RESULTS OF CZECH NATIONAL STUDY OF RADIATION EXPOSURE FROM RADIOTHERAPY OF NON-MALIGNANT DISEASES, IN PARTICULAR OF HEEL SPURS.

About 26 000 patients are treated per year with radiotherapy for non-malignant diseases in the Czech Republic. Approximately 75% of them are treated on X-ray therapy units and most of these patients undergo radiotherapy of heel spurs. The evaluation of radiation exposure of these patients was based on measured organ doses and on data from clinical practice.

COMPARISON OF DIFFERENT TECHNIQUES FOR EVALUATION OF DOSE DISTRIBUTIONS IN RADIOTHERAPY USING RADIOCHROMIC EBT3 FILMS.

In radiotherapy, radiochromic films can be used for verification of delivery of dose distributions calculated by treatment planning systems. The main objective of this work was to compare three different techniques for evaluation of dose distributions for prostate cancer treatment plans using radiochromic EBT3 films. These techniques are: red channel evaluation taking into account only a response of irradiated film (R), red channel evaluation taking into account a response of unirradiated and irradiated film (Rcor) and multichannel evaluation in FilmQA software (RGB).

Measurement of stray radiation within a scanning proton therapy facility: EURADOS WG9 intercomparison exercise of active dosimetry systems.

Purpose: To characterize stray radiation around the target volume in scanning proton therapy and study the performance of active neutron monitors.

Methods: Working Group 9 of the European Radiation Dosimetry Group (EURADOS WG9-Radiation protection in medicine) carried out a large measurement campaign at the Trento Centro di Protonterapia (Trento, Italy) in order to determine the neutron spectra near the patient using two extended-range Bonner sphere spectrometry (BSS) systems. In addition, the work focused on acknowledging the performance of different commercial active dosimetry systems when measuring neutron ambient dose equivalents, H(∗)(10), at several positions inside (8 positions) and outside (3 positions) the treatment room.

Organ and effective doses from verification techniques in image-guided radiotherapy.

The purpose of this work was an evaluation of organ doses and effective doses from three verification techniques in Image-Guided Radiotherapy: from kilovoltage (kV) cone beam computed tomography (CBCT) scans, from two orthogonal kV images and from two orthogonal megavoltage (MV) images for two different treatment sites: pelvis and head and neck (H&N). For comparison reasons, organ doses and effective doses from prostate and H&N radiotherapy were also evaluated. Measurements of organ doses were performed in a male anthropomorphic Rando phantom by means of thermoluminescent dosemeters.

Comparison of a conventional tracheal airway with the Combitube in an urban emergency medical services system run by physicians.

This prospective randomised study was performed to compare the use of the Esophageal-Tracheal Combitube(R) (ETC; Tyco Healthcare, Mansfield, MA; http://www.combitube.org) with a conventional tracheal airway (ETA) for airway management by experienced physicians of the Emergency Medical Services System of the City of Vienna in the prehospital setting.

Intraluminal brachytherapy and selfexpandable stents in nonresectable biliary malignancies--the question of long-term palliation.

Background/aims: To evaluate the effect of a combination of intraluminal brachytherapy and metallic stent implantation in the treatment of patients with nonresectable biliary tumors.

Methodology: Thirty-two patients aged 41-80 years with nonresectable biliary malignancies--Klatskin's tumor (n = 17), gallbladder carcinoma (n = 11) and carcinoma of papilla Vateri (n = 4)--were treated with a combination of intraluminal brachytherapy (source Ir192, high-dose radiation regimen, total dose 30 Gy) and metallic stent implantation. Intraluminal brachytherapy and stent insertion (metallic, spiral-Z stent) were performed percutaneously in all patients.

[Regional chemotherapy in experimental cholangiocarcinoma in pigs].

Background: Primary cholangiocarcinoma (PCC) accounts for cca 9% of all carcinomas of the liver and biliary system. Its prognosis of always unfavourable and treatment is difficult.

Methods And Results: In 25 pigs strain BU PCC was induced chemically with the aim to test the action of regional chemotherapy on the tumor tissue.

[Detection of the Ki-ras mutation as a specific and sensitive marker of pancreatic carcinoma].

The authors describe the procedure used for assessment of a Ki-ras mutation as a specific and sensitive marker of carcinoma of the pancreas. The reliability of the method was tested in five patients with carcinoma of the pancreas.

[Detection of point mutations on the Ki-ras gene using the PCR technique].

Present study was undertaken to detect Ki-ras point mutation at codon 12 in pancreatic adenocarcinomas (CaP) using the polymerase chain reaction-restriction fragment lengths polymorphism (PCR-RFLP). Three modifications of PCR-RFLP were performed with a mismatched primers creating a recognition site with only one allelic from (wild or mutated). Using two-step PCR-RFLP and two modifications of one-step PCR-RFLP we examined 5 resected adenocarcinomas of pancreas, 6 pancreatic juices and one DNA sample from peripheral blood of patient with generalized stadium of CaP.

[Treatment of duodenal ulcer with pantoprazole. A multicenter study].

Background: The inhibition of H+/K(+)-ATPase (proton pump) of gastric parietal cells by substituted benzimidazoles represents a new therapeutic approach in conditions connected with hypersecretion of hydrochloric acid. Pantoprazol is the newest member of this group of drugs. Monotherapy of duodenal ulcer with pantoprazole or ranitidine was evaluated in terms of healing rate, tolerance and compliance.

[Cathepsin B-like substance in the monitoring of chemically induced primary cholangiocarcinoma in swine].

Activity of beta-glucuronidase (GL), placentar izoenzyme of alkaline phosphatase (PLAP), cathepsin B (CB) and concentrations of carcinoembryonic antigen (CEA) were determined in serums and bile of pigs with experimental cholangiocarcinoma and in control animals. No differences in serum GL, PLAP, CB activities or CEA were observed. The same was found in bile for GL, PLAP and CEA.

[Treatment of pancreatic stones with extracorporeal lithotripsy with sonographic localization].

Background: Pancreatic stones may be treated by endoscopic extraction or by surgery. Extracorporeal shock wave lithotripsy increased possibility of noninvasive steps to their elimination. The aim of this study was to describe our first experience with this method.

[Tumors of the biliary tract: possibilities of multimodality therapy].

Background: Tumours of the biliary system (NBS) account for as many as 16% of all tumours of the GIT. Early diagnosis is difficult, contemporary treatment is not satisfactory and the prognosis is poor. It seems that one of the few therapeutic perspectives is multimodal treatment.

[Biliary-duodenal prosthesis in the palliative treatment of tumors in the subhepatic region].

In the group of 347 patients (pts) with biliary cancer (218 females and 129 males, age range 42-88 years), the large size bilio-duodenal endoprostheses (BDE) were inserted. The success rate in BDE implantation varied from 68 to 92% according to the localisation of the common bile duct stenosis and its anatomy. The BDE introduction was followed by step-by-step normalisation in laboratory markers of biliary obstruction in 76% of pts, the full functional capacity of BDE varied from 26 to 311 days (median 168 days).

[Regional chemotherapy in the treatment of biliary tract tumors].

Background: Subjective complaints of patients with tumours of the biliary tree are late, early diagnosis is difficult and frequently impossible, the therapeutic results are unsatisfactory and the prognosis is poor. Surgical intervention is in more than 90% palliative, the tumours are not radiosensitive and their sensitivity to systemically administered cytostatics is low. The perspective of some patients was improved by implantation of bilioduodenal endoprostheses.

[Stenosis of the papilla of Vater--clinical picture and possibilities of therapy].

Stenosis of the ampulla of Vater is encountered in as many as 10% of patients with biliary diseases. In general it is classified as tumourous, inflammatory of functional stenosis. In the clinical picture biliary dyspepsia associated with cholestasis predominates.

[Tumor markers in the diagnosis of tumors in the subhepatic area].

Concentrations of CA 19-9, CA 50, CA 195 and DUPAN-2 were followed in serum, bile and pancreatic juice of 65 patients with malignant or benign lesions of CBD and/or pancrease. In sera, significant differences between neoplasias and benign lesions were seen only in patients with tumors in stages III. and IV.

[Initial experience with the transjugular renal biopsy].

Transjugular renal biopsy is a new diagnostic method used for collection of tissue specimens for morphological examination in some indicated cases where the use of the standard percutaneous technique involves risk. The method has not been used so far in Czechoslovakia.

Airway management in a case of neck impalement: use of the oesophageal tracheal combitube airway.

A patient presented with neck impalement after a traffic accident. Respiratory arrest demanded immediate tracheal intubation, which was impossible as a wooden splinter had partially obstructed the pharynx and prevented laryngoscopy. An oesophageal tracheal Combitube airway was inserted successfully and the patient's lungs were ventilated adequately until tracheotomy was performed.

[Shock-wave lithotripsy in the treatment of 12 patients with choledocholithiasis using an apparatus manufactured in Czechoslovakia].

Lithotripsy by shock wave was performed in 12 patients with choledocholithiasis using the authors' own apparatus. The shock wave is created by an electric spark and the concentration is made by a rotational semi-elipsoid. The pressures attained in the second focus are 150 MPa.

Extracorporeal shock-wave lithotripsy of the common bile duct stone with ultrasound localization.

Extracorporeal shock-wave lithotripsy with ultrasonographic localization of the common bile duct stone was successfully performed. The apparatus used is described and the advantages and disadvantages of ultrasonographic versus X-ray common bile duct stone localization are discussed.