bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation and experiences of an intraoperative radiotherapy service
Authors: Armoogum K. , Ackland C. , Gardner J. 
Published: November 2006

Intraoperative radiotherapy (IORT) using a miniature X-ray source has the potential to impart the same clinical benefit as external beam radiotherapy (EBRT), in a single fraction. The patient benefits are significant, since IORT could replace several weeks of fractionated EBRT. We present our initial experiences of IORT using the Zeiss Intrabeam™ system for treating early stage breast cancer and intracranial malignancies. Implementing this treatment modality requires a multidisciplinary approach drawing on the expertise of surgeons, oncologists, medical physicists, anaesthesiologists, nursing staff and pathologists. Team coherence is facilitated by a nurse co-ordinator. We have treated 66 patients in 24 months. For breast tumours, the mean treatment time was 28.54 min and the applicator sizes ranged from 3.0 to 5.0cm (mode = 4.5cm). A dose of 5Gy is prescribed to spherical volume of 1cm from the applicator surface. For brain tumours, the mean treatment time was 19.70 min and the applicator sizes ranged from 1.5 to 3.5cm (mode = 2.5cm). Mean dose was 11.1Gy prescribed to a spherical volume of 0.5cm from the applicator surface.A multidisciplinary team is essential for the successful implementation of IORT. This paper describes how, through reliance on an oncology nurse specialist to co-ordinate the programme, we have successfully set-up an IORT service.
A feasibility study of an internal control methodology using hydrocortisone cream for the management of skin reactions in patients receiving radical radiation therapy for cancers of the head and neck
Authors: Sperduti A. , Cashell A. , Rocca C. , Hirji A. , Billingsley S. , Waldron J. , Pond G. 
Published: November 2006

Background: The literature on the evaluation of the management of radiation-induced dermatitis demonstrates the methodological difficulties of studying this subject. Therefore, the feasibility of a methodology whereby the patient acted as their own control was used to study acute cutaneous side effects for head and neck radiotherapy patients using 1% hydrocortisone cream (HC).Methods: Twenty patients were asked to apply Hyderm (1% hydrocortisone) cream twice daily to one side of the treatment area (either right or left) beginning on day one of radiation therapy and ending 2 weeks post-radiation therapy. The centres standard skin care protocol using mild soap and water and no creams was used on the other side of the neck. Once weekly the patients were assessed and scored using the Radiation-Induced Skin Reaction Scale and Radiotherapy and Oncology Group assessment scales and the patient completed a symptom scoring scale each week was a baseline assessment undertaken before they started treatment. To document compliance with study instructions, patients were asked to keep a calendar indicating when they applied the cream and to which side, and this was collected by clinical staff.Results: At the conclusion of the study, 12 patients were enrolled. During the course of the study it became increasingly obvious that the side to which patients were applying the Hyderm scored higher on the assessment scale, indicating an increased skin reaction than the control side. This was confirmed with the photographs and patient symptom scale. As a result of these increased reactions, the study ceased accrual earlier than anticipated and all patients were advised to discontinue Hyderm use.Conclusion: The increase in skin toxicity was unexpected, particularly as the institutional standard of care recommended the use of HC as treatment for radiation dermatitis. The number of patients in the study was too small to make conclusive statements about the efficacy of HC. We were able to confirm the feasibility of using an internal control methodology in these patients. Compliance results indicate the skin care instructions were clearly written and patients were able to follow them.
Dilemmas in gaining consent for radical radiotherapy from patients with early stage prostate cancer
Authors: Treeby J. 
Published: November 2006

Prostate cancer is a common male cancer, and arguably the form of cancer with least certainties about most appropriate form of treatment, leading to a greater freedom of choice among patients as to which treatment they wish to undertake.Department of Health guidelines state that to be valid, consent to treatment must be fully informed, and professional bodies demand that consent should be ongoing throughout a course of treatment. It is recognised that in spite of the wealth of information available, prostate cancer patients generally feel less well informed about their disease and treatment than those with any other form of cancer.Information about treatment efficacy and outcome is available from a wide variety of sources, of varying reliability, and patients can as easily receive too much information as they can too little. Bias from those imparting information cannot be excluded, and patient choices could be made on the basis of inaccurate or misleading information.Practitioners have a duty of care to ensure that patients receive a level of information appropriate to their level of understanding and ability to absorb knowledge, and longstanding legal precedents are established to ensure that risks as well as benefits of treatment are discussed with patients.
Open Standards and Resources in Systems Biology: collaborative scale-up toward virtual life
Authors: Le Novere Nicolas 
Published: November 2006

AbstractThe practise of Systems Biology relies on interfaces. Interfaces between the entities we study: the paradigm moved from a physical object centric view toward a relationship-centric one; interfaces between tools: From the retrieval of the primary data to the fine analysis of a model's behaviour, one uses many tools, more or less well connected; interfaces between individuals: To build any non-trivial mechanistic model requires to merge existing work and gather external expertise.If we want these interfaces to be generic enough to allow for anybody to leverage on existing toolkits, a fundamental requirement is the existence of community-developed well supported standards, but also open resources where to find the "lego" blocks. Over the last half-decade, several efforts have been launched in that direction,whether concerning encoding format, ontologies or databases. Some of them are now well-established in the field and play a significant role to improve its coherence but also to increase the size and the quality of quantitative models.
DARPP-32 is a robust integrator of dopamine and glutamate signals
Authors: Le Novere Nicolas , Fernandez Eric , Schiappa Renaud , Girault Jean-Antoine 
Published: November 2006

AbstractIntegration of neurotransmitter and neuromodulator signals in the striatum plays a central role in the functions and dysfunctions of the basal ganglia. DARPP-32 is a key actor of this integration in the GABAergic medium-size spiny neurons, in particular in response to dopamine and glutamate. When phosphorylated by cAMP-dependent protein kinase (PKA) DARPP-32 inhibits protein phosphatase-1 (PP1), whereas when phosphorylated by cyclin-dependent kinase 5 (CDK5) it inhibits PKA. DARPP-32 is also regulated by casein kinases and by several protein phosphatases. These complex and intricate regulations make simple predictions of DARPP-32 dynamic behaviour virtually impossible. We used detailed quantitative modelling of the regulation of DARPP-32 phosphorylation to improve our understanding of its function. The models included all the combinations of the three best characterized phosphorylation sites of DARPP-32, their regulation by kinases and phosphatases, and the regulation of those enzymes by cAMP and Ca2+ signals. Dynamic simulations allowed to observe the temporal relationships between cAMP and Ca2+ signals. We confirmed that the proposed regulation of protein phosphatase-2A (PP2A) by calcium can account for the observed decrease of Threonine 75 phosphorylation upon glutamate receptor activation. Sensitivity analysis showed that CDK5 activity is a major regulator of the response, as previously suggested. Conversely, the regulation of PP2A by PKA or by calcium, had little effect on the function of DARPP-32 in these conditions. The simulations showed that DARPP-32 is not only a robust signal integrator, but also a coincidence detector, the delay between cAMP and calcium signals affecting the response to the latter. This integration did not depend on the concentration of DARPP-32, while the absolute response on PP1 varied linearly. In silico mutants showed that Ser137 phosphorylation affects the coincidence detector function, and that constitutive phosphorylation in Ser137 transforms DARPP-32 in a quasi-irreversible switch. This work is a first attempt to better understand the complex interactions between cAMP and Ca2+ regulation of DARPP-32. Progressive inclusion of additional components should lead to a realistic model of signalling networks underlying the function of striatal neurons.
Assessment of takotsubo (ampulla) cardiomyopathy using iodine-123 metaiodobenzylguanidine scintigraphy
Authors: Pessoa Pinheiro M. C. , Xavier Salles S. , Lima Souza Leão R. , Mansur J. , de Almeida Altino S. , Carvalho Pires A. C. , Gutfilen B. , da Fonseca Barbosa L. M. 
Published: November 2006

Purpose: To evaluate the role of cardiac sympathetic innervation in patients whose clinical features consisted of chest pain, transient ST-segment elevation, left ventricular apical akinesis, minimal elevation of cardiac enzymes, and onset of symptoms shortly after a severe stress condition. Material and Methods: Five female patients, mean age 67±14 years, underwent thoracic 123I-MIBG (planar and SPECT) and 67Ga citrate (planar) scans within 5 days after the onset of symptoms. The 123I-MIBG myocardial washout rate between early (30 min) and delayed (3 hours) planar images was calculated. All patients presented findings consistent with takotsubo-like syndrome. Echocardiograms showed the characteristic wall motion pattern of significant apical dysfunction. Acute-phase coronary angiographies revealed a non-obstructive pattern. A peculiar apical akinesis and basal normokinesis were observed on the ventriculograms. Results: Impairment of cardiac neuronal uptake of 123I-MIBG based on a reduction of the heart-to-mediastinum uptake ratio was observed in all patients, while the washout rate was raised in four patients. All patients presented an apical uptake defect in the 123I-MIBG SPECT and planar images and a normal 67Ga scintigraphy. Conclusion: Our data indicate that ampulla cardiomyopathy (AC) is associated with a cardiac sympathetic innervation deficit characterized by a reduced global 123I-MIBG uptake and an apical uptake defect. The lack of 67Ga uptake in the acute phase of this syndrome indicates that AC is probably not associated with an inflammatory process.
Balloon occlusion test of the internal carotid artery: correlation with stump pressure and 99mTc-HMPAO SPECT
Authors: Kato K. , Tomura N. , Takahashi S. , Sakuma I. , Sasaki K. , Kitani H. , Watarai J. 
Published: November 2006

Purpose: To evaluate the correlation of stump pressure during balloon occlusion test and relative cerebral blood flow (relative CBF) as measured by 99mTc-hexamethylpropyleneamine oxime (99mTc-HMPAO) single-photon emission computed tomography (SPECT) after test occlusion. Material and Methods: Balloon occlusion test of the internal carotid artery (ICA) was performed in 25 patients. The count ratio of occluded hemisphere to non-occluded hemisphere was calculated on 99mTc-HMPAO SPECT. The ratio of mean stump pressure to mean arterial pressure during carotid occlusion during the balloon occlusion test was compared with the count ratio of 99mTc-HMPAO SPECT. Results: Two patients failed to tolerate even brief carotid occlusion. The other 23 patients showed no ischemic deficit during occlusion of the ICA. In 13 of these 23 patients, the ratios of mean stump pressure to mean arterial pressure were more than 50%, and the count ratios on SPECT were more than 85%. In 10 of 23 patients, the ratios of mean stump pressure to mean arterial pressure were less than 50%, and the count ratios on SPECT were variable. Conclusion: Maintenance of a mean stump pressure of 50% or more of the mean systemic pressure during test occlusion indicates adequate cerebral blood flow during carotid occlusion.
Hepatic intra-arterial injection of 3-bromopyruvate in rabbit vx2 tumor
Authors: Shin S. W. , Han H. , Choo S. W. , Yoo B. C. , Park C. K. , Do Y. S. , Lee J. H. , Lee D. H. , Choi D. , Choo I.-W. , Kim S. S. , Lee J. Y. 
Published: November 2006

Purpose: To evaluate the antitumoral effects of an intra-arterial injection of 3-bromopyruvate (3-BrPA) on liver VX2 tumor in rabbits. Material and Methods: Twenty rabbits with surgically implanted liver VX2 tumors were used. The rabbits were divided into three groups: a control, a saline, and a 3-BrPA group. Four rabbits were not treated at all, and they served as the control group. The saline group ( n = 6) received only intra-arterial saline injection. The 3-BrPA group ( n = 10) received an intra-arterial injection of 3-bromopyruvate through the hepatic artery. The delivered amounts of 3-bromopyruvate were as follows: 25 ml of 0.5 mM in six rabbits, 25 ml of 1.0 mM in two rabbits, and 25 ml of 2.0 mM in two rabbits. Four days after intra-arterial injection, the rabbits were sacrificed and histopathologic analysis of the explanted livers was performed with comparison of the tumor necrosis ratio (a percentage of the necrotic area versus the entire tumorous area) in each group. Results: The mean tumor necrosis ratio was 12.5±4.2%, 44.8±24.7%, and 49.4±14.3% in the control, saline, and 3-BrPA groups, respectively. Between the control and the saline group, and between the control and the 3-BrPA group the mean tumor necrosis ratio appeared to be significantly different ( P<0.05). However, there was no statistical difference in the mean tumor necrosis ratio between the saline and the 3-BrPA group ( P = 0.416). Conclusion: A single session of intra-arterial injection of 3-BrPA showed no better results in terms of tumor necrosis than that of saline injection in a rabbit VX2 tumor model.
Misrepresentation of surface rendering of pediatric brain malformations performed following spatial normalization
Authors: Wallis L. I. , Widjaja E. , Wignall E. L. , Wilkinson I. D. , Griffiths P. D. 
Published: November 2006

Purpose: To evaluate the effects of spatial normalization on volume rendering in cases of pediatric brain malformation. Material and Methods: Three-dimensional (3D) T1-weighted volume datasets were acquired in three children, one with pachygyria, one with a Dandy-Walker malformation associated with polymicrogyria, and one with dysgenesis of the corpus callosum. On the non-normalized datasets, the skull margins were cropped and the remainder stripped with the brain extraction technique (BET). The data were also normalized into standard anatomic reference space using pediatric templates prior to the BET script. The surface constructions obtained by both techniques were then compared for geometric distortions. Results: Normalization of 3D datasets resulted in significant distortions in the shape of the brain, with increased anterior–posterior dimensions and narrower transverse diameter in all three cases. In two cases, there were alterations in the appearance of the gyri and sulci, leading to a potential misinterpretation of the volume-rendered surface when the gyri and sulci were in fact normal. Conclusion: In pediatric brain, particularly those with congenital brain anomalies, normalization as a post-processing step should be avoided as this may lead to misrepresentation of brain morphometry.
Preoperative portal vein embolization with a mixture of gelatin sponge and iodized oil: efficacy and safety
Authors: Kakizawa H. , Toyota N. , Arihiro K. , Naito A. , Fujimura Y. , Hieda M. , Hirai N. , Tachikake T. , Matsuura N. , Murakami Y. , Itamoto T. , Ito K. 
Published: November 2006

Purpose: To evaluate whether portal vein embolization (PVE) using a mixture of gelatin sponge (GS) pieces and iodized oil is safe and effective in inducing hypertrophy of the future liver remnants (FLR). Material and Methods: PVE was performed in 14 patients (eight male and six female, mean age 65 years, range 35–81 years) diagnosed with malignant liver tumor before surgery, whose FLR volumes were judged too small to allow for safe resection. Liver volume change, biochemical data change, complications related to PVE, and postoperative complications were retrospectively evaluated. Results: PVE was successful in all patients, and there were no procedural complications. Absolute FLR volume and FLR/total liver volume (TLV) ratio increased by 102 cm3 and 8% (mean values), respectively. Planned hepatectomies were cancelled in three patients due to extrahepatic metastasis or bile duct infection. Five of the 11 patients (45%) who underwent hepatectomies had major postoperative complications. However, complications due to hepatic failure were not seen. In 10 patients, except one whose outcome was fatal outcome, the mean hospitalization days with and without major complications were 73 and 33 days, respectively. Conclusion: PVE using a mixture of GS and iodized oil seems to be effective and safe in inducing hypertrophy of the FLR.
Magnetic resonance enteroclysis in the diagnosis of small-intestinal crohn's disease: diagnostic accuracy and inter- and intra-observer agreement
Authors: Negaard A. , Sandvik L. , Mulahasanovic A. , Berstad A. E. , Klöw N.-E. 
Published: November 2006

Purpose: To evaluate the diagnostic accuracy and inter- and intra-observer agreement of magnetic resonance enteroclysis (MRE) in patients with or without Crohn's disease of the small intestine. Material and Methods: 60 consecutive patients with or without Crohn's disease examined with MRE were included. Two observers independently reviewed the MRE examinations, searching for 12 pathological signs. The reference standard was ileoscopy or surgery of the terminal ileum performed in 41 patients. Results: Crohn's disease of the small intestine was found in 24 (40%) patients. MRE findings of increased intestinal wall thickness, intestinal wall enhancement, intestinal wall ulcer, and inflammatory activity of the terminal ileum showed high sensitivity, specificity, and positive and negative predictive values. Intestinal stenosis had sensitivities ranging from 43% to 100%, depending on the cut-off value. Inter- and intra-observer agreement was good or excellent for most pathological signs. However, observer agreement of intestinal wall edema was only fair and moderate. Conclusion: MRE evaluated Crohn's disease with a high diagnostic accuracy in the terminal ileum. Most MRE variables were evaluated with good or excellent observer agreement, indicating that the method was highly reproducible. Our study supports the notion that MRE is an appropriate method for diagnosing Crohn's disease.
Increased sensitivity to pathological brain changes using co-registration of magnetic resonance imaging scans
Authors: Burdett J. , Stevens J. , Flügel D. , Williams E. , Duncan J. S. , Lemieux L. 
Published: November 2006

Purpose: To compare automatic software-based co-registration of serial magnetic resonance imaging (MRI) scans with conventional visual comparison, by expert neuroradiologists. Material and Methods: Sixty-four patients who were referred to our epilepsy MRI unit for cerebral imaging were identified as having potentially, non-, or slow-growing lesions or cerebral atrophy and followed with sequential scans over a period of up to 8 years, resulting in a total of 92 pairs of scans. Scans were categorized as showing either lesions or atrophy. Each pair of scans was reviewed twice for the presence of change, with and without co-registration, performed using automated software. Results: Co-registration and visual reporting without co-registration were discordant in the lesions group in nine out of 69 datasets (13%), and in 16 out of 23 pairs of scans in the atrophy group (69%). The most common cause of discordance was visual reporting not detecting changes apparent by co-registration. In three cases, changes detected visually were not detected following co-registration. Conclusion: In the group of patients studied, co-registration was more sensitive for detecting changes than visual comparison, particularly with respect to atrophic changes of the brain. With the increasing availability of sophisticated independent consoles attached to MRI scanners that may be used for image co-registration, we propose that serial T1-weighted volumetric MRI brain co-registration should be considered for integration into routine clinical practice to assess patients with suspected progressive disease.
Sequential dynamic gadolinium magnetic resonance perfusion-weighted imaging: effects on transit time and cerebral blood volume measurements
Authors: Griffiths P. D. , Pandya H. , Wilkinson I. D. , Hoggard N. 
Published: November 2006

Purpose: To evaluate if two gadolinium perfusion studies can be performed during the same table occupancy without degradation of the derived data in the second study. Material and Methods: Magnetic resonance (MR) perfusion studies of the whole brain were performed on 12 patients during the administration of two gadolinium boluses separated by 8 min. In six patients, gadolinium was given as two 20-ml administrations of standard 0.5 M chelate (Magnevist), whilst the other six patients received two 10-ml administrations of 1.0 M chelate (Gadovist). Results: There were no significant differences in subjective quality between the time–intensity curves of the first and second perfusion studies using either the 0.5 M or 1.0 M gadolinium chelate. The objective measurements in quality of the time–intensity curves (maximum signal change and full width at half maximum) changed by less than 5% of the original values on the second perfusion study. The first-moment mean transit times did not change significantly on the sequential studies. The regional cerebral blood volume tended to increase on the second study (by 15% on average), but this did not reach statistical significance. Conclusion: The results from two sequential dynamic gadolinium-based perfusion studies can be compared in a meaningful manner using the technique described.
Diffusion-weighted magnetic resonance imaging of treatment-associated changes in recurrent and residual medulloblastoma: preliminary observations in three children
Authors: Schubert M. I. , Wilke M. , Müller-Weihrich S. , Auer D. P. 
Published: November 2006

Purpose: To emphasize a possible role of magnetic resonance (MR) diffusion-weighted imaging (DWI) for lesion conspicuity and detection of treatment effects in children with medulloblastoma. Material and Methods: Three children with medulloblastoma (two residual and one recurrent) were examined repetitively by MR diffusion-weighted imaging. Regional assessment of the apparent diffusion coefficient (ADC) was done for tumorous lesions and periventricular white matter appearing normal on standard MR images. Results: All lesions were clearly visible on DWI. In the case of recurrent tumor, on one scan, DWI showed lesions that were not seen on contrast-enhanced MRI. Increase (41%) of ADC was seen in one lesion, which subsequently responded completely to treatment over 27 months' follow-up. Intermediate increases (23–26%) of ADC were found with partial therapy response in three lesions. In contrast, a decrease (-11%) of ADC in two lesions was seen with tumor progression. Conclusion: These observations may suggest a role for DWI in early detection of metastatic disease and treatment monitoring of medulloblastoma, warranting a formal study.