Feasibility study of helical tomotherapy for total body or total marrow irradiationa)

Total body radiation (TBI) has been used for many years as a preconditioning agent before bone marrow transplantation. Many side effects still plague its use. We investigated the planning and delivery of total body irradiation (TBI) and selective total marrow irradiation (TMI) and a reduced radiation dose to sensitive structures using image-guided helical tomotherapy. To assess the feasibility of using helical tomotherapy, (A) we studied variations in pitch, field width, and modulation factor on total body and total marrow helical tomotherapy treatments. We varied these parameters to provide a uniform dose along with a treatment times similar to conventional TBI (15-30 min). (B) We also investigated limited (head, chest, and pelvis) megavoltage CT (MVCT) scanning for the dimensional pretreatment setup verification rather than total body MVCT scanning to shorten the overall treatment time per treatment fraction. (C) We placed thermoluminescent detectors (TLDs) inside a Rando phantom to measure the dose at seven anatomical sites, including the lungs. A simulated TBI treatment showed homogeneous dose coverage (+/-10%) to the whole body. Doses to the sensitive organs were reduced by 35%-70% of the target dose. TLD measurements on Rando showed an accurate dose delivery (+/-7%) to the target and critical organs. In the TMI study, the dose was delivered conformally to the bone marrow only. The TBI and TMI treatment delivery time was reduced (by 50%) by increasing the field width from 2.5 to 5.0 cm in the inferior-superior direction. A limited MVCT reduced the target localization time 60% compared to whole body MVCT. MVCT image-guided helical tomotherapy offers a novel method to deliver a precise, homogeneous radiation dose to the whole body target while reducing the dose significantly to all critical organs. A judicious selection of pitch, modulation factor, and field size is required to produce a homogeneous dose distribution along with an acceptable treatment time. In addition, conformal radiation to the bone marrow appears feasible in an external radiation treatment using image-guided helical tomotherapy.

Prediction and prevention of transplant-related mortality from pulmonary causes after total body irradiation and allogeneic stem cell transplantation

Between July 1997 and August 2004, 146 consecutive patients with hematologic malignancies received a T cell-depleted peripheral blood stem cell transplant from an HLA-identical sibling by using total body irradiation (TBI) and cyclophosphamide conditioning regimens. Eighty-five patients received 13.6 Gy of TBI with no lung shielding, and 61 received lung shielding (total lung dose, 6-12 Gy). Ninety-four patients (65.5%) had standard-risk disease; the remainder had more advanced disease or unfavorable diagnoses. Of the 21 transplant-related deaths, 14 were from pulmonary causes (10 idiopathic pulmonary syndromes and 4 from infection) that occurred at a median of 90 days (range, 23-238 days) after transplantation. Independent risk factors for pulmonary transplant-related mortality (PTRM) were pretransplantation diffusion capacity for carbon monoxide (relative risk, 5.7 for diffusion capacity for carbon monoxide <85%), smoking (relative risk, 5.0), and CD34 cell dose (relative risk, 9.4 for a CD34 dose of <5 x 10(6) cells per kilogram). Patients receiving lung shielding had significantly lower PTRM (3.3% versus 14.1%; P = .02) and better overall survival (70% +/- 6% versus 52% +/- 5%; P = .04), but lung shielding was not a significant independent factor for determining PTRM. These results suggest that pulmonary mortality after TBI-based preparative regimens is predictable and that higher CD34 cell doses can reduce the risk.

Hematopoietic stem cell fate is established by the Notch-Runx pathway

Identifying the molecular pathways regulating hematopoietic stem cell (HSC) specification, self-renewal, and expansion remains a fundamental goal of both basic and clinical biology. Here, we analyzed the effects of Notch signaling on HSC number during zebrafish development and adulthood, defining a critical pathway for stem cell specification. The Notch signaling mutant mind bomb displays normal embryonic hematopoiesis but fails to specify adult HSCs. Surprisingly, transient Notch activation during embryogenesis via an inducible transgenic system led to a Runx1-dependent expansion of HSCs in the aorta-gonad-mesonephros (AGM) region. In irradiated adults, Notch activity induced runx1 gene expression and increased multilineage hematopoietic precursor cells approximately threefold in the marrow. This increase was followed by the accelerated recovery of all the mature blood cell lineages. These data define the Notch-Runx pathway as critical for the developmental specification of HSC fate and the subsequent homeostasis of HSC number, thus providing a mechanism for amplifying stem cells in vivo.

Myeloablative allografting for chronic lymphocytic leukemia: evidence for a potent graft-versus-leukemia effect associated with graft-versus-host disease

In all, 30 patients with CLL proceeded to myeloablative allogeneic BMT using related (n=20, 67%) or unrelated (n=10) donors, at the Princess Margaret Hospital (Toronto) (n=20) or the Leukemia/BMT Program of BC (Vancouver) (n=10), from 1989 to 2001. Median (range) interval from diagnosis to BMT was 4.8 (0.3-13) years, median number of prior therapies was three and median age 48 years. The preparative regimen included total body irradiation in 15 (50%). In all, 14 of 30 patients (47%) are alive, with median (range) follow up of 4.3 (2.4-10.5) years. All are in complete remission, two following therapy for post-BMT progression. Actuarial overall (OS) and event-free survival (EFS) at 5 years is 39% (OS 48% for related donor and 20% for unrelated donor BMT); cumulative incidence of nonrelapse mortality (NRM) and relapse is 47 and 19%, respectively. Both acute (RR=0.008, P=0.01) and chronic (RR=0.006, P=0.02) Graft-versus-host disease (GVHD) were associated with markedly decreased risk of relapse. Patients receiving grafts from unrelated donors had increased NRM (RR=3.6, P=0.02) and decreased OS (RR of death=3.4, P=0.002). Allogeneic BMT has resulted in long-term EFS in approximately 40% of patients with CLL. There is evidence for a strong graft-versus-leukemia effect associated with acute and chronic GVHD, resulting in near complete protection from relapse.

Comparison of lung function after myeloablative and 2 Gy of total body irradiation-based regimens for hematopoietic stem cell transplantation

Lung function decline is a well-recognized occurrence after myeloablative hematopoietic stem cell transplantation (HCT) that has not been studied after nonmyeloablative conditioning regimens. We examined the lung function of patients before and after 2-Gy total body irradiation-based nonmyeloablative and myeloablative preparative regimens. Before HCT, at day 100, and 1 year after HCT, nonmyeloablative patients had lower 1-second forced expiratory volume (FEV1), forced vital capacity, total lung capacity, residual volume, and carbon monoxide diffusion capacity. However, after transplantation, the risk for experiencing a >20% per year decrease of FEV 1 was significantly lower for nonmyeloablative than myeloablative patients >50 years of age (odds ratio, 0.3; 95% confidence interval, 0.1-0.8; P = .01). Lower pretransplantation FEV 1 was associated with a higher mortality rate for both groups, with the highest mortality risk among patients with a pretransplantation FEV 1 <60% (nonmyeloablative: hazard ratio, 3.9; 95% confidence interval, 1.9-8.0; myeloablative: hazard ratio, 7.2; 95% confidence interval, 2.5-21.2). These results suggest that despite having worse lung function, patients who receive the 2-Gy total body irradiation-based nonmyeloablative regimen will likely experience less pulmonary toxicity than patients who receive a myeloablative regimen, and this may have important clinical implications when deciding on a conditioning regimen for patients >50 years of age with compromised pretransplantation lung function.

Donor origin of multipotent adult progenitor cells in radiation chimeras

Multipotent adult progenitor cells (MAPCs) are bone marrow-derived stem cells that have extensive in vitro expansion capacity and can differentiate in vivo and in vitro into tissue cells of all 3 germinal layers: ectoderm, mesoderm, and endoderm. The origin of MAPCs within bone marrow is unknown. MAPCs are believed to be derived from the bone marrow stroma compartment as they are isolated within the adherent cell component. Numerous studies of bone marrow chimeras in the human and the mouse point to a host origin of bone marrow stromal cells. Mesenchymal stem cells (MSCs), which coexist with stromal cells, have also been proven to be of host origin after allogeneic bone marrow transplantation in numerous studies. We report here that following syngeneic bone marrow transplants into lethally irradiated C57BL6 mice, MAPCs are of donor origin.

Heterogeneity of engrafted bone-lining cells after systemic and local transplantation

The outcome of various osteoprogenitor-cell transplantation protocols was assessed using Col1a1-GFP reporter transgenic mice. The model requires the recipient mice to undergo lethal total body irradiation (TBI) followed by rescue with whole bone marrow. When the mice are rescued with total bone marrow from a Col1a1-GFP transgenic mouse, green fluorescence protein (GFP)-positive donor cells can be observed on most endosteal and trabecular bone surfaces. Although the cells express an osteoblast-restricted GFP, they fail to progress to osteocytes, do not form a mineralized matrix, and do not generate bone nodules in vitro. However when calvarial progenitor cells derived from the same transgenic mice are injected into the bone marrow space, osteogenesis by the donor cells is observed. Using different GFP colors that distinguish the donor and recipient osteoblasts, commingling of the 2 cells types is observed along the mineralizing osteoblast surface as well as within the osteocyte population of the endosteal bone. Despite the ability of the injected progenitor cells to produce bone within the injected bone, they lack the ability to form mineralized bone nodules when explanted to primary osteoblast culture. These reagents and imaging protocols will be useful in evaluating other cells having a better progenitor potential than calvarial-derived stromal cells.

Current status of radiant whole-body hyperthermia at temperatures >41.5 degrees C and practical guidelines for the treatment of adults. The German 'Interdisciplinary Working Group on Hyperthermia'

The term 'extreme' whole-body hyperthermia (WBH) describes the procedure of raising a patients' body-core temperature to 41.5-42.0 degrees C for 60 min. WBH represents the only hyperthermia technique that enables systemic heat treatment in patients with disseminated malignancies and is, therefore, usually combined with systemic chemotherapy. Up to now, several WBH-approaches have proved to be safe and associated with acceptable toxicity rates when radiant heat devices are employed. Until the late 1990s, the use of radiant WBH was restricted to a few specialized treatment centres worldwide. During the last 5 years, a larger number of WBH-devices were put into operation particularly in Germany. As a result, a novel generation on phase II trials on chemotherapy and adjunctive WBH in patients with various malignancies has been completed. Based on the promising results observed herein, first multi-centric phase III-trials on chemotherapy +/- WBH have been initiated, with a considerable number of patients treated at German institutions. The authors are members of the 'Interdisciplinary Working Group for Hyperthermia' ('Interdisziplinäre Arbeitsgruppe Hyperthermie'), a sub-group of the German Cancer Society. They formulated these guidelines in order to standardize the WBH treatment procedure and supportive measures, to provide some uniformity in the selection of patients to be treated and to define criteria of a successful WBH-treatment. These recommendations may be helpful to ensure the quality of WBH performed at different institutions.

Evaluation of radioprotective effects of Rajgira (Amaranthus paniculatus) extract in Swiss albino mice

The radioprotective efficacy of aqueous extract of Rajgira (Amaranthus paniculatus) leaves against whole body gamma radiation was studied in Swiss albino mice. The oral administration of Rajgira extract at 800 mg/kg body weight/day for 15 consecutive days before whole body exposure to radiation was found to be effective with the LD50/30 values of 6.33 and 8.62 Gy for irradiation alone and Rajgira+irradiation group, respectively, giving a dose reduction factor of 1.36. This effect of Rajgira accompanied the increased endogenous spleen colonies and the spleen weight without any side effect or toxicity, as well as the modulation of the radiation-induced decrease of reduced glutathione and the radiation-induced increase in lipid peroxidation assessed in the liver and the blood.

Whole-body exposure to 2.45GHz electromagnetic fields does not alter 12-arm radial-maze with reduced access to spatial cues in rats

Lai et al. [Lai H, Horita A, Guy AW. Microwave irradiation affects radial-arm maze performance in the rat. Bioelectromagnetics 1994;15(2):95-104] reported that exposure of rats to pulsed 2.45 GHz microwaves altered maze performance. Their maze was bordered by 20 cm high opaque walls. Using a maze test based on unrestrained access to spatial cues (no walls), we could not replicate this result [Cassel JC, Cosquer B, Galani R, Kuster N. Whole-body exposure to 2.45 GHz electromagnetic fields does not alter radial-maze performance in rats. Behav Brain Res 2004;155:37-43]. Here, we attempted another replication using a maze apparatus bordered by 30 cm high opaque walls. Performance of exposed rats was normal. These results show that microwave exposure as used herein does not alter spatial working memory, when access to spatial cues is reduced.

Blood–brain barrier and electromagnetic fields: Effects of scopolamine methylbromide on working memory after whole-body exposure to 2.45GHz microwaves in rats

We first verified that our 12-arm radial maze test enabled demonstration of memory deficits in rats treated with the muscarinic antagonist scopolamine hydrobromide (0.5mg/kg, i.p.). We then investigated whether a systemically-injected quaternary-ammonium derivate of this antagonist (scopolamine methylbromide; MBR), which poorly crosses the blood-brain barrier (BBB), altered maze performance after a 45-min exposure to 2.45 GHz electromagnetic field (EMF; 2 micros pulse width, 500 pps, whole-body specific energy absorption rate [SAR] of 2.0 W/kg, +/-2dB and brain averaged SAR of 3.0 W/kg, +/-3 dB); if observed, such an alteration would reflect changes in BBB permeability. The drug was injected before or after exposure. Controls were naive rats (no experience of the exposure device) and sham-exposed rats (experience of the exposure device without microwaves). In a final approach, rats were subjected to i.v. injections of Evans blue, a dye binding serum albumin, before or after EMF exposure. Whether scopolamine MBR was injected before or after exposure, the exposed rats did not perform differently from their naive or sham-exposed counterparts. Thus, EMFs most probably failed to disrupt the BBB. This conclusion was further supported by the absence of Evans blue extravasation into the brain parenchyma of our exposed rats.

Whole-body heating slows carotid baroreflex response in human subjects

Heat stress increases sympathetic activity and decreases parasympathetic activity to the heart. To test the hypothesis that carotid baroreflex responses of heart rate (HR) and systemic blood pressure become slowed with altered autonomic nerve activities during whole-body heat stress, we determined changes in HR and mean arterial pressure (MAP) in response to approximately 5 s of 40 mmHg neck pressure (NP) and of -65 mmHg neck suction (NS) in normothermia and during whole-body heating produced by a hot water-perfused suit. The NP and NS stimuli were triggered by R waves of an ECG during held expiration in the supine position. Whole-body heating did not alter the onset time of the HR and MAP responses during NP and NS. Whole-body heating significantly increased the time from onset of the HR response until peak of the response during NP (2.53 +/- 0.33 s in normothermia and 3.46 +/- 0.28 s during heating, P<0.05) and NS (1.20 +/- 0.23 s and 2.24 +/- 0.29 s, P<0.05). Whole-body heating significantly increased the time from onset of the MAP response until peak of the response during NP (4.31+/-0.46 s in normothermia, 6.67 +/- 0.56 s during heating, P<0.05) but not during NS (5.06 +/- 0.47 s and 4.50 +/- 0.60 s). These findings suggest that heat stress prolongs the response time of carotid-cardiac and carotid-vasomotor baroreflexes.

Genetic factors influencing bystander signaling in murine bladder epithelium after low-dose irradiation in vivo

Radiation-induced bystander effects occur in cells that are not directly hit by radiation tracks but that receive signals from hit cells. They are well-documented in vitro consequences of low-dose exposure, but their relevance to in vivo radiobiology is not established. To investigate the in vivo production of bystander signals, bladder explants were established from two strains of mice known to differ significantly in both short-term and long-term radiation responses. These were investigated for the ability of 0.5 Gy total-body irradiation in vivo to induce production of bystander signals in bladder epithelium. The studies demonstrate that irradiated C57BL/6 mice, but not CBA/Ca mice, produce bystander signals that induce apoptosis and reduce clonogenic survival in reporter HPV-G-transfected keratinocytes. Transfer of medium from explants established from irradiated animals to explants established from unirradiated animals confirmed these differences in bladder epithelium. The responses to the in vivo-generated bystander signal exhibit genotypic differences in calcium signaling and also in signaling pathways indicative of a major role for the balance of pro-apoptosis and anti-apoptosis proteins in determining the overall response. The results clearly demonstrate the in vivo induction of bystander signals that are strongly influenced by genetic factors and have implications for radiation protection, medical imaging, and radiotherapy.

Hematopoietic cell transplantation from HLA-identical sibling donors after low-dose radiation-based conditioning for treatment of CML

A total of 24 patients (median age 58; range, 27-71 years) with chronic myeloid leukemia (CML) in first chronic (CP1) (n=14), second chronic (n=4), or accelerated phase (n=6) who were not candidates for conventional hematopoietic cell transplantation (HCT), received nonmyeloablative HCT from HLA-matched siblings a median of 28.5 (range, 11-271) months after diagnosis. They were conditioned with 2 Gy total body irradiation (TBI) alone (n=8) or combined with fludarabine, 90 mg/m(2) (n=16). Postgrafting immunosuppression included cyclosporine and mycophenolate mofetil. All patients initially engrafted. However, 4 of 8 patients not given fludarabine experienced nonfatal rejection while all others had sustained engraftment. With a median follow-up of 36 (range, 4-49) months, 13 of 24 patients (54%) were alive and in complete remission. There were five (21%) deaths from nonrelapse mortality, one (4%) during the first 100 days after transplant. The proportions of grade II, III, and IV acute GVHD were 38, 4, and 8%, respectively. The 2-year estimate of chronic GVHD was 32%. The 2-year survival estimates for patients in CP1 (n=14) and beyond CP1 (n=10) were 70 and 56%, respectively. This study shows encouraging remission rates for patients with CML not eligible for conventional allografting.

Suppression of Thymic Lymphoma Induction by Life-Long Low-Dose-Rate Irradiation Accompanied by Immune Activation in C57BL/6 Mice

The induction of thymic lymphomas by whole-body X irradiation with four doses of 1.8 Gy (total dose: 7.2 Gy) in C57BL/6 mice was suppressed from a high frequency (90%) to 63% by preirradiation with 0.075 Gy X rays given 6 h before each 1.8-Gy irradiation. This level was further suppressed to 43% by continuous whole-body irradiation with 137Cs gamma rays at a low dose rate of 1.2 mGy/h for 450 days, starting 35 days before the challenging irradiation. Continuous irradiation at 1.2 mGy/h resulting in a total dose of 7.2 Gy over 258 days yielded no thymic lymphomas, indicating that this low-dose-rate radiation does not induce these tumors. Further continuous irradiation up to 450 days (total dose: 12.6 Gy) produced no tumors. Continuously irradiated mice showed no loss of hair and a greater body weight than unirradiated controls. Immune activities of the mice, as measured by the numbers of CD4+ T cells, CD40+ B cells, and antibody-producing cells in the spleen after immunization with sheep red blood cells, were significantly increased by continuous 1.2-mGy/h irradiation alone. These results indicate the presence of an adaptive response in tumor induction, the involvement of radiation-induced immune activation in tumor suppression, and a large dose and dose-rate effectiveness factor (DDREF) for tumor induction with extremely low-dose-rate radiation.

Cytological basis for enhancement of radiation-induced mortality by Friend leukaemia virus infection

PURPOSE

To analyse the cytological basis for enhancement of radiation-induced mortality by Friend leukaemia virus infection.

MATERIALS AND METHODS

Cellularity in haematopoietic tissues of C3H mice infected with FLV and/or whole-body irradiation was examined.

RESULTS

When mice were treated with a sublethal dose (3 Gy) of irradiation at 1 week after virus infection, most manifested a severe loss of cellularity in the spleen, bone marrow and peripheral blood 2 weeks after irradiation. More than 90% of the mice died within 1 month post-irradiation. However, this deleterious effect of virus infection on the survival of irradiated mice was observed only when they were irradiated at around 1 week after virus inoculation. Strain differences in the sensitivity to this effect were observed among virus-sensitive strains of mice.

CONCLUSIONS

The results indicate that Friend leukaemia virus infection can cause enhancement of radiation sensitivity of haematopoietic cells in host animals in a restricted manner in terms of genetic background and the interval between infection and irradiation.

The efficacy and reliability of lung protection during total body irradiation of patients with disseminated malignancies

The main problem in total body irradiation (TBI) is obtaining a homogenous dose distribution inside the whole irradiated body and ensuring appropriate dose reduction in the lungs. The process of irradiation should be comfortable for the patients and repeatable despite the size and age diversity among patients. The aim of this paper was 1) to check accuracy of the applied dose algorithm and reliability of the measurement technique used in the lung region during TBI taken alternatively on a Cobalt-60 unit and on 15 MV linear accelerators, and 2) to check if the described methodology made it possible to obtain reproducibly of the lowered level of the dose to the lungs for a diverse group of patients. TBI was performed as a preparatory regiment in children and adults with disseminated malignancies undergoing bone marrow transplantation (a dose of 12.6 Gy in the midline/central beam axis). Two consecutive groups of patients were retrospectively included in the study: 15 irradiated with Cobalt-60 and 15 with 15 MV photons. The doses were evaluated for three sections passing through the middle of the lungs and at their upper and lower sides. Two types of detectors: semiconductor and thermoluminescent ones were used simultaneously. The measured doses were evaluated statistically to reveal agreement between readings of the two types of detectors and agreement between the measured doses and those previously calculated. The results of measurements exhibited a not Gaussian-type distribution (dissymmetry). The Wilcoxon-type test revealed compliance between the doses measured with thermoluminescent (TL) and semiconductor (SEM) detectors for all sections passing through the lungs (p>0.05), excluding the lung exit (middle and lower sides) with the Cobalt therapy. The t-Student test used to compare the measured doses with those previously calculated revealed agreement (p>0.05) between the measured doses and those calculated for all lung sections for the 15 MV photon therapy, while for Cobalt therapy such an agreement was at some points doubtful. The calculation algorithm and measurement techniques have proved to be correct, which was revealed by agreement between the doses measured and those calculated. The shielding of the lungs during both types of fields was effective and reproducible as indicated by agreement between the doses measured with the two types of detectors. Better agreement between the measured and calculated doses was found for 15 MV photons than for the Cobalt unit.

[Effectiveness of repeated systematic radiotherapy for generalized prostate cancer]

Examination of 127 patients with generalized prostate cancer established a low prophylactic effect of systematic treatment with strontium-39 chloride: it failed to alleviate pain in metastatic cancer, nor was it followed by longer mean survival. Repeat systematic radiotherapy is not indicated when palliative measures such as hormonal therapy, local radiotherapy and chemotherapy are still effective.

Low dose total body irradiation followed by allogeneic lymphocyte infusion for refractory hematologic malignancy--an updated review

Allogeneic stem cell transplantation is curative for certain cancers, but the high doses of chemotherapy and radiotherapy used in conventional myeloablative conditioning regimens may lead to severe toxicity. In our initial study, we treated 25 patients with refractory cancers with 100 cGy total body irradiation (TBI) followed by allogeneic, non mobilized peripheral blood cells. Eighteen patients received sibling and 7 patients received unrelated cord blood stem cells. None of the 13 patients with solid tumors achieved donor chimerism or had a sustained response. Twelve patients with hematologic malignancies were treated, 1 received a cord blood transplant and 11 received sibling donor cells. Nine of these 11 patients achieved donor chimerism, ranging from 5% to 100%. Four patients had sustained complete remission of their cancers, and 2 are long-term survivors. The development of chimerism correlated with total previous myelotoxic chemotherapy (p < 0.001). This technique is now being extended into the haploidentical setting.

Effect of dose-rate and lung dose in total body irradiation on interstitial pneumonitis after bone marrow transplantation

The aim of this study is to evaluate the incidence of interstitial pneumonitis following fractionated total body irradiation conditioning for bone marrow transplantation with varying lung doses due to shielding technique and different dose-rates. Between 1987 and 2001, a total number of 105 patients have received total body irradiation conditioning for bone marrow transplantation for hematological malignancies at Gulhane Military Medical School. Twelve Gy fractionated total body irradiation was delivered in 6 fractions over 3 consecutive days with Co-60 teletherapy machine. Conditioning therapy included only cyclophosphamide (60 mg/ kg/day for two days) and total body irradiation. The median follow-up for patients was 12 months. Interstitial pneumonitis developed in 10 patients out of 105 patients (9.52%). The median total dose to lung was 9.60 Gy (8.88-10.90). The difference between total lung dose and interstitial pneumonitis was not significant. Pneumonitis development in the high dose-rate (>0.04 Gy/min) group versus low dose-rate (< or =0.04 Gy/min) group was statistically significant. Low dose-rate fractionated total body irradiation is a reliable conditioning program in bone marrow transplantation with effective lung sparing to avoid interstitial pneumonitis.

Whole-body exposure to 2.45 GHz electromagnetic fields does not alter radial-maze performance in rats

Mobile communication is based on utilization of electromagnetic fields (EMFs) in the frequency range of 0.3-300 GHz. Human and animal studies suggest that EMFs, which are in the 0.1 MHz-300 GHz range, might interfere with cognitive processes. In 1994, a report by Lai et al. [Bioelectromagnetics 15 (1994) 95-104] showed that whole-body exposure of rats to pulsed 2.45 GHz microwaves (2 micros pulse width, 500 pps, and specific absorption rate [SAR] 0.6 W/kg) for 45 min resulted in altered spatial working memory assessed in a 12-arm radial-maze task. Surprisingly, there has been only one attempt to replicate this experiment so far [Bioelectromagnetics 25 (2004) 49-57]; confirmation of the Lai et al. experiment failed. In the present study, rats were tested in a 12-arm radial-maze subsequently to a daily exposure to 2.45 GHz microwaves (2 micros pulse width, 500 pps, and SAR 0.6 W/kg) for 45 min. The performance of exposed rats was comparable to that found in sham-exposed or in naive rats (no contact with the exposure system). Regarding the methodological details provided by Lai et al. on their testing protocol, our results might suggest that the microwave-induced behavioral alterations measured by these authors might have had more to do with factors liable to performance bias than with spatial working memory per se.

Effects of whole-body 50-Hz magnetic field exposure on mouse Leydig cells

The main goal of this study was to evaluate the possible effect of whole-body magnetic field (MF) exposure on the steroidogenic capacity of Leydig cells in vitro. In four separate experiments, male CFLP mice were exposed to sinusoidal 50-Hz, 100-microT MF. The duration of exposure was 23.5 h/day over a period of 14 days. At the end of the exposure, interstitial (Leydig) cells were isolated from the testicles of the sham-exposed and exposed animals. The cells were cultured for 48 h in the presence or absence of 1, 10, or 100 mIU/ml human chorionic gonadotropin (hCG). The luteinizing hormone (LH) analog hCG was used to check the testosterone (T) response of the sham-exposed controls and to evaluate the possible effect of the whole-body MF exposure on the steroidogenic capacity of Leydig cells in vitro. Testosterone content of the culture media and blood sera was measured by radioimmunoassay (RIA). In the cultures obtained from MF-exposed animals, the hCG-stimulated T response was significantly higher (p < 0.01) compared with the sham-exposed controls, while the basal T production of cells and the level of serum T remained unaltered. No MF exposure-related histopathological alterations were found in testicles, epididymes, adrenals, prostates, and pituitary glands. The MF exposure did not affect the animal growth rate and the observed hematologic and serum chemical variables. Our results indicate a presumably direct effect of whole-body MF exposure on the hCG-stimulated steroidogenic response of mouse Leydig cells.

CT-based analysis of dose homogeneity in total body irradiation using lateral beam

A computed tomography (CT) based treatment planning system for total body irradiation (TBI) is presented and compared with the commonly practiced lateral treatment delivery. The TBI regimen has been proved to be an essential conditional regimen for patients undergoing bone marrow transplantation. The advantage of the TBI regimen with bone marrow transplantation (BMT) in hematological malignancies can be offset by toxicities arising from TBI in posttransplant complications. With the increasing survival rates, the evaluation of long‐term side effects and quality of life has become an important area of research interest. There have been several treatment techniques developed over the decades designed to achieve accurate dose delivery and dose homogeneity. This paper reports on the verification of the dose delivery for a basic lateral technique using thermoluminescent dosimeters (TLDs) placed in an anthropomorphic phantom and its correlation with CT‐based treatment planning. CT‐based treatment plans on several patients were used to evaluate the doses delivered to the whole body and critical organs. A large variation in doses delivered to the whole body was demonstrated, with some parts of the bone marrow failing to receive the prescribed dose and some critical organs, such as the lungs, receiving excessive doses. Placing the arms at the sides only partially compensates for the increased transmission of the lungs because the arms only shadow part of the lung. This study shows that CT‐based treatment planning for TBI provides precise and accurate dose calculations and allows for the correlation of clinical outcomes with the doses actually delivered to various organs.

PACS numbers: 87.53.Dq, 87.66.Xa, 87.66.Sq

Morphology of cerebral lesions in the Eker rat model of tuberous sclerosis

Tuberous sclerosis (TSC) is an autosomal dominant disorder, caused by mutations of either the TSC1 or TSC2 gene. Characteristic brain pathologies (including cortical tubers and subependymal hamartomas/giant astrocytomas) are thought to cause epilepsy, as well as other neurological dysfunction. The Eker rat, which carries a spontaneous germline mutation of the TSC2 gene (TSC2+/-), provides a unique animal model in which to study the relationship between TSC cortical pathologies and epilepsy. In the present study, we have analyzed the seizure propensity and histopathological features of a modified Eker rat preparation, in which early postnatal irradiation was employed as a "second hit" stimulus in an attempt to exacerbate cortical malformations and increase seizure propensity. Irradiated Eker rats had a tendency toward lower seizure thresholds (latencies to flurothyl-induced seizures) than seen in non-irradiated Eker rats (significant difference) or irradiated wild-type rats (non-significant difference). The majority of irradiated Eker rats exhibited dysplastic cytomegalic neurons and giant astrocyte-like cells, similar to cytopathologies observed in TSC lesions of patients. The most prominent features in these brains were hamartoma-like lesions involving large eosinophilic cells, similar to giant tuber cells in human TSC. In some cells from these hamartomas, immunocytochemistry revealed features of both neuronal and glial phenotypes, suggesting an undifferentiated or immature cell population. Both normal-appearing and dysmorphic neurons, as well as cells in the hamartomas, exhibited immunopositivity for tuberin, the protein product of the TSC2 gene.