A comparison of techniques for stereotactic radiotherapy by linear accelerator based on 3-dimensional dose distributions.

In order to establish the appropriate beam arrangement for use in stereotactic radiotherapy using a linear accelerator, dose volume distributions were calculated for a number of spherical targets in a head phantom and assessment was made by dose sparing of normal tissue outside the target volume. Using a single isocentre, fixed beam arrangements were compared with single and multiple non-coplanar isocentric arc rotations at target sizes from 10 to 55 mm diameter on a 6 MV Philips linear accelerator. From the dose-volume histograms produced, an arrangement of 3 or 4 arcs of rotation proved most suitable, in terms of sparing of normal tissue outside the target volume to high dose irradiation, across the range of target sizes studied.

Differential activation of mixed venous and arterial neutrophils in patients with sepsis syndrome and acute lung injury.

Neutrophil (PMN) functions, such as production of toxic oxygen (O2) metabolites, adherence, and chemotactic properties, are modified during local tissue inflammation and sepsis. We hypothesized that PMN would be primed during their transit through injured tissue beds, which in turn can lead to modulation or retention of the primed PMN by downstream tissues like the lungs. We tested this hypothesis by measuring the transpulmonary gradient of hydrogen peroxide (H2O2) production by zymosan-activated PMN.

Bragg-Gray theory and ion chamber dosimetry for photon beams.

The validity of the Bragg-Gray cavity theory in photon radiation dosimetry for photon energies from 10 keV to 10 MeV has been investigated quantitatively in this paper. A crucial assumption for Bragg-Gray cavity theory to be valid is that the dose from photon interactions in the detector material is negligible. The ratio, Fair, of the absorbed dose resulting from photon interactions in an air cavity, DPA(air), to that in air under the condition of charged-particle equilibrium, DCPE(air), has been used as a parameter to determine if the air cavity can be classified as a Bragg-Gray cavity.

Effect of sodium azide on hydrogen peroxide production by zymosan-activated human neutrophils.

Stimulated neutrophils (PMNs) produce large quantities of superoxide anion, which is the precursor for hydrogen peroxide (H2O2). We developed a new fluorimetric assay to measure the H2O2 released by zymosan A-activated PMNs utilizing the oxidation of p-hydroxyphenylacetic acid by H2O2 to its fluorescent dimer in the presence of horseradish peroxidase. Zymosan-activated PMNs isolated from nine healthy volunteers and 20 patients with acute hypoxemic respiratory failure (AHRF) released after 90 min 2.

Pathogenesis of pulmonary edema associated with intracisternal endotoxin in dogs.

To examine the role of central nervous system injury in the pathogenesis of pulmonary edema, we injected Escherichia coli endotoxin (5 mg/kg) into the cisterna magna of six dogs (group E) and compared, over 4 h, both the pulmonary edema and cerebrospinal fluid (CSF) abnormalities with those in six control dogs (group C). In group E, intracisternal endotoxin raised intracranial pressure from 21 +/- 6 to 38 +/- 8 cmH2O (P less than 0.001), CSF total protein from 18 +/- 6 to 54 +/- 19 mg/dl (P less than 0.

Alveolar pressure inhomogeneity and gas exchange during constant-flow ventilation in dogs.

Analysis of momentum transfer between inflow jets and resident gas during constant-flow ventilation (CFV) predicts inhomogeneity of alveolar pressures (PA) and volume, which might account for specific ventilation-variance in the lung. Using alveolar needles to measure pressures (PA) during CFV in eight anesthetized dogs with wide thoracotomy, we observed random dispersion of PA among lobes of up to 12.5 cmH2O.

Increased hydrogen peroxide in the expired breath of patients with acute hypoxemic respiratory failure.

Acute hypoxemic respiratory failure (AHRF) can result from diverse lung insults. Toxic oxygen metabolites have been implicated in this clinical condition and in animal models of pulmonary edema. Hydrogen peroxide (H2O2), an oxygen metabolite, mediates tissue injury.

Measurement of hydrogen peroxide in plasma and blood.

Measurement of the oxygen metabolite hydrogen peroxide (H2O2) in biological fluids such as plasma could be of interest because it might indicate participation of toxic oxygen species in tissue injury. Recently several reports claimed to measure H2O2 using spectrophotometric and high pressure liquid chromatographic (HPLC) techniques that utilize oxidation of a substrate to a product by a peroxidase. In such a system it is crucial to perform two control experiments to verify whether the measured substance is H2O2.

Benefits expected from simple conformal radiotherapy in the treatment of pelvic tumours.

In 20 patients with invasive bladder cancer suitable for radical radiotherapy, a simple conformal planning technique has been compared with conventional beam arrangements in terms of normal tissue sparing. The median treatment volume for the group was reduced from 2275 to 1416 cm3 by the introduction of conformal planning. More specifically, in 13/20 patients (65%) the percentage volume of rectum irradiated to 90% of the isocentric dose was reduced by more than 30%, although the extent of rectal sparing varied greatly between patients.

Pressure, flow, and density relationships in airway models during constant-flow ventilation.

Adequate CO2 elimination and normal arterial PCO2 levels can be maintained in dogs during apnea by delivering a continuous flow of inspired gas at high flow rate (1-3 l.min-1.kg-1) through tubes placed in the main-stem bronchi.

Recent developments in basic dosimetry.

CCEMRI(I) (1985) has recommended that from January 1st 1986 the Primary Standard Dosimetry Laboratories (PSDLs) should adopt new values for W/e (33.97 J/C), stopping powers for electrons (ICRU Report 37, 1984), g value in air for 60Co (3.2 X 10-3), and energy absorption coefficients [17].

Ventilation-perfusion inequality during constant-flow ventilation.

Previous work by Lehnert et al. (J. Appl.

Chamber-dependent wall correction factors in dosimetry.

The calculation of the response of ionisation chambers to different photon beam qualities used in radiotherapy requires electron stopping-power data. These data have recently been revised and are used here to derive a consistent set of correction factors for ionisation chambers of different wall and build-up cap composition. Theoretically derived parameters km and katt which relate the exposure calibration of an ionisation chamber to the absorbed dose to the air of the cavity, are compared with the experimentally derived product kmkatt showing generally good agreement but also significant discrepancies for plastic-walled chambers with inner graphite coatings.

Stopping-power ratio for a photon spectrum as a weighted sum of the values for monoenergetic photon beams.

Stopping-power ratios for water to air, Sw,air, have been calculated for 60Co and thin-target bremsstrahlung beams. The Monte Carlo method was used to generate depth-dependent Sw,air values and depth-absorbed-dose distributions in water for monoenergetic photon beams covering the energy range 0.1-50 MeV.

In vitro biaxial stress-strain response of human skin.

The development of new experimental methods and test equipment has permitted a study of the mechanical characteristics of unembalmed human cadaver skin. Excised tissue specimens were exposed to dynamic, biaxially applied displacements and forces in order to quantify the skin's anisotropic, viscoelastic stress-strain response. In addition to monotonically increasing displacement-time loadings, experiments were performed to measure the tissue's stress relaxation characteristics resulting from a suddenly applied displacement.

The biology of head and neck cancer. Detection and control by parallel histologic sections.

Microscopic fingers of epidermoid cancer can extend submucosally 1 to 3 cm from grossly discernible borders of upper aerodigestive tract cancers. These fingers are best detected by sectioning all surgical margins parallel to the margins. Microscopic disease was found at the original excisional margins in 75% of 70 cases.

Identification of a mutant human insulin predicted to contain a serine-for-phenylalanine substitution.

Using information gained from (i) the relative HPLC retention of an abnormal insulin present in the serum of a hyperinsulinemic diabetic patient and (ii) the loss of an Mbo II restriction site in one of the patient's insulin gene alleles, it was recently predicted that the mutant insulin contained a serine-for-phenylalanine substitution at position B24 or B25. We have now prepared human [SerB24]insulin and [SerB25]insulin by solid-phase peptide synthesis and semisynthesis using an improved approach whereby the protecting groups can be removed from the final product in a single step. During reversed-phase HPLC analysis, the two semisynthetic insulins were clearly separated from normal insulin and from each other.

Reductive methylation of insulin. Production of a biologically active tritiated insulin.

Reductive methylation of the three amino groups of porcine insulin was accomplished by incubation with formaldehyde and sodium cyanoborohydride. The two amino termini and the epsilon amino group of B29 lysine were each dimethylated within 1 h of incubation. The fully methylated insulin bound more tightly to a reverse phase column than did native insulin, had a slightly more acid isoelectric point, and maintained approximately 50% biological activity when examined with an insulin sensitive cultured cell line.