic effect of the flavonoid, fisetin (FIS), on human COLO205 colon cancer cells in the presence and absence of the HSP90 inhibitors, geldanamycin (GA) and radicicol (RAD). Compared to FIS treatment alone of COLO205 cells, GA and RAD significantly enhanced FIS-induced cytotoxicity, increased expression of cleaved caspase-3 and the PAPR protein, and produced a greater density of DNA ladder formation. GA and RAD also reduced the MMPs with induction of caspase-9 protein cleavage in FIS-treated COLO205 cells. Increased caspase-3 and -9 activities were detected in COLO205 cells treated with FIS+GA or FIS+RAD, and the intensity of DNA ladder formation induced by FIS+GA was reduced by adding the caspase-3 inhibitor, DEVD-FMK. A decrease in Bcl-2 but not Bcl-XL or Bax protein by FIS+GA or FIS+RAD was identified in COLO205 cells by Western blotting. A reduction in p53 protein with increased ubiquitin-tagged proteins was observed in COLO205 cells treated with FIS+GA or FIS+RAD. Furthermore, GA and RAD reduced the stability of the p53 protein in COLO205 cells under FIS stimulation. The evidence supports HSP90 inhibitors possibly sensitizing human colon cancer cells to FIS-induced apoptosis, and treating colon cancer by combining HSP90 inhibitors with FIS deserves further in vivo study

Functional characterization of cellulases identified from the cow rumen fungus Neocallimastix patriciarum W5 by transcriptomic and secretomic analyses

<p>Abstract</p> <p>Background</p> <p><it>Neocallimastix patriciarum</it> is one of the common anaerobic fungi in the digestive tracts of ruminants that can actively digest cellulosic materials, and its cellulases have great potential for hydrolyzing cellulosic feedstocks. Due to the difficulty in culture and lack of a genome database, it is not easy to gain a global understanding of the glycosyl hydrolases (<it>GHs</it>) produced by this anaerobic fungus.</p> <p>Results</p> <p>We have developed an efficient platform that uses a combination of transcriptomic and proteomic approaches to <it>N. patriciarum </it>to accelerate gene identification, enzyme classification and application in rice straw degradation. By conducting complementary studies of transcriptome (Roche 454 GS and Illumina GA IIx) and secretome (ESI-Trap LC-MS/MS), we identified 219 putative <it>GH </it>contigs and classified them into 25 <it>GH</it> families. The secretome analysis identified four major enzymes involved in rice straw degradation: β-glucosidase, endo-1,4-β-xylanase, xylanase B and Cel48A exoglucanase. From the sequences of assembled contigs, we cloned 19 putative cellulase genes, including the <it>GH1</it>, <it>GH3</it>, <it>GH5</it>, <it>GH6</it>, <it>GH9</it>, <it>GH18</it>, <it>GH43 </it>and <it>GH48 </it>gene families, which were highly expressed in <it>N. patriciarum </it>cultures grown on different feedstocks.</p> <p>Conclusions</p> <p>These <it>GH </it>genes were expressed in Pichia pastoris and/or Saccharomyces cerevisiae for functional characterization. At least five novel cellulases displayed cellulytic activity for glucose production. One β-glucosidase (W5-16143) and one exocellulase (W5-CAT26) showed strong activities and could potentially be developed into commercial enzymes.</p

Pan-cancer analysis of whole genomes

Cancer is driven by genetic change, and the advent of massively parallel sequencing has enabled systematic documentation of this variation at the whole-genome scale(1-3). Here we report the integrative analysis of 2,658 whole-cancer genomes and their matching normal tissues across 38 tumour types from the Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium of the International Cancer Genome Consortium (ICGC) and The Cancer Genome Atlas (TCGA). We describe the generation of the PCAWG resource, facilitated by international data sharing using compute clouds. On average, cancer genomes contained 4-5 driver mutations when combining coding and non-coding genomic elements; however, in around 5% of cases no drivers were identified, suggesting that cancer driver discovery is not yet complete. Chromothripsis, in which many clustered structural variants arise in a single catastrophic event, is frequently an early event in tumour evolution; in acral melanoma, for example, these events precede most somatic point mutations and affect several cancer-associated genes simultaneously. Cancers with abnormal telomere maintenance often originate from tissues with low replicative activity and show several mechanisms of preventing telomere attrition to critical levels. Common and rare germline variants affect patterns of somatic mutation, including point mutations, structural variants and somatic retrotransposition. A collection of papers from the PCAWG Consortium describes non-coding mutations that drive cancer beyond those in the TERT promoter(4); identifies new signatures of mutational processes that cause base substitutions, small insertions and deletions and structural variation(5,6); analyses timings and patterns of tumour evolution(7); describes the diverse transcriptional consequences of somatic mutation on splicing, expression levels, fusion genes and promoter activity(8,9); and evaluates a range of more-specialized features of cancer genomes(8,10-18).Peer reviewe

Portable 12-lead ECG Recorder

心臟疾病對現代人的健康影響已成為不容忽視的問題。而在常見的心臟疾病中，急性心肌梗塞又具有相對較高的猝死風險。急性心肌梗塞的發生是由於粥狀斑塊破裂，進而阻斷冠狀動脈的血液循環。嚴重者會引發心衰竭甚至死亡。在眾多的診斷方法中，心電圖由於具有非侵入性及連續量測之優點而成為最廣泛的應用。雖然單一導程或三導程之心電圖即具有偵測急性心肌梗塞發作期間ST波段及T波之異常波形變化之能力，但是所能提供的診斷訊息仍嫌不足。若要達到更為精確診斷之目的，則需要十二導程心電圖。 本研究的目標是建構一個可攜的裝置，針對十二導程心電圖作即時的監控。目前，有許多心電圖之即時監測系統：其中絕大多數只提供三個或單一導程的記錄方式；另外也有以軟體方式合成十二導程的心電圖訊號，然而這並非真正的十二導程心電圖，此種量測方式與實際量測之間存在無法避免的誤差。另一方面，若採用十二導程心電圖同時記錄的方法，硬體空間與功率消耗勢必高達單一導程的12倍。因此本系統使用了多工的技術，不僅於硬體空間及功率消耗大幅減少，所需頻寬也可獲得顯著改善。 本研究達成了一個低功率消耗、精巧便於攜帶之十二導程心電圖及時記錄系統。期許本系統的完成能對心臟疾病的高危險群病變之即時監控有所助益。Heart disease has become a non-ignorable threat nowadays. Recently, one of the most common cardiac diseases, acute myocardial infarction (AMI), is becoming seriously because of its high risk. AMI occurs when the atherosclerotic plaque ruptures and blocks one or more coronary arteries. It would lead to heart failure or death. Among the diagnostic tests, electrocardiograph (ECG) is a widely accepted tool since its non-invasive and continuous monitoring. Generally, ST segment/T wave abnormalities, which are considered as the early sign of AMI, could be detected on 1-lead or 3-lead ECG. However, the information that 1-lead of 3-lead ECG could provide is not enough for the purpose of precise diagnosis. In the detection of highly time-dependent cardiac diseases, such as AMI, a 12-lead ECG is necessary. The aim of this study is to develop a portable device for real-time 12-lead ECG recording. At present, there are many systems for real-time ECG monitoring. Most of them afford three or less leads for recording and some of them with synthesized 12-lead ECG. However, a problem of the synthesized 12-lead ECG is that non-avoidable errors would be induced by the approximation in the synthesis process. On the other hand, if we try to record all of the 12-lead waveforms at the same time, the power consumption and the dimension of system will be 12 times of an 1-lead system. Therefore, the technique of multiplexing was applied in our design. Not only the size and power consumption were dramatically reduced, the bandwidth requirement was also decreased accordingly. A portable real-time 12-lead ECG recording system with low power consumption has been developed in this study. By the implementation of this system, we honestly hope that this device could be helpful in real-time monitoring of high-risk cardiac diseases.誌謝………………………………………………………… i錄………………………………………………………… ii目錄……………………………………………………… iv文摘要…………………………………………………… v文摘要…………………………………………………… vi、前言…………………………………………………… 1-1 研究背景與動機……………………………………… 1-2 研究目的……………………………………………… 2、研究方法與系統設計………………………………… 4-1 系統架構……………………………………………… 5-2 威氏中間點產生電路………………………………… 6-3 緩衝放大級…………………………………………… 7-4 多工切換模組………………………………………… 8-4-1 通道選擇元件……………………………………… 8-4-2 放大及濾波電路…………………………………… 9-5 控制單元……………………………………………… 11-6 電源供應電路………………………………………… 12-7 韌體程式設計………………………………………… 13、實驗結果……………………………………………… 16-1 系統外觀……………………………………………… 16-2 印刷電路板製作……………………………………… 17-3 頻率響應……………………………………………… 21-4 輸出波形結果………………………………………… 22、討論與結論…………………………………………… 23-1 多工切換之突波現象………………………………… 23-2 結論…………………………………………………… 24-3 未來展望……………………………………………… 25考文獻…………………………………………………… 26錄一 心電圖基本原理………………………………… 28錄二 十二導程心電圖………………………………… 29amp;#8195

Signal Feature Extraction for Predicting Surface Roughness of Inconel 718 in Milling Process and Cutting Parameter Optimization via Genetic Algorithm

銑削加工的表面品質受到許多因素影響，如:切削速度、切削深度、進給速率等加工參數、機台振動、刀具磨耗等。傳統加工只憑藉著經驗或是試誤法決定加工參數，這樣不僅不易掌握加工的品質也增加了時間與成本，所以在要求的製造效率下如果能事先知道掌握加工品質以求解決參數最佳化是有其必要性。 本研究主要透過銑削加工難切削材料Inconel718之過程，同步量測其主軸與虎鉗振動與主軸電流訊號，在不同之加工參數設定下，如:每刃進給、切削深度與切削速度，探討工件表面粗糙度(Ra值)，與振動訊號、加工參數、電流訊號特徵的關聯性，並運用類神經網路進行表面粗糙度預測。實驗中透過不同之訊號處理與分析方法，如:包絡線分析、平均方根、峰度、偏度、快速傅立葉轉換、以及頻率正規化，得到訊號特徵，並藉由相關性分析比較篩選出與表面粗糙度Ra值較具相關性之特徵，再將篩選出的特徵做為倒傳遞類神經網路之輸入層參數來進行表面粗糙度預測。 銑削參數最佳化是利用基因遺傳演算法做為最佳化的工具，藉由先前建構出的加工預測模型並使用此模型預測的Ra值為限制條件，以得到最大的體積移除率為目標，藉由基因遺傳演算法的過程得到加工參數，分析結果亦比較與討論不同類別之特徵輸入的預測效果以及實際Ra值與預測Ra值之差異跟參數最佳化的驗證。摘要 i Abstract ii 目錄 iv 圖目錄 vii 表目錄 ix 第一章 緒論 - 1 - 1-1 前言 - 1 - 1-2 文獻回顧 - 2 - 1-3 研究動機 - 4 - 1-4 論文大綱 - 5 - 第二章 理論 - 6 - 2-1包絡線分析(Envelope Analysis) - 6 - 2-2希爾伯特黃轉換(Hilbert-Huang Transform) - 6 - 2-2-1固有模態函數(Instrinsic Mode Functions) - 7 - 2-2-2經驗模態分解法(Emipirical Mode Decompostion) - 7 - 2-3皮爾森相關性分析(Pearson Correlation Coefficient) - 9 - 2-4類神經網路(Artificial Neural Network) - 10 - 2-4-1學習規則 - 12 - 2-4-2倒傳遞神經網路(Back Propagation Neural Network) - 12 - 2-5基因遺傳演算法(Genetic Algorithm) - 15 - 2-5-1遺傳法則介紹 - 15 - 2-5-2編碼方式 - 16 - 2-5-3 適應性函數 - 17 - 2-5-4 選擇 - 17 - 2-5-5交配 - 18 - 2-5-6 突變 - 19 - 第三章 實驗架設與規劃 - 20 - 3-1實驗架設 - 20 - 3-1-1 實驗加工設備 - 22 - 3-1-2 實驗加工刀具 - 23 - 3-1-3 實驗工件材料 - 23 - 3-1-5 擷取卡 - 24 - 3-1-4 加速規 - 26 - 3-1-6 表面粗糙度儀量測設備 - 27 - 3-1-7 Servo guide - 28 - 3-2 實驗規劃 - 28 - 3-2-1 加工參數配置 - 29 - 3-2-2訊號擷取與取樣頻率 - 30 - 3-2-3 表驗粗糙度量測方式 - 30 - 第四章 實驗結果與討論 - 31 - 4-1訊號分析流程 - 31 - 4-2 穩定加工訊號擷取 - 32 - 4-3 振動訊號趨勢項移除 - 34 - 4-4 訊號包絡線分析 - 37 - 4-5 訊號處理與分析 - 38 - 4-5-1非轉速相關振動訊號特徵 - 38 - 4-5-2頻率正規化與點數插補 - 39 - 4-6特徵訊號篩選 - 42 - 4-6-1時域訊號特徵相關性分析 - 43 - 4-6-2頻域訊號特徵相關性分析 - 43 - 4-7 倒傳遞類神經網路 - 45 - 4-7-1 倒傳遞類神經網路結果比較 - 46 - 4-8基因遺傳演算法流程 - 50 - 4-8-1 建立適應性函數 - 52 - 4-8-2 參數編碼與適應值計算 - 52 - 4-8-3最佳化加工參數與預測值 - 59 - 第五章 結論與未來展望 - 62 - 5-1結論 - 62 - 5-2未來展望 - 64 - 參考文獻 - 65