bluuebunny/crossref_metadata_2025_split huggingface dataset:
Information and support radiographers: a critical review of the role and its significance for the provision of cancer services
Authors: Colyer H. , Hlahla T. 
Published: August 2006

The purpose of this paper is twofold; firstly, to present for wider consideration data collected about the role of information and support radiographers (ISRs) in the United Kingdom and secondly, to review critically issues of significance arising from the initial data collection and content analysis.The empirical material is taken from a much larger survey of Oncology Centres1 whose aim was to analyse the extent and effectiveness of information and support services for cancer patients in order to evaluate service provision in a less developed country. A short, self completed postal questionnaire to identified information and support radiographers was employed. It sought to identify the main components of the ISR role, underpinning qualifications, limitations and potential for development. 64% of ISRs surveyed responded (n = 22) and the findings are presented for consideration in this paper.The discussion comprises a critical review by the first author of some issues raised by the findings in the context of the national service framework for integrated provision2 and current developments in the practice and processes of therapeutic radiography. Specifically, the relative contribution of different aspects of the role of the ISR are evaluated, examining the benefits to patients and professionals alike. The difficulties of trailblazing a new role in a traditional, hierarchical service are explored. The necessity of a profession specific base for information and support provision in clinical oncology is questioned and it is suggested that, professionally, there are both advantages and disadvantages to this role development, but there is support for a less predatory, more interprofessional approach.
Quality control and error detection in the radiotherapy treatment process
Authors: Bate Marie-Thérèse , Speleers Bruno , Vakaet Luc A.M.L. , De Neve Wilfried J. 
Published: August 2006

Purpose: In 1995, a post of quality control (QC) officer was established in the Radiotherapy Department of the University Hospital Gent (R-UZG). We report here the evolution of error detection in the domain of information transfer during the different steps of the treatment chain, in our department, since the creation of this job.Material and Methods: From January 1995 to December 1997 (1995 n = 831; 1996: n = 1095; 1997: n = 1091), data on errors were recorded. At the start, an inventory was made of the existing situation and a Quality Assurance (QA) program was outlined for process control. According to the site of origin of errors in the treatment preparation chain, errors were separated into five levels: medical treatment prescription, simulation, treatment planning, treatment data transfer and daily set-up.Results: The total number of errors found was 459 in 1995; 809 in 1996 and 1046 in 1997. During 1995 and 1996 the medical prescription protocols were adapted to the increasing need of the radiation technologists for more information. This explains an increased number of errors (from 80/459 to 276/809) in 1996. After a period of adaptation, the number of errors decreased in 1997 (257/1046). The second level, where many errors were found, is at the transfer phase (1995: 181/459 1996: 210/809; 1997: 336/1046). Most of these errors were made during the transfer of data from the prescription chart to the computer. These errors were due to lack of attention, human mistakes and calculation errors. The number of errors during simulation increased due to rotation of personnel in 1996. The increase persisted in 1997 for the same reason. Transfer errors due to the automatic transfer of leaf settings decreased (1995:18/29; 1996:15/17; 1997:7/31) Thanks to the start of QC management, errors were detected and corrected in the entire treatment process at R-UZG. Once changes were accepted, new challenges were initiated. After each evaluation, initiatives were taken to try to decrease specific errors. Changing attitudes was a difficult and slow process, but progress was made. The most important change in attitude certainly was the acceptation of the concept of QC.
Ultrasound guided I–125 permanent prostate implants: seed calibration and radiation exposure levels
Authors: Que William , Videla Nelson , Langer Deanna 
Published: August 2006

Purpose: (1) To present data on I–125 seed calibration in a clinical setting so that reasonable tolerance levels can be set for the discrepancy in seed strength between manufacturer specified value and institution measured value; (2) To present data on measured exposure rates and estimate radiation exposure levels associated with I–125 prostate implants.Methods and Materials: Ten percent of each batch for 50 batches of I–125 seeds were calibrated using an HDR 1000 PLUS well chamber with a single source holder. Exposure rates due to I–125 were measured by survey meters with a scintillation probe designed for low energy photon counting, as well as a survey meter of the ionization chamber type. Exposure rates of an unshielded I–125 seed, a needle loaded with three seeds, and 54 prostate implant patients immediately after the implant were obtained.Results: Compared to the manufacturer stated midrange seed strength for a batch of seeds, the average seed strength of sampled seeds had maximum deviations of ±8%, however for 45 out of 50 batches the deviation was less than ±5%. Measured single seed strength deviated up to ±12% from the manufacturer stated midrange value, and between −11% to 7% from the mean of the sampled batch. The exposure rate of a 1.39×107 Bq (0.375 mCi) unshielded I–125 seed was about 1.548×10−8C/kgh (0.06 mR/h) at 1 m, and 1.29×10−6C/kgh (5 mR/h) at 10 cm. For a needle loaded with three seeds, the exposure rate was 1.29×10−8C/kgh (0.05 mR/h) at the handle, and 1.29×10−7C/kgh (0.5 mR/h) along the shaft. For patients implanted with I–125 seeds in the prostate, the average exposure rate was 3.61×10−8C/kgh (0.14 mR/h) at 1m, and 4.13×10−7C/kgh (1.6 mR/h) at the pelvis surface.Conclusions: For the mean seed strength a first action level should be set at a deviation of at least 5% deviation from the manufacturer stated midrange value. For individual seeds, a first action level set at 10% deviation from the manufacturer stated midrange value seems reasonable. A person performing I–125 seed calibration or seed loading could receive up to 0.5 mSv (50 mR) per case to the hands. In the first year following an I–125 prostate implant, the spouse of the patient could receive slightly over 1mSv from the I–125 in the patient. A co-worker should not receive more than 0.5 mSv from the patient.
Towards an evidence-based 3D conformal radiotherapy prostate protocol: what is the role of spiral CT?
Authors: Newnham John 
Published: August 2006

Aim: To define the role of spiral CT in evolving an evidence-based 3D Conformal Radiotherapy (CRT) prostate protocol at Lincoln, UK.Discussion: Tumour doses traditionally prescribed at this centre to the prostate planning target volume (PTV) (64 Gy in 32 fractions) cannot be further escalated without modification of existing technique and may currently be inadequate to obtain the highest probability of local control. Prostate CRT has been demonstrated to be well tolerated with both conventional and escalated doses, however as 3D CRT PTV margins are tightened, prostate position has to be reliably predicted to avoid geographic misses or unacceptable normal tissue toxicity. The question of prostate position variability might be addressed by sequential on-treatment spiral CT scans at this centre. Spiral CT offers specific advantages of speed, small detail conspicuity, and arbitrary axial reconstruction compared to conventional CT with no attached dose penalty. Spiral CT coupled to the next generation of radiotherapy treatment planning systems (RTPs) may soon replace the CT virtual-simulator. There are significant hardware discrepancies between some present generation CT couch tops and linac couch tops. Recently published CT studies that consider prostate position variability may be fundamentally and significantly flawed due to these couch top differences. Due to a paucity of reported evidence regarding immobilisation methods, a spiral CT study is warranted to assess efficacy of immobilization method for an evidence-based prostate protocol. Confirmative spiral CT research at this centre into prostate position variability is required to select adequate margins to form the PTV for an evidence-based 3D CRT prostate protocol. Such a spiral CT study could be integrated with the immobilisation study and may separate or define the correlation (which at present is both unclear and unreported) between pelvic immobilization and prostate position variability. Initial PTV margins defined by expanding the CTV in three dimensions using an ellipsoid with major axes 1.65 times one standard deviation of prostatic displacement reported in initial studies to obtain margins of 0.7 cm laterally, 0.7 cm cranio-caudally and 1.1 cm in the AP direction are presently indicated for this centre's evidence-based prostate protocol.Conclusion: Spiral CT will provide the essential data set for 3D CRT planning for an evidence-based prostate protocol at Lincoln. Confirmative research using spiral CT is also warranted to assess daily prostate position variability and help define the prostate PTV for an evidence based prostate protocol at this centre.
Financial implication of conformal prostate treatment
Authors: Flinton D. M. , Desai P. 
Published: August 2006

Objective: The objective of this study was to directly compare the cost of conformal radiotherapy used with the RTo1 trial with that of non-conformal radiotherapy of the prostate.Method: Two methods were employed to establish the cost, a simplistic top-down method and the more complicated bottom-up method that involved breaking down the cost elements of the respective treatments and undertaking a non-participative timing study on 37 patients undergoing radiotherapy. Costs were then ascribed based on the time the staff and equipment were utilised.Results: The total cost of radiotherapy using the top-down method for both non-conformal radiotherapy and 32 fraction conformal radiotherapy was £2890.88, compared with £3342.58 for conformal radiotherapy using 37 fractions. The costs of the bottom-up method were £2485.67 for non-conformal radiotherapy, £2717.67 for 32 fraction conformal radiotherapy and £3110.52 for conformal radiotherapy using a 37 fraction regime.Conclusions: Conformal radiotherapy of the prostate costs significantly more than non-conformal radiotherapy which reflects the increase in complexity of the technique. Cost differences arose due to increased time in the planning stage and in the actual treatment because of an increase in equipment and staffing costs during treatment.
Pilot study to investigate the toxicity of Aloe vera gel in the management of radiation induced skin reactions for post-operative primary breast cancer
Authors: Dudek Dana J. , Thompson Jennifer , Meegan Martina M. , Haycocks Tara R. , Barbieri Clarice , Manchul Lee A. 
Published: August 2006

The purpose of this Phase 2 Breast Skin Care Pilot Study was to compare the acute skin reaction in patients undergoing radiation therapy for early breast cancer who use Aloe vera gel on the irradiated skin, with the acute skin reaction in patients from our earlier study who followed a normal skin care routine. Two secondary objectives were to assess patient compliance with the use of Aloe vera gel and the ease of using two skin toxicity scoring tools.A total of 109 patients undergoing radiotherapy following surgery for breast cancer between October 1997 and February 1998 consented to participate in this study. Each patient applied the Aloe vera gel three times daily to the irradiated area during radiation treatment. Skin reactions were assessed objectively on a weekly basis during radiation using the Radiation Therapy Oncology Group (RTOG) and the Acute Skin Reaction Index (ASRI) skin scoring tools and subjectively by patients. All patients were followed for up to 3 weeks following treatment.The use of Aloe vera gel did not increase the acute skin reactions due to irradiation when compared with the two arms of the previous Phase 1 Breast Skin Care Study. This pilot study demonstrated that patients could safely use Aloe vera gel while undergoing radiation therapy treatments. All patients complied uniformly with the instructions of using the gel during the study. The ASRI skin scoring tool was easier to use and more sensitive in displaying differences in skin reactions in comparison to the RTOG scale.
Id‐1 modulates senescence and TGF‐β1 sensitivity in prostate epithelial cells
Authors: Di Kaijun , Ling Ming‐tat , Tsao Sai Wah , Wong Yong Chuan , Wang Xianghong 
Published: August 2006

Background information. Loss of sensitivity to TGF‐β1 (transforming growth factor β1)‐induced growth arrest is an important step towards malignant transformation in human epithelial cells, and Id‐1 (inhibitor of differentiation or DNA binding‐1) has been associated with cell proliferation and cell‐cycle progression. Here, we investigated the role of Id‐1 in cellular sensitivity to TGF‐β1.Results. Using an immortalized prostate epithelial cell line, NPTX cells, we suppressed Id‐1 expression through antisense strategy. We found that inhibition of Id‐1 expression suppressed cell proliferation and at the same time induced cellular senescence and G2/M cell‐cycle arrest. In addition, inactivation of Id‐1 made cells more vulnerable to TGF‐β1‐induced growth arrest. The sensitization effect on TGF‐β1 was associated with up‐regulation of two downstream effectors of the TGF‐β1 pathway, p21WAF1/Cip1 and p27KIP1.Conclusion. Our results indicate that endogenous Id‐1 levels might be a crucial factor in the development of resistance to TGF‐β1‐induced growth suppression in human prostate epithelial cells.
New comprehension of the apicoplast of Sarcocystis by transmission electron tomography
Authors: Tomova Cveta , Geerts Willie J.C. , Müller‐Reichert Thomas , Entzeroth Rolf , Humbel Bruno M. 
Published: August 2006

Background information. Apicomplexan parasites (like Plasmodium, Toxoplasma, Eimeria and Sarcocystis) contain a distinctive organelle, the apicoplast, acquired by a secondary endosymbiotic process analogous to chloroplasts and mitochondria. The apicoplast is essential for long‐term survival of the parasite. This prokaryotic origin implies that molecular and metabolic processes in the apicoplast differ from those of the eukaryotic host cells and therefore offer options for specific chemotherapeutic treatment. We studied the apicoplast in high‐pressure frozen and freeze‐substituted cysts of Sarcocystis sp. from roe deer (Capreolus capreolus) to get better insight in apicoplast morphology.Results and conclusions. We observed that the apicoplast contains four continuous membranes. The two inner membranes have a circular shape with a constant distance from each other and large‐sized protein complexes are located between them. The two outer membranes have irregular shapes. The periplastid membrane also contains large‐sized protein complexes, while the outer membrane displays protuberances into the parasite cytoplasm. In addition, it is closely associated with the endoplasmic reticulum by ‘contact sites’.
Artificial muscles based on liquid crystal elastomers
Authors: Li Min-Hui , Keller Patrick 
Published: August 2006

This paper presents our results on liquid crystal (LC) elastomers as artificial muscle, based on the ideas proposed by de Gennes. In the theoretical model, the material consists of a repeated series of main-chain nematic LC polymer blocks, N, and conventional rubber blocks, R, based on the lamellar phase of a triblock copolymer RNR. The motor for the contraction is the reversible macromolecular shape change of the chain, from stretched to spherical, that occurs at the nematic-to-isotropic phase transition in the main-chain nematic LC polymers.We first developed a new kind of muscle-like material based on a network of side-on nematic LC homopolymers. Side-on LC polymers were used instead of main-chain LC polymers for synthetic reasons. The first example of these materials was thermo-responsive, with a typical contraction of around 35–45% and a generated force of around 210 kPa. Subsequently, a photo-responsive material was developed, with a fast photochemically induced contraction of around 20%, triggered by UV light.We then succeeded in preparing a thermo-responsive artificial muscle, RNR, with lamellar structure, using a side-on nematic LC polymer as N block.Micrometre-sized artificial muscles were also prepared. This paper illustrates the bottom-up design of stimuli-responsive materials, in which the overall material response reflects the individual macromolecular response, using LC polymer as building block.
Optimized ultrasound‐mediated gene transfection in cancer cells
Authors: Feril Loreto B. , Ogawa Ryohei , Tachibana Katsuro , Kondo Takashi 
Published: August 2006

Ultrasound‐mediated gene transfection (sonotransfection) is a promising physical method for gene therapy, especially for cancer gene therapy. To investigate the optimal sonotransfection conditions and to determine whether the optimal transfection rate using sonotransfection is comparable to that of electrotransfection or liposome‐mediated transfection, we sonicated different cancer cell lines (U937, HeLa, PC‐3, Meth A and T‐24) using a 1‐MHz unfocused ultrasound at different intensities, pulse repetition frequencies and exposure times. The ideal ultrasound conditions were noted to be at 1.5 Watt/cm2 pulsed at 0.5 Hz with a duty factor of 50%. The results showed that transfection rate increased with the number of pulses, and peaked between 10 and 15 pulses before it started to decline. Using such optimal conditions, we have shown that sonotransfection is superior to electrotransfection and liposome‐mediated transfection at the fixed conditions used in the present study. These findings suggest that sonotransfection could be a better alternative to other non‐viral methods (e.g. electroporation and liposome‐mediated transfection) of gene transfection, particularly in cancer gene therapy. (Cancer Sci 2006; 97: 1111–1114)
Review article: mode of action and delivery of 5‐aminosalicylic acid – new evidence
Authors: DESREUMAUX P. , GHOSH S. 
Published: August 2006

SummaryThe effectiveness of sulfasalazine depends on the splitting of the diazo bond in the molecule by the action of bacteria in the large bowel, releasing the pharmacologically active moiety, 5‐aminosalicylic acid. The development of pH‐dependent, delayed‐release formulations of 5‐aminosalicylic acid abolished the toxicity associated with the sulfapyridine part of sulfasalazine.5‐aminosalicylic acid is now believed to act by activating a class of nuclear receptors involved in the control of inflammation, cell proliferation, apoptosis and metabolic function, the γ form of peroxisome proliferator‐activated receptors. These receptors are expressed at particularly high levels in colon epithelial cells, where their expression appears to be at least in part stimulated by gut bacteria. Other drugs known to act via peroxisome proliferator‐activated receptor‐γ, such as rosiglitazone and the selective peroxisome proliferator‐activated receptor‐γ ligand GW1929, can be displaced from their binding sites on the peroxisome proliferator‐activated receptor‐γ molecule by 5‐aminosalicylic acid at concentrations of 5‐aminosalicylic acid that correspond with the concentrations found in the lumen of ulcerative colitis patients taking oral mesalazine.Genetically engineered heterozygous knockout mice (peroxisome proliferator‐activated receptor‐γ±) are particularly susceptible to colonic inflammation, and inflammation is more severe in these mice, in response to chemicals that induce experimental colonic ulcers. In these experimental models, 5‐aminosalicylic acid is ineffective in peroxisome proliferator‐activated receptor‐γ± mice. This new insight provides a mechanistic foundation for the possibility that long‐term treatment with 5‐aminosalicylic acid can reduce the risk of colorectal cancer in patients with ulcerative colitis.
PI3K/Akt‐dependent Epo‐induced signalling and target genes in human early erythroid progenitor cells
Authors: Sivertsen Einar Andreas , Hystad Marit Elise , Gutzkow Kristine Bjerve , Døsen Guri , Smeland Erlend Bremertun , Blomhoff Heidi Kiil , Myklebust June Helen 
Published: August 2006

SummaryErythropoietin (Epo) is the major regulator of differentiation, proliferation and survival of erythroid progenitors, but the Epo‐induced changes in gene expression that lead to these effects are not fully understood. The aim of this study was to examine how Epo, via activation of phosphatidylinositol 3‐kinase (PI3K)/Akt, exerts its role in the development of erythroid progenitors from CD34+ cells, and to identify early Epo target genes in human erythroid progenitors. In CD34+ progenitor cells, Epo alone was able to induce cell cycle progression as demonstrated by upregulation of cyclin D3, E and A leading to hyperphosphorylation of the retinoblastoma protein (RB). These effects were completely counteracted by the PI3K inhibitor LY294002. Furthermore, enforced expression of an activated form of Akt kinase highly augmented Epo‐induced erythropoiesis. Fluorescent‐activated cell sorting (FACS)‐sorted CD34+CD71+CD45RA−GPA− erythroid progenitors stimulated with Epo in the presence or absence of LY294002 were subjected to gene expression profiling. Several novel target genes of Epo were identified, and the majority were regulated in a PI3K‐dependent manner, including KIT (CD117) and CDH1 (E‐cadherin). FACS analysis of Epo‐stimulated erythroid progenitors showed that the increased mRNA expression of KIT and CDH1 was accompanied by an induction of the corresponding proteins CD117 and E‐cadherin.
Gene expression analysis of myeloid and lymphoid lineage markers during mouse haematopoiesis
Authors: Sakhinia E. , Byers R. , Bashein A. , Hoyland J. , Buckle A.‐M. , Brady G. 
Published: August 2006

SummaryExpression profiling of haematopoietic cells is hampered by the heterogeneous nature of haematopoietic tissues and the absolute rarity of early unrestricted progenitors. To overcome this, the expression profile of lymphoid and myeloid‐associated genes (LEF1, EBF, CD19, Sox‐4, B29, CD45, C‐fms, lysozyme, PU.1 and CD5) were investigated in 40 mouse myeloid haematopoietic precursors covering the entire haematopoietic hierarchy from multipotential to committed single lineages. The lineage‐specific expression seen in single‐cell studies was confirmed by examining fractionated bone marrow, whole tissues and differentiation of the multipotent cell line FDCP (Factor Dependent Cell Paterson) mix. Analysis of the 40 single myeloid precursors failed to detect expression of lymphoid‐associated genes, LEF1, EBF, CD19 and CD5, despite detection in lymphoid cell controls. Surprisingly, the lymphoid‐associated genes, Sox‐4 and B29 were detected in the single myeloid precursors, which was confirmed in bone marrow and a multipotential myeloid cell line. The pattern of Sox‐4 and B29, is consistent with a potential role in the commitment of bipotential granulocytic/macrophage precursors towards the granulocyte or macrophage lineage. In addition to providing baseline values for myeloid and lymphoid lineage markers during mouse haematopoiesis, these results highlight the importance of single‐cell analysis in the study of complex tissues.