Risk of breast fibrosis following irradiation using a breast-specific SBRT system compared with conventional APBI

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Background: To determine the dosimetric characteristics and risk of breast fibrosis using a normal tissue complication probability (NTCP) model in conjunction with a novel preoperative stereotactic radiotherapy system called the GammaPod. Results are compared with linac based post-lumpectomy APBI plans for the same cohort.

Methods: The GammaPod breast SBRT system consists of a Co-60 irradiation unit in combination with an immobilization device with embedded fiducials. Eight patients were enrolled in an IRB-approved protocol and underwent CT scans in the prone position with breast immobilization. A preoperative target (GTV) was synthesized to match the tumor location and volume reported in imaging studies obtained prior to surgery (0.3-2.4 cc). The GTV was expanded by 1.5 cm to create a CTV, and a PTV was created using an additional 0.3 cm margin. The PTV was prescribed 25.5 Gy in 3 fx, which is radiobiologically equivalent to conventional APBI doses of 38.5 Gy in 10 fx. Following the radioablative experience in NSCLC, we also planned to deliver 60.0 Gy to the GTV+0.3 cm as a simultaneous boost in conjunction with the 25.5 Gy PTV prescription dose. For comparison, linac-based treatment plans were created for the same cohort following NSABP B-39 guidelines. Whole breast dosimetry was analyzed in terms of biologically equivalent dose (BED) and Lyman NTCP analysis was performed.

Results: The volume of ipsilateral breast receiving 10, 20, 50, and 100% of the prescribed dose was substantially smaller in GammaPod vs. APBI plans, with cohort averages of 19.3, 13.0, 7.1 and 4.0% vs. 75.8, 67.3, 48.1 and 27.6% respectively (p<0.001). Even though the PTV equivalent uniform BED (EUD) was substantially higher in GammaPod plans (87.9 Gy vs. 57.3 Gy), the ipsilateral breast EUD was still smaller in these plans, 18.9 ± 5.0 Gy vs. 47.2 ± 3.2 Gy (p<0.001). Corresponding NTCP predictions for breast fibrosis rates following GammaPod and APBI treatments were 0.2 ± 0.1% vs. 2.8 ± 0.8% (p<0.001), respectively.

Conclusions: The GammaPod system improves upon traditional post-lumpectomy linac-based APBI by decreasing dose to the ipsilateral breast as well as the predicted rates of breast fibrosis.

Stereotactic radiosurgery for early-stage breast cancer: A new paradigm

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Background: Stereotactic radiosurgery (SRS) has not been widely used for breast cancer partly due to: 1) the lack of a suitable immobilization device; and 2) the lack of a delivery system that can concentrate a high radiation dose noninvasively. We have developed a SRS system that effectively addresses these obstacles and demonstrated the dosimetric feasibility of simultaneously ablating the intact tumor and sterilizing the tumor bed.

Methods: A breast immobilization device consists of a solid outer cup with embedded stereotactic frame and a porous inner cup; the two cups join at the chest wall side by a soft goggle-like lip for comfort. A negative pressure is applied to the space between the two cups to immobilize the breast tissues. 15 patients with surgical clips in their breast underwent a geometric reproducibility trial, in which the patients received two CT scans spaced 10-60 minutes while wearing the cup. A SRS delivery system uses 36 Co-60 sources that rotate around a focal point to produce 36 non-coplanar arcs. The breast cup is locked on the treatment couch with the patient in prone position. The couch moves dynamically during treatment, allowing the focal spots to “paint” the desired 3D dose distribution.

Results: The reproducibility of the 42 available clips was 1.83 mm ± 1.08 mm (2 std) and patients reported good comfort. 8 treatment plans simultaneously delivering an ablative dose of 18Gy to an intact tumor plus a 3mm margin (CTV1) and 10Gy to the tumor bed (CTV2 = CTV1+1cm) have been developed and verified with measurements. The dose-volume histograms showed very uniform dose coverage with 98% of CTV1 receiving 18Gy and 100% of tumor bed receiving 10Gy. On average, only 21% of the normal breast receives greater than 5Gy, safe to deliver 3 fractions of such doses.

Conclusions: A breast-specific SRS system has been developed. Dosimetric studies illustrated the feasibility of managing early-stage breast cancer with SRS. Clinical studies that will identify patients in whom current forms of surgery and postoperative radiation may be eliminated are planned, allowing completion of local therapies noninvasively within a few days rather than months.

Differential requirements for c-Myc in chronic hematopoietic hyperplasia and acute hematopoietic malignancies in Pten-null mice

Myeloproliferative disorders (MPDs), lymphoproliferative disorders (LPDs), acute T-lymphocytic or myeloid leukemia and T-lymphocytic lymphoma were developed in inducible Pten (phosphatase and tensin homolog, deleted on chromosome ten)-knockout mice (Pten(-/-)). The appearance of these multiple diseases in one animal model provides an opportunity to study the pathogenesis of multiple diseases simultaneously. To study whether Myc function is required for the development of these hematopoietic disorders in Pten(-/-) mice, we generated inducible Pten/Myc double-knockout mice (Pten(-/-)/Myc(-/-)). By comparing the hematopoietic phenotypes of these double-knockout mice with those of Pten(-/-) mice, we found that both sets of animals developed MPDs and LPDs. However, none of the compound-mutant mice developed acute leukemia or lymphoma. Interestingly, in contrast to the MPDs that developed in Pten(-/-) mice, which are dominated by granulocytes, megakaryocytes predominate in the MPDs of Pten(-/-)/Myc(-/-) mice. Our study suggests that the deregulation of phosphoinositide 3-kinase/Akt signaling in Pten(-/-) hematopoietic cells protects these cells from apoptotic cell death, resulting in chronic proliferative disorders. However, owing to the differential requirement for Myc in granulocyte as compared to megakaryocyte proliferation, Myc deletion converts Pten(-/-) MPDs from granulocyte- to megakaryocyte-dominated conditions. Myc is absolutely required for the development of acute hematopoietic malignancies.

Evidence of dissipative solitons in Yb³⁺:CaYAlO₄

Operation of an end-pumped Yb³⁺:CaYAlO₄ laser operating in the positive dispersion regime is experimentally investigated. The laser emitted strongly chirped pulses with extremely steep spectral edges, resembling the characteristics of dissipative solitons observed in fiber lasers. The results show that dissipative soliton emission constitutes another operating regime for mode locked Yb³⁺-doped solid state lasers, which can be explored for the generation of stable large energy femtosecond pulses.

Enhanced osseointegration of titanium implant through the local delivery of transcription factor SATB2

Titanium implants are widely used in dentistry and orthopedic surgery. Nevertheless, bone regeneration around the implant is a relatively slow process, after placement. This study assessed whether SATB2 can enhance osseointegration of a titanium implant. To determine the effect of SATB2 in implant integration, two different viruses encoding SATB2 (PBABE-Satb2 virus or RCAS-Satb2 virus) were locally administered to the bone defect prior to titanium implant placement in our established transgenic TVA mice. Seven and 21 days post implantation, the femurs were isolated for quantitative real-time RT-PCR, H&E staining, immunohistochemical (IHC) staining, and microcomputed tomography (microCT) analysis. Quantitative real-time RT-PCR results demonstrated that the in vivo overexpression of SATB2 enhanced expression levels of potent osteogenic transcription factors and bone matrix proteins. We also found that 21 days after implantation, there were no significant differences in the expression levels of SATB2, Osx, Runx2, COLI, OC, and BSP between the RCAS-Satb2 group and the RCAS group. Histological analysis showed that SATB2 overexpression significantly enhanced new bone formation and bone-to-implant contact after implantation. IHC staining analysis revealed that forced expression of SATB2 increased the number of BSP-positive cells surrounding the implant. MicroCT analysis demonstrated that in vivo overexpression of SATB2 significantly increased the density of the newly formed bone surrounding the implant. These results conclude that in vivo overexpression of SATB2 significantly accelerates osseointegration of titanium implants and SATB2 can serve as a potent molecule in promoting tissue regeneration.

Laser generation of elliptical nanometre and sub-nanometre bump arrays on NiP/Al data storage disks and their effect on stiction performance

Elliptical nano-bumps on nickel-phosphorus coated aluminium (NiP/Al) hard disks were fabricated by a laser texturing system (maximum power 8 W, maximum frequency 300 kHz). By carefully selecting the level of laser power attenuation and defocus offset distance, bump height can be controlled below 6 nm and down to the sub-nanometre scale. This type of laser-induced texture (elliptical shape) on a disk surface is expected to provide better control of the stiction force along with the smallest separation distance between the head slider and the disk. Quantitative modelling based on the classical Hertzian theory for elliptic contacts has been carried out with the purpose of predicting the stiction behaviour of the presented elliptical shaped sub-10 nm bumps. It has been found that an elliptical shape not only reduces the overall stiction performance of the laser texturing zone (LZT) compared to the conventional circular shape but also extends the occurrence of the 'stiction wall' towards the sub-10 nm regime for ultra-low-glide applications.

A stromal cell-derived factor-1 releasing matrix enhances the progenitor cell response and blood vessel growth in ischaemic skeletal muscle

Although many regenerative cell therapies are being developed to replace or regenerate ischaemic muscle, the lack of vasculature and poor persistence of the therapeutic cells represent major limiting factors to successful tissue restoration. In response to ischaemia, stromal cell-derived factor-1 (SDF-1) is up-regulated by the affected tissue to stimulate stem cell-mediated regenerative responses. Therefore, we encapsulated SDF-1 into alginate microspheres and further incorporated these into an injectable collagen-based matrix in order to improve local delivery. Microsphere-matrix impregnation reduced the time for matrix thermogelation, and also increased the viscosity reached. This double-incorporation prolonged the release of SDF-1, which maintained adhesive and migratory bioactivity, attributed to chemotaxis in response to SDF-1. In vivo, treatment of ischaemic hindlimb muscle with microsphere-matrix led to increased mobilisation of bone marrow-derived progenitor cells, and also improved recruitment of angiogenic cells expressing the SDF-1 receptor (CXCR4) from bone marrow and local tissues. Both matrix and SDF-1-releasing matrix were successful at restoring perfusion, but SDF-1 treatment appeared to play an earlier role, as evidenced by arterioles that are phenotypically older and by increased angiogenic cytokine production, stimulating the generation of a qualitative microenvironment for a rapid and therefore more efficient regeneration. These results support the release of implanted SDF-1 as a promising method for enhancing progenitor cell responses and restoring perfusion to ischaemic tissues via neovascularisation.

Search for three-jet resonances in pp collisions at square root(s)=7 TeV

A search for three-jet hadronic resonance production in pp collisions at a center-of-mass energy of 7 TeV has been conducted by the CMS Collaboration at the LHC, using a data sample corresponding to an integrated luminosity of 35  pb(-1). Events with high jet multiplicity and a large scalar sum of jet transverse momenta are analyzed using a signature-based approach. The number of expected standard model background events is found to be in good agreement with the observed events. Limits on the cross section times branching ratio are set in a model of gluino pair production with an R-parity-violating decay to three quarks, and the data rule out such particles within the mass range of 200 to 280  GeV/c2.

Direct laser writing of near-IR step-index buried channel waveguides in rare earth doped YAG

A new (to our knowledge) ultrashort laser pulse irradiation regime that allows us to directly modify and increase the refractive index of rare earth doped YAG polycrystalline ceramics has been identified. Single-mode buried channel waveguides in both Ho:YAG and Er:YAG ceramics at the near-IR wavelengths of 1.55 μm and 1.95 μm are demonstrated by fabricating positive square step-index cores. Minimum propagation losses of 1.5 dB cm(-1) at a 1.51 μm wavelength have been preliminarily obtained. Confocal microluminescence mapping reveals that the increased refractive index regions retain the near-IR spectral properties of Er3+ ions in the YAG crystalline matrix.

Molecular cloning, functional characterization and phylogenetic analysis of TRAIL in Japanese pufferfish Takifugu rubripes

In this study, the complementary DNA (cDNA) of Japanese pufferfish Takifugu rubripes tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) was cloned by reverse-transcription PCR. The open reading frame of the TRAIL consisted of 870 bases. The deduced amino-acid sequence of the TRAIL showed a high homology with the sequences of other teleosts. Recombinant soluble TRAIL was fused with a small ubiquitin-related modifier gene to enhance the soluble expression level in Escherichia coli BL21 (DE3). In vitro, the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrasodium bromide (MTT) assay indicated that the purified soluble TRAIL was able to induce apoptosis of Jurkat and HeLa cells in a dose-dependent manner.

The FLOWERING LOCUS T orthologous gene of Platanus acerifolia is expressed as alternatively spliced forms with distinct spatial and temporal patterns

The FLOWERING LOCUS T (FT) protein is a likely component of the 'florigen' signal that plays a crucial role in regulating the transition from vegetative to reproductive growth. Here, we report the isolation of full-length cDNAs and the corresponding genomic clones encoding orthologous FT proteins (PaFT) of London plane (Platanus acerifolia Willd). Two genes with high sequence identity were isolated (PaFT1-2), but 34 different transcript products were identified, comprising 21 splice forms produced by alternative splicing of the PaFT pre-mRNAs. Expression of the alternative splicing forms of PaFT varied according to tissue type and developmental stage. PaFT transcripts were detected throughout adult trees, whereas in juvenile trees they were only detected in dormant sub-petiolar buds. In adult trees, levels of the various alternative splicing PaFT forms were related to flower development stage and tree dormancy. Ectopic expression of the archetypal splice form of PaFT-A in tobacco and Arabidopsis developed multiple altered phenotypes, notably early flowering and attenuation of apical dominance. The evidence in this study indicates that complex alternative processing of PaFT transcripts in P. acerifolia may be associated with multiple regulatory roles, including initiation of flowering, flower development, apical dominance, tree dormancy and dormancy release.

Observation of χ(c1) decays into vector meson pairs φφ, ωω, and ωφ

Using (106±4)×10⁻⁶ ψ(3686) events accumulated with the BESIII detector at the BEPCII e⁺e⁻ collider, we present the first measurement of decays of χ(c1) to vector meson pairs φφ, ωω, and ωφ. The branching fractions are measured to be (4.4±0.3±0.5)×10⁻⁴, (6.0±0.3±0.7)×10⁻⁴, and (2.2±0.6±0.2)×10⁻⁵, for χ(c1)→φφ, ωω, and ωφ, respectively, which indicates that the hadron helicity selection rule is significantly violated in χ(cJ) decays. In addition, the measurement of χ(cJ)→ωφ provides the first indication of the rate of doubly OZI-suppressed χ(cJ) decay. Finally, we present improved measurements for the branching fractions of χ(c0) and χ(c2) to vector meson pairs.

Measurement of the t-channel single top quark production cross section in pp collisions at √s=7 TeV

Electroweak production of the top quark is measured for the first time in pp collisions at √=7  TeV, using a data set collected with the CMS detector at the LHC and corresponding to an integrated luminosity of 36  pb⁻¹. With an event selection optimized for t-channel production, two complementary analyses are performed. The first one exploits the special angular properties of the signal, together with background estimates from the data. The second approach uses a multivariate analysis technique to probe the compatibility with signal topology expected from electroweak top-quark production. The combined measurement of the cross section is 83.6±29.8(stat+syst)±3.3(lumi)  pb, consistent with the standard model expectation.

Metastatic endometrial stromal sarcoma of the lung: importance of immunohistochemical staining, clinical history and imaging studies

Proper evaluation of lung nodules is a difficult issue for clinical management of patients. Discriminating metastatic endometrial stromal sarcoma (ESS) from other primary spindle cell neoplasms of the lung using histological analysis can be challenging. This is particularly true when an adequate clinical history is lacking, because ESS metastasis can be delayed by a couple of decades. To emphasize the importance of the correlation of pathological findings with clinical history and imaging studies, we investigated 11 cases of ESS (seven low grade and four high grade) metastatic to the lung. All cases presented with one to multiple unilateral or bilateral lung nodules that were detected by chest computed tomography. Primary ESS was diagnosed from hysterectomy specimens except for one by endometrial biopsy, 0.5 to 23 years prior to metastasis. Immunohistochemical studies showed that all ESS cases were moderately to strongly positive for Bcl-2 and CD10 with >50% of tumor cells stained, except for one high grade ESS that was negative for CD10. Eight (72.7%) and seven (63.6) of the 11 cases showed positive estrogen and progesterone receptors, respectively, with a majority of positive cases showing diffuse and moderate to strong staining. Strong but patchy staining for CD34 was detected in one (9.1%) case with smooth muscle differentiation. CK7 and TTF-1 were negative in all cases. Two (18.2%) cases exhibited patchy and strong positivity for caldesmon. Two (18.2%) low grade ESS cases showed moderate to strong AE1/AE3 positivity in >50% of tumor cells, one of which also showed moderate CK19 and Cam 5.2 staining in >30% of tumor cells. One should be cautious when assessing spindle cell neoplasms of the lung in women with a history of hysterectomy. Correlation of clinical history and imaging studies with histological and immunohistochemical findings is essential to diagnosis of metastatic ESS to the lung.