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Hutchison D, Sobrado S, Corbett S, Leroy S, Morgan K, Daugherty R, Prillaman G, Kern NG. Parental perception of contrast enhanced voiding ultrasonography urodynamics vs fluoroscopic urodynamics. J Pediatr Urol 2023; 19:783.e1-783.e5. [PMID: 37704527 DOI: 10.1016/j.jpurol.2023.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/22/2023] [Accepted: 08/25/2023] [Indexed: 09/15/2023]
Abstract
INTRODUCTION/OBJECTIVES Contrast enhanced voiding ultrasonography (ceVUS) has not been widely reported to be used during video urodynamics (UDS). We previously reported on the feasibility of this. In this study, we aimed to understand how parents perceived their child's experience of undergoing ceVUS during UDS compared to fluoroscopic (fluoro) UDS. METHODS Children who underwent both fluoro UDS and ceVUS UDS were recruited. Parents were asked to complete a questionnaire to evaluate their experience with both studies. Demographics including gender, age at study, and diagnosis were collected to account for differences in perception. Statistical analysis was performed. RESULTS 53 patients were included: 31 girls, 22 boys. Diagnoses included myelomeningocele (67.9%), low/tethered cord (13.2%), closed spinal dysraphism (9.4%), posterior urethral valve (1.9%), cloacal anomaly (1.9%), caudal regression (1.9%), myeloschisis (1.9%), and cerebral palsy (1.9%). There was no statistical difference in mean age at fluoro UDS and ceVUS UDS (77.3 months vs 99.7 months respectively, p = 0.09). All 53 parents (100%) were satisfied/very satisfied with their ceVUS experience; 48 parents (90.6%) preferred ceVUS, 3 parents (5.7%) preferred fluoro UDS, and 2 (3.8%) were neutral. On average, parents perceived ceVUS to be more comfortable (72.7%) and produce better results (67.4%) than fluoro UDS. The majority felt that both studies allowed the same contact with their child (52.3%) and took the same amount of time (50.0%). However 29.5% felt ceVUS was faster and 34.1% felt ceVUS allowed more contact with their child (Fig. 1). 26 parents (49.1%) specifically noted no radiation as the reason why they preferred ceVUS over fluoro. The average age at ceVUS UDS was younger in those who preferred ceVUS UDS compared to those who preferred fluoro UDS (94.6 months vs 180.0 months, p = 0.03). The average age at fluoro UDS was younger in those who preferred ceVUS UDS vs fluoro UDS (73.1 months vs 144 months, p = 0.03). Gender's influence on preference approached significance (p = 0.07); all 3 parents who preferred fluoro UDS had male children. CONCLUSIONS The majority of parents preferred ceVUS over fluoro UDS. ceVUS was perceived to be more comfortable and provide better results. Many parents highlighted no radiation and no fluoroscopic machinery as factors in preference of ceVUS over fluoro. The parents who preferred ceVUS UDS had children who had both studies done at an earlier age compared to the parents who preferred fluoro UDS.
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Affiliation(s)
- Dylan Hutchison
- Department of Urology, University of Virginia, Charlottesville, VA, USA.
| | | | - Sean Corbett
- Department of Urology, University of Virginia, Charlottesville, VA, USA.
| | - Susan Leroy
- Department of Urology, University of Virginia, Charlottesville, VA, USA.
| | - Kathryn Morgan
- Department of Urology, University of Virginia, Charlottesville, VA, USA.
| | - Reza Daugherty
- Department of Radiology, University of Virginia, Charlottesville, VA, USA.
| | - Grace Prillaman
- School of Medicine, University of Virginia, Charlottesville, VA, USA.
| | - Nora G Kern
- Department of Urology, University of Virginia, Charlottesville, VA, USA.
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Iovoli AJ, Prasad S, Ma SJ, Fekrmandi F, Malik NK, Fung-Kee-Fung S, Farrugia MK, Singh AK. Long-Term Survival and Failure Outcomes of Single-Fraction Stereotactic Body Radiation Therapy in Early Stage NSCLC. JTO Clin Res Rep 2023; 4:100598. [PMID: 38124792 PMCID: PMC10730364 DOI: 10.1016/j.jtocrr.2023.100598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 10/12/2023] [Accepted: 10/30/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction This study aims to report our 13-year institutional experience with single-fraction stereotactic body radiation therapy (SF-SBRT) for early stage NSCLC. Methods A single-institutional retrospective review of patients with biopsy-proven peripheral cT1-2N0M0 NSCLC undergoing definitive SF-SBRT between September 2008 and May 2022 was performed. All patients were treated to 27 Gy with heterogeneity corrections or 30 Gy without. Primary outcomes were overall survival and progression-free survival. Secondary outcomes included local failure, nodal failure, distant failure, and second primary lung cancer. Results Among 263 eligible patients, the median age was 76 years (interquartile range [IQR]: 70-81 y) and median follow-up time was 27.2 months (IQR: 14.25-44.9 mo). Median tumor size was 1.9 cm (IQR: 1.4-2.6 cm), and 224 (85%) tumors were T1. There were 92 patients (35%) alive at the time of analysis with a median follow-up of 34.0 months (IQR: 16.6-50.0 mo). Two- and five-year overall survival was 65% and 26%, respectively. A total of 74 patients (28%) developed disease progression. Rates of five-year local failure, nodal failure, distant failure, and second primary lung cancer were 12.7%, 14.7%, 23.5%, and 12.0%, respectively. Conclusions Consistent with multiple prospective randomized trials, in a large real-world retrospective cohort, SF-SBRT for peripheral early stage NSCLC was an effective treatment approach.
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Affiliation(s)
- Austin J. Iovoli
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Sharan Prasad
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
| | - Sung Jun Ma
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Fatemeh Fekrmandi
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Nadia K. Malik
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Simon Fung-Kee-Fung
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Mark K. Farrugia
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Anurag K. Singh
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
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Duguay T, Housset V, Bouché PA, Hardy A, Bauer T. Prospective observational analysis of intraoperative radiation exposure with a mini C-arm intensifier in percutaneous forefoot surgery. Orthop Traumatol Surg Res 2023; 109:103705. [PMID: 37832868 DOI: 10.1016/j.otsr.2023.103705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 05/13/2023] [Accepted: 05/17/2023] [Indexed: 10/15/2023]
Abstract
INTRODUCTION Percutaneous forefoot surgery has been associated with higher radiation exposure than the conventional approach. However, there is little data on forefoot surgery using a mini C-arm intensifier. We, therefore, conducted a prospective study to (1) evaluate the intraoperative radiation received by the surgeon during percutaneous forefoot surgery with a mini C-arm; (2) compare the radiation received by the surgeon with the guidelines for occupational exposure issued by the International Commission on Radiological Protection (ICRP) (20 millisieverts per year [mSv/year] for the whole body, 500mSv/year for the hands, and 20mSv/year for the lens of the eye); and (3) compare the radiation received during percutaneous forefoot surgery with that of the open approach, which has already been reported in the literature. HYPOTHESIS The radiation received by the surgeon during percutaneous forefoot surgery with a mini C-arm is lower than the ICRP guidelines, and the findings reported in the literature. MATERIALS AND METHODS This prospective single-center study was conducted from September 2020 to May 2021. A total of 639 feet (i.e., 435 patients) were included. Of these 639 feet, 336 (52%) were hallux valgus repairs, 49 (8%) were stand-alone procedures of the lateral rays, and 124 (19%) were a combination of both. The radiation dose data was retrieved from the mini C-arm daily: dose-area product (DAP) in centigray per square centimeter (cGy/cm2) and radiation exposure duration in seconds. The doses received by the surgeon were collected every month by 4 passive dosimeters (hand, eye lens, and chest [on and under the lead apron]) and 2 active dosimeters (on and under the lead apron). RESULTS The DAP emitted by the mini C-arm during an operating day was 0.10±0.01cGy/cm2 (range, 0.0-3.9), and the mean daily radiation duration was 34.7±19.3seconds (range, 0.7-226.8). There was a mean of 8±8 (range, 1-18) elective procedures per operating day. The daily reading on the active dosimeter worn on the lead apron was 0.002±0 microSv (range, 0-0.04), while the one worn under the apron was 0.001±0 microSv (range, 0-0.03). The equivalent doses over the 7-month study period for the hand, eye lens, and chest (over and under the apron) were 0.14mSv, 0mSv, 0.22mSv, and 0mSv, respectively. DISCUSSION/CONCLUSION The radiation exposure in percutaneous forefoot surgery with a mini C-arm intensifier observed in our study was lower than the ICRP recommendations and literature findings during open surgery. LEVEL OF EVIDENCE IV; prospective study without a control group.
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Affiliation(s)
- Tristan Duguay
- Clinique du Landy, 23, rue du Landy, 93400 Saint-Ouen-sur-Seine, France.
| | - Victor Housset
- Orthopaedic and Traumatologic Department, Hôpital Ambroise Paré, 9, avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France
| | - Pierre Alban Bouché
- Orthopaedic and Traumatologic Department, Hôpital Lariboisière, 2, rue Ambroise Paré, 75010 Paris, France
| | - Alexandre Hardy
- Clinique du Sport, 36, boulevard Saint Marcel, 75005 Paris, France
| | - Thomas Bauer
- Orthopaedic and Traumatologic Department, Hôpital Ambroise Paré, 9, avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France
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Boustani J, Huguet F, Vendrely V. Practice-changing clinical trials in radiation oncology for gastrointestinal malignancies in 2021-2023. Cancer Radiother 2023; 27:768-777. [PMID: 38415359 DOI: 10.1016/j.canrad.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 08/22/2023] [Indexed: 02/29/2024]
Abstract
Gastrointestinal cancers are one of the most frequent cancers and a leading cause of cancer deaths worldwide. We provide an overview of the most important practice-changing trials that were either published or presented at the international scientific meetings in 2021-2023. Highlights included reports on three phase III trials (CONCORDE/PRODIGE 26, ARTDECO, and a study by Xu et al.) that evaluated dose escalation in the definitive setting for locally advanced oesophageal cancers, as well as two phase III trials that evaluated the role of chemotherapy (neo-AEGIS) and targeted therapy (NRG/RTOG 1010) in the neoadjuvant setting for adenocarcinoma oesophageal cancers or gastroesophageal junction cancer. CheckMate 577 evaluated nivolumab in patients who had residual pathological disease after neoadjuvant chemoradiation followed by complete resection. The use of radiation therapy for borderline and locally advanced pancreatic cancer is also discussed (SMART and CONKO-007 trials). Stereotactic body radiation therapy followed by sorafenib was compared to sorafenib alone in patients with hepatocellular carcinoma in the NRG/RTOG 1112 study. New options in the management of rectal cancer are emerging such as total neoadjuvant treatment (PRODIGE 23, RAPIDO, PROSPECT), organ preservation (OPRA, OPERA), and the role of immunotherapy in patients with DNA mismatch-repair deficient/microsatellite instability. Finally, preliminary results of the ACT 4 trial that evaluated de-escalation in anal cancer are presented.
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Affiliation(s)
- J Boustani
- Department of Radiation Oncology, centre hospitalier universitaire de Besançon, Besançon, France; Inserm, EFS BFC, UMR 1098, RIGHT, Greffon-hôte-tumeur interactions/Ingénierie cellulaire et génique, université de Franche-Comté, Besançon, France.
| | - F Huguet
- Department of Radiation Oncology, hôpital Tenon, AP-HP, Sorbonne université, Paris, France
| | - V Vendrely
- Department of Radiation Oncology, centre hospitalier universitaire de Bordeaux, Bordeaux, France; BoRdeaux Institute of onCology (BRIC), UMR1312, Inserm, université de Bordeaux, 33000, Bordeaux, France
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Arndt K, Ore AS, Quinn J, Fabrizio A, Crowell K, Messaris E, Cataldo T. Outcomes Following Recent and Distant Neoadjuvant Radiation in Rectal Cancer: An Institutional Retrospective Review and Analysis of NSQIP. Clin Colorectal Cancer 2023; 22:474-484. [PMID: 37863792 DOI: 10.1016/j.clcc.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/06/2023] [Accepted: 07/08/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Neoadjuvant chemoradiotherapy (nCRT) is the standard of care in locally advanced rectal cancer (LARC). However, radiation therapy is thought to increase operative difficulty due to induction of fibrosis. Total neoadjuvant therapy (TNT) protocols increase the time between completion of radiation and surgical resection which may lead to increased operative difficulty and complications. METHODS A single institution retrospective review of patients ≥18 years with LARC undergoing nCRT from 2015 to 2022. Patients were dichotomized in 2 cohorts: <90 days from radiation to surgery (recent radiation), and ≥90 days from radiation to surgery (distant radiation). Institutional data was compared to National Surgical Quality Improvement Program (NSQIP) rectal cancer data from 2016 to 2020. Outcomes included intraoperative complications, 30-day morbidity, and oncologic outcomes. RESULTS One hundred forty-six institutional patients included, 120 had recent radiation, 26 had distant radiation. Thirty-day morbidity and intraoperative complications did not differ. There was greater radial margin positivity (7% vs. 24%), fewer lymph nodes harvested (17 ± 5 vs. 15 ± 6), and a lower rate of complete mesorectal dissection (88% vs. 65%,) in distant radiation patients 3059 patients were included in NSQIP analysis, 2029 completed radiation <90 days before surgery and 1030 without radiation 90 days before surgery. Patients without radiation 90 days preoperatively had more radial margin positivity (9.2% vs. 4.6%), organ space infection (8.6% vs. 6.4%), and pneumonia (2.2% vs. 0.9%). CONCLUSION The present study suggests that increased time between radiation and surgery results in more challenging dissection with less complete mesorectal dissection and increased radial margin positivity without increasing technical complications.
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Affiliation(s)
- Kevin Arndt
- Division of Colorectal Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
| | - Ana Sofia Ore
- Division of Colorectal Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Jeanne Quinn
- Division of Colorectal Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Anne Fabrizio
- Division of Colorectal Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Kristen Crowell
- Division of Colorectal Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Evangelos Messaris
- Division of Colorectal Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Thomas Cataldo
- Division of Colorectal Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
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Abbas N, Mustafa Z, Abodayeh K, Shatnawi TA, Shatanawi W. Darcy resistant of Soret and Dufour impact of radiative induced magnetic field sutterby fluid flow over stretching cylinder. Heliyon 2023; 9:e22503. [PMID: 38282920 PMCID: PMC10812901 DOI: 10.1016/j.heliyon.2023.e22503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 11/13/2023] [Accepted: 11/14/2023] [Indexed: 01/30/2024] Open
Abstract
The incompressible two-dimensional steady flow of Sutterby fluid over a stretching cylinder is taken into account. The magnetic Reynolds number is not deliberated low in the present analysis. Radiation and variable thermal conductivity are considered to debate the impact on the cylindrical surface. The Dufour and Soret impacts are considered on the cylinder. The mathematical model is settled by employing boundary layer approximations in the form of differential equations. The system of differential equations becomes dimensionless using suitable transformations. The dimensionless nonlinear differential equations are solved through a numerical scheme(bvp4c technique). The flow parameters of physical effects on the velocity, temperature, heat transfer rate, and friction between surface and liquid are presented in tabular as well as graphical form. The velocity function declined by improving the values of the Sponginess parameter. The fluid temperature is reduced by increment in curvature parameter.
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Affiliation(s)
- Nadeem Abbas
- Department of Mathematics and Sciences, College of Humanities and Sciences, Prince Sultan University, Riyadh, 11586, Saudi Arabia
| | - Zead Mustafa
- Department of Mathematics, Faculty of Science, The Hashemite University, P.O Box 330127, Zarqa, 13133, Jordan
| | - Kamaleldin Abodayeh
- Department of Mathematics and Sciences, College of Humanities and Sciences, Prince Sultan University, Riyadh, 11586, Saudi Arabia
| | - Taqi A.M. Shatnawi
- Department of Mathematics, Faculty of Science, The Hashemite University, P.O Box 330127, Zarqa, 13133, Jordan
| | - Wasfi Shatanawi
- Department of Mathematics and Sciences, College of Humanities and Sciences, Prince Sultan University, Riyadh, 11586, Saudi Arabia
- Department of Mathematics, Faculty of Science, The Hashemite University, P.O Box 330127, Zarqa, 13133, Jordan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, 40402, Taiwan
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Tamaki Y, Yamashita K, Nakajima D, Omichi Y, Takahashi Y, Takai M, Tamaki S, Goto T, Hayashi H, Higashino K, Tsuruo Y, Sairyo K. Radiation exposure doses to the surgical team during hip surgery is significantly higher during lateral imaging than posteroanterior imaging: a cadaveric simulation study. J Occup Med Toxicol 2023; 18:27. [PMID: 38037166 PMCID: PMC10688452 DOI: 10.1186/s12995-023-00396-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 11/23/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Fluoroscopy is indispensable when determining appropriate and effective interventions in orthopedic surgery. On the other hand, there is growing concern about the health hazards of occupational radiation exposure. The aim of this cadaveric simulation study was to measure radiation exposure doses to the surgical team during hip surgery. METHODS We reproduced the intraoperative setting of hip surgery using 7 fresh frozen cadavers (5 male, 2 female) to simulate patients and mannequins to simulate the surgeon, scrub nurse, and anesthesiologist. Six real-time dosimeters were mounted at sites corresponding to the optic lens, thyroid gland, chest, gonads, foot, and hand on each mannequin. The radiation exposure dose to each team member was measured during posteroanterior and lateral fluoroscopic imaging. RESULTS Radiation exposure doses to the surgeon were significantly higher during 3 min of lateral imaging than during 3 min of posteroanterior imaging at the optic lens (8.1 times higher), thyroid gland (10.3 times), chest (10.8 times), and hand (19.8 times) (p = 0.018, p = 0.018, p = 0.018, and p = 0.018, respectively). During lateral imaging, the radiation doses to the nurse were 0.16, 0.12, 0.09, 0.72, and 0.38 times those to the surgeon at the optic lens, thyroid, chest, gonads, and foot, respectively. The radiation dose to the anesthesiologist was zero at all anatomic sites during posteroanterior imaging and very small during lateral imaging. CONCLUSIONS Radiation exposure dose was significantly higher during lateral imaging up to 19.8 times comparing to the posteroanterior imaging. It is effective to reduce the lateral imaging time for reducing the intraoperative radiation exposure. In addition, appropriate distance from fluoroscopy resulted in very low exposure for nurses and anesthesiologists. Surgeon should pay attention that surgical staff do not get closer than necessary to the irradiation field.
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Affiliation(s)
- Yasuaki Tamaki
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan
| | - Kazuta Yamashita
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
| | - Daiki Nakajima
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan
| | - Yasuyuki Omichi
- Department of Orthopedics, Tokushima Municipal Hospital, 2-34 Kitajosanjima, Tokushima, 770-0812, Japan
| | - Yoshinori Takahashi
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan
| | - Michihiro Takai
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan
| | - Shunsuke Tamaki
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan
| | - Tomohiro Goto
- Department of Orthopedics, Tokushima Municipal Hospital, 2-34 Kitajosanjima, Tokushima, 770-0812, Japan
| | - Hiroaki Hayashi
- Department of Pharmaceutical and Health Sciences, Kanazawa University Graduate School, Kakuma-Machi, Kanazawa City, Ishikawa, 920-1192, Japan
| | - Kosaku Higashino
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan
| | - Yoshihiro Tsuruo
- Department of Anatomy, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan
| | - Koichi Sairyo
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan
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Sun LWH, Asana Marican HT, Beh LK, Shen H. Imaging the radioprotective effect of amifostine in the developing brain using an apoptosis-reporting transgenic zebrafish. Int J Radiat Biol 2023; 100:433-444. [PMID: 37922446 DOI: 10.1080/09553002.2023.2280011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 10/03/2023] [Indexed: 11/05/2023]
Abstract
PURPOSE Normal tissue radioprotectants alleviate radiation-induced damages and preserve critical organ functions. Investigating their efficacy in vivo remains challenging, especially in enclosed organs like the brain. An animal model that enables direct visualization of radiation-induced apoptosis while possessing the structural complexity of a vertebrate brain facilitates these studies in a precise and effective manner. MATERIALS AND METHODS We employed a secA5 transgenic zebrafish expressing secreted Annexin V fused with a yellow fluorescent protein to visualize radiation-induced apoptosis in vivo. We developed a semi-automated imaging method for standardized acquisition of apoptosis signals in batches of zebrafish larvae. Using these approaches, we studied the protective effect of amifostine (WR-2721) in the irradiated zebrafish larval brain. RESULTS Upon 2 Gy total-body 137Cs irradiation, increased apoptosis could be visualized at high resolution in the secA5 brain at 2, 24, and 48 hour post irradiation (hpi). Amifostine treatment (4 mM) during irradiation reduced apoptosis significantly at 24 hpi and preserved Wnt active cells in the larval brain. When the 2 Gy irradiation was delivered in combination with cisplatin treatment (0.1 mM), the radioprotective effect of amifostine was also observed. CONCLUSIONS Our study reveals the radioprotective effect of amifostine in the developing zebrafish larval brain, and highlights the utility of secA5 transgenic zebrafish as a novel system for investigating normal tissue radioprotectants in vivo.
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Affiliation(s)
- Lucas W H Sun
- Singapore Nuclear Research and Safety Initiative, National University of Singapore, Singapore
| | | | - Lih Khiang Beh
- Singapore Nuclear Research and Safety Initiative, National University of Singapore, Singapore
| | - Hongyuan Shen
- Singapore Nuclear Research and Safety Initiative, National University of Singapore, Singapore
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Selby PB, Calabrese EJ. How self-interest and deception led to the adoption of the linear non-threshold dose response (LNT) model for cancer risk assessment. Sci Total Environ 2023; 898:165402. [PMID: 37454843 DOI: 10.1016/j.scitotenv.2023.165402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/06/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
This paper clarifies scientific contributions and deceptive/self-serving decisions of William L. Russell and Liane Russell that led to the adoption of the linear non-threshold (LNT) model for cancer risk assessment by the US EPA. By deliberately failing to report an extremely large cluster of mutations in the control group of their first experiment, and thereby greatly suppressing its mutation rate, the Russells incorrectly claimed that the male mouse was 15-fold more susceptible to ionizing-radiation-induced gene mutations as compared with fruit flies. This self-serving error not only propelled their research program into one of great prominence, but it also promoted the LNT-based doubling dose (DD) concept in radiation genetics/cancer risk assessment, by the US National Academy of Sciences (NAS) Biological Effects of Atomic Radiation (BEAR) I Genetics Panel (1956). The DD concept became a central element in their recommendation that regulatory agencies switch from a threshold to an LNT model. This error occurred because of a decision by W. Russell not to report that a large cluster of control group mutations found in an experiment for which preliminary results were reported in 1951. This failure to report that cluster and similar clusters continued throughout the careers of the Russells, resulting in massive overestimation of low dose radiation risks supporting the LNT. The Russell database and the repeated claim that those data show that there is no threshold dose rate for mutation in irradiated mouse stem-cell spermatogonia, have provided mechanistic validation supporting the epidemiological LNT hypothesis for radiation-induced leukemias and cancers. This reanalysis supports the threshold model for both males and females, thereby rebutting epidemiological extrapolations from the NAS and EPA claiming support for the LNT hypothesis for cancer risk assessment. The implications of the Russell errors/deceptions, how/why they occurred, and their impact upon society are enormous and need to be addressed by scientific/regulatory agencies, affecting regulatory and litigation activities.
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Affiliation(s)
- Paul B Selby
- Retired from Oak Ridge National Laboratory at Oak Ridge, TN, Home Address: 4088 Nottinghill Gate Road, Upper Arlington, OH 43220, USA
| | - Edward J Calabrese
- Department of Environmental Health Sciences, Morrill I, N344, University of Massachusetts, Amherst, MA 01003, USA.
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Jackson IL, Doyle-Eisele M. Animal model considerations for medical countermeasure development for radiation and sulfur mustard exposures. Disaster Med Public Health Prep 2023:1-20. [PMID: 37937347 DOI: 10.1017/dmp.2023.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
Development of medical countermeasures (MCM) to mitigate and/or treat the pulmonary complications associated with exposure to chemical, radiological, and/or nuclear weapons is a United States (U.S.) national public health preparedness posture priority. Pulmonary exposure to either sulfur mustard vapor or radiation causes oxidative damage, vascular injury, hyperinflammation, and pro-fibrotic signaling cascades that lead to life-threatening and potentially debilitating lung disease. There is no MCM currently approved by the U.S. Food and Drug Administration (FDA) to mitigate and/or treat lung injury caused by sulfur mustard or radiation exposure. Thus, there remains a major unmet public health need for development of threat-agnostic, host-directed therapeutics that target common pathophysiological mechanisms underlying the progression of acute and/or late lung injury independent of the etiology of disease. This review describes the clinical manifestations and underlying mechanisms of sulfur mustard and radiation-induced lung injury and regulatory considerations for MCM development under the non-traditional Animal Rule pathway.
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Al Mutairi M, Lerp H, Al Hanosh N, Macasero W, Al Beshr MF, Wronski T. Revisiting the radiation of Gazella arabica on the Arabian Peninsula and testing the suitability of captive breeding stock for reintroduction, using mitochondrial and nuclear markers. Saudi J Biol Sci 2023; 30:103823. [PMID: 37928742 PMCID: PMC10622698 DOI: 10.1016/j.sjbs.2023.103823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/17/2023] [Accepted: 09/29/2023] [Indexed: 11/07/2023] Open
Abstract
Today, the Arabian gazelle (G. arabica) occurs only in small, scattered populations on the Arabian Peninsula and is classified as 'vulnerable', due to intensive hunting and competition with livestock. The taxonomy of this threatened species is still under debate, hampering conservation efforts while ex-situ breeding programs could be an appropriate conservation measure to prevent the species from going extinct. In our study, we attempted to elucidate the radiation of G. arabica on the Arabian Peninsula, and to ask whether the population genetic structure allows to distinguish between discrete conservation units. We used mitochondrial markers, microsatellite markers, and three intron markers to identify conservation units, to match them with genotypes found in the captive breeding stock held in Saudi Arabia, and to ensure that genotype diversity of potential founder individuals corresponds to that prevailing at targeted reintroduction sites. The sequence divergence was low among nuclear and mitochondrial markers, with gazelles originating from the north of the Arabian Peninsula showing the largest diversity, while south-western and eastern populations showed a decreased diversity. A haplotype network based on the relatively heterogeneous cytochrome b gene found no signs of a prolonged separate evolutionary history of any investigated mainland population, suggesting limitations of gene-flow after the colonization of the Arabian Peninsula leading to a founder effect-like distribution of mitochondrial haplotypes. The ex-situ breeding population held in Saudi Arabia showed a good haplotype diversity, underlining its general suitability for reintroductions. However, it is recommended that genetic data of founders should be assessed prior to future reintroduction.
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Affiliation(s)
- Mohamed Al Mutairi
- Terrestrial Wildlife Conservation Department, National Centre for Wildlife (NCW), P.O. Box 61681, Riyadh 11575, Saudi Arabia
| | - Hannes Lerp
- Natural History Collections, Museum Wiesbaden, Friedrich-Ebert-Allee 2, 65185 Wiesbaden, Germany
| | - Naif Al Hanosh
- King Khalid Wildlife Research Centre, National Centre for Wildlife (NCW), P.O. Box 61681, Riyadh 11575, Saudi Arabia
| | - William Macasero
- King Khalid Wildlife Research Centre, National Centre for Wildlife (NCW), P.O. Box 61681, Riyadh 11575, Saudi Arabia
| | - Mohammed F. Al Beshr
- King Saud University, Faculty of Science, Department of Zoology, P.O Box 800, Riyadh 11421, Saudi Arabia
| | - Torsten Wronski
- Faculty of Science, School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK
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112
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Sosa AJ, Thames HD, Sanders JW, Choi SL, Nguyen QN, Mok H, Ron Zhu X, Shah S, Mayo LL, Hoffman KE, Tang C, Lee AK, Pugh TJ, Kudchadker R, Frank SJ. Proton therapy for the management of localized prostate cancer: Long-term clinical outcomes at a comprehensive cancer center. Radiother Oncol 2023; 188:109854. [PMID: 37597805 DOI: 10.1016/j.radonc.2023.109854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 08/02/2023] [Accepted: 08/09/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND AND PURPOSE Proton therapy (PT) has emerged as a standard-of-care treatment option for localized prostate cancer at our comprehensive cancer center. However, there are few large-scale analyses examining the long-term clinical outcomes. Therefore, this article aims to evaluate the long-term effectiveness and toxicity of PT in patients with localized prostate cancer. MATERIALS AND METHODS Review of 2772 patients treated from May 2006 through January 2020. Disease risk was stratified according to National Comprehensive Cancer Network guidelines as low [LR, n = 640]; favorable-intermediate [F-IR, n = 850]; unfavorable-intermediate [U-IR, n = 851]; high [HR, n = 315]; or very high [VHR, n = 116]. Biochemical failure and toxicity were analyzed using Kaplan-Meier estimates and multivariate models. RESULTS The median patient age was 66 years; the median follow-up time was 7.0 years. Pelvic lymph node irradiation was prescribed to 28 patients (1%) (2 [0.2%] U-IR, 11 [3.5%] HR, and 15 [12.9%] VHR). The median dose was 78 Gy in 1.8-2.0 Gy(RBE) fractions. Freedom from biochemical relapse (FFBR) rates at 5 years and 10 years were 98.2% and 96.8% for the LR group; 98.3% and 93.6%, F-IR; 94.2% and 90.2%, U-IR; 94.3% and 85.2%, HR; and 86.1% and 68.5%, VHR. Two patients died of prostate cancer. Overall rates of late grade ≥ 3 GU and GI toxicity were 0.87% and 1.01%. CONCLUSIONS Proton therapy for localized prostate cancer demonstrated excellent clinical outcomes in this large cohort, even among higher-risk groups with historically poor outcomes despite aggressive therapy.
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Affiliation(s)
- Alan J Sosa
- Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Howard D Thames
- Departments of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jeremiah W Sanders
- Departments of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Seungtaek L Choi
- Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Quynh-Nhu Nguyen
- Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Henry Mok
- Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - X Ron Zhu
- Departments of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shalin Shah
- Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lauren L Mayo
- Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Karen E Hoffman
- Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Chad Tang
- Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Andrew K Lee
- Texas Center for Proton Therapy, Irving, TX, USA
| | | | - Reena Kudchadker
- Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Steven J Frank
- Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Liu Z, Xu K, Pan S, Zhang N, Wang D, Chen Y, Zhao Y, Wang S, Li J, Tong X. Manganese-enhanced magnetic resonance assessment of changes in hippocampal neural function after the treatment of radiation-induced brain injury with bone marrow mesenchymal stem cells. Brain Res Bull 2023; 204:110795. [PMID: 37863438 DOI: 10.1016/j.brainresbull.2023.110795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/03/2023] [Accepted: 10/17/2023] [Indexed: 10/22/2023]
Abstract
The role of bone marrow mesenchymal stem cells (BMSCs) in treating radiation-induced brain injury (RIBI) is not completely understood, and assessment methods to directly characterize neurological function are lacking. In this study, we aimed to evaluate the effects of BMSCs treatment on changes in hippocampal neural function in Sprague-Dawley(SD) rats with RIBI, and to evaluate the therapeutic effect of BMSCs by manganese-enhanced magnetic resonance imaging (MEMRI). First, we assessed cognitive function after RIBI treatment with BMSCs using the Morris water maze. Next, we used MEMRI at two time points to observe the treatment effect and explore the correlation between MEMRI and cognitive function. Finally, we evaluated the expression of specific hippocampal neurofunctional proteins, the ultrastructure of hippocampal nerves, and the histological changes in the hippocampus. After BMSCs treatment of RIBI, cognitive dysfunction improved significantly, the expression of hippocampal neurofunctional proteins was increased, the integrity of the hippocampal neural structure was protected, and nerve cell survival was enhanced. The improvement in neurological function was successfully detected by MEMRI, and MEMRI was highly correlated with cognitive function and histological changes. These results suggest that BMSCs treatment of RIBI is an optional modality, and MEMRI can be used for treatment evaluation.
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Affiliation(s)
- Zhanhong Liu
- College of Medical Technology, Qiqihar Medical University, Qiqihar 161006, China
| | - Kaina Xu
- College of Medical Technology, Qiqihar Medical University, Qiqihar 161006, China
| | - Shichao Pan
- College of Medical Technology, Qiqihar Medical University, Qiqihar 161006, China
| | - Na Zhang
- Department of Radiotherapy, the Third Affiliated Hospital of Qiqihar Medical University, Qiqihar 161006, China
| | - Dapeng Wang
- Department of Radiotherapy, the Third Affiliated Hospital of Qiqihar Medical University, Qiqihar 161006, China
| | - Ying Chen
- Department of Radiotherapy, the Third Affiliated Hospital of Qiqihar Medical University, Qiqihar 161006, China
| | - Yaru Zhao
- Department of Radiotherapy, the Third Affiliated Hospital of Qiqihar Medical University, Qiqihar 161006, China
| | - Siqi Wang
- Department of Radiotherapy, the Third Affiliated Hospital of Qiqihar Medical University, Qiqihar 161006, China
| | - Jing Li
- Department of Radiotherapy, the Third Affiliated Hospital of Qiqihar Medical University, Qiqihar 161006, China
| | - Xu Tong
- Department of Radiotherapy, the Third Affiliated Hospital of Qiqihar Medical University, Qiqihar 161006, China.
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Schiffer W, Pedersen LN, Lui M, Bergom C, Mitchell JD. Advances in Screening for Radiation-Associated Cardiotoxicity in Cancer Patients. Curr Cardiol Rep 2023; 25:1589-1600. [PMID: 37796395 PMCID: PMC10682284 DOI: 10.1007/s11886-023-01971-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 10/06/2023]
Abstract
PURPOSE OF REVIEW Radiation is foundational to the treatment of cancer and improves overall survival. Yet, it is important to recognize the potential cardiovascular effects of radiation therapy and how to best minimize or manage them. Screening-both through imaging and with biomarkers-can potentially identify cardiovascular effects early, allowing for prompt initiation of treatment to mitigate late effects. RECENT FINDINGS Cardiac echocardiography, magnetic resonance imaging (MRI), computed tomography, and measurements of troponin and natriuretic peptides serve as the initial screening tests of choice for RICD. Novel imaging applications, including positron emission tomography and specific MRI parameters, and biomarker testing, including myeloperoxidase, growth differentiation factor 15, galectin 3, micro-RNA, and metabolomics, hold promise for earlier detection and more specific characterization of RICD. Advances in imaging and novel applications of biomarkers have potential to identify subclinical RICD and may reveal opportunities for early intervention. Further research is needed to elucidate optimal imaging screening modalities, biomarkers, and surveillance strategies.
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Affiliation(s)
- Walter Schiffer
- Cardiovascular Division, Department of Medicine, Washington University School of Medicine, 660 S. Euclid Ave, CB 8086, St. Louis, MO, 63110, USA
- Cardio-Oncology Center of Excellence, Washington University School of Medicine, St. Louis, MO, USA
| | - Lauren N Pedersen
- Cardio-Oncology Center of Excellence, Washington University School of Medicine, St. Louis, MO, USA
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, USA
| | - Matthew Lui
- Cardiovascular Division, Department of Medicine, Washington University School of Medicine, 660 S. Euclid Ave, CB 8086, St. Louis, MO, 63110, USA
| | - Carmen Bergom
- Cardio-Oncology Center of Excellence, Washington University School of Medicine, St. Louis, MO, USA
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, USA
- Alvin J. Siteman Cancer Center, Washington University in St. Louis, St. Louis, MO, USA
| | - Joshua D Mitchell
- Cardiovascular Division, Department of Medicine, Washington University School of Medicine, 660 S. Euclid Ave, CB 8086, St. Louis, MO, 63110, USA.
- Cardio-Oncology Center of Excellence, Washington University School of Medicine, St. Louis, MO, USA.
- Alvin J. Siteman Cancer Center, Washington University in St. Louis, St. Louis, MO, USA.
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Bayadsi H, Brink PVD, Erlandsson M, Gudbjornsdottir S, Sebraoui S, Koorem S, Nordin P, Hennings J, Englund O. The correlation between small papillary thyroid cancers and gamma radionuclides Cs-137, Th-232, U-238 and K-40 using spatially-explicit, register-based methods. Spat Spatiotemporal Epidemiol 2023; 47:100618. [PMID: 38042537 DOI: 10.1016/j.sste.2023.100618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 08/26/2023] [Accepted: 09/17/2023] [Indexed: 12/04/2023]
Abstract
A steep increase of small papillary thyroid cancers (sPTCs) has been observed globally. A major risk factor for developing PTC is ionizing radiation. The aim of this study is to investigate the spatial distribution of sPTC in Sweden and the extent to which prevalence is correlated to gamma radiation levels (Caesium-137 (Cs-137), Thorium-232 (Th-232), Uranium-238 (U-238) and Potassium-40 (K-40)) using multiple geospatial and geostatistical methods. The prevalence of metastatic sPTC was associated with significantly higher levels of Gamma radiation from Th-232, U-238 and K-40. The association is, however, inconsistent and the prevalence is higher in densely populated areas. The results clearly indicate that sPTC has causative factors that are neither evenly distributed among the population, nor geographically, calling for further studies with bigger cohorts. Environmental factors are believed to play a major role in the pathogenesis of the disease.
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Affiliation(s)
- Haytham Bayadsi
- Department of Surgical and Perioperative Sciences/Surgery, Umeå University, Sweden.
| | - Paul Van Den Brink
- Department of Natural Sciences, Design and Sustainable Development, Mid-Sweden University, Östersund Campus, Sweden
| | - Mårten Erlandsson
- Department of Aquatic Resources, Swedish University of Agricultural Sciences (SLU), Uppsala, Sweden
| | | | - Samy Sebraoui
- Institute of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Sofi Koorem
- Department of Surgical and Perioperative Sciences/Surgery, Umeå University, Sweden
| | - Pär Nordin
- Department of Surgical and Perioperative Sciences/Surgery, Umeå University, Sweden
| | - Joakim Hennings
- Department of Surgical and Perioperative Sciences/Surgery, Umeå University, Sweden
| | - Oskar Englund
- Department of Natural Sciences, Design and Sustainable Development, Mid-Sweden University, Östersund Campus, Sweden
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Atajanova T, Rahman MM, Konieczkowski DJ, Morris ZS. Radiation-associated secondary malignancies: a novel opportunity for applying immunotherapies. Cancer Immunol Immunother 2023; 72:3445-3452. [PMID: 37658906 DOI: 10.1007/s00262-023-03532-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/16/2023] [Indexed: 09/05/2023]
Abstract
Radiation is commonly used as a treatment intended to cure or palliate cancer patients. Despite remarkable advances in the precision of radiotherapy delivery, even the most advanced forms inevitably expose some healthy tissues surrounding the target site to radiation. On rare occasions, this results in the development of radiation-associated secondary malignancies (RASM). RASM are typically high-grade and carry a poorer prognosis than their non-radiated counterparts. RASM are characterized by a high mutation burden, increased T cell infiltration, and a microenvironment that bears unique inflammatory signatures of prior radiation, including increased expression of various cytokines (e.g., TGF-β, TNF-α, IL4, and IL10). Interestingly, these cytokines have been shown to up-regulate the expression of PD-1 and/or PD-L1-an immune checkpoint receptor/ligand pair that is commonly targeted by immune checkpoint blocking immunotherapies. Here, we review the current understanding of the tumor-immune interactions in RASM, highlight the distinct clinical and molecular characteristics of RASM that may render them immunologically "hot," and propose a rationale for the formal testing of immune checkpoint blockade as a treatment approach for patients with RASM.
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Affiliation(s)
- Tavus Atajanova
- Biochemistry and Biophysics Program, Amherst College, Amherst, MA, 01002, USA
- Department of Sociology, Amherst College, Amherst, MA, 01002, USA
- Department of Human Oncology, University of Wisconsin-Madison, Madison, WI, 53726, USA
| | - Md Mahfuzur Rahman
- Department of Human Oncology, University of Wisconsin-Madison, Madison, WI, 53726, USA
| | - David J Konieczkowski
- Department of Radiation Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, 43210, USA
| | - Zachary S Morris
- Department of Human Oncology, University of Wisconsin-Madison, Madison, WI, 53726, USA.
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Shaikh MH, Dawson A, Prokopec SD, Barrett JW, Y F Zeng P, Khan MI, Ryan SEB, Cecchini M, Palma DA, Mymryk JS, Boutros PC, Nichols AC. Loss of LRP1B expression drives acquired chemo and radio-resistance in HPV-positive head and neck cancer. Oral Oncol 2023; 146:106580. [PMID: 37778229 DOI: 10.1016/j.oraloncology.2023.106580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 09/01/2023] [Accepted: 09/26/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVES Although human papillomavirus positive (HPV+) oropharyngeal squamous cell carcinoma (OPSCC) patients typically experience excellent survival, 15-20 % of patients recur after treatment with chemotherapy and radiation. Therefore, there is a need for biomarkers of treatment failure to guide treatment intensity. MATERIALS AND METHODS Whole genome sequencing was carried out on HPV+OPSCC patients who were primarily treated with concurrent chemotherapy (cisplatin) and radiation. We then explored whether the loss of LRP1Bwas sufficient to drive an aggressive phenotype, and promote a resistance to cisplatin and radiation therapy both in vitro using HPV+ cell lines (93VU147T, UMSCC47, UWO37 and UWO23) and in vivo. RESULTS Through integrative genomic analysis of three HPV+OPSCC tumour datasets, we identified that deletion of LRP1B was enriched in samples that recurred following chemo-radiation. Knockdown using siRNA in four HPV+ cell lines (UWO23, UWO37, UMSCC47 and 93VU147T) resulted in increased proliferation of all cases. CRISPR/Cas9 deletion of LRP1B in the same cell line panel demonstrated increased proliferation, clonogenic growth and migration, as well as resistance to both cisplatin and radiation in LRP1B deleted cells compared to their respective non-targeting control cells. Cell line derived xenograft studies indicated that the LRP1B knockout tumours were more resistant to cisplatin and radiation therapy compared to their controls invivo. CONCLUSION Taken together, our work implicates LRP1B deletion as a potential biomarker for identifying treatment resistant HPV+ OPSCC cases.
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Affiliation(s)
- Mushfiq H Shaikh
- Department of Otolaryngology-Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada
| | - Alice Dawson
- Department of Otolaryngology-Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada; Department of Pathology and Laboratory Medicine, University of Western Ontario, London, Ontario, Canada
| | | | - John W Barrett
- Department of Otolaryngology-Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada; Department of Oncology, University of Western Ontario, London, Ontario, Canada
| | - Peter Y F Zeng
- Department of Otolaryngology-Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada
| | - Mohammed I Khan
- Department of Otolaryngology-Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada
| | - Sarah E B Ryan
- Department of Otolaryngology-Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada; Department of Pathology and Laboratory Medicine, University of Western Ontario, London, Ontario, Canada
| | - Matthew Cecchini
- Department of Pathology and Laboratory Medicine, University of Western Ontario, London, Ontario, Canada
| | - David A Palma
- Department of Otolaryngology-Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada; Department of Oncology, University of Western Ontario, London, Ontario, Canada
| | - Joe S Mymryk
- Department of Otolaryngology-Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada; Department of Oncology, University of Western Ontario, London, Ontario, Canada; Department of Microbiology & Immunology, University of Western Ontario, London, Ontario, Canada
| | - Paul C Boutros
- Department of Human Genetics, University of California, Los Angeles, CA, USA; Department of Urology, University of California, Los Angeles, CA, USA; Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, CA, USA; Institute for Precision Health, University of California, Los Angeles, CA, USA; Jonsson Comprehensive Cancer Centre, University of California, Los Angeles, CA, USA
| | - Anthony C Nichols
- Department of Otolaryngology-Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada; Department of Oncology, University of Western Ontario, London, Ontario, Canada.
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ElSherif A, Freyvogel Ramirez M, Moore EC, Dietz JR, Tu C, Valente SA. Mastectomy margins for ductal carcinoma-in-situ (DCIS): 18 Years of follow-up. Am J Surg 2023; 226:646-651. [PMID: 37481406 DOI: 10.1016/j.amjsurg.2023.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/28/2023] [Accepted: 07/10/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND In patients undergoing mastectomy for ductal carcinoma in situ (DCIS), the significance of a positive or close (<2 mm) margin and associated recurrence risk is unclear. The study sought to evaluate risk of recurrence in relation to the mastectomy surgical margin. METHODS A single institution retrospective review of patients with DCIS who underwent mastectomy between 2000 and 2010 was performed. Patient demographics, tumor biology, margin status and adjuvant therapy were recorded. The incidence of local recurrence (LR), distant metastasis were analyzed. RESULTS A total of 282 patients with DCIS were identified. Overall, 12.3% of patients had a pathological positive/close margin (n = 9 tumor on ink and n = 36 <2 mm). Adjuvant radiation was administered to 11 patients with a positive or close margin. At a median follow-up of 12 years, LR was 3.4% (n = 10). None of the patients with LR had a positive or close margin. Additionally, none of the patients who received radiation developed LR. CONCLUSION Risk of recurrence after mastectomy for DCIS is low and appears to be unrelated to margin status or the use of radiation therapy.
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MESH Headings
- Humans
- Female
- Carcinoma, Intraductal, Noninfiltrating/radiotherapy
- Carcinoma, Intraductal, Noninfiltrating/surgery
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Mastectomy
- Follow-Up Studies
- Breast Neoplasms/radiotherapy
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/radiotherapy
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Ductal, Breast/pathology
- Retrospective Studies
- Mastectomy, Segmental
- Neoplasm Recurrence, Local/epidemiology
- Neoplasm Recurrence, Local/surgery
- Margins of Excision
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Affiliation(s)
- Ayat ElSherif
- Division of Breast Surgery, Department of General Surgery, Cleveland Clinic, Cleveland, OH, United States
| | - Mary Freyvogel Ramirez
- Division of Breast Surgery, Department of General Surgery, Cleveland Clinic, Cleveland, OH, United States
| | - Edwina C Moore
- Division of Breast Surgery, Department of General Surgery, Cleveland Clinic, Cleveland, OH, United States
| | - Jill R Dietz
- Allegheny Health Network Cancer Institute, Pittsburgh, PA, United States
| | - Chao Tu
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, United States
| | - Stephanie A Valente
- Division of Breast Surgery, Department of General Surgery, Cleveland Clinic, Cleveland, OH, United States.
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Al-Manei K, Sobkowiak MJ, Nagadia RH, Heymann R, Sällberg Chen M, Özenci V. Mycobiota profile of oral fungal infections in head and neck cancer patients receiving radiotherapy: A 6-year retrospective MALDI-TOF mass spectrometry study. Oral Oncol 2023; 146:106556. [PMID: 37611433 DOI: 10.1016/j.oraloncology.2023.106556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/14/2023] [Accepted: 08/13/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVES Head and neck cancer (HNC) impairs patient immunity and increases susceptibility to oral fungal infections (OFIs). Effectively treating such infections requires accurate identification of the causative pathogens. This study aimed to characterize the mycobiota profile of OFIs in HNC patients undergoing radiation treatment (RT). MATERIALS AND METHODS A 6-year retrospective analysis of oral mucosal samples from HNC patients with a history of RT and OFIs between 2014 and 2019 was conducted using Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) profiling. Samples from the Clinical Microbiology Laboratory at Karolinska University Hospital were evaluated for mycobiota diversity and species co-occurrence patterns in the ongoing-RT and post-RT groups. RESULTS A total of 190 oral fungi (88% Candida, 5% Pichia) were isolated from 162 HNC patients receiving RT. In the ongoing-RT group, the emergent non-albicans Candida (NAC) species; F. solani and C. jadinii, were detected for the first time. The dominant pathogens in both ongoing and post-RT groups were C. albicans, C. glabrata, P. kudriavzevii, C. parapsilosis, and C. tropicalis, as shown by Venn analysis. Network analysis revealed greater fungi diversity and multi-species co-occurrence in the ongoing-RT group. C. albicans commonly co-occurred with C. glabrata in both ongoing-RT (21%) and post-RT groups (30%). CONCLUSION MALDI-TOF MS identified a wide range of oral fungal species in HNC patients receiving RT. While C. albicans remains the most prevalent OFIs pathogen, multi-species co-occurrence and novel NACs were noted. Understanding the ecological interactions among these causative pathogens could significantly advance the development of effective therapeutics for treating OFIs in HNC patients.
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Affiliation(s)
- Khaled Al-Manei
- Unit of Oral Diagnostics and Surgery, Department of Dental Medicine, Karolinska Institutet, Huddinge 14104, Sweden; Division of Endodontics, Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Michał Jacek Sobkowiak
- Unit of Oral Diagnostics and Surgery, Department of Dental Medicine, Karolinska Institutet, Huddinge 14104, Sweden
| | - Rahul Harshad Nagadia
- Unit of Oral Diagnostics and Surgery, Department of Dental Medicine, Karolinska Institutet, Huddinge 14104, Sweden; Department of Head and Neck Surgery, National Cancer Centre Singapore, and Singapore General Hospital, Singapore; Department of Oral and Maxillofacial Surgery, National Dental Centre Singapore, Singapore
| | - Robert Heymann
- Unit of Oral Diagnostics and Surgery, Department of Dental Medicine, Karolinska Institutet, Huddinge 14104, Sweden; Medical Unit for Reconstructive Plastic- and Craniofacial Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Margaret Sällberg Chen
- Unit of Oral Diagnostics and Surgery, Department of Dental Medicine, Karolinska Institutet, Huddinge 14104, Sweden.
| | - Volkan Özenci
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Huddinge 14104, Sweden; Department of Clinical Microbiology F72, Karolinska University Hospital, Huddinge 14104, Sweden.
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Davis NF, Tzelves L, Geraghty R, Lombardo R, Yuan C, Petrik A, Neisius A, Gambaro G, Jung H, Shepherd R, Tailly T, Somani B, Skolarikos A. Comparison of Treatment Outcomes for Fluoroscopic and Fluoroscopy-free Endourological Procedures: A Systematic Review on Behalf of the European Association of Urology Urolithiasis Guidelines Panel. Eur Urol Focus 2023; 9:938-953. [PMID: 37277273 DOI: 10.1016/j.euf.2023.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 04/25/2023] [Accepted: 05/23/2023] [Indexed: 06/07/2023]
Abstract
CONTEXT Endourological procedures frequently require fluoroscopic guidance, which results in harmful radiation exposure to patients and staff. One clinician-controlled method for decreasing exposure to ionising radiation in patients with urolithiasis is to avoid the use of intraoperative fluoroscopy during stone intervention procedures. OBJECTIVE To comparatively assess the benefits and risks of "fluoroscopy-free" and fluoroscopic endourological interventions in patients with urolithiasis. EVIDENCE ACQUISITION A systematic review of the literature from 1970 to 2022 was performed using the MEDLINE/PubMed, Embase, and Cochrane controlled trials databases and ClinicalTrials.gov. Primary outcomes assessed were complications and the stone-free rate (SFR). Studies reporting data on ureteroscopy and percutaneous nephrolithotomy (PCNL) were eligible for inclusion. Secondary outcomes were operative duration, hospital length of stay, conversion from a fluoroscopy-free to a fluoroscopic procedure, and requirement for an auxiliary procedure to achieve stone clearance. EVIDENCE SYNTHESIS In total, 24 studies (12 randomised and 12 observational) out of 834 abstracts screened were eligible for analysis. There were 4564 patients with urolithiasis in total, of whom 2309 underwent a fluoroscopy-free procedure and 2255 underwent a comparative fluoroscopic procedure for treatment of urolithiasis. Pooled analysis of all procedures revealed no significant difference between the groups in SFR (p = 0.84), operative duration (p = 0.11), or length of stay (p = 0.13). Complication rates were significantly higher in the fluoroscopy group (p = 0.009). The incidence of conversion from a fluoroscopy-free to a fluoroscopic procedure was 2.84%. Similar results were noted in subanalyses for ureteroscopy (n = 2647) and PCNL (n = 1917). When only randomised studies were analysed (n = 12), the overall complication rate was significantly in the fluoroscopy group (p < 0.001). CONCLUSIONS For carefully selected patients with urolithiasis, fluoroscopy-free and fluoroscopic endourological procedures have comparable stone-free and complication rates when performed by experienced urologists. In addition, the conversion rate from a fluoroscopy-free to a fluoroscopic endourological procedure is low at 2.84%. These findings are important for clinicians and patients, as the detrimental health effects of ionising radiation are negated with fluoroscopy-free procedures. PATIENT SUMMARY We compared treatments for kidney stones with and without the use of radiation. We found that kidney stone procedures without the use of radiation can be safely performed by experienced urologists in patients with normal kidney anatomy. These findings are important, as they indicate that the harmful effects of radiation can be avoided during kidney stone surgery.
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Affiliation(s)
- Niall F Davis
- Department of Urology, Beaumont Hospital and Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Lazaros Tzelves
- Department of Urology, Sismanogleio Hospital, National and Kapodistrian University of Athens, Athens, Greece; Department of Urology/Uro-oncology, University College of London Hospitals NHS Trust, London, UK
| | - Robert Geraghty
- Department of Urology, Freeman Hospital, Newcastle-upon-Tyne, UK
| | - Riccardo Lombardo
- Department of Urology ,Sant' Andrea Hospital, Sapienza University, Rome, Italy
| | - Cathy Yuan
- Division of Gastroenterology, McMaster University and Cochrane UGPD Group, Hamilton, Canada
| | - Ales Petrik
- First Faculty of Medicine, Charles University, Prague, Czechia
| | - Andrea Neisius
- Department of Urology, Bruederkrankenhaus Trier, Johannes Gutenberg University, Mainz, Germany
| | - Giovanni Gambaro
- Department of Medicine, Nephrology and Dialysis Unit, University of Verona, Verona, Italy
| | - Helene Jung
- Department of Urology, Lillebaelt and Vejle Hospitals, University of Southern Denmark Odense, Denmark
| | - Robert Shepherd
- European Association of Urology Guidelines Office, Arnhem, The Netherlands
| | - Thomas Tailly
- Department of Urology, University Hospital Ghent, Ghent, Belgium
| | - Bhaskar Somani
- Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Andreas Skolarikos
- Department of Urology, Sismanogleio Hospital, National and Kapodistrian University of Athens, Athens, Greece.
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Venkidesh BS, Shankar SR, Narasimhamurthy RK, Rao SBS, Mumbrekar KD. Radioprotective potential of probiotics against gastrointestinal and neuronal toxicity: a preclinical study. Clin Transl Oncol 2023; 25:3165-3173. [PMID: 37071338 PMCID: PMC10514165 DOI: 10.1007/s12094-023-03184-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 04/01/2023] [Indexed: 04/19/2023]
Abstract
PURPOSE Radiotherapy is a critical component of cancer treatment, along with surgery and chemotherapy. Approximately, 90% of cancer patients undergoing pelvic radiotherapy show gastrointestinal (GI) toxicity, including bloody diarrhea, and gastritis, most of which are associated with gut dysbiosis. In addition to the direct effect of radiation on the brain, pelvic irradiation can alter the gut microbiome, leading to inflammation and breakdown of the gut-blood barrier. This allows toxins and bacteria to enter the bloodstream and reach the brain. Probiotics have been proven to prevent GI toxicity by producing short-chain fatty acids and exopolysaccharides beneficial for protecting mucosal integrity and oxidative stress reduction in the intestine and also shown to be beneficial in brain health. Microbiota plays a significant role in maintaining gut and brain health, so it is important to study whether bacterial supplementation will help in maintaining the gut and brain structure after radiation exposure. METHODS In the present study, male C57BL/6 mice were divided into control, radiation, probiotics, and probiotics + radiation groups. On the 7th day, animals in the radiation and probiotics + radiation groups received a single dose of 4 Gy to whole-body. Posttreatment, mice were sacrificed, and the intestine and brain tissues were excised for histological analysis to assess GI and neuronal damage. RESULTS Radiation-induced damage to the villi height and mucosal thickness was mitigated by the probiotic treatment significantly (p < 0.01). Further, radiation-induced pyknotic cell numbers in the DG, CA2, and CA3 areas were substantially reduced with bacterial supplementation (p < 0.001). Similarly, probiotics reduced neuronal inflammation induced by radiation in the cortex, CA2, and DG region (p < 0.01). Altogether, the probiotics treatment helps mitigate radiation-induced intestinal and neuronal damage. CONCLUSION In conclusion, the probiotic formulation could attenuate the number of pyknotic cells in the hippocampal brain region and decrease neuroinflammation by reducing the number of microglial cells.
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Affiliation(s)
- Babu Santhi Venkidesh
- Department of Radiation Biology & Toxicology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Saligrama R Shankar
- Department of Radiation Biology & Toxicology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Rekha Koravadi Narasimhamurthy
- Department of Radiation Biology & Toxicology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Satish Bola Sadashiva Rao
- Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, 576104, India
- Manipal Academy of Higher Education, Manipal, 576104, India
| | - Kamalesh Dattaram Mumbrekar
- Department of Radiation Biology & Toxicology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, 576104, India.
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Wang X, Zhu J, Zuo Y, Niu S, Yang P, Shang P, Niu J. Study on fast algorithm of neutron radiation field under complex terrain scenario based on ensemble learning approach. J Environ Radioact 2023; 268-269:107244. [PMID: 37515862 DOI: 10.1016/j.jenvrad.2023.107244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 07/08/2023] [Accepted: 07/16/2023] [Indexed: 07/31/2023]
Abstract
In this study a prediction algorithm has been proposed to rapidly figure out neutron radiation field for nuclear explosion under complex terrain scenario based on ensemble learning approach, which could be an impossibility for traditional radiation transport simulation methodology. By analyzing the influence of complex surface morphology on the radiation field, a series of characteristic parameters which could characterize the topographic features and their influence on the transport of neutrons and secondary gamma in the atmosphere have been extracted with the application of DEM, and the sample sethas been constructedwith the MC simulation results of terrain samples generated by random algorithm, to be used to train the prediction model for the neutron radiation field of nuclear explosion. In order to verify the actual prediction performance of the model, the study has implemented the prediction for the neutron flux, neutron tissue dose and secondary gamma tissue dose under the authentic urban and mountainous terrain scenarios, and analyzed and compared the results from fast prediction and MC simulation in different evaluation dimensions. The comparisons suggest that both of the results are in good agreement with each other, demonstrating that the fast prediction models preliminarily possess the engineering application value. In addition, a feasible approach to improve the generalization performance of the prediction model for various radiation scenarios has been proposed, which could be deemed as a reference for further research.
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Affiliation(s)
- Xuedong Wang
- Northwest Institute of Nuclear Technology, Xi'an, 710024, China
| | - Jinhui Zhu
- Northwest Institute of Nuclear Technology, Xi'an, 710024, China.
| | - Yinghong Zuo
- Northwest Institute of Nuclear Technology, Xi'an, 710024, China
| | - Shengli Niu
- Northwest Institute of Nuclear Technology, Xi'an, 710024, China
| | - Peng Yang
- Northwest Institute of Nuclear Technology, Xi'an, 710024, China
| | - Peng Shang
- Northwest Institute of Nuclear Technology, Xi'an, 710024, China
| | - Jinlin Niu
- Northwest Institute of Nuclear Technology, Xi'an, 710024, China
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Tasoulas J, Schrank TP, Smith BD, Agala CB, Kim S, Sheth S, Shen C, Yarbrough WG, Hackman T, Sullivan CB. Time to treatment patterns of head and neck cancer patients before and during the Covid-19 pandemic. Oral Oncol 2023; 146:106535. [PMID: 37625360 DOI: 10.1016/j.oraloncology.2023.106535] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023]
Abstract
OBJECTIVES The delivery of healthcare has changed significantly over the past decades. This study analyzes the clinicodemographic factors and treatment patterns of head and neck squamous cell carcinoma (HNSCC) patients between 2004 and 2020. MATERIALS AND METHODS Retrospective cohort analysis of HNSCC patients from the National Cancer Data Base from 2004 to 2020. RESULTS A total of 164,290 patients were included. Increased times from diagnosis to definitive surgery (TTS) were seen across all facility types (academic centers, AC; non-academic centers, NAC) between 2004 and 2019, with NAC affected more. TTS < 15 days (RR = 1.05, 95%CI:1.05-1.09) and > 75 days (1.07, 95%CI:1.05-1.09) were associated with increased mortality risk. This association was more prominent among HPV + HNSCC (RR = 1.45; 95%CI:1.18-1.78). Treatment in AC was associated with a decreased mortality risk (RR = 0.94, 95%CI:0.93-0.95). Despite the universal increase in wait times from 2004 to 2019, short-term mortality was significantly decreased from 2016 to 2019, relative to 2004-2007 (3-month mortality: RR = 0.77, 95%CI:0.70-0.85; 12-month mortality: RR = 0.80, 95%CI:0.77-0.84). Wait times decreased in 2020. CONCLUSIONS TTS increased between 2004 and 2019, with NAC affected more. However, despite longer wait times, short-term survival increased significantly. Very short (<15 days) and very long (>75 days) TTS were associated with increased mortality risk. Patients with HPV + HNSCC have the highest increase among those treated > 75 days from diagnosis. Treatment at AC was associated with improved survival, which could be explained by the presence of multidisciplinary teams and subspecialists that may be less available at NAC. The 2021 NCDB data are required for a comprehensive analysis of wait times in 2020.
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Affiliation(s)
- Jason Tasoulas
- Department of Otolaryngology - Head and Neck Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Travis P Schrank
- Department of Otolaryngology - Head and Neck Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Blaine D Smith
- Department of Otolaryngology - Head and Neck Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Chris B Agala
- Department of Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sulgi Kim
- Department of Otolaryngology - Head and Neck Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Siddharth Sheth
- Division of Oncology, Department of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Colette Shen
- Department of Radiation Oncology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Wendell G Yarbrough
- Department of Otolaryngology - Head and Neck Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Pathology and Laboratory Medicine, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Trevor Hackman
- Department of Otolaryngology - Head and Neck Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Christopher Blake Sullivan
- Department of Otolaryngology - Head and Neck Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Koester SW, Rhodenhiser EG, Dabrowski SJ, Benner D, Rumalla K, Scherschinski L, Catapano JS, Graffeo CS, Srinivasan VM, Lawton MT. Radiation-Induced Cerebral Cavernous Malformations: A Single-Center Experience and Systematic Literature Review. World Neurosurg 2023; 179:222-232.e2. [PMID: 37595838 DOI: 10.1016/j.wneu.2023.08.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/20/2023]
Abstract
OBJECTIVE Radiation was first demonstrated to be associated with cavernomagenesis in 1992. Since then, a growing body of literature has shown the unique course and presentation of radiation-induced cavernous malformations (RICMs). This study summarizes the literature on RICMs and presents a single-center experience. METHODS A prospectively maintained single institution vascular malformation database was searched for all cases of intracranial cavernous malformation (January 1, 1997-December 31, 2021). For patients with a diagnosis of RICM, information on demographic characteristics, surgical treatments, radiation, and surgical outcomes was obtained and analyzed. A comprehensive literature search was conducted using PubMed, Embase, Cochrane, and Web of Science databases for all reported cases of RICM. RESULTS A retrospective review of 1662 patients treated at a single institution yielded 10 patients with prior radiation treatment in the neck or head region and a subsequent diagnosis of intracranial RICM. The median (interquartile range) latency between radiation and presentation was 144 (108-192) months. Nine of 10 patients underwent surgery; symptoms improved for 5 patients, worsened for 3, and were stable for 1. The systematic literature review yielded 64 publications describing 248 patients with RICMs. Of the 248 literature review cases, 71 (28.6%) involved surgical resection. Of 39 patients with reported surgical outcomes, 32 (82%) experienced improvement. CONCLUSIONS RICMs have a unique course and epidemiology. RICMs should be considered when patients with a history of radiation present with neurologic impairment. When RICMs are identified, symptomatic patients can be treated effectively with surgical excision and close follow-up.
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Affiliation(s)
- Stefan W Koester
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Emmajane G Rhodenhiser
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Stephen J Dabrowski
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Dimitri Benner
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Kavelin Rumalla
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Lea Scherschinski
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Joshua S Catapano
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Christopher S Graffeo
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Visish M Srinivasan
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Michael T Lawton
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
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Abstract
Hybrid positron emission tomography (PET)/magnetic resonance imaging (MRI) is highly suited for abdominal pathologies. A precise co-registration of anatomic and metabolic data is possible thanks to the simultaneous acquisition, leading to accurate imaging. The literature shows that PET/MRI is at least as good as PET/CT and even superior for some indications, such as primary hepatic tumors, distant metastasis evaluation, and inflammatory bowel disease. PET/MRI allows whole-body staging in a single session, improving health care efficiency and patient comfort.
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Affiliation(s)
- Álvaro Badenes Romero
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Athinoula A Martinos Center for Biomedical Imaging, Harvard Medical School, Charlestown, MA, USA; Department of Nuclear Medicine, Joan XXIII Hospital, Tarragona, Spain
| | - Felipe S Furtado
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Athinoula A Martinos Center for Biomedical Imaging, Harvard Medical School, Charlestown, MA, USA
| | - Madaleine Sertic
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Reece J Goiffon
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Umar Mahmood
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Onofrio A Catalano
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Athinoula A Martinos Center for Biomedical Imaging, Harvard Medical School, Charlestown, MA, USA.
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Alshipli M, Aladailah MW, Marashdeh MW, Oglat AA, Akhdar H, Tashlykov OL, Banat R, Walaa AT. Fe-nanoparticle effect on polypropylene for effective radiation protection: Simulation and theoretical study. Med Eng Phys 2023; 121:104066. [PMID: 37985023 DOI: 10.1016/j.medengphy.2023.104066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 10/10/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023]
Abstract
An evaluation of the gamma-neutron shielding capabilities of polymer nanocomposite materials based on polypropylene and iron nanoparticles is presented in this study. The chemical composition of the materials is (100-x) PP-Fex, (where x = 0.1, 0.3, 0.5, 1, 2 and 5 wt percent). For the proposed polymer samples with photon energies ranging from 30 to 2000 KeV, the mass attenuation coefficient (MAC), a crucial parameter for studying gamma-ray shielding capability, was calculated using the Geant4 Monte Carlo code. Results were compared with those predicted by EpiXS. The values of the Geant4 code and the EpiXS software were both found to be in excellent agreement. Using the mass attenuation coefficient values, we determined the linear attenuation coefficients, electron density, effective atomic number, and half value layer for all the samples. The shielding properties of the polymer samples were also evaluated by estimating both the fast neutron removal cross-section and the mean free path of the fast neutron at energies between 0.25 and 5.5 keV. The study's findings indicate a positive correlation between the Fe nanoparticle content and the gamma-ray shielding performance of PP-Fe polymer samples. Out of the several glasses that were evaluated, it was found that the PP-Fe5 polymer sample demonstrates the highest efficacy in terms of gamma-ray shielding. Moreover, the polymer sample PP-Fe5, which consists of 5 mol% of iron (Fe), exhibits the highest value of ∑R (1.10650 cm-1) and the lowest value of the mean free path for fast neutrons. This indicates that the PP-Fe5 possesses better gamma-neutron shielding efficiency.
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Affiliation(s)
- Marwan Alshipli
- Medical Imaging and Radiography Department, Aqaba University of Technology, Aqaba, Jordan.
| | - M W Aladailah
- Ural Federal University, 19 Mira St., Yekaterinburg, Russia
| | - M W Marashdeh
- Department of Physics, College of Science, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, 11623, Saudi Arabia
| | - Ammar A Oglat
- Department of Medical Imaging, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, 13133, Jordan
| | - H Akhdar
- Department of Physics, College of Science, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, 11623, Saudi Arabia
| | - O L Tashlykov
- Ural Federal University, 19 Mira St., Yekaterinburg, Russia
| | - Raid Banat
- Chemistry Department, Al al-Bayt University, Mafraq, Jordan
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Ramisetty SK, Garg P, Mohanty A, Mirzapoiazova T, Yue E, Wang E, Horne D, Awasthi S, Kulkarni P, Salgia R, Singhal SS. Regression of ovarian cancer xenografts by depleting or inhibiting RLIP. Biochem Pharmacol 2023; 217:115847. [PMID: 37804871 DOI: 10.1016/j.bcp.2023.115847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/20/2023] [Accepted: 10/04/2023] [Indexed: 10/09/2023]
Abstract
Ovarian cancer (OC) is the most prevalent and deadly cancer of the female reproductive system. Women will continue to be impacted by OC-related morbidity and mortality. Despite the fact that chemotherapy with cisplatin is the main component as the first-line anticancer treatment for OC, chemoresistance and unfavorable side effects are important obstacles to effective treatment. Targets for effective cancer therapy are required for cancer cells but not for non-malignant cells because they are expressed differently in cancer cells compared to normal cells. Targets for cancer therapy should preferably be components that already exist in biochemical and signalling frameworks and that significantly contribute to the development of cancer or regulate the response to therapy. RLIP is an important mercapturic acid pathway transporter that is crucial for survival and therapy resistance in cancers, therefore, we examined the role of RLIP in regulating essential signalling proteins involved in relaying the inputs from upstream survival pathways and mechanisms contributing to chemo-radiotherapy resistance in OC. The findings of our research offer insight into a novel anticancer effect of RLIP depletion/inhibition on OC and might open up new therapeutic avenues for OC therapy.
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Affiliation(s)
- Sravani K Ramisetty
- Department of Medical Oncology, Beckman Research Institute, City of Hope Comprehensive Cancer Center and National Medical Center, Duarte, CA 91010, USA
| | - Pankaj Garg
- Department of Chemistry, GLA University, Mathura, Uttar Pradesh 281406, India
| | - Atish Mohanty
- Department of Medical Oncology, Beckman Research Institute, City of Hope Comprehensive Cancer Center and National Medical Center, Duarte, CA 91010, USA
| | - Tamara Mirzapoiazova
- Department of Medical Oncology, Beckman Research Institute, City of Hope Comprehensive Cancer Center and National Medical Center, Duarte, CA 91010, USA
| | - Er Yue
- Department of Medical Oncology, Beckman Research Institute, City of Hope Comprehensive Cancer Center and National Medical Center, Duarte, CA 91010, USA
| | - Edward Wang
- Department of Medical Oncology, Beckman Research Institute, City of Hope Comprehensive Cancer Center and National Medical Center, Duarte, CA 91010, USA
| | - David Horne
- Department of Molecular Medicine, Beckman Research Institute, City of Hope Comprehensive Cancer Center and National Medical Center, Duarte, CA 91010, USA
| | - Sanjay Awasthi
- Cayman Health, CTMH Doctors Hospital in Cayman Islands, George Town, Cayman Islands
| | - Prakash Kulkarni
- Department of Medical Oncology, Beckman Research Institute, City of Hope Comprehensive Cancer Center and National Medical Center, Duarte, CA 91010, USA
| | - Ravi Salgia
- Department of Medical Oncology, Beckman Research Institute, City of Hope Comprehensive Cancer Center and National Medical Center, Duarte, CA 91010, USA
| | - Sharad S Singhal
- Department of Medical Oncology, Beckman Research Institute, City of Hope Comprehensive Cancer Center and National Medical Center, Duarte, CA 91010, USA.
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Cheki M, Mostafaei S, Hanafi MG, Farasat M, Talaiezadeh A, Ghasemi MS, Modava M, Abdollahi H. Radioproteomics modeling of metformin-enhanced radiosensitivity: an animal study. Jpn J Radiol 2023; 41:1265-1274. [PMID: 37204669 DOI: 10.1007/s11604-023-01445-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/08/2023] [Indexed: 05/20/2023]
Abstract
PURPOSE Metformin is considered as radiation modulator in both tumors and healthy tissues. Radiomics has the potential to decode biological mechanisms of radiotherapy response. The aim of this study was to apply radiomics analysis in metformin-induced radiosensitivity and finding radioproteomics associations of computed tomography (CT) imaging features and proteins involved in metformin radiosensitivity signaling pathways. MATERIALS AND METHODS A total of 32 female BALB/c mice were used in this study and were subjected to injection of breast cancer cells. When tumors reached a mean volume of 150 mm3, mice were randomly divided into the four groups including Control, Metformin, Radiation, and Radiation + Metformin. Western blot analysis was performed after treatment to measure expression of proteins including AMPK-alpha, phospho-AMPK-alpha (Thr172), mTOR, phospho-mTOR (Ser2448), phospho-4EBP1 (Thr37/46), phospho-ACC (Ser79), and β-actin. CT imaging was performed before treatment and at the end of treatment in all groups. Radiomics features extracted from segmented tumors were selected using Elastic-net regression and were assessed in terms of correlation with expression of the proteins. RESULTS It was observed that proteins including phospho-mTOR, phospho-4EBP1, and mTOR had positive correlations with changes in tumor volumes in days 28, 24, 20, 16, and 12, while tumor volume changes at these days had negative correlations with AMPK-alpha, phospho-AMPK-alpha, and phospho-ACC proteins. Furthermore, median feature had a positive correlation with AMPK-alpha, phospho-ACC, and phospho-AMPK-alpha proteins. Also, Cluster shade feature had positive correlations with mTOR and p-mTOR. On the other hand, LGLZE feature had negative correlations with AMPK-alpha and phospho-AMPK-alpha. CONCLUSION Radiomics features can decode proteins that involved in response to metformin and radiation, although further studies are warranted to investigate the optimal way to integrate radiomics into biological experiments.
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Affiliation(s)
- Mohsen Cheki
- Cancer Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
- Department of Medical Imaging and Radiation Sciences, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Shayan Mostafaei
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | | | - Maryam Farasat
- Department of Radiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | | | - Mohammad Modava
- Department of Electrical Engineering, Faculty of Engineering, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Hamid Abdollahi
- Department of Radiology Technology, Faculty of Allied Medical Sciences, Kerman University of Medical Sciences, Kerman, Iran.
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, BC, Canada.
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129
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Seyedpour N, Motevaseli E, Taeb S, Nowrouzi A, Mirzaei F, Bahri M, Dehghan-Manshadi HR, Zhale M, Rashidi K, Azmoonfar R, Yahyapour R, Najafi M. Protective Effects of Alpha-lipoic Acid, Resveratrol, and Apigenin against Oxidative Damages, Histopathological Changes, and Mortality Induced by Lung Ir radiation in Rats. Curr Radiopharm 2023; 17:CRP-EPUB-135776. [PMID: 37909433 DOI: 10.2174/0118744710244357231018070313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 08/30/2023] [Accepted: 09/08/2023] [Indexed: 11/03/2023]
Abstract
AIM This study investigated the protective effects of three antioxidants on radiationinduced lung injury. BACKGROUND Oxidative stress is one of the key outcomes of radiotherapy in normal tissues. It can induce severe injuries in lung tissue, which may lead to pneumonitis and fibrosis. Recently, interest in natural chemicals as possible radioprotectors has increased due to their reduced toxicity, cheaper price, and other advantages. OBJECTIVE The present study was undertaken to evaluate the radioprotective effect of Alpha-lipoic Acid (LA), Resveratrol (RVT), and Apigenin (APG) against histopathological changes and oxidative damage and survival induced by ionizing radiation (IR) in the lung tissues of rats. METHODS First, the lung tissue of 50 mature male Wistar rats underwent an 18 Gy gamma irradiation. Next, the rats were sacrificed and transverse sections were obtained from the lung tissues and stained with hematoxylin and eosin (H and E) and Mason trichrome (MTC) for histopathological evaluation. Then, the activity of Glutathione peroxidase (GPx), Superoxide Dismutase (SOD), and Malondialdehyde (MDA) was measured by an ELISA reader at 340, 405, and 550 nm. RESULTS Based on the results of this study, IR led to a remarkable increase in morphological changes in the lung. However, APG, RVT, and LA could ameliorate the deleterious effects of IR in lung tissue. IR causes an increase in GPX level, and APG+IR administration causes a decrease in the level of GPX compared to the control group. Also, the results of this study showed that RVT has significant effects in reducing MDA levels in the short term. In addition, compared to the control group, IR and RVT+IR decrease the activity of SOD in the long term in the lung tissues of rats. Also, the analysis of results showed that weight changes in IR, LA+IR, APG+IR, and control groups were statistically significant. CONCLUSION APG and RVT could prevent tissue damage induced by radiation effects in rat lung tissues. Hence, APG, LA, and RVT could provide a novel preventive action with their potential antioxidant anti-inflammatory properties, as well as their great safety characteristic.
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Affiliation(s)
- Nasrin Seyedpour
- Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Tehran, Iran
- Nanomedicine Research Association (NRA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Elahe Motevaseli
- Department of Molecular Medicine, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahram Taeb
- Department of Radiology, School of Paramedical Sciences, Guilan University of Medical Sciences, Rasht, Iran
| | - Azin Nowrouzi
- Department of Clinical Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Mirzaei
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mina Bahri
- Central Research Laboratory, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohsen Zhale
- Department of Anatomical Sciences, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, I.R. Iran
| | - Khodabakhsh Rashidi
- Research Center of Oils and Fats, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Rasool Azmoonfar
- Department of Radiology, School of Paramedical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Rasoul Yahyapour
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Najafi
- Medical Technology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Department of Radiology and Nuclear Medicine, School of Paramedical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
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130
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Vera-Chang MN, Danforth JM, Stuart M, Goodarzi AA, Brand M, Richardson RB. Profound DNA methylomic differences between single- and multi-fraction alpha ir radiations of lung fibroblasts. Clin Epigenetics 2023; 15:174. [PMID: 37891670 PMCID: PMC10612361 DOI: 10.1186/s13148-023-01564-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/05/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Alpha (α)-radiation is a ubiquitous environmental agent with epigenotoxic effects. Human exposure to α-radiation at potentially harmful levels can occur repetitively over the long term via inhalation of naturally occurring radon gas that accumulates in enclosed spaces, or as a result of a single exposure from a nuclear accident. Alterations in epigenetic DNA methylation (DNAm) have been implicated in normal aging and cancer pathogenesis. Nevertheless, the effects of aberrations in the methylome of human lung cells following exposure to single or multiple α-irradiation events on these processes remain unexplored. RESULTS We performed genome-wide DNAm profiling of human embryonic lung fibroblasts from control and irradiated cells using americium-241 α-sources. Cells were α-irradiated in quadruplicates to seven doses using two exposure regimens, a single-fraction (SF) where the total dose was given at once, and a multi-fraction (MF) method, where the total dose was equally distributed over 14 consecutive days. Our results revealed that SF irradiations were prone to a decrease in DNAm levels, while MF irradiations mostly increased DNAm. The analysis also showed that the gene body (i.e., exons and introns) was the region most altered by both the SF hypomethylation and the MF hypermethylation. Additionally, the MF irradiations induced the highest number of differentially methylated regions in genes associated with DNAm biomarkers of aging, carcinogenesis, and cardiovascular disease. The DNAm profile of the oncogenes and tumor suppressor genes suggests that the fibroblasts manifested a defensive response to the MF α-irradiation. Key DNAm events of ionizing radiation exposure, including changes in methylation levels in mitochondria dysfunction-related genes, were mainly identified in the MF groups. However, these alterations were under-represented, indicating that the mitochondria undergo adaptive mechanisms, aside from DNAm, in response to radiation-induced oxidative stress. CONCLUSIONS We identified a contrasting methylomic profile in the lung fibroblasts α-irradiated to SF compared with MF exposures. These findings demonstrate that the methylome response of the lung cells to α-radiation is highly dependent on both the total dose and the exposure regimen. They also provide novel insights into potential biomarkers of α-radiation, which may contribute to the development of innovative approaches to detect, prevent, and treat α-particle-related diseases.
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Affiliation(s)
- Marilyn N Vera-Chang
- Radiobiology and Health Branch, Chalk River Laboratories, Canadian Nuclear Laboratories, Chalk River, ON, K0J 1J0, Canada
| | - John M Danforth
- Departments of Biochemistry and Molecular Biology and Oncology, Cumming School of Medicine, Robson DNA Science Centre, Charbonneau Cancer Institute, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Marilyne Stuart
- Environment and Waste Technologies Branch, Chalk River Laboratories, Canadian Nuclear Laboratories, Chalk River, ON, K0J 1J0, Canada
| | - Aaron A Goodarzi
- Departments of Biochemistry and Molecular Biology and Oncology, Cumming School of Medicine, Robson DNA Science Centre, Charbonneau Cancer Institute, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Marjorie Brand
- Ottawa Hospital Research Institute, Ottawa, ON, K1H 8L6, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, K1H 8L6, Canada
| | - Richard B Richardson
- Radiobiology and Health Branch, Chalk River Laboratories, Canadian Nuclear Laboratories, Chalk River, ON, K0J 1J0, Canada.
- McGill Medical Physics Unit, Cedars Cancer Centre-Glen Site, Montreal, QC, H4A 3J1, Canada.
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131
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Stauder MC. Radiation for inflammatory breast cancer: Updates. Int Rev Cell Mol Biol 2023; 384:25-46. [PMID: 38637098 DOI: 10.1016/bs.ircmb.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
Inflammatory breast cancer (IBC) is a diagnosis based on a constellation of clinical features of edema (peau d'orange) of a third or more of the skin of the breast with a palpable border and a rapid onset of breast erythema. Incidence of IBC has increased over time, although it still makes up only 1-4% of all breast cancer diagnoses. Despite recent encouraging data on clinical outcomes, the published local-regional control rates remain consistently lower than the rates for non-IBC. In this review, we focus on radiotherapy, provide a framework for multi-disciplinary care for IBC, describe local-regional treatment techniques for IBC; highlight new directions in the management of patients with metastatic IBC and offer an introduction to future directions regarding the optimal treatment and management of IBC.
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Affiliation(s)
- Michael C Stauder
- Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, Department of Breast Radiation Oncology, Division of Radiation Oncology, University of Texas MD Anderson Cancer Center, Holcombe Blvd, Houston, TX, United States.
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132
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Zhang Z, Liu Y, Zhao W, Ji M. Radiation impacts gene redundancy and biofilm regulation of cryoconite microbiomes in Northern Hemisphere glaciers. Microbiome 2023; 11:228. [PMID: 37848997 PMCID: PMC10583317 DOI: 10.1186/s40168-023-01621-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/14/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Glaciers harbor diverse microorganisms adapted to extreme conditions with high radiation, fluctuating temperature, and low nutrient availability. In glacial ecosystems, cryoconite granules are hotspots of microbial metabolic activity and could influences the biogeochemical cycle on glacier surface. Climate change could influence glacier dynamics by changing regional meteorological factors (e.g., radiation, precipitation, temperature, wind, and evaporation). Moreover, meteorological factors not only influence glacier dynamics but also directly or indirectly influence cryoconite microbiomes. However, the relationship of the meteorological factors and cryoconite microbiome are poorly understood. RESULTS Here, we collected 88 metagenomes from 26 glaciers distributed in the Northern Hemisphere with corresponding public meteorological data to reveal the relationship between meteorological factors and variation of cryoconite microbiome. Our results showed significant differences in taxonomic and genomic characteristics between cryoconite generalists and specialists. Additionally, we found that the biogeography of both generalists and specialists was influenced by solar radiation. Specialists with smaller genome size and lower gene redundancy were more abundant under high radiation stress, implying that streamlined genomes are more adapted to high radiation conditions. Network analysis revealed that biofilm regulation is a ubiquitous function in response to radiation stress, and hub genes were associated with the formation and dispersion of biofilms. CONCLUSION These findings enhance our understanding of glacier cryoconite microbiome variation on a hemispheric scale and indicate the response mechanisms to radiation stress, which will support forecasts of the ecological consequences of future climate change. Video Abstract.
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Affiliation(s)
- Zhihao Zhang
- State Key Laboratory of Tibetan Plateau Earth System, Resources and Environment (TPESRE), Institute of Tibetan Plateau Research, Chinese Academy of Sciences, Beijing, 100101, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yongqin Liu
- State Key Laboratory of Tibetan Plateau Earth System, Resources and Environment (TPESRE), Institute of Tibetan Plateau Research, Chinese Academy of Sciences, Beijing, 100101, China.
- University of Chinese Academy of Sciences, Beijing, 100049, China.
- Center for Pan-Third Pole Environment, Lanzhou University, Lanzhou, 730000, China.
| | - Weishu Zhao
- State Key Laboratory of Microbial Metabolism, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, 200240, China
- SJTU Yazhou Bay Institute of Deepsea Sci-Tech, Yongyou Industrial Park, Sanya, 572024, China
- International Center for Deep Life Investigation (IC-DLI), Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Mukan Ji
- Center for Pan-Third Pole Environment, Lanzhou University, Lanzhou, 730000, China
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133
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Butterworth SJ, Barton F, Lloyd JR. Extremophilic microbial metabolism and radioactive waste disposal. Extremophiles 2023; 27:27. [PMID: 37839067 PMCID: PMC10577106 DOI: 10.1007/s00792-023-01312-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 09/12/2023] [Indexed: 10/17/2023]
Abstract
Decades of nuclear activities have left a legacy of hazardous radioactive waste, which must be isolated from the biosphere for over 100,000 years. The preferred option for safe waste disposal is a deep subsurface geological disposal facility (GDF). Due to the very long geological timescales required, and the complexity of materials to be disposed of (including a wide range of nutrients and electron donors/acceptors) microbial activity will likely play a pivotal role in the safe operation of these mega-facilities. A GDF environment provides many metabolic challenges to microbes that may inhabit the facility, including high temperature, pressure, radiation, alkalinity, and salinity, depending on the specific disposal concept employed. However, as our understanding of the boundaries of life is continuously challenged and expanded by the discovery of novel extremophiles in Earth's most inhospitable environments, it is becoming clear that microorganisms must be considered in GDF safety cases to ensure accurate predictions of long-term performance. This review explores extremophilic adaptations and how this knowledge can be applied to challenge our current assumptions on microbial activity in GDF environments. We conclude that regardless of concept, a GDF will consist of multiple extremes and it is of high importance to understand the limits of polyextremophiles under realistic environmental conditions.
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Affiliation(s)
- Sarah Jane Butterworth
- Department of Earth and Environmental Sciences, Research Centre for Radwaste Disposal and Williamson Research Centre, The University of Manchester, Manchester, UK
| | - Franky Barton
- Department of Earth and Environmental Sciences, Research Centre for Radwaste Disposal and Williamson Research Centre, The University of Manchester, Manchester, UK.
| | - Jonathan Richard Lloyd
- Department of Earth and Environmental Sciences, Research Centre for Radwaste Disposal and Williamson Research Centre, The University of Manchester, Manchester, UK.
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Yumoto T, Hongo T, Koide Y, Obara T, Tsukahara K, Naito H, Nakao A. Radiation in an emergency situation: attempting to respect the patient's beliefs as reported by a minor. BMC Med Ethics 2023; 24:80. [PMID: 37794408 PMCID: PMC10552384 DOI: 10.1186/s12910-023-00962-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/25/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Each individual's unique health-related beliefs can greatly impact the patient-clinician relationship. When there is a conflict between the patient's preferences and recommended medical care, it can create a serious ethical dilemma, especially in an emergency setting, and dramatically alter this important relationship. CASE PRESENTATION A 56-year-old man, who remained comatose after out-of-hospital cardiac arrest, was rushed to our hospital. The patient was scheduled for emergency coronary angiography when his adolescent daughter reported that she and her father held sincere beliefs against radiation exposure. We were concerned that she did not fully understand the potential consequences if her father did not receive the recommended treatment. A physician provided her with in depth information regarding the risks and benefits of the treatment. While we did not want to disregard her statement, we opted to save the patient's life due to concerns about the validity of her report. CONCLUSIONS Variations in beliefs regarding medical care force clinicians to incorporate patient beliefs into medical practice. However, an emergency may require a completely different approach. When faced with a patient in a life-threatening condition and unconscious, we should take action to prioritize saving their life, unless we are highly certain about the validity of their advance directives.
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Affiliation(s)
- Tetsuya Yumoto
- Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita- ku, Okayama, 700-8558, Japan.
| | - Takashi Hongo
- Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita- ku, Okayama, 700-8558, Japan
| | - Yasuhiro Koide
- Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita- ku, Okayama, 700-8558, Japan
| | - Takafumi Obara
- Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita- ku, Okayama, 700-8558, Japan
| | - Kohei Tsukahara
- Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita- ku, Okayama, 700-8558, Japan
| | - Hiromichi Naito
- Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita- ku, Okayama, 700-8558, Japan
| | - Atsunori Nakao
- Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita- ku, Okayama, 700-8558, Japan
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135
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Gulej R, Nyúl-Tóth Á, Ahire C, DelFavero J, Balasubramanian P, Kiss T, Tarantini S, Benyo Z, Pacher P, Csik B, Yabluchanskiy A, Mukli P, Kuan-Celarier A, Krizbai IA, Campisi J, Sonntag WE, Csiszar A, Ungvari Z. Elimination of senescent cells by treatment with Navitoclax/ABT263 reverses whole brain ir radiation-induced blood-brain barrier disruption in the mouse brain. GeroScience 2023; 45:2983-3002. [PMID: 37642933 PMCID: PMC10643778 DOI: 10.1007/s11357-023-00870-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 07/06/2023] [Indexed: 08/31/2023] Open
Abstract
Whole brain irradiation (WBI), a commonly employed therapy for multiple brain metastases and as a prophylactic measure after cerebral metastasis resection, is associated with a progressive decline in neurocognitive function, significantly impacting the quality of life for approximately half of the surviving patients. Recent preclinical investigations have shed light on the multifaceted cerebrovascular injury mechanisms underlying this side effect of WBI. In this study, we aimed to test the hypothesis that WBI induces endothelial senescence, contributing to chronic disruption of the blood-brain barrier (BBB) and microvascular rarefaction. To accomplish this, we utilized transgenic p16-3MR mice, which enable the identification and selective elimination of senescent cells. These mice were subjected to a clinically relevant fractionated WBI protocol (5 Gy twice weekly for 4 weeks), and cranial windows were applied to both WBI-treated and control mice. Quantitative assessment of BBB permeability and capillary density was performed using two-photon microscopy at the 6-month post-irradiation time point. The presence of senescent microvascular endothelial cells was assessed by imaging flow cytometry, immunolabeling, and single-cell RNA-sequencing (scRNA-seq). WBI induced endothelial senescence, which associated with chronic BBB disruption and a trend for decreased microvascular density in the mouse cortex. In order to investigate the cause-and-effect relationship between WBI-induced senescence and microvascular injury, senescent cells were selectively removed from animals subjected to WBI treatment using Navitoclax/ABT263, a well-known senolytic drug. This intervention was carried out at the 3-month post-WBI time point. In WBI-treated mice, Navitoclax/ABT263 effectively eliminated senescent endothelial cells, which was associated with decreased BBB permeability and a trend for increased cortical capillarization. Our findings provide additional preclinical evidence that senolytic treatment approaches may be developed for prevention of the side effects of WBI.
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Affiliation(s)
- Rafal Gulej
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary
| | - Ádám Nyúl-Tóth
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary
- International Training Program in Geroscience, Institute of Biophysics, Biological Research Centre, Eötvös Loránd Research Network, Szeged, Hungary
| | - Chetan Ahire
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Jordan DelFavero
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Priya Balasubramanian
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA
| | - Tamas Kiss
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- International Training Program in Geroscience, First Department of Pediatrics, Semmelweis University, Budapest, Hungary
- Eötvös Loránd Research Network and Semmelweis University (ELKH-SE) Cerebrovascular and Neurocognitive Disorders Research Group, Budapest, Hungary
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Translational Medicine, Semmelweis University, Budapest, Hungary
- Graduate School, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Stefano Tarantini
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA
| | - Zoltan Benyo
- Eötvös Loránd Research Network and Semmelweis University (ELKH-SE) Cerebrovascular and Neurocognitive Disorders Research Group, Budapest, Hungary
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Translational Medicine, Semmelweis University, Budapest, Hungary
- Graduate School, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Pal Pacher
- Laboratory of Cardiovascular Physiology and Tissue Injury, National Institute On Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Boglarka Csik
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary
| | - Andriy Yabluchanskiy
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary
| | - Peter Mukli
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary
| | - Anna Kuan-Celarier
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - István A Krizbai
- International Training Program in Geroscience, Institute of Biophysics, Biological Research Centre, Eötvös Loránd Research Network, Szeged, Hungary
- Institute of Life Sciences, Vasile Goldiş Western University of Arad, Arad, Romania
| | | | - William E Sonntag
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Anna Csiszar
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Zoltan Ungvari
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary.
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA.
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Dorman T, Drever B, Plumridge S, Gregory K, Cooper M, Roderick A, Arruzza E. Radiation dose to staff from medical X-ray scatter in the orthopaedic theatre. Eur J Orthop Surg Traumatol 2023; 33:3059-3065. [PMID: 37004602 PMCID: PMC10504098 DOI: 10.1007/s00590-023-03538-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 03/21/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE Given the growing demand for intraoperative imaging, there is increased concern for radiation dose for orthopaedic surgical staff. This study sought to determine the distribution of scatter radiation from fluoroscopic imaging in the orthopaedic surgical environment, with particular emphasis on the positions of personnel and the type of orthopaedic surgery performed. METHODS A radiation survey detector was deployed at various angles and distances around an anthropomorphic phantom. The scatter dose rate in microsieverts per hour (µSv/h) was recorded using consistent exposure parameters for five common surgical procedures. A C-arm unit produced radiation for the hip arthroscopy, hip replacement and knee simulations, whilst a mini C-arm unit produced fluoroscopy for the foot and hand simulations. RESULTS Readings were tabulated, and coloured heatmaps were generated from scatter measurements for each of the five procedures. Positions corresponding to the typical location of the surgical staff (surgeon, surgical assistant, anaesthetist, instrument (scrub) nurse, circulation (scout) nurse and anaesthetic nurse) were superimposed on heatmaps. The surgeon's proximity to the radiation source meant this position experienced the greatest amount of radiation in all five surgical procedures. Mini C-arm doses were considered low in all procedures for positions, with and without lead protection. CONCLUSION This investigation demonstrated the distribution of scattered radiation dose experienced at different positions within the orthopaedic surgical theatre. It reinforces the importance of staff increasing their distance from the primary beam where possible, reducing exposure time and increasing shielding with lead protection.
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Affiliation(s)
- T Dorman
- Jones Radiology, Eastwood, South Australia, 5063, Australia
| | - B Drever
- Jones Radiology, Eastwood, South Australia, 5063, Australia
| | - S Plumridge
- Jones Radiology, Eastwood, South Australia, 5063, Australia
| | - K Gregory
- SA Radiation, Adelaide, South Australia, 5067, Australia
| | - M Cooper
- SA Radiation, Adelaide, South Australia, 5067, Australia
| | - A Roderick
- Sportsmed, Stepney, South Australia, 5069, Australia
- UniSA Clinical & Health Sciences, University of South Australia, Adelaide, South Australia, 5000, Australia
| | - E Arruzza
- Jones Radiology, Eastwood, South Australia, 5063, Australia.
- UniSA Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, 5000, Australia.
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Beltran-Bless AA, Kacerovsky-Strobl S, Gnant M. Explaining risks and benefits of loco-regional treatments to patients. Breast 2023; 71:132-137. [PMID: 37634470 PMCID: PMC10472006 DOI: 10.1016/j.breast.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/15/2023] [Accepted: 08/20/2023] [Indexed: 08/29/2023] Open
Abstract
Treatment for early-stage breast cancer is complex, requiring multidisciplinary care with a multitude of treatment options available for each patient. Coupled with the rising importance of shared decision-making, patient-physician conversations are progressively more complicated. These conversations require frank disclosure of risks and benefits of the different treatment modalities in a way that is individualized for each patient and simple to understand. In most patients, breast conserving therapy with radiation should be presented as the gold-standard local treatment given similar long-term and improved quality of life outcomes. De-escalation is currently at the forefront of research in loco-regional treatments, and further investigations are required to best determine the optimal patient populations for reduced sentinel lymph node sampling, omission of sentinel lymph node biopsy altogether and omission of radiation treatment. For future trials, better endpoints need to be established considering patient-centered outcomes as well as recurrence.
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Affiliation(s)
- Ana-Alicia Beltran-Bless
- Division of Medical Oncology and Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
| | - Stephanie Kacerovsky-Strobl
- Breast Health Center, St. Francis Hospital, Vienna, Austria; Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria.
| | - Michael Gnant
- Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria; Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria.
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138
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Taghavi K, Kusel A, Webb N, McCahy P, Badawy M, Ditchfield M. The burden of radiation exposure in children requiring percutaneous nephrolithotomy. J Pediatr Urol 2023; 19:559.e1-559.e7. [PMID: 37302924 DOI: 10.1016/j.jpurol.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND Children undergoing investigation and management for complex upper tract urolithiasis often require multimodal imaging. The significance of related radiation exposure in stone care pathways has received little attention in the published literature. STUDY DESIGN Medical records of paediatric patients undergoing percutaneous nephrolithotomy were retrospectively analysed to ascertain the modalities used and determine extent of radiation exposure occurring during each care pathway. Radiation dose simulation and calculation was performed a priori. The cumulative effective dose (mSv) and cumulative organ dose (mGy) for radiosensitive organs was calculated. RESULTS A total of 140 imaging studies were included from the care pathways of 15 children with complex upper tract urolithiasis. Median follow-up was 9.6 years (range: 6.7-16.8 years). The average number of imaging studies with ionising radiation per patient was nine, with a cumulative effective dose of 18.3 mSv across all modalities. The most common modalities were: mobile fluoroscopy (43%), x-ray (24%), and computed tomography (18%). The cumulative effective dose per study type was greatest for CT (4.09 mSv), followed by fixed and mobile fluoroscopy (2.79 mSv and 1.82 mSv, respectively). CONCLUSION There is high general awareness of radiation exposure involved in CT scanning with resultant caution in employing this modality in paediatric patients. However, the significant radiation exposure relating to fluoroscopy (whether fixed or mobile) is less well documented in children. We recommend implementing steps to minimise radiation exposure by optimisation and avoidance of certain modalities where possible. Paediatrics urologists must employ strategies to minimise radiation exposure in children with urolithiasis, given the significant exposures encountered.
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Affiliation(s)
- Kiarash Taghavi
- Department of Paediatric Urology, Monash Children's Hospital, Monash Health, Melbourne, Australia; Department of Paediatrics, Monash University, Melbourne, Australia.
| | - Amanda Kusel
- Department of Paediatric Urology, Monash Children's Hospital, Monash Health, Melbourne, Australia
| | - Nathalie Webb
- Department of Paediatric Urology, Monash Children's Hospital, Monash Health, Melbourne, Australia; School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Philip McCahy
- Department of Urology, Monash Health, Melbourne, Australia; School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Mohamed Badawy
- Monash Health Imaging, Monash Health, Clayton, Victoria, Australia; Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Michael Ditchfield
- Department of Paediatrics, Monash University, Melbourne, Australia; Monash Health Imaging, Monash Health, Clayton, Victoria, Australia
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139
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Tavakol DN, Nash TR, Kim Y, He S, Fleischer S, Graney PL, Brown JA, Liberman M, Tamargo M, Harken A, Ferrando AA, Amundson S, Garty G, Azizi E, Leong KW, Brenner DJ, Vunjak-Novakovic G. Modeling and countering the effects of cosmic radiation using bioengineered human tissues. Biomaterials 2023; 301:122267. [PMID: 37633022 PMCID: PMC10528250 DOI: 10.1016/j.biomaterials.2023.122267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 08/28/2023]
Abstract
Cosmic radiation is the most serious risk that will be encountered during the planned missions to the Moon and Mars. There is a compelling need to understand the effects, safety thresholds, and mechanisms of radiation damage in human tissues, in order to develop measures for radiation protection during extended space travel. As animal models fail to recapitulate the molecular changes in astronauts, engineered human tissues and "organs-on-chips" are valuable tools for studying effects of radiation in vitro. We have developed a bioengineered tissue platform for studying radiation damage in individualized settings. To demonstrate its utility, we determined the effects of radiation using engineered models of two human tissues known to be radiosensitive: engineered cardiac tissues (eCT, a target of chronic radiation damage) and engineered bone marrow (eBM, a target of acute radiation damage). We report the effects of high-dose neutrons, a proxy for simulated galactic cosmic rays, on the expression of key genes implicated in tissue responses to ionizing radiation, phenotypic and functional changes in both tissues, and proof-of-principle application of radioprotective agents. We further determined the extent of inflammatory, oxidative stress, and matrix remodeling gene expression changes, and found that these changes were associated with an early hypertrophic phenotype in eCT and myeloid skewing in eBM. We propose that individualized models of human tissues have potential to provide insights into the effects and mechanisms of radiation during deep-space missions and allow testing of radioprotective measures.
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Affiliation(s)
| | - Trevor R Nash
- Department of Biomedical Engineering, Columbia University, New York, NY 10032, USA
| | - Youngbin Kim
- Department of Biomedical Engineering, Columbia University, New York, NY 10032, USA
| | - Siyu He
- Department of Biomedical Engineering, Columbia University, New York, NY 10032, USA
| | - Sharon Fleischer
- Department of Biomedical Engineering, Columbia University, New York, NY 10032, USA
| | - Pamela L Graney
- Department of Biomedical Engineering, Columbia University, New York, NY 10032, USA
| | - Jessie A Brown
- Institute for Cancer Genetics, Columbia University, New York, NY 10032, USA
| | - Martin Liberman
- Department of Biomedical Engineering, Columbia University, New York, NY 10032, USA
| | - Manuel Tamargo
- Department of Biomedical Engineering, Columbia University, New York, NY 10032, USA
| | - Andrew Harken
- Center for Radiological Research, Columbia University, New York, NY 10032, USA
| | - Adolfo A Ferrando
- Institute for Cancer Genetics, Columbia University, New York, NY 10032, USA
| | - Sally Amundson
- Center for Radiological Research, Columbia University, New York, NY 10032, USA
| | - Guy Garty
- Center for Radiological Research, Columbia University, New York, NY 10032, USA
| | - Elham Azizi
- Department of Biomedical Engineering, Columbia University, New York, NY 10032, USA
| | - Kam W Leong
- Department of Biomedical Engineering, Columbia University, New York, NY 10032, USA
| | - David J Brenner
- Center for Radiological Research, Columbia University, New York, NY 10032, USA
| | - Gordana Vunjak-Novakovic
- Department of Biomedical Engineering, Columbia University, New York, NY 10032, USA; Irving Comprehensive Cancer Center, Columbia University, New York, NY 10032, USA; Department of Medicine, Columbia University, New York, NY 10032, USA.
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Sykes DAW, Waguia R, Abu-Bonsrah N, Price M, Dalton T, Sperber J, Owolo E, Hockenberry H, Bishop B, Kruchko C, Barnholtz-Sloan JS, Erickson M, Ostrom QT, Goodwin CR. Associations between urbanicity and spinal cord astrocytoma management and outcomes. Cancer Epidemiol 2023; 86:102431. [PMID: 37478632 DOI: 10.1016/j.canep.2023.102431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND The management of spinal cord astrocytomas (SCAs) remains controversial and may include any combination of surgery, radiation, and chemotherapy. Factors such as urbanicity (metropolitan versus non-metropolitan residence) are shown to be associated with patterns of treatment and clinical outcomes in a variety of cancers, but the role urbanicity plays in SCA treatment remains unknown. METHODS The Central Brain Tumor Registry of the United States (CBTRUS) analytic dataset, which combines data from CDC's National Program of Cancer Registries (NPCR) and NCI's Surveillance, Epidemiology, and End Results Programs, was used to identify individuals with SCAs between 2004 and 2019. Individuals' county of residence was classified as metropolitan or non-metropolitan. Multivariable logistic regression models were used to evaluate associations between urbanicity and SCA. Cox proportional hazard models were constructed to assess the effect of urbanicity on survival using the NPCR survival dataset (2004-2018). RESULTS 1697 metropolitan and 268 non-metropolitan SCA cases were identified. The cohorts did not differ in age or gender composition. The populations had different racial/ethnic compositions, with a higher White non-Hispanic population in the non-metropolitan cohort (86 % vs 66 %, p < 0.001) and a greater Black non-Hispanic population in the metropolitan cohort (14 % vs 9.9 %, p < 0.001). There were no significant differences in likelihood of receiving comprehensive treatment (OR=0.99, 95 % CI [0.56, 1.65], p = >0.9), or survival (hazard ratio [HR]=0.92, p = 0.4) when non-metropolitan and metropolitan cases were compared. In the metropolitan cohort, there were statistically significant differences in SCA treatment patterns when stratified by race/ethnicity (p = 0.002). CONCLUSIONS Urbanicity does not significantly impact SCA management or survival. Race/ethnicity may be associated with likelihood of receiving certain SCA treatments in metropolitan communities.
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Affiliation(s)
- David A W Sykes
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA
| | - Romaric Waguia
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA
| | - Nancy Abu-Bonsrah
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mackenzie Price
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA; Central Brain Tumor Registry of the United States, Hinsdale, IL, USA
| | - Tara Dalton
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA
| | - Jacob Sperber
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA
| | - Edwin Owolo
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA
| | | | - Brandon Bishop
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA
| | - Carol Kruchko
- Central Brain Tumor Registry of the United States, Hinsdale, IL, USA
| | - Jill S Barnholtz-Sloan
- Central Brain Tumor Registry of the United States, Hinsdale, IL, USA; Trans-Divisional Research Program (TDRP), Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute, Bethesda, MD, USA; Center for Biomedical Informatics & Information Technology (CBIIT), National Cancer Institute, Bethesda, MD, USA
| | - Melissa Erickson
- Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Quinn T Ostrom
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA; Central Brain Tumor Registry of the United States, Hinsdale, IL, USA; The Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Durham, NC, USA; Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
| | - C Rory Goodwin
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA.
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Sigvartssøn MKK, Bak EN, Nørnberg P, Jensen SJK, Thøgersen J, Begnhøj M, Finster K. Investigation of the Cytotoxicity of Mars-Relevant Minerals upon Abrasion. Astrobiology 2023; 23:1090-1098. [PMID: 37672600 DOI: 10.1089/ast.2023.0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Since the Viking Labeled Release experiments were carried out on Mars in the 1970s, it has been evident that the martian surface regolith has a strong oxidizing capacity that can convert organic compounds into CO2 and probably water. While H2O2 was suggested originally for being the oxidizing agent responsible for the outcome of the Viking experiments, recent analyses of the martian regolith by the Phoenix lander and by consecutive missions point toward radiation-mediated decomposition products of perchlorate salts as the primary oxidant. In a series of experiments, we have shown that abrasion and triboelectric charging of basalt by simulated saltation could be an additional way of activating regolith. We have also shown that abraded basalt with a chemical composition close to that of martian regolith is toxic to several bacterial species and thus may affect the habitability of the martian surface. In the present study, we investigated the effect of the quantitatively most important minerals (olivine, augite, and plagioclase) and iron oxides (hematite, magnetite, and maghemite) on the survival of bacterial cells to elucidate whether a specific mineral that constitutes basalt is responsible for our observations. We observed that suspensions of iron-containing minerals olivine and augite in phosphate-buffered saline (1 × PBS) significantly reduce the number of surviving cells of our model organism Pseudomonas putida after 24 h of incubation. In contrast, the iron-free mineral plagioclase showed no effect. We also observed that suspending abraded olivine and augite in 1 × PBS led to a dramatic increase in pH compared to the pH of 1 × PBS alone. The sudden increase in pH caused by the presence of these minerals may partly explain the observed cytotoxicity. The cytotoxic effect of augite could be relieved when a strong buffer (20 × PBS) was used. In contrast, olivine, despite the stronger buffer, maintained its cytotoxicity. Iron oxides per se have no negative effect on the survival of our test organism. Overall, our experiments confirm the cytotoxicity of basalt and show that no single constituent mineral of the basalt can account for its toxicity. We could show that abraded iron-containing minerals (olivine and augite) change the pH of water when brought into suspension and thereby could affect the habitability of martian regolith.
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Affiliation(s)
| | - Ebbe Norskov Bak
- Department of Biology, Microbiology section, Aarhus University, Aarhus C, Denmark
| | - Per Nørnberg
- Department of Biology, Microbiology section, Aarhus University, Aarhus C, Denmark
- Department of Geoscience, Aarhus University, Aarhus C, Denmark
| | | | - Jan Thøgersen
- Department of Chemistry, Aarhus University, Aarhus C, Denmark
| | - Mikkel Begnhøj
- Department of Biology, Microbiology section, Aarhus University, Aarhus C, Denmark
- Department of Chemistry, Aarhus University, Aarhus C, Denmark
| | - Kai Finster
- Department of Biology, Microbiology section, Aarhus University, Aarhus C, Denmark
- Stellar Astrophysics Centre, Department of Physics and Astronomy, Aarhus University, Aarhus C, Denmark
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Wang J, Zhao J, Meng Z, Guo R, Yang R, Liu C, Gao J, Xie Y, Jiao X, Fang H, Zhao J, Wang Y, Cao J. ATP protects anti-PD-1/ radiation-induced cardiac dysfunction by inhibiting anti-PD-1 exacerbated cardiomyocyte apoptosis, and improving autophagic flux. Heliyon 2023; 9:e20660. [PMID: 37842574 PMCID: PMC10570000 DOI: 10.1016/j.heliyon.2023.e20660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 09/28/2023] [Accepted: 10/03/2023] [Indexed: 10/17/2023] Open
Abstract
The synergy between radiotherapy and immunotherapy in treating thoracic cancers presents a potent therapeutic advantage, yet it also carries potential risks. The extent and nature of cumulative cardiac toxicity remain uncertain, prompting the need to discern its mechanisms and devise effective mitigation strategies. Radiation alone or in combination with an anti- Programmed cell death protein1 (PD-1) antibody significantly reduced cardiac function in C57BL/6J mice, and this pathologic effect was aggravated by anti-PD-1 (anti-PD-1 + radiation). To examine the cellular mechanism that causes the detrimental effect of anti-PD-1 upon cardiac function after radiation, AC16 human cardiomyocytes were used to study cardiac apoptosis and cardiac autophagy. Radiation-induced cardiomyocyte apoptosis was significantly promoted by anti-PD-1 treatment, while anti-PD-1 combined radiation administration blocked the cardiac autophagic flux. Adenosine 5'-triphosphate (ATP) (a molecule that promotes lysosomal acidification) not only improved autophagic flux in AC16 human cardiomyocytes, but also attenuated apoptosis induced by radiation and anti-PD-1 treatment. Finally, ATP administration in vivo significantly reduced radiation-induced and anti-PD-1-exacerbated cardiac dysfunction. We demonstrated for the first time that anti-PD-1 can aggravate radiation-induced cardiac dysfunction via promoting cardiomyocyte apoptosis without affecting radiation-arrested autophagic flux. ATP enhanced cardiomyocyte autophagic flux and inhibited apoptosis, improving cardiac function in anti-PD-1/radiation combination-treated animals.
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Affiliation(s)
- Jing Wang
- Department of Physiology, Shanxi Medical University, Taiyuan, Shanxi 030001, China
- Department of Thoracic Radiotherapy, Shanxi Provincial Cancer Hospital, Taiyuan, Shanxi 030013, China
| | - Jing Zhao
- Department of Physiology, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Zhijun Meng
- Department of Physiology, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Rui Guo
- Department of Physiology, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Ruihong Yang
- Department of Thoracic Radiotherapy, Shanxi Provincial Cancer Hospital, Taiyuan, Shanxi 030013, China
| | - Caihong Liu
- Department of Physiology, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Jia Gao
- Department of Physiology, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Yaoli Xie
- Department of Physiology, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Xiangying Jiao
- Department of Physiology, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Heping Fang
- Department of Physiology, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Jianli Zhao
- Department of Biomedical Engineering, University of Alabama at Birmingham, AL 35294, USA
| | - Yajing Wang
- Department of Biomedical Engineering, University of Alabama at Birmingham, AL 35294, USA
| | - Jimin Cao
- Department of Physiology, Shanxi Medical University, Taiyuan, Shanxi 030001, China
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Banla LI, Tzeng A, Baillieul JP, Kandekhar MJ, Fitzgerald KJ, LoPiccolo J, Poitras HA, Soto DE, Rotow JK, Singer L, Willers H, Kozono DE, Janne PA, Mak RH, Piotrowska Z, Keane FK, Kann BH. Pneumonitis in Patients Receiving Thoracic Radiotherapy and Osimertinib: A Multi-Institutional Study. JTO Clin Res Rep 2023; 4:100559. [PMID: 37732171 PMCID: PMC10507641 DOI: 10.1016/j.jtocrr.2023.100559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/01/2023] [Accepted: 08/06/2023] [Indexed: 09/22/2023] Open
Abstract
Introduction Thoracic radiotherapy (TRT) is increasingly used in patients receiving osimertinib for advanced NSCLC, and the risk of pneumonitis is not established. We investigated the risk of pneumonitis and potential risk factors in this population. Methods We performed a multi-institutional retrospective analysis of patients under active treatment with osimertinib who received TRT between April 2016 and July 2022 at two institutions. Clinical characteristics, including whether osimertinib was held during TRT and pneumonitis incidence and grade (Common Terminology Criteria for Adverse Events version 5.0) were documented. Logistic regression analysis was performed to identify risk factors associated with grade 2 or higher (2+) pneumonitis. Results The median follow-up was 10.2 months (range: 1.9-53.2). Of 102 patients, 14 (13.7%) developed grade 2+ pneumonitis, with a median time to pneumonitis of 3.2 months (range: 1.5-6.3). Pneumonitis risk was not significantly increased in patients who continued osimertinib during TRT compared with patients who held osimertinib during TRT (9.1% versus 15.0%, p = 0.729). Three patients (2.9%) had grade 3 pneumonitis, none had grade 4, and two patients had grade 5 events (2.0%, diagnosed 3.2 mo and 4.4 mo post-TRT). Mean lung dose was associated with the development of grade 2+ pneumonitis in multivariate analysis (OR = 1.19, p = 0.021). Conclusions Although the overall rate of pneumonitis in patients receiving TRT and osimertinib was relatively low, there was a small risk of severe toxicity. The mean lung dose was associated with an increased risk of developing pneumonitis. These findings inform decision-making for patients and providers.
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Affiliation(s)
| | - Alice Tzeng
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - John P. Baillieul
- Department of Radiation Oncology, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Melin J. Kandekhar
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kelly J. Fitzgerald
- Department of Radiation Oncology, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Jaclyn LoPiccolo
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Holly A. Poitras
- Department of Radiation Oncology, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Daniel E. Soto
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Julia K. Rotow
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Lisa Singer
- Department of Radiation Oncology, University of California San Francisco, San Francisco, California
| | - Henning Willers
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - David E. Kozono
- Department of Radiation Oncology, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Pasi A. Janne
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Raymond H. Mak
- Department of Radiation Oncology, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Zofia Piotrowska
- Department of Medicine, Division of Hematology/ Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Florence K. Keane
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Benjamin H. Kann
- Department of Radiation Oncology, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
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Varshney S, Kumar L, Dwivedi UK, Narayan P. Experimental Investigation of X-Ray Radiation Shielding and Radiological Properties for Various Natural Composites. Asian Pac J Cancer Prev 2023; 24:3555-3561. [PMID: 37898863 PMCID: PMC10770659 DOI: 10.31557/apjcp.2023.24.10.3555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 10/20/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND Shielding from radiation and plan dose verification is vital during the potential applications in industrial and medical applications. A number of natural composites have been investigated for protecting against high-energy X-ray shielding. OBJECTIVE The aim is to learn about how natural composites behave under various X-ray energies at STP. MATERIAL AND METHODS The radiological parameters of wood samples were determined using computed tomography imaging, specifically relative electron density (RED), Hounsfield units (HUs), and mass density (MD). Percentage attenuation was measured using a semiflux ionization chamber incorporated with a brass build-up cap and an ionization chamber placed at the beam Isocenter for a different type of natural composite. Measurements are being carried out on a Linear accelerator at an SSD of 110 cm with different collimator sizes. RESULTS Measured values of HUs, RED, and MD were -232 ± 40, 0.738 ± 0.039, 0.768 ± 0.024 g/cc,-368 ± 41, 0.662 ± 0.047, 0.632 ± 0.024 g/cc, -334 ± 44, 0.639 ± 0.042, 0.666 ± 0.026 g/cc, -370±61, 0.604±0.059, 0.63± 0.036 g/cc, -433±39, 0.543±0.038, 0.608 ± 0.035 g/cc, -382±54, 0.5±0.052, 0.618 ± 0.0316 g/cc, -292±68, 0.680±0.066, 0.708 ± 0.039 g/cc, -298±27, 0.680±0.0229, 0.702± 0.131 g/cc, for Acacia Nilotica, Mangifera Indica, Azadirachta Indica, Tectona Grandis L, Ficus Religiosa, Tecomella Undulata, Sesamum Indicum, Pinus respectively. CONCLUSION Measurements show that attenuation is affected by the energy of incident photons, collimator opening, and the type of density of the wood. Various radiological parameters were determined for wood samples that can be utilized to create inhomogeneous phantoms in dosimetry. The largest attenuation is found in Acacia Nilotica and Sesamum Indicum, while the lowest attenuation is found in Ficus religiosa.
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Affiliation(s)
- Sonal Varshney
- Department of Physics, Amity School of Applied Sciences, Amity University Rajasthan, Jaipur (India).
- Department of Radiation Oncology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
| | - Lalit Kumar
- Department of Radiation Oncology, Max Super Specialty Hospital, Saket, New Delhi, India.
| | - Umesh K Dwivedi
- Department of Physics, Amity School of Applied Sciences, Amity University Rajasthan, Jaipur (India).
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Akuwudike P, López-Riego M, Ginter J, Cheng L, Wieczorek A, Życieńska K, Łysek-Gładysińska M, Wojcik A, Brzozowska B, Lundholm L. Mechanistic insights from high resolution DNA damage analysis to understand mixed radiation exposure. DNA Repair (Amst) 2023; 130:103554. [PMID: 37595330 DOI: 10.1016/j.dnarep.2023.103554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/31/2023] [Accepted: 08/07/2023] [Indexed: 08/20/2023]
Abstract
Cells exposed to densely ionising high and scattered low linear energy transfer (LET) radiation (50 % dose of each) react more strongly than to the same dose of each separately. The relationship between DNA double strand break location inside the nucleus and chromatin structure was evaluated, using high-resolution transmission electron microscopy (TEM) in breast cancer MDA-MB-231 cells at 30 min post 5 Gy. Additionally, response to high and/or low LET radiation was assessed using single (1 ×1.5 Gy) versus fractionated dose delivery (5 ×0.3 Gy). By TEM analysis, the highest total number of γH2AX nanobeads were found in cells irradiated with alpha radiation just prior to gamma radiation (called mixed beam), followed by alpha, then gamma radiation. γH2AX foci induced by mixed beam radiation tended to be surrounded by open chromatin (lighter TEM regions), yet foci containing the highest number of beads, i.e. larger foci representing complex damage, remained in the heterochromatic areas. The γH2AX large focus area was also greater in mixed beam-treated cells when analysed by immunofluorescence. Fractionated mixed beams given daily induced the strongest reduction in cell viability and colony formation in MDA-MB-231 and osteosarcoma U2OS cells compared to the other radiation qualities, as well as versus acute exposure. This may partially be explained by recurring low LET oxidative DNA damage by every fraction together with a delay in recompaction of chromatin after high LET, demonstrated by low levels of heterochromatin marker H3K9me3 at 2 h after the last mixed beam fraction in MDA-MB-231. In conclusion, early differences in response to complex DNA damage may lead to a stronger cell kill induced by fractionated exposure, which suggest a therapeutic potential of combined high and low LET irradiation.
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Affiliation(s)
- Pamela Akuwudike
- Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, 106 91 Stockholm, Sweden
| | - Milagrosa López-Riego
- Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, 106 91 Stockholm, Sweden
| | - Józef Ginter
- Biomedical Physics Division, Faculty of Physics, University of Warsaw, 02-093 Warsaw, Poland
| | - Lei Cheng
- Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, 106 91 Stockholm, Sweden
| | - Anna Wieczorek
- Division of Medical Biology, Institute of Biology, Jan Kochanowski University, 25-406 Kielce, Poland
| | - Katarzyna Życieńska
- Biomedical Physics Division, Faculty of Physics, University of Warsaw, 02-093 Warsaw, Poland
| | | | - Andrzej Wojcik
- Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, 106 91 Stockholm, Sweden
| | - Beata Brzozowska
- Biomedical Physics Division, Faculty of Physics, University of Warsaw, 02-093 Warsaw, Poland
| | - Lovisa Lundholm
- Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, 106 91 Stockholm, Sweden.
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146
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Hassan AB, Almaiman SA, AlFaris NA, AlTamimi JZ, AlGhamdi FA. Validation of low dosages of γ-radiation and their effect on red beetle mortality, storability characteristics, and nutritional value of sorghum (Sorghum bicolor L. Moench) grain. Saudi J Biol Sci 2023; 30:103808. [PMID: 37771371 PMCID: PMC10522891 DOI: 10.1016/j.sjbs.2023.103808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/21/2023] [Accepted: 09/09/2023] [Indexed: 09/30/2023] Open
Abstract
This research was undertaken to validate the low dosages of γ-radiation of sorghum to examine the efficiency of gamma irradiation doses in quality attributes and storability of sorghum grain. Infested sorghum grains with the red flour beetle at the adult stage were irradiated at 0.25, 0.5, 0.75, 1.0, and 2.0 kGy emitted by 60CO. Subsequently, the mortality rate of the red flour beetle as affected by gamma doses was estimated and the storability characteristics and nutritional value of sorghum grains were measured. Eventually, the Partial Least Squares regression (PLS) analysis was executed to confirm the optimum dose of gamma which eliminate the red flour beetle and enhanced the grain quality. Results provide that the storability characteristics were enhanced after treatments. However, the changes in the germination rate of the grains were not different significantly after radiation. On the other hand, the radiation process enhanced sorghum grins' nutritional quality. Both tannins and phytic acid content dropped significantly and the digestibility and solubility of protein were gradually incremented in the grains. The PLS results indicated that using 1 and 2 kGy reflect the utmost effective dosage for sorghum. It can be concluded that this method is a potent rapid and operative preservation process to the alternate smoking chemical procedure for improving sorghum's nutritional and functional quality and prolong its shelf life. Possibility of providing effective and rapid quarantine security as an alternative to chemical fumigation protocol to extend shelf life and enhance the nutritional and functional quality of sorghum.
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Affiliation(s)
- Amro B. Hassan
- Department of Food Science and Nutrition, College of Food and Agricultural Science, King Saud University, P.O. Box 2460, Riyadh 11451, Saudi Arabia
| | - Salah A. Almaiman
- Department of Food Science and Nutrition, College of Food and Agricultural Science, King Saud University, P.O. Box 2460, Riyadh 11451, Saudi Arabia
| | - Nora Abdullah. AlFaris
- Department of Physical Sports Sciences, College of Education, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Jozaa Zaidan. AlTamimi
- Department of Physical Sports Sciences, College of Education, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Fatima Ali. AlGhamdi
- Department of Physical Sports Sciences, College of Education, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
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147
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Kuklane K, Eggeling J, Kemmeren M, Heus R. Local effects of printed logos and reflective striping fixed to firefighter clothing material packages under low radiation exposure. Ind Health 2023; 61:357-367. [PMID: 36171107 PMCID: PMC10542473 DOI: 10.2486/indhealth.2022-0126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
Notifications that related 1st degree burns to reflective striping and impermeable clothing elements did reach the investigators, while the mechanisms behind this phenomenon are still unclear. Material tests for thermal and evaporative resistance, and for heat transmission under dry and wet conditions at low radiation levels were done to evaluate the performance of protective clothing with and without printed logos or reflective striping. The results under the specified conditions showed reduction of heat loss capacity under impermeable elements from dry to wet conditions. Reflective surfaces, even when more impermeable, showed still lower heat transmission through the textile package than materials without striping under tested moisture and radiation combinations. It can be expected that the reported 1st degree burns were related to clothing design and tightness/fit rather than to reflective striping. However, due to the fine balance between clothing thermal and evaporative resistance, outer material emissivity, moisture quantity and location in clothing and applied radiation level, a different setup could lead to different results.
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Affiliation(s)
- Kalev Kuklane
- NACB, Netherland Institute for Public Safety (NIPV), The Netherlands
| | | | - Maurice Kemmeren
- COLS, Netherland Institute for Public Safety (NIPV), The Netherlands
| | - Ronald Heus
- NACB, Netherland Institute for Public Safety (NIPV), The Netherlands
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148
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Holladay L, Luu J, Balendra V, Kmetz K. Current and potential treatment of colorectal cancer metastasis to bone. Cancer Treat Res Commun 2023; 37:100763. [PMID: 37839182 DOI: 10.1016/j.ctarc.2023.100763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/30/2023] [Accepted: 09/13/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Colorectal cancer (CRC) with subsequent bone metastasis is associated with a poor prognosis compared with patients who do not develop bone metastasis. However, metastasis in bone is rare, contrasted with more common locations such as the liver and lungs. As a result, the treatment methods targeting CRC bone lesions are limited. This review aims to compile information regarding current and potential medical and surgical treatment methods for colorectal cancer with specific regard to bone metastasis. METHODS A computer-based literature review of animal- and human-based studies was conducted using multiple database searches. Case reports were excluded. RESULTS Preliminary findings demonstrate that treatments specifically targeting bone metastasis due to colorectal cancer are categorized by local vs. systemic treatment. The primary goals are the alleviation of skeletal-related events and improvement in quality of life. Current options include: chemotherapy, radiation, monoclonal antibodies, and surgery. Emerging options include intratumoral mellitin, MRgFUS, and bone microenvironment targeting. CONCLUSION Treatment of CRC metastasis to bone is necessary to slow down metastatic progression, alleviate symptoms, and improve quality of life. With a possible rise in bone metastasis due to increased overall CRC survival rates, more clinical trials should be performed to address this growing concern.
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Affiliation(s)
- Lauren Holladay
- Anne Burnett Marion School of Medicine at Texas Christian University, Fort Worth, TX, USA.
| | - Jennie Luu
- The University of the Incarnate Word School of Osteopathic Medicine, San Antonio, TX, USA
| | | | - Kevin Kmetz
- Texas A&M University, College Station, TX, USA
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149
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Monda S, Pratsinis M, Lui H, Noel O, Chandrasekar T, Evans CP, Dall'Era MA. Secondary Bladder Cancer After Prostate Cancer Treatment: An Age-matched Comparison Between Radiation and Surgery. Eur Urol Focus 2023:S2405-4569(23)00199-2. [PMID: 37722954 DOI: 10.1016/j.euf.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/18/2023] [Accepted: 09/06/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND Secondary malignancy is a long-term risk of radiation. External beam radiation therapy (EBRT) for prostate cancer treatment has been associated with later development of bladder cancer and worse bladder cancer features. OBJECTIVE We sought to provide an updated comparison of the long-term risk of bladder cancer after different localized prostate cancer treatments. DESIGN, SETTING, AND PARTICIPANTS Using the Surveillance, Epidemiology, and End Results (SEER) cancer registry, we compared an age-matched subset of patients who underwent radical prostatectomy (RP) with those who underwent EBRT, brachytherapy (BT), EBRT + BT, and RP followed by EBRT (RPtoEBRT) between 2000 and 2018. Our final cohort included 261 609 patients with a median follow-up of 11.6 yr. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Our primary outcomes were time to bladder cancer diagnosis, muscle-invasive bladder cancer diagnosis, and bladder cancer death. We used cause-specific hazard models considering death as a competing event. A similar analysis was performed on lung cancer, as a surrogate marker for smoking. We also compared proportions of variant histology, high-grade, and invasive disease among bladder cancers that occurred after radiation versus RP using chi-square testing. RESULTS AND LIMITATIONS All radiation groups were associated with bladder cancer diagnosis; hazard ratios (HRs) were 1.72, 1.85, 1.80, and 1.53 for EBRT, BT, EBRT + BT, and RPtoEBRT, respectively, using RP as a referent (all p < 0.001). HRs for bladder cancer death were even higher: 2.39, 2.57, and 3.02 for EBRT, BT, and EBRT + BT, respectively (all p < 0.001), except for RPtoEBRT (HR 1.43, p = 0.28). Lung cancer diagnosis was also associated with radiation but at lower HRs-1.63, 1.32, 1.42, and 1.30 for EBRT, BT, EBRT + BT, and RPtoEBRT, respectively (all p < 0.001). There were a higher proportion of ≥T2, ≥T3, and sarcomatoid variant bladder cancers after radiation (all p < 0.01) CONCLUSIONS: The risk of developing and dying from bladder cancer is increased in patients treated with radiation compared with those treated with RP. The risk was similar for BT and EBRT. Bladder cancers after radiation are more likely to be sarcomatoid variant and present as muscle invasive. PATIENT SUMMARY We observed the rates of bladder cancer after patients had undergone surgery or radiation for prostate cancer, and found higher rates of bladder cancer after radiation. We also observed that bladder cancers that occur after radiation tend to be more aggressive.
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Affiliation(s)
- Steven Monda
- Department of Urologic Surgery, University of California Davis, Sacramento, CA, USA.
| | - Manolis Pratsinis
- Department of Urologic Surgery, University of California Davis, Sacramento, CA, USA; Department of Urology, St. Gallen Hospital, St. Gallen, Switzerland
| | - Hansen Lui
- Department of Urologic Surgery, University of California Davis, Sacramento, CA, USA
| | - Onika Noel
- Department of Urologic Surgery, University of California Davis, Sacramento, CA, USA; Department of Urology, University of Texas Health San Antonio, San Antonio, TX, USA
| | | | - Christopher P Evans
- Department of Urologic Surgery, University of California Davis, Sacramento, CA, USA
| | - Marc A Dall'Era
- Department of Urologic Surgery, University of California Davis, Sacramento, CA, USA
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150
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Sun Z, Chu Y, Xiao J, Yang Y, Meng F, Wang X, Dong Y, Zhu J, Wu Y, Qin L, Ke Y, Liu B, Liu Q. Enhanced systemic tumor suppression by in situ vaccine combining radiation and OX40 agonist with CpG therapy. J Transl Med 2023; 21:619. [PMID: 37700338 PMCID: PMC10498626 DOI: 10.1186/s12967-023-04504-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 09/04/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND In situ tumor vaccine has been gradually becoming a hot research field for its advantage of achieving personalized tumor therapy without prior antigen identification. Various in situ tumor vaccine regimens have been reported to exert considerable antitumor efficacy in preclinical and clinical studies. However, the design of in situ tumor vaccines still needs further optimization and the underlying immune mechanism also waits for deeper investigation. METHODS A novel triple in situ vaccine strategy that combining local radiation with intratumoral injection of TLR9 agonist CpG and OX40 agonist was established in this sturdy. Local and abscopal antitumor efficacy as well as survival benefit were evaluated in the bilateral tumors and pulmonary metastasis model of B16F10 melanoma. In situ vaccine-induced immune responses and immune-associated variation in tumor environment were further investigated using multiparameter flow cytometry and RNA sequencing. Base on the analysis, the RT + CpG + αOX40 triple in situ vaccine was combined with checkpoint blockade therapy to explore the potential synergistic antitumor efficacy. RESULTS Enhanced tumor suppression was observed with minimal toxicity in both treated and untreated abscopal tumors after receiving RT + CpG + αOX40 triple vaccine. The introduction of local radiation and OX40 agonist benefit more to the inhibition of local and abscopal lesions respectively, which might be partially attributed to the increase of effector memory T cells in the tumor microenvironment. Further analysis implied that the triple in situ vaccine did not only activate the microenvironment of treated tumors, with the upregulation of multiple immune-associated pathways, but also enhanced systemic antitumor responses, thus achieved superior systemic tumor control and survival benefit. Moreover, the triple in situ vaccine synergized with checkpoint blockade therapy, and significantly improved the therapeutic effect of anti-programmed cell death protein (PD)-1 antibody. CONCLUSION This triple combining in situ vaccine induced intensive antitumor responses, mediated effective systemic tumor control and survival benefit, and displayed impressive synergistic antitumor effect with checkpoint blockade therapy. These data preliminary confirmed the efficacy, feasibility and safety of the triple combining in situ vaccine, suggesting its great application potential as both monotherapy and a part of combined immunotherapeutic regimens in clinical scenario.
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Affiliation(s)
- Zhichen Sun
- The Comprehensive Cancer Centre of Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yanhong Chu
- The Comprehensive Cancer Centre of Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
- The Clinical Cancer Institute of Nanjing University, Nanjing, China
| | - Jie Xiao
- The Comprehensive Cancer Centre of Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
- The Clinical Cancer Institute of Nanjing University, Nanjing, China
| | - Yueling Yang
- Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
| | - Fanyan Meng
- The Comprehensive Cancer Centre of Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
- The Clinical Cancer Institute of Nanjing University, Nanjing, China
| | - Xinyue Wang
- The Comprehensive Cancer Centre of Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
- The Clinical Cancer Institute of Nanjing University, Nanjing, China
| | - Yanbing Dong
- The Comprehensive Cancer Centre of Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
- The Clinical Cancer Institute of Nanjing University, Nanjing, China
| | - Junmeng Zhu
- The Comprehensive Cancer Centre of Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
- The Clinical Cancer Institute of Nanjing University, Nanjing, China
| | - Yirong Wu
- The Comprehensive Cancer Centre of Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
- The Clinical Cancer Institute of Nanjing University, Nanjing, China
| | - Lanqun Qin
- The Comprehensive Cancer Centre of Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, China
| | - Yaohua Ke
- The Comprehensive Cancer Centre of Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
- The Clinical Cancer Institute of Nanjing University, Nanjing, China
| | - Baorui Liu
- The Comprehensive Cancer Centre of Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
- The Clinical Cancer Institute of Nanjing University, Nanjing, China.
| | - Qin Liu
- The Comprehensive Cancer Centre of Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
- The Clinical Cancer Institute of Nanjing University, Nanjing, China.
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