Verification of field match lines in whole breast radiation therapy using Cherenkov imaging.

Purpose: In mono-isocentric radiation therapy treatment plans designed to treat the whole breast and supraclavicular lymph nodes, the fields meet at isocenter, forming the match line. Insufficient coverage at the match line can lead to recurrence, and overlap over weeks of treatment can lead to increased risk of healthy tissue toxicity. Cherenkov imaging was used to assess the accuracy of delivery at the match line and identify potential incidents during patient treatments.

Detective quantum efficiency of intensified CMOS cameras for Cherenkov imaging in radiotherapy.

In this study the metric of detective quantum efficiency (DQE) was applied to Cherenkov imaging systems for the first time, and results were compared for different detector hardware, gain levels and with imaging processing for noise suppression. Intensified complementary metal oxide semiconductor cameras using different image intensifier designs (Gen3 and Gen2+) were used to image Cherenkov emission from a tissue phantom in order to measure the modulation transfer function (MTF) and noise power spectrum (NPS) of the systems. These parameters were used to calculate the DQE for varying acquisition settings and image processing steps.

Deliver us from evil? The temptation, realities, and neuroethico-legal issues of employing assessment neurotechnologies in public safety initiatives.

In light of the recent events of terrorism and publicized cases of mass slayings and serial killings, there have been calls from the public and policy-makers alike for neuroscience and neurotechnology (neuroS/T) to be employed to intervene in ways that define and assess, if not prevent, such wanton acts of aggression and violence. Ongoing advancements in assessment neuroS/T have enabled heretofore unparalleled capabilities to evaluate the structure and function of the brain, yet each and all are constrained by certain technical and practical limitations. In this paper, we present an overview of the capabilities and constraints of current assessment neuroS/T, address neuro-ethical and legal issues fostered by the use and potential misuse of these approaches, and discuss how neuroethics may inform science and the law to guide right and sound applications of neuroS/T to "deliver us from evil" while not being led into temptations of ampliative claims and inapt use.

Radiation dose from volumetric helical perfusion CT of the thorax, abdomen or pelvis.

Purpose: To evaluate the radiation doses delivered during volumetric helical perfusion CT of the thorax, abdomen or pelvis.

Materials And Methods: The dose-length product (DLP) and CT dose index (CTDIvol) were recorded and effective dose (E) determined for patients undergoing CT (4D adaptive spiral) for tumour evaluation. Image noise and contrast to noise (CNR) at peak enhancement were also assessed for quality.

Synthesis and structures of some new types of lithium beta-diketiminates.

The tetracyclic dilithio-Si,Si'-oxo-bridged bis(N,N'-methylsilyl-beta-diketiminates) 2 and 3, having an outer LiNCCCNLiNCCCN macrocycle, were prepared from [Li{CH(SiMe(3))SiMe(OMe)(2)}](infinity) and 2 PhCN. They differ in that the substituent at the beta-C atom of each diketiminato ligand is either SiMe(3) (2) or H (3). Each of and has (i) a central Si-O-Si unit, (ii) an Si(Me) fragment N,N'-intramolecularly bridging each beta-diketiminate, and (iii) an Li(thf)(2) moiety N,N'-intermolecularly bridging the two beta-diketiminates (thf = tetrahydrofuran).

Synthesis and structures of a 3-sila-beta-diketiminatomagnesium bromide, ketenimide and triflate.

The crystalline compounds [Mg(Br)(L)(thf)].0.5Et2O [L = {N(R)C(C6H3Me2-2,6)}2SiR, R = SiMe3] (1), [Mg(L){N=C=C(C(Me)=CH)2CH2}(D)2] [D = NCC6H3Me2-2,6 (2), thf (3)] and [{Mg(L)}2{mu-OSO(CF3)O-[mu}2] (4) were prepared from (a) Si(Br)(R){C(C6H3Me2-2,6)=NR}2 and Mg for (1), (b) [Mg(SiR3)2(thf)2] and 2,6-Me2C6H3CN (5 mol for (2), 3 mol for (3)), and (c) (2) + Me3SiOS(O)2CF3 for (4); a coproduct from (c) is believed to have been the trimethylsilyl ketenimide Me3SiN=C=C{C(Me)=CH}2CH2 (5).

Sodium and potassium 3-sila-beta-diketiminates show new coordination modes.

The reaction between the lithium 3-sila-beta-diketiminate (1) and the appropriate MOBut yielded the crystalline sodium (2) or potassium (3) 3-sila-beta-diketiminate in high yield; X-ray crystal data and NMR spectra show new coordination modes for the [N(R)C(Ar)Si(R)C(Ar)N(R)]- ligand (R = SiMe3, Ar = C6H3Me(2)-2,6).

Late cognitive effects of early treatment with phenobarbital.

We previously reported that IQ was significantly lowered in a group of toddler-aged children randomly assigned to receive phenobarbital or placebo for febrile seizures and there was no difference in the febrile seizure recurrence rate. We retested these children 3-5 years later, after they had entered school, to determine whether those effects persisted over the longer term and whether later school performance might be affected. On follow-up testing of 139 (of the original n = 217) Western Washington children who had experienced febrile seizures, we found that the phenobarbital group scored significantly lower than the placebo group on the Wide Range Achievement Test (WRAT-R) reading achievement standard score (87.

Cerebrospinal fluid analysis in children with seizures.

Cerebrospinal fluid (CSF) examinations of 212 children aged two to 24 months with idiopathic nonfebrile seizures, complex febrile seizures, or status epilepticus, who had a lumbar puncture within 24 hours of the convulsion, were reviewed to determine whether an idiopathic convulsion can result in CSF abnormalities. Children with complex febrile seizures had a median CSF white blood cell count of 1 cell/mm3 (range 0-19 cells/mm3) and a median CSF polymorphonuclear (PMN) cell count of 0 cells/mm3 (range 0-8 cells/mm3). The CSF white blood cell (WBC) count was elevated above the upper limit of normal of 5 cells/mm3 in 9.

First febrile seizures. Characteristics of the child, the seizure, and the illness.

Through interviews with parents, data were gathered about 910 first febrile seizures in children aged 8 to 34 months. A male preponderance of 57% was found (P < .001).

Does phenobarbital used for febrile seizures cause sleep disturbances?

The effect of phenobarbital on total sleep time, night awakenings, and lengthy awakenings was examined as part of a randomized trial of children with febrile seizures; information about sleep patterns was gathered by parental observation. Children were between ages 8-36 months at enrollment and were examined subsequently for 2 1/2 years. Night awakenings were not more common in children assigned to phenobarbital except for those who were poor sleepers at the beginning of the study.

Stiripentol in atypical absence seizures in children: an open trial.

Stiripentol (STP) was added to the antiepileptic drug (AED) regimen of 10 patients with uncontrolled atypical absence seizures (more than one seizure a day). Seven boys and three girls aged 6-16 years participated in the study. Concomitant AEDs included various combinations of phenobarbital (PB), phenytoin (PHT), carbamazepine (CBZ), and valproate (VPA).

Epilepsy in schizencephaly: abnormal cortical organization studied by somatosensory evoked potentials.

Median nerve short-latency somatosensory evoked potentials (MN-SSEP) are recorded from the scalp to assess parietal lobe function and from the cortex to identify primary sensory and motor areas before epilepsy surgery. Nevertheless, the origins of many of the MN-SSEP waveforms and the reliability of this technique for localizing the central sulcus are not definitively known. We studied a child with a unilateral, closed, right parietal schizencephalic cleft and frequent simple partial seizures before the child underwent cortical resection.

An objective method for the assessment of psychosocial problems in adolescents with epilepsy.

Psychosocial problems in adolescents with epilepsy have been of concern for many years, but have been difficult to assess. This article presents the multicenter development of the Adolescent Psychosocial Seizure Inventory (APSI), an empirically based self-report test patterned after the Washington Psychosocial Seizure Inventory, which is used to evaluate psychosocial problems in adults. After pilot work, 120 adolescents with epilepsy from five centers in North America took the APSI and were interviewed by professionals with respect to adequacy of adjustment in eight psychosocial areas.

Risk of febrile seizures in childhood in relation to prenatal maternal cigarette smoking and alcohol intake.

The case-control study of febrile seizures in childhood described here, comprising 472 case-control pairs in western Washington, was designed to investigate the importance of prenatal exposures as risk factors for febrile seizures and to determine the degree to which two clinical subtypes of febrile seizures (simple and complex) have different risk factors. Maternal cigarette smoking and alcohol intake during pregnancy were associated with the risk of a febrile seizure in the child. Prenatal maternal cigarette smoking was associated with a twofold increase in the risk of a simple febrile seizure (95% confidence interval 1.

Phenobarbital for febrile seizures--effects on intelligence and on seizure recurrence.

Phenobarbital is widely used in the treatment of children with febrile seizures, although there is concern about possible behavioral and cognitive side effects. In 217 children between 8 and 36 months of age who had had at least one febrile seizure and were at heightened risk of further seizures, we compared the intelligence quotients (IQs) of a group randomly assigned to daily doses of phenobarbital (4 to 5 mg per kilogram of body weight per day) with the IQs of a group randomly assigned to placebo. After two years, the mean IQ was 7.

Pinealomas and germinomas in children.

A series of 34 pinealomas and intracranial germinomas in childhood (age less than 20), from two tumor registries, is analyzed. Male to female ratio was 2:1. Median age was 12 years.

Adult occurrence of medulloblastoma.

We analyze a series of 44 medulloblastomas in patients aged 20 and older, listed in the Connecticut Tumor Registry. Average age was 34.1 years.

Infantile spasms. Comparative trial of nitrazepam and corticotropin.

Fifty-two patients were enrolled in a four-week randomized multicenter study comparing nitrazepam and corticotropin in the treatment of infantile spasms. The drugs' efficacy was evaluated in 48 patients, all less than 2 years of age. Both treatments resulted in a statistically significant reduction in spasm frequency from that at baseline, but the difference between treatments was not significant.

Neuropsychological abilities of children with epilepsy.

One hundred eighteen epileptic children, aged 6-15 years, underwent detailed neuropsychological testing including the Wechsler Intelligence Scale for Children-Revised and the age-appropriate Halstead-Reitan battery. Eight had classical absence seizures only, eight had classic absence seizures and generalized tonic-clonic seizures, 30 had generalized tonic-clonic seizures only, 31 had partial seizures only, 20 had partial seizures and generalized seizures, 15 had atypical absence seizures, and five had minor motor seizures. A control group of 100 children without seizures, matched to the general population for intelligence and matched to the seizure cases for age, underwent identical testing.

Astrocytomas in childhood: a population-based study.

A population-based study of astrocytomas occurring in children is reported. A population-based study eliminates referral bias and the bias of a series based on the experience of a given medical center or a particular surgeon. In a 42-year period, 179 such cases were diagnosed.

Frontoparietal astrocytoma causing absence seizures and bilaterally synchronous epileptiform discharges.

We describe an 8-year-old child who had had seizures since age 2. Initially, the seizures involved staring and turning the head to the left. Later, his seizures were brief, frequent staring spells.

Medulloblastoma in childhood: an epidemiological study.

The authors have reviewed 143 cases of medulloblastoma in children aged 19 years or younger who were treated in a 42-year period and reported in the Connecticut Tumor Registry. About 20 cases have occurred in each 5-year period since 1950, but 31 were seen between 1955 and 1959. Correspondingly, an excessive number of children born in the period 1954 to 1958 have developed medulloblastomas.