Miracle-dz/UniFAR-FTUs huggingface dataset:
SU-E-T-645: Treatment of Multiple Brain Metastases Using Stereotactic Radiosurgery with Single-Isocenter Volumetric Modulated Arc Therapy: Comparison with Conventional Dynamic Conformal Arc and Static Beam Stereotactic Radiosurgery.

PURPOSE To investigate the treatment of multiple brain metastases using stereotactic radiosurgery with single-isocenter volumetric modulated arc therapy (VMAT) compared with conventional multi-isocenter dynamic conformal arc therapy (DCAT) and three-dimensional conformal radiation therapy (3D-CRT). METHODS Seventeen patients with 2 to 5 brain metastatic lesions were studied. The number of patients with 5, 4, 3, and 2 lesions were 4, 5, 4, and 4, respectively. For patients treated with DCAT/3D-CRT plans, VMAT plans were retrospectively generated, and vice versa. Single-isocenter set up was employed in VMAT plans while the number of isocenters was proportional to the number of lesions in DCAT/3D-CRT plans. The DCAT/3D-CRT and VMAT plans were generated using iPlan® RT Dose Version 4.1. 1 (BrainLAB, Germany) and Eclipse™ Version 8.6 (Varian, USA) treatment planning system, respectively. All plans were designed to be delivered on Novalis Tx™ system (Varian, USA and BrainLAB, Germany), in which the accelerator equipped with a high definition multileaf collimator (HDMLC). RESULTS Conformity index for VMAT plans were equivalent to or better than that for DCAT/3D-CRT plans. While VMAT and DCAT/3D-CRT plans were similar in target coverage, quality of coverage for VMAT plans was better. However, the volume receiving 5Gy was 46% larger for VMAT plans. In addition, the distance from individual lesion to the VMAT isocenter has no impact on VMAT plans. Compared with DCAT/3D-CRT plans, the mean monitor units (MU) decreased by 42% and the estimated treatment time decreased by 49% for VMAT plans. CONCLUSIONS This work suggests that single-isocenter VMAT is promising for stereotactic radiosurgery in the treatment of multiple brain metastases. Single-isocenter VMAT is able to achieve comparable conformity, target coverage and quality of coverage with significantly superior delivery efficiency.
Interleukin 6 Variable Number of Tandem Repeats (VNTR) Gene Polymorphism in Centenarians

Recent population‐based studies identified the magnitude of interleukin 6 (IL6) serum levels as a marker for functional disability, and a predictor of disability and mortality among the elderly. We investigated whether there was evidence in Southern Italy of an association between the IL6 gene variable number of tandem repeats (VNTR) polymorphism and extreme longevity, and tested for the possible interaction of apolipoprotein E (APOE) alleles with the IL6 VNTR alleles. Four alleles coding for variants of four different lengths have been identified: allele A [760 base pairs (bp)], allele B (680 bp), allele C (640 bp), and allele D (610 bp). IL6 VNTR and APOE allele and genotype frequencies were studied in a total of 61 centenarians and 94 middle‐aged subjects from Southern Italy. The IL6 VNTR allele B was overrepresented in the younger control group compared with centenarians (odds ratio: 0.56, 95% confidence interval: 0.35–0.88, Bonferroni p‐value < 0.05). No interactions between IL6 VNTR alleles and APOE alleles on the odds ratios to reach extreme longevity were evaluated for the smallest number of subjects in centenarians and younger controls. Our findings suggested that the presence of the IL6 VNTR allele B could be detrimental for reaching extreme longevity.
Evaluation of the RF heating of a generic deep brain stimulator exposed in 1.5 T magnetic resonance scanners

The radio frequency (RF) electromagnetic field of magnetic resonance (MR) scanners can result in significant tissue heating due to the RF coupling with the conducting parts of medical implants. The objective of this article is to evaluate the advantages and shortcomings of a new four‐tier approach based on a combined numerical and experimental procedure, designed to demonstrate safety of implants during MR scans. To the authors' best knowledge, this is the first study analyzing this technique. The evaluation is performed for 1.5 T MR scanners using a generic model of a deep brain stimulator (DBS) with a straight lead and a helical lead. The results show that the approach is technically feasible and provides sound and conservative information about the potential heating of implants. We demonstrate that (1) applying optimized tools results in reasonable uncertainties for the overall evaluation; (2) each tier reduces the overestimation by several dB at the cost of more demanding evaluation steps; (3) the implant with the straight lead would cause local temperature increases larger than 18 °C at the RF exposure limit for the normal operating mode; (4) Tier 3 is not sufficient for the helical implant; and (5) Tier 4 might be too demanding to be performed for complex implants. We conclude with a suggestion for a procedure that follows the same concept but is between Tier 3 and 4. In addition, the evaluation of Tier 3 has shown consistency with current scan practice, namely, the resulting heat at the lead tip is less than 3.5 °C for the straight lead and 0.7 °C for the helix lead for scans at the current applied MR scan restrictions for deep brain stimulation at a head average SAR of 0.1 W/kg. Bioelectromagnetics 34:104–113, 2013. © 2012 Wiley Periodicals, Inc.
Choroid plexus papilloma in children: Diagnostic and surgical considerations

Background: Choroid plexus papilloma (CPP) is a benign neoplasm that arises from the ventricular choroid plexus. The clinical features, radiological characteristics, and treatment have been discussed in this study for a pediatric population. Methods: Over an eight-year period, seven pediatric (≤12 years) CPP patients were treated. Tumors were located in the lateral ventricle (n = 4), IVth ventricle (n = 2), and in both the lateral and IIIrd ventricles (n = 1). The patients presented predominantly with features of raised intracranial pressure. Total microsurgical excision was carried out in all cases. Results: There was complete relief of symptoms at follow-up in six patients. A 2.5 year-old child with a large trigonal CPP with hydrocephalus leading to complete visual impairment, died due to postoperative hypokalemia that caused ventricular fibrillation. One of our patients required a postoperative, permanent CSF diversion procedure while another required a subduroperitoneal shunt for persisting postoperative subdural CSF collection. Conclusions: Coagulation of the tumor under constant irrigation to shrink and excise it in toto, avoids excessive bleeding during surgery. The vascular pedicle supplying the tumor should be adequately dealt with during the last part of tumor removal as retraction of a bleeding pedicle may result in ventricular hemorrhage and brain edema. Following surgery, an external ventricular drain for three days helps in preventing the development of acute hydrocephalus in lateral ventricular lesions, and the color of the drained CSF gives an estimate of the ventricular hemostasis achieved. Total excision is usually possible in these cases with excellent postoperative outcomes.
The effects of oral contraceptives on androgen levels and their relevance to premenstrual mood and sexual interest: a comparison of two triphasic formulations containing norgestimate and either 35 or 25 microg of ethinyl estradiol.

PURPOSE This study compared two oral contraceptives (OCs) with the same triphasic regimen of progestin (norgestimate 0.18, 0.215 and 0.25 mg) but differing doses of ethinyl estradiol (EE) - 25 and 35 microg EE - in their effects on androgens, mood and sexual interest in women starting on OCs. METHODS Total testosterone (T), free testosterone (FT), sex-hormone-binding globulin (SHBG) and dehydroepiandrosterone sulphate (DHEA-S), together with measures of mood [Beck Depression Inventory (BDI)], sexual interest [Dyadic and Solitary subscales of the Sexual Desire Inventory (SDI)] and self-reported side effects were assessed before starting on the OC and again after 3 months of use. RESULTS Sixty women, all university students, were randomized to receive either the 25 microg EE (N/EE25) or the 35 microg EE (N/EE35) pill; 12 women discontinued, leaving 48 who completed the 3-month study. Their mean age was 19.7 years (18-30) and they were predominantly white and single. Both OCs produced reductions in mean T [N/EE35: from 1.33 to 0.60 nmol/L, p<. 001; N/EE25: from 1.12 to 1.02 nmol/L; nonsignificant (NS)] and FT (N/EE35: from 41.3 to 4.4 pmol/L, p<.001; N/EE25: from 25.4 to 7.9 pmol/L, p<.01), but the reduction in both T and FT was significantly greater with the higher EE dose (N/EE35) (p=.05 and p=.03, respectively). DHEA-S was also reduced with both formulations (N/EE35: from 7.26 to 5.22 micromol/L); N/EE25: from 7.50 to 5.39 micromol/L), although the reduction was only significant in the N/EE35 group (p<.02). Considerable variability in changes in mood was evident with both OCs, with some women showing predominantly negative effects (10 in N/EE35, 5 in N/EE25); others, positive effects (9 in N/EE35, 17 in N/EE25) and some, no change (four in each group). Women using N/EE25 were significantly more likely to show improvement in premenstrual mood than those in the N/EE35 group (p<.02), although there was no correlation between changes in BDI and FT or DHEA-S. Sexual interest scores did not change significantly from baseline to posttreatment with either OC (N/EE35: dyadic, from 40.5 to 39.6, NS; solitary, from 5.9 to 6.4, NS; N/EE25: dyadic, from 36.7 to 37.0, NS; solitary, from 5.0 to 4.2, NS). CONCLUSION The lower EE pill reduced FT less and was associated with greater improvement in premenstrual mood. A causal relation between these two effects is uncertain.
The synthesis and high‐level expression of a β2‐adrenergic receptor gene in a tetracycline‐inducible stable mammalian cell line

High‐level expression of G‐protein‐coupled receptors (GPCRs) in functional form is required for structure–function studies. The main goal of the present work was to improve expression levels of β2‐adrenergic receptor (β2‐AR) so that biophysical studies involving EPR, NMR, and crystallography can be pursued. Toward this objective, the total synthesis of a codon‐optimized hamster β2‐AR gene suitable for high‐level expression in mammalian systems has been accomplished. Transient expression of the gene in COS‐1 cells resulted in 18 ± 3 pmol β2‐AR/mg of membrane protein, as measured by saturation binding assay using the β2‐AR antagonist [3H] dihydroalprenolol. Previously, we reported the development of an HEK293S tetracycline‐inducible system for high‐level expression of rhodopsin. Here, we describe construction of β2‐AR stable cell lines using the HEK293S‐TetR‐inducible system, which, after induction, express wild‐type β2‐AR at levels of 220 ± 40 pmol/mg of membrane protein corresponding to 50 ± 8 μg/15‐cm plate. This level of expression is the highest reported so far for any wild‐type GPCR, other than rhodopsin. The yield of functional receptor using the single‐step affinity purification is 12 ± 3 μg/15‐cm plate. This level of expression now makes it feasible to pursue structure–function studies using EPR. Furthermore, scale‐up of β2‐AR expression using suspension cultures in a bioreactor should now allow production of enough β2‐AR for the application of biophysical techniques such as NMR spectroscopy and crystallography.
The suitability of hexyl cinnamic aldehyde as a calibrant for the murine local lymph node assay

The murine local lymph node assay (LLNA) for the prospective identification of contact allergens assesses skin sensitization potential as a function of proliferative activity induced in lymph nodes draining the site of topical exposure to test chemical. This method has been endorsed recently as a stand alone test for the identification of contact allergens. We have now examined the suitability of hexyl cinnamic aldehyde (HCA), a recommended positive control for skin sensitization testing, as a calibrant for comparing the consistency of LLNA responses with time, and between laboratories, and thus for the routine assessment of assay reliability. Standard LLNAs were performed with CBA strain mice in 3 independent laboratories over a period of 8 years. Dose‐response curves were used to derive mathematically the EC3 value (the estimated concentration of chemical necessary to cause a stimulation index (SI) of 3 compared with proliferation induced by concurrent vehicle controls). In each laboratory, 6 separate experiments were conducted using a single concentration of HCA (25%). Very similar stimulation indices were achieved, with mean values of 9.0, 6.5 and 6.6 recorded. A total of 10 dose‐response experiments were performed independently in the 3 laboratories and these revealed that there was very little inter‐laboratory, or temporal, variation in EC3 values. These data confirm that HCA responses in the LLNA are very stable and demonstrate that HCA provides a suitable calibrant for determining assay sensitivity and performance.
Serum lipid levels in pregnancies complicated by preeclampsia

CONTEXT AND OBJECTIVE: Pre-eclampsia is a disorder that occurs only during pregnancy. Postpartum changes relating to lipid metabolism may contribute towards the endothelial lesions observed in preeclampsia. Thus, the aim of the present study was to evaluate the lipid profile among patients who present preeclampsia and correlate these parameters with 24-hour proteinuria. DESIGN AND SETTING: Cross-sectional analytical study including 77 pregnant patients seen at Hospital Dório Silva. METHODS: This study involved 42 women with preeclampsia and 35 healthy pregnant women in the third trimester of pregnancy as controls. Blood samples were obtained from all the patients, and the serum levels of triglycerides, total cholesterol, low-density lipoproteins (LDL), high-density lipoproteins (HDL) and very low density lipoproteins (VLDL) were determined. Cases and controls were matched for maternal age, gestational week and body mass index. RESULTS: The VLDL and triglyceride values from the women with preeclampsia were significantly higher than those of the healthy women. There was a positive correlation between increased proteinuria and higher VLDL and triglyceride levels in patients with preeclampsia. CONCLUSION: Among the patients with preeclampsia, higher VLDL and triglyceride levels were positively correlated with proteinuria. These observations indicate that the pregnant women who presented elevated lipid levels were more susceptible to cardiovascular disorders and, consequently, pre-eclampsia.
Severe preeclampsia and the very-low-birth-weight infant. The controversy over delivery mode continues.

OBJECTIVE To compare the effects of labor induction with those of cesarean delivery without labor on neonatal outcome in pregnancies complicated by severe preeclampsia and delivery of very-low-birth-weight infants. STUDY DESIGN This retrospective study covered 400 singleton, live-born infants who weighed 750-1,500 g at birth and were delivered because of severe preeclampsia. Outcome in infants delivered by cesarean section without labor was compared with that in infants exposed to labor induction. RESULTS Of the 400 women with severe preeclampsia who delivered infants between 750 and 1,500 g; 280 (70%) had labor induced, and 120 (30%) delivered without labor. Vaginal delivery was accomplished by 182 (65%) women in the induced group. Apgar scores of < or = 3 at five minutes was more common in the labor-induced group (6% versus 3%, P = .04); however, other neonatal outcomes, including respiratory distress syndrome, ventricular hemorrhage, sepsis, seizures and neonatal death, were similar in the two groups. Data analysis of the induced group did not reveal an association between route of delivery and neonatal outcome. Outcome in both groups was satisfactory at six months. CONCLUSION Induction of labor in women with severe preeclampsia is not harmful to very-low-birth-weight infants and appears to be a safe mode of delivery.
Effect of Preoperative Finasteride on the Volume or Length Density of Prostate Vessels, Intraoperative, Postoperative Blood Loss during and after Monopolar Transurethral Resection of Prostate: A Dose Escalation Randomized Clinical Trial Using Stereolog Methods.

PURPOSE To evaluate the effects of two preoperative treatment courses with Finasteride on intraoperative and postoperative bleeding complications and prostate blood vessel characteristics in men who underwent transurethral resection of prostate (TURP) using monopolar energy. MATERIALS AND METHODS Men scheduled for TURP were randomized into group 1 (control n = 25, no medication), group 2 and 3 (n = 20 in each, 5 mg Finasteride daily for 2 and 4 weeks before TURP; respectively). Hematocrit level in the irrigation fluid, weight of the resected prostate chips, decreases in blood hemoglobin (Hb) level 6 and 24 hours after the operation together with volume and length density of prostate vessels using stereological methods were compared. RESULTS The three groups were matched regarding preoperative demographic data, resection time and weight of the resected tissue. Men who received preoperative Finasteride (groups 2 and 3) had significantly lower hematocrit levels in irrigation fluid than control group (control, 0.59 ± 0.85, group 2, 0.25 ± 0.4, group 3, 0.175 ± 0.16; P = .028; Power = .80). However, no statistically significant difference was found in hematocrit level in irrigation fluid between groups 2 and 3 (0.25 ± 0.4 vs. 0.175 ± 0.16, 95% confidence interval (CI) = -0.28-0.42; P = . 68). These values were independent of the weight of the resected tissue and resection time. There were no significant differences between the three groups in the decrease in Hb 6 hours (P = .58) and 24 hours after TURP (P = .65). The stereological and histological characteristics of blood vessels in suburethral prostate tissue were similar in all three groups. CONCLUSION A 2-week preoperative course of daily Finasteride seems sufficient to significantly reduce intraoperative blood loss; this effect was independent of the weight of the resected tissue and resection time. Neither the 2-week nor the 4-week presurgical Finasteride regimen could significantly decrease postoperative blood loss, and neither regimen induced significant changes in characteristics of prostate tissue blood vessels.
Association of PTPN22+1858C/T polymorphism with Type 1 diabetes in the North Indian population

A nonsynonymous SNP +1858C/T (rs2476601) in the protein tyrosine phosphatase, nonreceptor type 22(PTPN22) gene leading to Arg 620 Trp substitution is known to be associated with susceptibility to type 1 diabetes (T1D) and several other autoimmune diseases. We studied this polymorphism in 145 T1D patients and 210 healthy controls from North India. The minor allele +1858T was observed to be significantly increased among patients as compared to healthy controls (2.76% vs 0.5%, P = 0.027, OR = 5.93; 95% CI = 1.4–24.8). The association was also observed at the level of heterozygous C/T genotype (5.5% vs 0.95%, P = 0.026, OR = 6.07; 95% CI = 1.43–25.6). The T allele and C/T genotype were predominantly found among patients who were positive for both glutamic acid decarboxylase 65 (GAD65) and insulin antigen 2 (IA2) autoantibodies and showed significantly increased frequencies (10%, P = 0.034, OR = 11.67; 95% CI = 1.58–84.1 and 20%, P = 0.031, OR = 13.0; 95% CI = 1.66–97.5, respectively) as compared to patients negative for these autoantibodies (0.95% and 1.9%, respectively). The results suggest that the PTPN22+1858T allele is positively associated with T1D in the North Indian population.
Outcome analyses after the first admission to an intensive care unit in patients with advanced cancer referred to a phase I clinical trials program.

PURPOSE This study assessed outcomes of individuals with advanced cancer who required admission to an intensive care unit (ICU) after referral for an early clinical trial because they did not respond to conventional therapy. PATIENTS AND METHODS Outcome analyses were conducted for 212 consecutive patients admitted to The University of Texas MD Anderson Cancer Center ICU after being seen in the phase I clinic starting on May 1, 2007. All data were obtained by a review of electronic medical records of patients. RESULTS The median survival of 212 patients with advanced cancer referred to phase I care after the initial ICU admission was 3.2 weeks (95% CI, 2.5 to 4.9 weeks). Patients who underwent cardiopulmonary resuscitation (CPR) succumbed within a median survival of 1 day (75% and 25% estimated survival of 1 and 3 days, respectively). Patients admitted for a postsurgical intervention did better than patients admitted for a nonsurgical intervention (median survival, 21.5 versus 2.1 weeks; P < .0001). The multivariate analysis revealed that a nonsurgical intervention, hypoalbuminemia, and higher Acute Physiology and Chronic Health Evaluation II scores were associated with poor overall survival. CONCLUSION The outcome of patients in a phase I clinic after initial ICU admission was poor, particularly when admission was for a nonsurgical intervention and/or when CPR was needed.
Test/retest reproducibility of iodine-123-betaCIT SPECT brain measurement of dopamine transporters in Parkinson's patients.

UNLABELLED Iodine-123-beta-CIT has been used as a probe of dopamine transporters in Parkinson's disease patients using SPECT. We studied the test/retest reproducibility of SPECT measures in Parkinson's disease patients and healthy controls obtained after injection of [123I])beta-CIT in part to assess the utility of this tracer for longitudinal evaluation of striatal dopamine transporters as a marker of disease progression. METHODS Seven Parkinson's disease patients and seven healthy control subjects participated in two [123I]beta-CIT SPECT scans separated by 7-21 days. Subjects were imaged at 24 hr post injection of 360 MBq (9.7 mCi) of [123I]beta-CIT. Two outcome measures were evaluated; 1) the ratio of specific striatal (activity associated with DA transporter binding) to nondisplaceable uptake, also designated V3," and 2) the total specific striatal uptake (%SSU) expressed as a percentage of injected radiotracer dose. For both measures, test/retest variability was calculated as the absolute difference of test minus retest divided by the mean of test/retest and expressed as a percent. In addition, the reproducibility of left and right striatal asymmetry and putamen:caudate ratios were determined. RESULTS The two outcome measures demonstrated excellent test/retest reproducibility for both the Parkinson's disease and healthy subject groups with variability of striatal V3" = 16.8 +/- 13.3% and percent striatal uptake = 6.8 +/- 3.4% for Parkinson's disease patients and V3" = 12.8 +/- 8.9% and %SSU = 7.0 +/- 3.9% for control subjects. There were no statistically significant differences in test/retest variability between control subjects and Parkinson's disease patients for either outcome measure. The reproducibility of left/right asymmetry indices and putamen-to-caudate ratios showed no patient versus control subject differences. The asymmetry index had greater test/retest variability than the other outcome measures. CONCLUSION These data suggest that SPECT imaging performed at 24 hr postinjection of [123I]beta-CIT permits calculation of reliable and reproducible measures of dopamine transporters in both Parkinson's disease patients and control subjects and supports the feasibility of using [123I]beta-CIT in the evaluation of disease progression in Parkinson's disease.