Comparative analysis on the 5'-untranslated region of bovine viral diarrhea virus isolated in Korea

Samples of 249 bovine abortuses, one intestine, and four diarrheal stools from 254 cows were collected, and bovine viral diarrhea virus (BVDV) was detected by reverse transcription-polymerase chain reaction (RT-PCR). Subsequently, virus isolation was preformed with PCR-positive samples, and then PCR product of 5^′-untranslated region (UTR) of BVDV isolate was sequenced and analyzed. Among the samples collected, 20 (from 17 bovine abortuses, one intestine, and two diarrheal stools) were positive for BVDV RT-PCR; four BVDVs (from two bovine abortuses, one intestine, and one diarrheal stool) were isolated. When the four isolates were biotyped in cell culture, one BVDV isolate from a bovine abortus was cytopathic and the others were non-cytopathic. In addition, three isolates were genotyped as BVDV-1 and one isolate from a diarrheal stool as BVDV-2. In phylogenetic analysis, it suggested that the BVDV-2 isolate in Korea is closer to the North American strains than Asian strains. This is the first report on the identification and isolation of BVDV-2 in Korea.

Agricultural recycling of the by-product concentrate of livestock wastewater treatment plant processed with VSEP RO and bio-ceramic SBR

One of the problems in a reverse osmosis process for livestock wastewater treatment is disposal of the by-product concentrate. The agricultural recycling of the concentrate is more cost saving than a further treatment. Application of the concentrate reduces the chemical fertilizer amendment. The agricultural recycling of the concentrate from the Kimhae livestock wastewater treatment plant, processed with the VSEP RO and bio-ceramic SBR, was studied. The concentrate includes non-biodegradable humic ubstance and residual inorganic ions (NH4+, NO3-, PO4(3-), K+, etc.). The contents of N, P and K were 1,650, 382 and 2,059 mg L(-1), respectively. The total acidity of humic acids extracted from the concentrate was 5.17 cmol(+) g(-1), composed of 2.38 cmol(+) g(-1) of carboxylic group and 2.79 cmol(+) g(-1) of phenolic hydroxyl group. Coliforms and E. coli were not detected in the concentrate. The yield of rice plant with the concentrate applied to it resulted in similar production to that with chemical fertilizer applied. The water extractable nitrate content of the concentrate-applied land did not exceed that of chemical fertilizer applied, at soil depths of 30 and 60 cm. The percolated amount of nitrate into the water table in arable land with the concentrate applied showed a similar level to that treated with the chemical fertilizer.

The cerebrovascular response to traditional acupuncture after stroke

Acupuncture is useful in treating the nausea and vomiting related to chemotherapy, adult postoperative surgery pain and postoperative dental pain. We obtained single-photon emission computed tomography (SPECT) brain perfusion images of six patients with middle cerebral artery occlusion obtained before and after acupuncture and compared the changes in regional cerebral blood flow (rCBF) to those in normal control. Images were obtained before and after acupuncture at six traditional acupoints (LI 4, 10, 11, 15 and 16 and TE5) in the affected arm. The baseline image was subtracted from the postacupuncture image, to produce a subtraction image displaying only voxels with values >2 SD from the mean and those voxels were coregistered to the baseline SPECT or T2-weighted MRI. Similar images were obtained before and after acupuncture of eight normal volunteers. Statistical parametric mapping with a threshold of P =0.001 and a corrected P of 0.05 was performed for group comparison between postacupuncture and baseline SPECT. Focally increased CBF was seen in all patients especially in the hypoperfused zone surrounding the ischaemic lesion, the ipsilateral or contralateral sensorimotor area, or both. Normal subjects showed increased rCBF mainly in the parahippocampal gyrus, premotor area, frontal and temporal areas bilaterally and ipsilateral globus pallidus. Acupuncture stimulation after stroke patients appears to activate perilesional or use-dependent reorganised sites and might be a way of looking at brain reorganisation.

Clinicopathological characteristics of gastric carcinoma in young patients

BACKGROUND AND AIMS

Gastric carcinoma is a common disease that usually affects older patients, rarely younger patients. Although the relationship between prognosis and the age of patients with gastric carcinoma is controversial, most investigators have suggested that young patients have a poorer prognosis. This study examined the clinicopathological features of young patients with gastric carcinoma.

PATIENTS AND METHODS

We retrospectively reviewed the hospital records of 1,833 patients with gastric carcinoma to compare the clinicopathological findings in young (aged <36 years) and older (aged >/= 36 years) patients during the period 1988 to 1998 in a tertiary referral center in Gwangju City. Overall survival was the main outcome measure.

RESULTS

Of the 1,833 patients, 137 (7.5%) were in the young age group. There were no significant differences in depth of invasion, lymph node invasion, hepatic metastasis, peritoneal dissemination, tumor stage or rate of curative resection. A significantly higher percentage of young patients had poorly differentiated histology ( P=0.0001). The young patients with curatively resected gastric carcinoma had a better survival rate than young patients with non-resected gastric carcinoma ( P<0.001). The 5-year survival rates of young and older patients did not differ statistically (39.6% vs 42.4%; P=0.254).

CONCLUSION

Young patients with gastric carcinoma do not have a worse prognosis than older patients. The important prognostic factor was whether the patients underwent curative resection.

Postoperative chemoradiotherapy for gastric cancer

BACKGROUND

We report the results of postoperative chemoradiotherapy after curative resection in gastric cancer patients.

PATIENTS AND METHODS

Patients with gastric cancer staged IB to IV(M0) were treated with chemoradiotherapy after curative resection with extensive (D2) lymph node dissection. Nodal metastases were observed in 261 (90%) patients. The chemotherapy consisted of fluorouracil 400 mg/m(2) plus leucovorin 20 mg/m(2) for 5 days, followed by 4500 cGy of radiotherapy for 5 weeks with fluorouracil and leucovorin on the first 4 days and the last 3 days of radiotherapy. Two 5-day cycles of chemotherapy were given 4 weeks after the completion of radiotherapy.

RESULTS

Of 290 patients accrued, 229 (79%) patients completed chemoradiotherapy as planned. With a median follow-up of 49 months, 114 (34%) patients have relapsed: 33 (29%) locoregional relapses, 76 (67%) peritoneal relapses and 41 (36%) distant metastases. The 5-year overall and relapse-free survivals were 60% and 57%, respectively. Tolerance was acceptable, the main toxicity being neutropenia.

CONCLUSIONS

This postoperative chemoradiotherapy after curative resection of gastric cancer was feasible, with acceptable toxicities. Whether this adjuvant therapy in gastric cancer patients that have undergone a D2 lymph node dissection impacts on survival or reduces the incidence of relapses remains to be studied.

Anti-protozoal efficacy of medicinal herb extracts against Toxoplasma gondii and Neospora caninum

The purpose of this study was to determine whether alcohol extracts of herbs (Sophora flavescens Aiton, Sinomenium acutum (Thunb.) Rehder and E.H. Wilson, Pulsatilla koreana (Yabe ex Nakai) Nakai ex T. Mori, Ulmus macrocarpa Hance and Torilis japonica (Houtt.) DC.) from South Korea, possess in vitro anti-protozoal activity against cultures of Toxoplasma gondii and Neospora caninum. These herbs have been used as human anti-parasitics in Asian countries for many years. Alcohol extracts of these herbs were serially diluted to final concentrations ranging from 625 to 19.5 ng/ml in media and added to wells containing either T. gondii or N. caninum tachyzoites in equine dermal (ED) cells. Parasite growth inhibition was measured using 3H-uracil incorporation as compared to untreated controls. T. japonica inhibited T. gondii proliferation by 99.3, 95.5, 73.0 and 54.0% in the range from 156 to 19.5 ng/ml, and S. flavescens inhibited T. gondii proliferation by 98.7, 83.0 and 27.2% in the range from 156 to 39 ng/ml. T. japonica inhibited N. caninum proliferation by 97.8, 97.9, 85.3 and 46.4% in the range from 156 to 19.5 ng/ml. S. flavescens inhibited N. caninum proliferation by 98.6, 97.0, 69.5 and 14.0% in the range from 156 to 19.5 ng/ml. Toxicity to host cells was noted when concentrations of T. japonica and S. flavescens exceeded 625 ng/ml. The herb extracts from S. acutum, Pulsatilla koreana, and U. macrocarpa also showed toxicity at higher levels but did not achieve the same inhibition effects at the lower concentrations against T. gondii and N. caninum as T. japonica and S. flavescens.

Long-term evaluation of mice model infected with Helicobacter pylori: focus on gastric pathology including gastric cancer

BACKGROUND

Long-term evaluation of gastric pathology after H. pylori infection is very important in order to reveal its clinical implications, since debate still exists on the gastric carcinogenesis provoked by H. pylori infection in animal models.

AIM

Either to evaluate the long-term outcome of H. pylori infection or to determine how H. pylori could provoke gastric cancer in the mice model.

METHODS

Four-week-old specific pathogen free C57BL/6 mice (n = 115) were infected with SS1, the mouse-adapted H. pylori strain. After 4, 8, 16, 24, 36, 50 and 80 weeks of bacterial infection, the H. pylori-infected mice were sacrificed.

RESULTS

After 80 weeks of infection, almost all the H. pylori-infected mice developed hyperplastic gastritis, but did not show any evidence of gastric adenoma, dysplasia or carcinoma. PCNA positive cells were most abundant after 50 weeks and tended to decrease thereafter up to 80 weeks, whereas apoptosis began to be noted 8 weeks after H. pylori infection, showing 7-8 apoptotic cells/high power field, and tending to increase as time passed. Normally observed neutral mucin decreased during the experiment, showing the most marked decrease 50 weeks after H. pylori infection. In contrast, acidic mucin was noted from 50 weeks after infection.

CONCLUSION

The SS1-infected mouse seems to be a suitable animal model for H. pylori-related research, and H. pylori itself does not induce gastric cancer in normal wild-type mouse model following long-term exposure, which could be explained by the balance that exists between cell proliferation and apoptosis.

Articular chondrocyte apoptosis in equine osteoarthritis

Osteoarthritis (OA) is the most common joint disease in horses. Chondrocyte apoptosis has been implicated as a major pathological OA change in humans and experimental animals but no studies have been performed on equine OA. Articular cartilage was collected from three normal and five OA horses. Histopathological changes were scored by a modified Mankin grading system. A terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) assay was performed to identify chondrocyte apoptosis. Nitric oxide (NO) production from chondrocytes was indirectly evaluated by immunohistochemistry with polyclonal antibody to nitrotyrosine. The histopathological score and percentage of chondrocyte apoptosis from the OA cartilages were significantly higher than from normal cartilages. There was a significant correlation between histopathological grade and the percentage of chondrocyte apoptosis. OA cartilages exhibited stronger immunoreactivity to nitrotyrosine than normal cartilage. Topographical distributions of chondrocyte apoptosis, cartilage matrix degeneration, and NO production overlapped in equine OA cartilages, suggesting that these pathological phenomena are closely interrelated.

Biodegradation of microbial and synthetic polyesters by fungi

A variety of biodegradable polyesters have been developed in order to obtain useful biomaterials and to reduce the impact of environmental pollution caused by the large-scale accumulation of non-degradable waste plastics. Polyhydroxyalkanoates, poly(epsilon-caprolactone), poly( l-lactide), and both aliphatic and aromatic polyalkylene dicarboxylic acids are examples of biodegradable polyesters. In general, most aliphatic polyesters are readily mineralized by a number of aerobic and anaerobic microorganisms that are widely distributed in nature. However, aromatic polyesters are more resistant to microbial attack than aliphatic polyesters. The fungal biomass in soils generally exceeds the bacterial biomass and thus it is likely that fungi may play a considerable role in degrading polyesters, just as they predominantly perform the decomposition of organic matter in the soil ecosystem. However, in contrast to bacterial polyester degradation, which has been extensively investigated, the microbiological and environmental aspects of fungal degradation of polyesters are unclear. This review reports recent advances in our knowledge of the fungal degradation of microbial and synthetic polyesters and discusses the ecological importance and contribution of fungi in the biological recycling of waste polymeric materials in the biosphere.

Effect of maturation media and oocytes derived from sows or gilts on the development of cloned pig embryos

In order to develop a culture system and recipient cytoplasm that could improve the developmental competence of somatic cell nuclear transfer (SCNT) embryos for successful cloning of pigs, we evaluated the effect of donor oocytes and in vitro maturation (IVM) media on maturation of oocytes and developmental competence of SCNT embryos. In Experiment 1, oocytes derived from sows or gilts were matured in two IVM media (TCM-199 versus NCSU-23) and maturation of oocytes was evaluated by the status of chromatin configuration, the diameter of matured oocytes, the thickness of the zona pellucida, and the size of the perivitelline space (PVS). Sow oocytes matured in TCM-199 (S-TCM group) and NCSU-23 (S-NCSU group) showed significantly higher (P<0.05) maturation rates (S-TCM and S-NSCU, 86+/-4 and 82+/-4%, respectively) when evaluated by metaphase-II status than the gilt oocytes matured in TCM-199 (G-TCM group, 71+/-3%) and in NCSU-23 (G-NCSU-23 group, 71+/-3%). Oocyte diameter, the thickness of the zona pellucida, and the perivitelline space of sow oocytes (S-TCM and S-NCSU) were larger than those of gilt oocytes (G-TCM and G-NCSU) after IVM (P<0.05). In Experiment 2, SCNT was performed, using in vitro-matured oocytes from each group as recipient cytoplasm and porcine fetal fibroblasts as karyoplasts. The reconstructed embryos were electrically fused and activated, and cleavage and blastocyst formation were monitored under a stereomicroscope. The total cell number of flattened blastocysts stained with 5 microM bisbenzimide on day 7 were counted. In addition, in vitro matured non-enucleated oocytes were also electrically activated (parthenogenetic activation) and pronuclear formation was monitored. No difference in pronuclear formation rate after parthenogenetic activation and fusion rate after SCNT was observed among experimental groups. A significantly higher cleavage rate (P<0.05) was observed in S-TCM (69+/-4%) when compared with only G-NCSU (58+/-4%), but not with G-TCM (60+/-4%) or S-NCSU (68+/-4%). The rate of blastocyst formation was significantly higher (P<0.05) in sow oocytes (24% in S-TCM and S-NCSU), when compared to that observed in G-TCM (15%), and G-NCSU (14%). When the same source of oocytes was used, there was no significant difference in rate of blastocyst formation in the two culture media. Total cell number of blastocysts were not significantly different among experimental groups. In conclusion, the present study clearly demonstrated that sow oocytes have a greater developmental competence than gilt oocytes, regardless of the maturation medium examined.

Phase II study of oxaliplatin, 5-fluorouracil and leucovorin in previously platinum-treated patients with advanced gastric cancer

BACKGROUND

Oxaliplatin shows preclinical activity in many cancer cell lines that are resistant to cisplatin, and also has synergism with 5-fluorouracil (5-FU). We undertook this study to evaluate the efficacy and toxicities of a combined oxaliplatin, 5-FU and leucovorin (LV) continuous infusion regimen in patients with advanced gastric cancer who progressed during or after treatment with 5-FU and platinum compounds.

PATIENTS AND METHODS

Twenty-six patients with advanced gastric cancer, whose disease progressed while receiving, or after discontinuing, chemotherapy with a 5-FU and platinum regimen, were enrolled in this study. Treatment comprised oxaliplatin (85 mg/m2 on day 1) as a 2-h infusion followed by bolus 5-FU (400 mg/m2 on day 1), and 48-h infusion of 5-FU 2.4-3.0 g/m2 concurrently with LV 150 mg/m2. Cycles were repeated at 2-week intervals.

RESULTS

Of the 23 evaluable patients, there were six partial responses (response rate 26%). All responding patients were among those who entered into this trial immediately after failure of previous chemotherapy with 5-FU and cisplatin. The median time to progression was 4.3 months and the median overall survival was 7.3 months. The most common hematologic toxicity was grade 1-2 anemia in 39 cycles (39%). No grade 4 leukopenia or thrombocytopenia were observed. The most common non-hematologic toxicity was nausea/vomiting (33%). Peripheral neuropathy of grade 1 or 2 was noted (27%), but there was no grade 3 or 4 neurotoxicity.

CONCLUSIONS

This phase II study of oxaliplatin, 5-FU and LV continuous infusion showed activity in previously platinum-treated patients with advanced gastric cancer, with acceptable toxicities.

Malignant peripheral nerve sheath tumor with divergent mesenchymal differentiations in a dog

A malignant peripheral nerve sheath tumor with divergent osteogenic, myxomatous, and myoblastic differentiations is described in a 10.5-year-old male Labrador Retriever dog. The tumor involved the sixth and seventh cervical spinal cord segments and nerves. The diagnosis was based on the results of histopathology, electron microscopy, and immunohistochemistry.

Clinicopathologic features of mucinous gastric carcinoma

BACKGROUND/AIMS

Mucinous gastric carcinoma (MGC) is a histopathologic subtype of gastric carcinoma with a poor prognosis. The purpose of this study was to compare the disease course of MGC with non-mucinous gastric carcinoma (NMGC) and study the clinicopathologic features that influence the prognosis of MGC patients.

METHODS

We reviewed the records of 2,383 patients with a confirmed histologic diagnosis of gastric carcinoma. There were 157 patients with MGC compared to 2,226 with NMGC.

RESULTS

A depth of invasion greater than T3 was more frequently found in MGC than in NMGC. The mean number of lymph nodes with metastases was 2.78 in MGC and 2.28 in NMGC (p < 0.001). There were more MGC patients with TNM stages II through IV (UICC classification). The overall survival rate was lower for the MGC group (46.5%) than for the NMGC group (64.0%; p < 0.05). Depth of invasion, lymph node metastases, and stage at diagnosis were significant factors affecting the outcome.

CONCLUSION

The factors influencing the poorer prognosis (lower 5-year survival rate) of MGC are the advanced stage at the time of diagnosis, lymph node metastases, and a higher TNM status. Mucinous histologic type itself was not an independent predictive factor in survival.

Parastrongylus (=Angiostrongylus) cantonensis now endemic in Louisiana wildlife

Parastrongylus (=Angiostrongylus) cantonensis, a lung worm of rats, was first reported in the United States in 1987, with a probable introduction by infected rats from ships docking in New Orleans, Louisiana, during the mid-1980s. Since then, it has been reported in nonhuman primates and a boy from New Orleans, and in a horse from Picayune, Mississippi, a distance of 87 km from New Orleans. Parastrongylus cantonensis infection is herein reported in a lemur (Varencia variegata rubra) from New Iberia, Louisiana, a distance of 222 km from New Orleans, and in a wood rat (Neotomafloridanus) and in 4 opossums (Didelphis virginiana) from Baton Rouge, Louisiana, a distance of 124 km from New Orleans. The potential of a great variety of gastropods serving as intermediate hosts in Louisiana may pose a threat to wildlife as well as to domesticated animals in the areas where infected Norway rats (Rattus norvegicus) are present.

Effect of transfusion of fresh-frozen plasma on recipients' antibodies to hepatitis B surface antigen and hepatitis B surface antigen status in countries where hepatitis B virus is endemic

BACKGROUND AND OBJECTIVES

Antibodies to hepatitis B virus (HBV) that are passively acquired through transfusions may lead to confusion and inappropriate clinical decisions. We evaluated the effects of transfusing fresh-frozen plasma (FFP) on serological tests for HBV antibodies in patients without such antibodies.

MATERIALS AND METHODS

Tests for HBV surface antigen (HBsAg), and for antibodies to HBV surface antigen (anti-HBs) and HBV core antigen (anti-HBc), were carried out using enzyme immunoassay on the FFP and sera of 50 patients transfused with FFP containing anti-HBs.

RESULTS

After FFP transfusion, the incidences of 'false' positivity for anti-HBs and anti-HBc were 64% (32/50) and 100% (seven of seven), respectively, and of 'false' negativity for HBsAg was 18.8% (three of 16) in previously positive patients. The post-transfusion seropositivity for antibodies results from passive transmission, whereas the inability to detect HBsAg is the result of decreased detectable levels.

CONCLUSIONS

Laboratory staff and clinicians alike should be cautious in interpreting the results of the HBV marker tests in patients who have recently been transfused, and in obtaining specimens for such studies.

Comparison of two fibrin glues in anastomoses and skin closure

To control intra-operative haemorrhage, fibrin glues are preferred by many surgeons because of their biological advantages and convenience of application. Manufacturers have developed a few kinds of fibrin glues with a little difference in their composition. This study was to compare the effectiveness of two commercially available fibrin glues; Greenplast (Green Cross P. D. Company, Yongin, Korea) and Tisseel (Baxter-Immuno AG, Vienna, Austria). They were applied experimentally to several kinds of surgery in dogs - renal vessel anastomosis, partial splenectomy, intestinal anastomosis and incision skin wound - and evaluated for their haemostatic and adhesive effects. When the two glues were applied in renal vessel anastomosis, the amount of haemorrhage in artery and vein decreased significantly. They also decreased the haemorrhage in partial splenectomy. At 10 min after application of the glues to an incision skin wound, the tensile strengths developed were significantly higher than that of control. The present study indicates that two-component fibrin glues have a haemostatic effect as a mechanical barrier in renal vessel anastomosis and an adhesive effect in the early stage of incision skin wound closure, and the two glues have similar effects with no complications.

Multifocal primary CNS T cell lymphoma of the spinal cord

The majority of primary central nervous system lymphomas (PCNSL) are of B cell origin, and those of T cell origin are a distinct rarity. Furthermore, spinal cord involvement of T cell PCNSL is extremely rare and only a small number of cases have been reported. The authors report a case of multifocal T cell PCNSL mainly involving the intramedullary (IM) portion ofthe spinal cord in a 57-year-old woman. Neurological examination showed right leg weakness and hypesthesia below the T10 level. Magnetic resonance images revealed multiple well enhancing masses in the IM portion ofthe cervical and thoracic spinal cord and the cerebellum. Cytological examination of the cerebrospinal fluid revealed no malignant cells. As the mass at the C7 level was the largest among multiple masses, open biopsy was performed at that level. Histopathological examination confirmed malignant peripheral T cell lymphoma, unspecified (PTCL-U), small- and medium-sized cell type. Clinical and laboratory investigations failed to reveal any evidence of lymphomatous deposits elsewhere in the body. After biopsy, the patient received cranio-spinal irradiation, which included the whole brain and the spinal neuraxis. The clinical course, pathological findings and treatments are discussed and a review of the literature included.

Lymphosarcoma in a sea otter (Enhydra lutris)

Lymphoblastic lymphosarcoma involving the mesenteric lymph node and thymus was discovered in a 4 yr old male sea otter (Enhydra lutris). Diagnosis was based on gross and light microscopic studies. The cause of this neoplasm was not determined. This is the first case of lymphosarcoma reported in sea otters.

Observation and analysis of residual stress development resulting from OH impurity in optical fibers

We report experimental results on the development of residual stress due to OH impurity in optical fibers. The effect of OH impurity on residual stress is demonstrated by direct residual stress measurement. The residual stress at the outer-cladding/jacketing-tube boundary of the fiber drawn at 3.48 N was found to be -61 MPa . The residual compressive stress is attributed to the viscosity decrease induced by a significant OH impurity at the boundary, as measured by a Fourier transform infrared microscope.

Endocarditis associated with Escherichia coli in a sea lion (Zalophus californianus)

Endocarditis associated with Escherichia coli was diagnosed in a 2-year-old male California sea lion (Zalophus californianus). The diagnosis was based on light microscopic examination and bacterial isolation from the valvular lesion. This is the first case of bacterial endocarditis reported in a sea lion.

A high statistics measurement of the Lambda(+)(c) lifetime

A high statistics measurement of the Lambda(+)(c) lifetime from the Fermilab fixed-target FOCUS photoproduction experiment is presented. We describe the analysis technique with particular attention to the determination of the systematic uncertainty. The measured value of 204.6 +/- 3.4 (stat) +/- 2.5 (syst) fs from 8034 +/- 122 Lambda(+)(c)-->pK(-)pi(+) decays represents a significant improvement over the present world average.

Quantitative analysis of errors in fractionated stereotactic radiotherapy

Fractionated stereotactic radiotherapy (FSRT) offers a technique to minimize the absorbed dose to normal tissues; therefore, quality assurance is essential for these procedures. In this study, quality assurance for FSRT of 58 cases, between August 1995 and August 1997 are described, and the errors for each step and overall accuracy were estimated. Some of the important items for FSRT procedures are: accuracy in CT localization, transferred image distortion, laser alignment, isocentric accuracy of linear accelerator, head frame movement, portal verification, and various human errors. A geometric phantom, that has known coordinates was used to estimate the accuracy of CT localization. A treatment planning computer was used for checking the transferred image distortion. The mechanical isocenter standard (MIS), rectilinear phantom pointer: (RLPP), and laser target localizer frame (LTLF) were used for laser alignment and target coordinates setting. Head-frame stability check was performed by a depth confirmation helmet (DCH). A film test was done to check isocentric accuracy and portal verification. All measured data for the 58 patients were recorded and analyzed for each item. 4-MV x-rays from a linear accelerator, were used for FSRT, along with homemade circular cones with diameters from 20 to 70 mm (interval: 5 mm). The accuracy in CT localization was 1.2+/-0.5 mm. The isocentric accuracy of the linear accelerator, including laser alignment, was 0.5+/-0.2 mm. The reproducibility of the head frame was 1.1+/-0.6 mm. The overall accuracy was 1.7+/-0.7 mm, excluding human errors.