A Case of 5-Fluorouracil-Induced Cardiac Arrest.

Background: Coronary artery vasospasm after administration of fluorouracil (5-FU) is a rare complication. Commonly presenting as chest pain during or shortly after 5-FU infusions, vasospasm can place patients at risk for ventricular dysrhythmia, myocardial ischemia, and infarction. Although not fully understood, any 5-FU cardiotoxicity seems to be multifactorial, and patients with coronary artery disease and renal dysfunction may be at particular risk.

Draft Genome Sequence of a Community-Associated Methicillin-Resistant Panton-Valentine Leukocidin-Positive Staphylococcus aureus Sequence Type 30 Isolate from a Pediatric Patient with a Lung Infection in Brazil.

The sequence of methicillin-resistant Staphylococcus aureus strain B6 (sequence type 30 [ST30], spa type t433, staphylococcal chromosomal cassette mec element [SCCmec] type IVc, Panton-Valentine leukocidin [PVL] positive), isolated from a pediatric patient with a lung infection in Niterói, Rio de Janeiro, Brazil, is described here. The draft genome sequence includes a 2.8-Mb chromosome, accompanied by a 20-kb plasmid containing blaZ and two small cryptic plasmids.

Surgical management of traumatic L2-L3 spondyloptosis.

Subluxation of a vertebra secondary to an injury (ie, traumatic spondyloptosis) is most commonly seen in the lumbosacral joint. This extremely rare spinal destabilization is caused by congenital defects, degeneration, tumors, infection, or trauma and is accompanied by severe neurologic debilitation. The patient's neurological function can be preserved when surgical team members have knowledge of spinal injuries, surgical interventions, positioning and its implications, and an awareness of the risks to the patient.

A Javascript library that uses Windows Script Host (WSH) to analyze prostate motion data fragmented across a multitude of Excel files by the Calypso 4D Localization System.

The Calypso 4D Localization System records prostate motion continuously during radiation treatment. It stores the data across thousands of Excel files. We developed Javascript (JScript) libraries for Windows Script Host (WSH) that use ActiveX Data Objects, OLE Automation and SQL to statistically analyze the data and display the results as a comprehensible Excel table.

Seed-based transrectal ultrasound-fluoroscopy registration method for intraoperative dosimetry analysis of prostate brachytherapy.

Prostate brachytherapy is an effective treatment option for early-stage prostate cancer. During a prostate brachytherapy procedure, transrectal ultrasound (TRUS) and fluoroscopy imaging modalities complement each other by providing good visualization of soft tissue and implanted seeds, respectively. Therefore, the registration of these two imaging modalities, which are readily available in the operating room, could facilitate intraoperative dosimetry, thus enabling physicians to implant additional seeds into the underdosed portions of the prostate while the patient is still on the operating table.

Intraoperative ultrasound-fluoroscopy fusion can enhance prostate brachytherapy quality.

Purpose: To evaluate a transrectal ultrasound (TRUS)-fluoroscopy fusion-based intraoperative dosimetry system.

Method And Materials: Twenty-five patients were treated for prostate cancer with Pd-103 implantation. After the execution of the treatment plan, two sets of TRUS images were collected using the longitudinal and axial transducers of a biplanar probe.

Semiautomatic 3-D prostate segmentation from TRUS images using spherical harmonics.

Prostate brachytherapy quality assessment procedure should be performed while the patient is still on the operating table since this would enable physicians to implant additional seeds immediately into the prostate if necessary thus reducing the costs and increasing patient outcome. Seed placement procedure is readily performed under fluoroscopy and ultrasound guidance. Therefore, it has been proposed that seed locations be reconstructed from fluoroscopic images and prostate boundaries be identified in ultrasound images to perform dosimetry in the operating room.

Syntactic parsing of medical reports using evolutionary optimization.

We report on a syntactic parser for medical reports which uses a genetic algorithm to efficiently identify the highest ranking parse configuration based on a scoring scheme developed as part of our prior work. The approach was tested on a set of 250 sentences from the domain of radiology. Performance time and comparison to exhaustive methods are given.

Intraoperative fluoroscopic dose assessment in prostate brachytherapy patients.

Purpose: To evaluate a fluoroscopy-based intraoperative dosimetry system to guide placement of additional sources to underdosed areas, and perform computed tomography (CT) verification.

Methods And Materials: Twenty-six patients with prostate carcinoma treated with either I-125 or Pd-103 brachytherapy at the Puget Sound VA using intraoperative postimplant dosimetry were analyzed. Implants were performed by standard techniques.

Detection and correction of patient movement in prostate brachytherapy seed reconstruction.

Intraoperative dosimetry of prostate brachytherapy can help optimize the dose distribution and potentially improve clinical outcome. Evaluation of dose distribution during the seed implant procedure requires the knowledge of 3D seed coordinates. Fluoroscopy-based seed localization is a viable option.

Three-dimensional seed reconstruction from an incomplete data set for prostate brachytherapy.

Intra-operative dosimetry in prostate brachytherapy requires 3D coordinates of the implanted, radioactive seeds. Since CT is not readily available during the implant operation, projection x-rays are commonly used for intra-operative seed localization. Three x-ray projections are usually used.

Application of influence diagrams to prostate intensity-modulated radiation therapy plan selection.

The purpose is to incorporate clinically relevant factors such as patient-specific and dosimetric information as well as data from clinical trials in the decision-making process for the selection of prostate intensity-modulated radiation therapy (IMRT) plans. The approach is to incorporate the decision theoretic concept of an influence diagram into the solution of the multiobjective optimization inverse planning problem. A set of candidate IMRT plans was obtained by varying the importance factors for the planning target volume (PTV) and the organ-at-risk (OAR) in combination with simulated annealing to explore a large part of the solution space.

Parametric shape modeling using deformable superellipses for prostate segmentation.

Automatic prostate segmentation in ultrasound images is a challenging task due to speckle noise, missing boundary segments, and complex prostate anatomy. One popular approach has been the use of deformable models. For such techniques, prior knowledge of the prostate shape plays an important role in automating model initialization and constraining model evolution.

Three-dimensional seed reconstruction for prostate brachytherapy using Hough trajectories.

In order to perform intra-operative or post-implant dosimetry in prostate brachytherapy, the 3D coordinates of the implanted radioactive seeds must be determined. Film or fluoroscopy based seed reconstruction techniques use back projection of x-ray data obtained at two or three x-ray positions. These methods, however, do not perform well when some of the seed images are undetected.

Automatic section segmentation of medical reports.

Automated segmentation of medical reports can significantly enhance the productivity of the healthcare departments. While many algorithms have been developed for document summarization, passage retrieval, and story segmentation of news feeds, much less effort has been devoted to parsing of medical documents. We present an algorithm specifically developed for medical applications.

Tomosynthesis-based localization of radioactive seeds in prostate brachytherapy.

Accurately assessing the quality of prostate brachytherapy intraoperatively would be valuable for improved clinical outcome by ensuring the delivery of a prescribed tumoricidal radiation dose to the entire prostate gland. One necessary step towards this goal is the robust and rapid localization of implanted seeds. Several methods have been developed to locate seeds from x-ray projection images, but they fail to detect completely-overlapping seeds, thus necessitating manual intervention.

Isodose patterns in patients with inadequate prostate brachytherapy coverage.

Purpose: The development of a practical, real-time dosimetry system should result in improved implant dose distributions and higher prostate cancer control rates. Our purpose here is to demonstrate that intraoperative isodose reconstruction in relation to the seed distribution, even without accurate registration with the prostatic volume, can likely identify an inadequate implant intraoperatively and guide corrective seed placement.

Methods And Materials: A total of 102 Pd-103 implants performed by standard techniques, using a modified peripheral loading pattern, were studied.

Spatial accuracy of fractionated IMRT delivery studies in canine paraspinal irradiation.

Intensity modulated radiation therapy (IMRT) theoretically allows detailed tailoring of the dose distribution in tissue. The goal of this study was to determine if a method of dynamic IMRT could be used to deliver a high dose of radiation to a concave shaped target around the cervical spinal cord. Fifteen young adult dogs from our laboratory population were randomly divided into two groups.

Random and systematic beam modulator errors in dynamic intensity modulated radiotherapy.

This paper reports on the dosimetric effects of random and systematic modulator errors in delivery of dynamic intensity modulated beams. A sliding-widow type delivery that utilizes a combination of multileaf collimators (MLCs) and backup diaphragms was examined. Gaussian functions with standard deviations ranging from 0.

Modification of prostate implants based on postimplant treatment margin assessment.

Purpose: To quantify the extent of additional source placement needed to perfect an implant after execution by standard techniques, assuming that uniform 5 mm treatment margins (TMs) is the criteria for perfection.

Materials And Methods: Ten consecutive, unselected patients treated with 1-125 brachytherapy were studied. Source placement is planned just inside or outside of the prostatic margin, to achieve a minimum 5 mm TM and a central dose of 150%-200% of the prescription dose.

Ultrasonography and fluoroscopic fusion for prostate brachytherapy dosimetry.

Purpose: To investigate the feasibility of performing postimplant and intraoperative dosimetry for prostate brachytherapy by fusing transrectal ultrasound (TRUS) and fluoroscopic data.

Methods And Materials: Registration of ultrasound (prostate boundary) and fluoroscopic (seed) data requires spatial markers that are detectable by both imaging modalities. In this study, the needle tips were considered as such fiducials.

Enhanced vascularization and survival of neural transplants with ex vivo angiogenic gene transfer.

Restoration of brain function by neural transplants is largely dependent upon the survival of donor neurons. Unfortunately, in both rodent models and human patients with Parkinson's disease the survival rate of transplanted neurons has been poor. We have employed a strategy to increase the availability of nutrients to the transplant by increasing the rate at which blood vessels are formed.