Dosimetric comparison of dose distributions in episcleral plaque brachytherapy

Purpose/Objective: Brachytherapy of intraocular tumors with 125I eye plaques has become a successful treatment modality and a viable alternat ive to enucleation. Plaque Simulator (PS) is an eye plaque treatment planning system (TPS) that uses TG-43 dosimetry. We aimed to verify the performance of the PS routinely used to plan patients having intraocular tumors. Materials and Methods: Relative dose distributions, including central axis depth dose and off axis dose profiles of Collaborative Ocular Melanoma Study (COMS) plaques with 14, 16, 18 and 20 mm in diameter, loaded with model I25.S16 seeds were measured using 1x1x1 mm3 Thermo Luminesans Dosimetry (TLD) cubes and computed using MCNP5 Monte Carlo code and Plaque Simulator (PS) TPS. Measurements and calculations were compared by normalizing 5 mm distance at the central axis of the plaque i.e COMS point

Electromyographic Evaluation of Early Stage Results of Exoscopic Microdecompressive Spinal Surgery in Dogs

Background: Spinal surgical interventions are generally used in the treatment of various spinal pathologies such as vertebral fracture, luxation-subluxation, congenital vertebral deformities, discal hernia, infection and tumor. Minimally invasive spinal surgery contributes to rapid recovery by reducing iatrogenic muscle damage and postoperative pain. In minimally invasive spinal surgery, a new hybrid imaging technique, the exoscope, has been developed in the last decade The purpose of this study was to report efficacy of the exoscopic microdecompressive spinal surgery (MDSS) and its early postoperative electromyography (EMG) results in dogs.Materials, Methods & Results:The material of this study consisted of the owned 10 dogs with spinal cord injury resulted from the different etiologies. On the basis of examinations, medical support (fluid therapy, corticosteroid, etc.) was applied to the required dogs. Exoscopic MDSS was performed under general anesthesia in dogs. The neurologic, radiologic and EMG examination were completed at pre- and postoperative periods. EMG results at postoperative 1st week showed increased conduction velocity and amplitudes in 3 cases. There was no significant change in a case. And, there was a slight slowdown in conduction velocity and significant decrease in amplitudes in a case. At postoperative 4th week, ther was increased conduction velocity and amplitudes in 8 cases and needle EMG showed that spontan muscle activity was normal in 5 cases, mild in 2 cases, moderate a case and severe in a case. But spontan muscle activity was unfollowed in a case. Postoperative outcomes were poor in 3 cases, fair in 3 cases, good in 3 cases and unfollowed in a case. Discussion: Spinal cord injuries encountered in veterinary medicine have significant morbidity and mortality. In spinal patients, in addition to neurological examination, lesion localization can be determined using imaging techniques such as radiology, computed tomography, and MRI. EMG and somatosensory evoked potentials examinations are used to evaluate quantitative functional recovery, especially in spinal cord injuries. EMG also provides an opportunity to evaluate muscle activation patterns during recovery. Exoscopic spinal surgery is the newest hybrid imaging technique. Exoscopic MDSS facilitated manipulation by providing adequate illumination and vision at the exploration site. Exoscopic MDSS has the advantages of microscopic surgery and is a new technique that can be applied in dogs with spinal pathology

Dosimetric phantom consistency of TMR-10 protocol in homogeneous and inhomogeneous regions in gamma knife radiosurgery planning

Introduction: The algorithms used in the GammaPlan treatment planning system are “Tissue Maximum Ratio (TMR) classical,”“TMR 10,” and “convolution” algorithms, respectively. In this study, the consistency of dosimetric measurements with the TMR 10 protocol used in SRC (stereotactic radiosurgery) planning in lesions located in homogeneous and inhomogeneous regions in different intracranial location scenarios was investigated. Methods: In this study, the accuracy of administration of multiple metastasis treatment on the Gamma Knife Perfexion device was investigated. Computed tomography was performed with 1 mm cross-section intervals of CIRS brand Atom randofantoma. Critical organs and three different brain metastases located in homogeneous and heterogeneous regions, which are not on the same plane with each other, were drawn on the phantom. Planned target volume (PTV) volumes were created without margining the drawn gross tumor volumes, and three separate plans were made for three different PTV volumes. All plans were calculated using the TMR 10 algorithm. Critical organ doses were kept below the brain-SRC criteria for all calculated plans. Gafchromic EBT-3 film was placed on the sections with the target volume drawn on the phantoms and irradiated (1600 cGy, 50% isodose area). Measurements were made three times. The measured film results and the doses calculated from the planning were compared with gamma index analysis for different tolerance values. Results: In our study, for three different lesions planned and irradiated with different gradient index values, a difference of 2.11–9.58% was observed between the values calculated with the TMR-10 protocol and the values obtained in the dosimet- ric measurement. A decrease in consistency was observed, especially in inhomogeneous region placements. Discussion and Conclusion: There may be inconsistency between the TMR-10 protocol and actual dosimetric measurements, especially around inhomogeneous intracranial structures. We hope that this inconsistency will decrease in the future with the developing dose calculation protocols

Kırşehir yöresinde herpes zosterli 166 hastanın klinik ve demografik özelliklerinin değerlendirilmesi

Background and Design: Herpes zoster (HZ) occurs by reactivation of the latent varicella zoster virus at dorsal root ganglia. In the literature, there are studies on socio-demographic and clinical characteristics of patients with HZ in our country and in the world, however, there has been no study performed in our region. We aimed to evaluate demographic and clinical characteristics of patients with HZ and to investigate differences and similarities with other epidemiological studies in Turkey and in the world. Materials and Methods: One hundred sixty-six patients clinically diagnosed with HZ by dermatologists between January 2015 and December 2016 and were followed for 3 months in terms of possible complications were included this study. Demographic and clinical characteristics of the patients were recorded. Results: The mean age of the patients was 51.48±21.05 (1-90) years. Eighty-seven patients were female (52.4%), 79 were male (47.6%). Thirteen patients (7.8%) were in the pediatric age group (<18). The frequency of patient admission was highest in December and lowest in March. The most frequent locations of the lesions were thoracic (76 patients, 45.8%) and lumbar (40 patients, 24.1%) regions. The lesions were on the left side of the body in 96 (57.8%) and right side in 70 (42.2%) patients. The most frequent triggering factor was emotional stress. Post-herpetic neuralgia (27.7%) was the most frequently seen complication. The most common systemic comorbidity was hypertension. Malignancy was present in only 3 patients (1.8%). Conclusion: Our data were highly comparable with other studies. However, occurrence of HZ mostly during the winter and in the left side of the body was the difference from other studies. We conclude that further country-wide studies with larger number of patients are needed in order to clarify the epidemiological and clinical characteristics of HZ in our country.Amaç: Herpes zoster (HZ) dorsal kök ganglionlarında latent kalan varisella zoster virüsün reaktive olmasıyla ortaya çıkar. Literatürde ülkemizde ve dünyada HZ’nin sosyo-demografik ve klinik özelliklerini değerlendiren çalışmalar vardı ancak bölgemizde yapılan bir çalışma yoktu. Çalışmamızda HZ tanısı konulan hastaların klinik ve demografik özelliklerini incelemeyi ve Türkiye ve dünyadaki diğer epidemiyolojik çalışmalarla benzerlik ve farklılıklarını araştırmayı amaçladık. Gereç ve Yöntem: Ocak 2015-Aralık 2016 tarihleri arasında dermatologlar tarafından HZ tanısı konulan 166 hasta çalışmaya dahil edildi ve olası komplikasyonlar açısından 3 ay boyunca takip edildi. Hastaların demografik ve klinik özellikleri kaydedildi. Bulgular: Hastaların yaşları 1 ile 90 yaş arasında değişmekteydi (ortalama yaş: 51,48±21,05). Hastaların 81’i (%52,4) kadın, 79’u (%47,6) erkekti. Hastaların 13’ü (%7,8) pediatrik yaş grubunda (<18) idi. Hasta başvuruları aralık ayında en yüksek, mart ayında en düşük seviyedeydi. En sık etkilenen bölgeler torasik (76 hasta, %45,8) ve lumbar (40 hasta, %24,1) idi. Lezyonlar, 96 hastada (%57,8) vücudun sol tarafında, 70 hastada (%42,2) sağ tarafında gözlendi. En sık tetikleyici faktör emosyonel stresdi. En sık görülen komplikasyon postherpetik nevraljiydi (46 hasta, %27,7). En sık görülen sistemik hastalık hipertansiyondu. Sadece 3 hastada (%1,8) malignite mevcuttu. Sonuç: Çalışmamızın verileri diğer çalışmalar ile büyük oranda benzerdi. Ancak farklı olarak HZ en fazla kış mevsiminde saptandı ve vücudun sol tarafında tutulum daha sıktı. Türkiye’de HZ’nin klinik ve epidemiyolojik özelliklerini açıklığa kavuşturmak için daha fazla sayıda hastayla, ülke genelinde yapılacak çalışmalara ihtiyaç duyulduğunu düşünmekteyiz

Deformable MRI fusion for intracranial SRS: Can we trust?

Purpose/Objective: The aim of this study is to evaluate the reliability of MRI fusion for the determination of target volume when performing CT based intracranial stereotactic radiosurgery. Materials and Methods: Patients treated with CT based intracranial stereotactic radiosurgery with various diagnoses are included in the study. All patients were immobilized using stereotactic thermoplastic masks prior to simulation. The planning CT was obtained both with and without iv contrast with 1mm slice thickness

Predicting clinical outcomes in neuroblastoma with genomic data integration

Background: Neuroblastoma is a heterogeneous disease with diverse clinical outcomes. Current risk group models require improvement as patients within the same risk group can still show variable prognosis. Recently collected genome-wide datasets provide opportunities to infer neuroblastoma subtypes in a more unified way. Within this context, data integration is critical as different molecular characteristics can contain complementary signals. To this end, we utilized the genomic datasets available for the SEQC cohort patients to develop supervised and unsupervised models that can predict disease prognosis. Results: Our supervised model trained on the SEQC cohort can accurately predict overall survival and event-free survival profiles of patients in two independent cohorts. We also performed extensive experiments to assess the prediction accuracy of high risk patients and patients without MYCN amplification. Our results from this part suggest that clinical endpoints can be predicted accurately across multiple cohorts. To explore the data in an unsupervised manner, we used an integrative clustering strategy named multi-view kernel k-means (MVKKM) that can effectively integrate multiple high-dimensional datasets with varying weights. We observed that integrating different gene expression datasets results in a better patient stratification compared to using these datasets individually. Also, our identified subgroups provide a better Cox regression model fit compared to the existing risk group definitions. Conclusion: Altogether, our results indicate that integration of multiple genomic characterizations enables the discovery of subtypes that improve over existing definitions of risk groups. Effective prediction of survival times will have a direct impact on choosing the right therapies for patients.No sponso

Meme kanseri tanısı ile göğüs duvarına radyoterapi uygulanan hastalarda iki farklı tekniğin karşılaştırılması

Amaç: Meme kanseri tanısı ile mastektomi olan hastaların tedavi planlamasında kullanılan alan içi alan FIF ve 3-boyutlu konformal radyoterapi 3B-KRT tekniklerinin dozimetrik karşılaştırılması yapıldı. Gereç ve yöntemler: Meme kanseri tanısı ile modifiye radikal mastektomi operasyonu uygulanan yirmi hasta çalışmaya dahil edildi. Her hasta için göğüs duvarına yönelik iki farklı tedavi planı yapıldı. Planlanan hedef hacim PTV , risk altındaki organlar ipsilateral akciğer, kalp, sol asendan koroner arter ve karşı meme , doz homojenite indeksi DHI ve tedavi için gerekli olan monitör ünitler MU açısından FIF plan ile 3B-KRT planları karşılaştırıldı. İstatistiksek analizde student t test kullanıldı. Bulgular: FIF tekniği kullanıldığında PTV ve ipsilateral akciğerdeki maksimum dozlar anlamlı olarak azaldı. Aynı şekilde, ipsilateral akciğer hacminin % 30’unun aldığı doz FIF tekniği ile anlamlı olarak azaldı. FIF tekniği ile daha az MU kullanılarak daha homojen doz dağılımı elde edildiği görüldü. Sonuç: Meme kanseri nedeni ile göğüs duvarına yönelik radyoterapi uygulanan hastalarda FIF tekniği ile 3B-KRT karşılaştırıldığında FIF tekniğinin PTV’de daha iyi bir doz dağılımı sağladığı görülmüştür. Ayrıca, tedavi için gerekli olan MU’nun daha düşük olması da göz önüne alındığında FIF tekniği göğüs duvarı ışınlamalarında 3B-KRT’ye göre daha avantajlı olarak görünmektedi

Optimum Support Policy Component for the Development of Agricultural Production: Potato Producer

The present study aimed to determine the optimum policy component in an example of potato cultivation development based on the principle of the efficient use of scarce resources and maximizing the benefit of the producer. Agricultural support policies are commonly implemented by adopting a top-down approach. Regarding benefit maximization at the target group level, policies for agricultural products should be determined with a bottom-up approach. In this manner, in the present study, potato producers were determined to be the target group. Therefore, this study investigated the policy component that provides the highest benefit in line with the demands, expectations, and tendencies of the target group. The micro-data obtained from the potato-growing enterprises operating in provinces where potato cultivation was intensively carried out within the scope of Turkey constituted the research data. A face-to-face survey technique was used as the method for collecting the producer data. Simple descriptive statistics and one of the multivariate analysis techniques, conjoint analysis, were applied in the analysis and evaluation of the data. The optimum policy component setup was determined to be “Price and Payment Support: Above Market Price and 2 months term, Support Area and Amount: to production, 25.47 USD/da (23.04 EUR/da), time of announcement for the supports: pre-planting, and producer’s declaration: I do (I declare)” for the potato product. Accordingly, the necessity of a bottom-up approach in the planning and implementation of an agricultural support policy in Turkey is explained based on the results obtained. Therefore, it is considered necessary and beneficial to measure the level of producer benefits on the focus of applications that encourage potato production

Habits of using social media and the internet in psoriasis patients

Introduction: Psoriasis significantly affects the patients quality of life, which often leads patients to seek online information about this disease. Objectives: To explore the habits of patients with psoriasis related to their use of social media (SM) and the internet to obtain information about their disease. Methods: 1,520 patients completed the survey and the Dermatology Life Quality Index (DLQI) questionnaire. The Psoriasis Area Severity Index scores (PASI) and clinical data of the patients were recorded by their physicians. Results: Of the 1,114 patients that reported using SM and internet, 48.38% regularly and 31.14% sometimes resorted to obtain information about psoriasis. The use of SM and internet for psoriasis was statistically significantly higher among young people (P = 0.000), those with university or higher education (P = 0.009), higher DLQI (P = 0.000) and PASI (P = 0.011) scores, facial (P = 0.050), scalp (P = 0.032), hand (P = 0.048), genital (P = 0.001) and inverse (P = 0.000) involvement, and arthralgia/arthritis (P = 0.006). The participants mostly used the Google (86%) and Facebook (41%). More than half of the participants (62.8%) expected dermatologists to inform society that psoriasis is not contagious. Conclusions: Internet and SM being widely available and offering substantial information to be easily accessed make it very attractive for patients to use these platforms to investigate diseases, including psoriasis. If what is presented on SM conflicts with what the physician says, patients mostly trust the latter, but at the same time, they tend not to share the results of their online inquiries with their physicians