Laherradurin Inhibits Tumor Growth in an Azoxymethane/Dextran Sulfate Sodium Colorectal Cancer Model In Vivo

Colorectal cancer (CRC) is the third most common neoplasia in the world. Its mortality rate is high due to the lack of specific and effective treatments, metastasis, and resistance to chemotherapy, among other factors. The natural products in cancer are a primary source of bioactive molecules. In this research, we evaluated the antitumor activity of an acetogenin (ACG), laherradurin (LH), isolated from the Mexican medicinal plant Annona macroprophyllata Donn.Sm. in a CRC murine model. The CRC was induced by azoxymethane-dextran sulfate sodium (AOM/DSS) in Balb/c mice and treated for 21 days with LH or cisplatin. This study shows for the first time the antitumor activity of LH in an AOM/DSS CRC model. The acetogenin diminished the number and size of tumors compared with cisplatin; the histologic studies revealed a recovery of the colon tissue, and the blood toxicity data pointed to less damage in animals treated with LH. The TUNEL assay indicated cell death by apoptosis, and the in vitro studies exhibited that LH inhibited cell migration in HCT116 cells. Our study provides strong evidence of a possible anticancer agent for CRC.

Effects of chronic exposure to cold stress on ovarian functions in prepubertal rats

Ovarian functions are modulated by the hypothalamus-pituitary-ovary axis and neural signals. Stress modifies the activity of the sympathetic nervous system. In adult female rats, cold stress results in higher noradrenergic and steroidogenic activity of the ovary, anovulation and the presence of ovarian cysts; however, it is unknown whether this response occurs in prepubertal rats. The purpose of this study was to analyse the effects of cold stress initiated in the prepubertal stage of female rats on ovarian function. Female rats 24 days old were exposed to three, five or eight weeks of cold stress. Autopsies were performed at the end of each stress period. The parameters analysed were the number of ova shed by ovulating animals; the number of ovulating animals; the serum concentrations of progesterone, testosterone, and oestradiol; and the ovarian concentrations of norepinephrine and 3-methoxy-4-hydroxyphenyl-glycol. Our results show that chronic cold stress applied to prepubertal rats did not modify the number of ovulating animals, the total number of ova shed, or progesterone and testosterone concentrations in any of the periods analysed. Oestradiol concentration was lower in the animals exposed to five or eight weeks of stress. The ovarian norepinephrine concentration was higher in the animals exposed to three weeks of stress and was lower at eight weeks of stress. No changes in ovarian morphology were observed. Our data suggest that the changes in noradrenergic activity resulting from chronic cold stress experienced in the prepubertal stage do not modify ovarian architecture or affect the ovulatory response in adulthood.

Suprachiasmatic nucleus and vagus nerve trigger preovulatory LH and ovulation

In brief

In the proestrus day, the neural and endocrine signals modulate ovarian function. This study shows vagus nerve plays a role in the multisynaptic pathways of communication between the suprachiasmatic nucleus and the ovaries where such neural information determines ovulation.

Abstract

The suprachiasmatic nucleus (SCN) regulates the activity of several peripheral organs through a parasympathetic-sympathetic pathway. Previously, we demonstrated that atropine (ATR) microinjection in the right SCN of rats during proestrus blocks ovulation. In the present study, we analysed whether the vagus nerve is one of the neural pathways by which the SCN regulates ovulation. For this, CIIZ-V strain cyclic rats on the day of proestrus were microinjected with a saline solution (vehicle) or ATR in the right or left SCN, which was followed by ventral laparotomy or ipsilateral vagotomy to the microinjection side. Some animal groups were sacrificed (i) on the same day of the surgery to measure oestradiol, progesterone and luteinizing hormone (LH) levels or (ii) at 24 h after surgery to evaluate ovulation. The left vagotomy in rats microinjected with ATR in the left SCN did not modify ovulation. In rats with ATR microinjection in the right SCN, the right vagotomy increased the levels of steroids and LH on the proestrus and ovulatory response. The present results suggest that the right vagus nerve plays a role in the multisynaptic pathways of communication between the SCN and the ovaries and indicate that such neural information participates in the regulation of the oestradiol and progesterone surge, which triggers the preovulatory peak of LH and determines ovulation.

Influence of the speed of deflation of the stent delivery system in the myocardial blush and ST-segment resolution in primary angioplasty: a randomized study

Introduction

Distal embolization may compromise the results of primary angioplasty. Our aim is to analyze the influence of the speed of deflation of the stent delivery system on the myocardial blush ≥2 and on the ST-Segment resolution ≥70%.

Methods

From December 2016 to February 2019, all consecutive patients with ST-elevation myocardial infarction who underwent urgent coronary angiography at our institution who were susceptible of thrombectomy, IIB-IIIA inhibitors and direct stenting were randomized 1:1 to fast deflation of the stent delivery system (group 1, n=103) or to slow deflation at 1 atm/second (group 2, n=107). Pre- and postdilatation was not allowed per protocol. The primary outcomes were the myocardial blush ≥2 and the ST-Segment resolution ≥70% while the size of myocardial damage, ejection fraction at discharge and at 12 months and total and cardiovascular mortality at 12 months were the secondary outcomes. A multivariate analysis was performed to analyze the influence of the speed of deflation of the stent delivery system in both primary end-points in case of possible imbalances among groups despite the randomization.

Results

Both groups represented 47% of the 447 procedures of primary angioplasty performed in that period. Baseline characteristics of the whole cohort: female gender 46 (21.9%), age 59.5±10.6 years, diabetes 35 (16.7%), Killip class IV 5 (2.4%), total ischemic time 177.5 (124–275) minutes and door to balloon time 84 (66–120.5) minutes. There were not differences in clinical or angiographic characteristics between both groups, although there was a non-significant trend towards larger reference vessel diameter in the slow deflation group (2.74±0.42 vs. 2.86±0.47, p=0.07). The study was prematurely stopped with 50% of the calculated sample size due to futility. The primary endpoint of myocardial blush ≥2 occurred in 77 (74.7%) vs. 79 (75.2%), p=0.93 and ST-Segment resolution ≥70% in 54 (53.9%) vs. 59 (55.5%), p=0.75 in group 1 and 2, respectively, without differences in any of the secondary endpoints. The speed of deflation of the stent delivery system did not show any influence on the MB or ST-Segment resolution ≥70% in the multivariate analysis. Predictors of myocardial blush ≥2 were systolic blood pressure at admission, creatinine clearance <60 ml/min and maximal diameter postprocedure. Diabetes, previous infarction, left anterior descending, TIMI ≥2 before intervention, TIMI 3 after intervention and collateral supply grade ≥2 were predictors of ST segment resolution≥70% with an area under the curve of 0.71 (0.63–0.80) and 0.75 (0.68–0.82), respectively.

Conclusions

In our series, the speed of deflation of the stent delivery system in primary angioplasty did not modified the myocardial blush ≥2 or ST-Segment resolution ≥70% and neither showed any influence in clinical outcomes, size of myocardial infarction by biomarkers and ejection fraction.

Funding Acknowledgement

Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Abbott Laboratories

Recent results for the one-proton transfer reaction in the 18O+48Ti collision at 275 MeV

The 18O+48Ti reaction was studied at the energy of 275 MeV for the first time under the NUMEN and NURE experimental campaigns with the aim to investigate the complete net of reaction channels potentially involved in the 48Ca→48Ti double charge exchange transition. Such a transition is of great interest because of its relevance to the extraction of 48Ca→48Ti double beta decay nuclear matrix element. The relevant experiment was carried out at the MAGNEX facility of INFN-LNS in Catania. Angular distribution measurements for the various reaction products were performed by using the MAGNEX large acceptance magnetic spectrometer. The present contribution is focused on the analysis of the one-proton transfer channel with emphasis on the particle identification technique and the estimation of background contaminations.

Administration of a VIP-antagonist in vivo modifies ovarian hormone secretion in a rat model with polycystic ovary syndrome

AIMS

In the cyclic rat in estrus, the vasoactive intestinal peptide (VIP) has an impact on ovarian function, which depends on the endocrine status of the animal. In this work, we aimed to clarify the participation of VIP in the pathophysiological condition of polycystic ovary syndrome (PCOS) using a model of PCOS induced by estradiol valerate (EV-PCOS) in rats.

MAIN METHODS

In the cyclic rat in estrus and in the EV-PCOS model, we analyzed the acute effects of blocking VIP receptors with the use of an antagonist (Ant-VIP) injected into the left or right ovarian bursa on the steroidogenic response and ovarian catecholamine levels.

KEY FINDINGS

In the cyclic animal in estrus, the treatment with Ant-VIP in the left ovarian bursa resulted in a reduction in testosterone serum levels and in ovarian levels of dopamine and 3,4-dihydroxyphenylacetic acid (DOPAC), without changes in 4-hydroxy-3-methoxyphenyl (MHPG) and norepinephrine (NE). When the treatment was applied on the right side, only MHPG levels increased. In the EV-PCOS model, the treatment with Ant-VIP in the left ovarian bursa increased testosterone, estradiol, MHPG, and NE levels. When the treatment was performed on the right side, progesterone levels decreased and estradiol increased, without changes in ovarian catecholamines.

SIGNIFICANCE

The binding of VIP to its receptors differentially regulates steroidogenesis in the cyclic animal in estrus and in the EV-PCOS model. The blocking of VIP signaling produces changes in ovarian catecholamines.

10-MV SBRT FFF IRRADIATION TECHNIQUE IS ASSOCIATED TO THE LOWEST PERIPHERAL DOSE: THE OUTCOME OF 142 TREATMENT PLANS FOR THE 10 MOST COMMON TUMOUR LOCATIONS

There is a growing interest in the combined use of Stereotactic Body Radiation Therapy (SBRT) with Flattening Filter Free (FFF) due to the high local control rates and reduced treatment times, compared to conventionally fractionated treatments. It has been suggested that they may also provide a better radiation protection to radiotherapy patients as a consequence of the expected decrease in peripheral doses. This work aims to determine this reduction in unattended out-of-field regions, where no CT information is available but an important percentage of second primary cancers occur. For that purpose, ten different cases suitable for SBRT were chosen. Thus, 142 different treatment plans including SBRT, as well as 3D-CRT, IMRT and VMAT (with standard fractionation) in low and high energies for Varian (FF and FFF), Siemens and Elekta machines were created. Then, photon and neutron peripheral dose in 14 organs were assessed and compared using two analytical models. For the prostate case, uncomplicated and cancer free control probability estimation was also carried out. As a general behavior, SBRT plans led to the lowest peripheral doses followed by 3D-CRT, VMAT and IMRT, in this order. Unflattened beams proved to be the most effective in reducing peripheral doses, especially for 10 MV. The obtained results suggest that FFF beams for SBRT with 10 MV represent the best compromise between dose delivery efficiency and peripheral dose reduction.

In Adult Rats With Polycystic Ovarian Syndrome, Unilateral or Bilateral Vagotomy Modifies the Noradrenergic Concentration in the Ovaries and the Celiac Superior Mesenteric Ganglia in Different Ways

In rats with polycystic ovarian syndrome (PCOS) induced by estradiol valerate (EV) injection, sectioning of the vagus nerve in the juvenile stage restores ovulatory function, suggesting that the vagus nerve stimulates the onset and development of PCOS. We analyzed whether in adult rats, the role played by the vagus nerve in PCOS development is associated with the nerve’s regulation of noradrenergic activity in the celiac superior mesenteric ganglion (CSMG). Ten-day-old rats were injected with corn oil [vehicle (Vh)] or EV (2 mg). At 76 days of age, rats injected with Vh or EV were subjected to sham surgery or the sectioning of one or both vagus nerves (vagotomy). The animals were sacrificed at 80–82 days of age at vaginal estrus smear. Compared to Vh-treated animals, EV-induced PCOS rats showed a lack of ovulation, the presence of follicular cysts, and a high concentration of testosterone, without changes in noradrenaline concentrations in the CSMG or ovaries. In PCOS rats, sham surgery lowered serum testosterone and noradrenaline concentrations in the CSMG but did not restore ovulation. In animals with PCOS, vagotomy lowered testosterone concentrations to a larger degree than in sham-surgery animals. The ovaries of rats with PCOS and vagotomy showed fresh corpora lutea, indicating ovulation. In EV-treated rats with unilateral vagotomy, the concentration of noradrenaline in the CSMG was similar to that in rats with PCOS and sham surgery, which did not ovulate, while in the ovaries of PCOS rats with left or bilateral vagotomy, the noradrenaline concentration was lower than that in sham-surgery-treated animals. Our results suggest that the vagus nerve regulates PCOS development through a different mechanism than the increase in the noradrenergic activity in the CSMG; however, in ovaries, the restoration of ovulation is associated with a decrease in ovarian noradrenaline.

Optical communications downlink from a low-earth orbiting 1.5U CubeSat

In this article, we present the first demonstration of an optical communications downlink from a low-earth orbiting free-flying CubeSat. Two 1.5U vehicles, AC7-B&C, built under NASA's Optical Communications and Sensors Demonstration (OCSD) program were launched in November 2017 and subsequently placed into a 450-km, 51.6° inc. circular orbit. Pseudorandom data streams using on-off key (OOK) modulation were transmitted from AC-7B to a 40 cm aperture telescope located at sea level in El Segundo, CA. At 200 Mbps, without forward error correction (FEC), we achieved a 115-second link that was ~78% error free, with the remaining portion exhibiting an error rate below 1E-5. At the time of the engagement, the 1064-nm laser transmitter was operating at 2 W (half capacity) with a full width half maximum (FWHM) beam divergence of ~1 mrad, which was approximately double the anticipated pointing accuracy of the vehicle.

The nuclear matrix elements of 0νββ decay and the NUMEN project at INFN-LNS

The goal of NUMEN project is to access experimentally driven information on Nuclear Matrix Elements (NME) involved in the neutrinoless double beta decay (0νββ), by high-accuracy measurements of the cross sections of Heavy Ion (HI) induced Double Charge Exchange (DCE) reactions. The knowledge of the nuclear matrix elements is crucial to infer the neutrino average masses from the possible measurement of the half-life of 00νββ decay and to compare experiments on different isotopes. In particular, the (18O, 18Ne) and (20Ne, 20O) reactions are performed as tools for β+β+ and β-β- decays, respectively. The experiments are performed at INFN - Laboratory Nazionali del Sud (LNS) in Catania using the Superconducting Cyclotron (CS) to accelerate the beams and the MAGNEX magnetic spectrometer to detect the reaction products. The measured cross sections are very low, limiting the present exploration to few selected isotopes of interest in the context of typically low-yield experimental runs. In order to make feasible a systematic study of all the candidate nuclei, a major upgrade of the LNS facility is foreseen to increase the experimental yield of about two orders of magnitude. To this purpose, frontier technologies are going to be developed for both the accelerator and the detection systems. In parallel, advanced theoretical models will be developed to extract the nuclear structure information from the measured cross sections.

Characterization of radon levels in soil and groundwater in the North Maladeta Fault area (Central Pyrenees) and their effects on indoor radon concentration in a thermal spa

Radon levels in the soil and groundwater in the North Maladeta Fault area (located in the Aran Valley sector, Central Pyrenees) are analysed from both geological and radiation protection perspectives. This area is characterized by the presence of two important normal faults: the North Maladeta fault (NMF) and the Tredós Fault (TF). Two primary aspects make this study interesting: (i) the NMF shows geomorphic evidence of neotectonic activity and (ii) the presence of a thermal spa, Banhs de Tredós, which exploits one of the several natural springs of the area and needs to be evaluated for radiation dosing from radon according to the European regulation on basic safety standards for protection against ionizing radiation. The average soil radon and thoron concentrations along a profile perpendicular to the two normal faults - 22 ± 3 kBq·m^-3 and 34 ± 3 kBq·m^-3, respectively - are not high and can be compared to the radionuclide content of the granitic rocks of the area, 25 ± 4 Bq·kg^-1 for ²²⁶Ra and 38 ± 2 Bq·kg^-1 for ²²⁴Ra. However, the hypothesis that the normal faults are still active is supported by the presence of anomalies in both the soil radon and thoron levels that are unlikely to be of local origin together with the presence of similar anomalies in CO₂ fluxes and the fact that the highest groundwater radon values are located close to the normal faults. Additionally, groundwater ²²²Rn data have complemented the hydrochemistry data, enabling researchers to better distinguish between water pathways in the granitic and non-granitic aquifers. Indoor radon levels in the spa vary within a wide range, [7-1664] Bq·m^-3 because the groundwater used in the treatment rooms is the primary source of radon in the air. Tap water radon levels inside the spa present an average value of 50 ± 8 kBq·m^-3, which does not exceed the level stipulated by the Spanish Nuclear Safety Council (CSN) of 100 kBq·m^-3 for water used for human consumption. This finding implies that even relatively low radon concentration values in water can constitute a relevant indoor radon source when the transfer from water to indoor air is efficient. The estimated effective dose range of values for a spa worker due to radon inhalation is [1-9] mSv·y^-1. The use of annual averaged radon concentration values may significantly underestimate the dose in these situations; therefore, a detailed dynamic study must be performed by considering the time that the workers spend in the spa.

The Neural Signals of the Superior Ovarian Nerve Modulate in an Asymmetric Way the Ovarian Steroidogenic Response to the Vasoactive Intestinal Peptide

The superior ovarian nerve (SON) provides neuropeptide-Y, norepinephrine and vasoactive intestinal peptide (VIP) to the ovaries. Ovarian steroidogenesis is modulated by the SON. In the cyclic rat, the acute steroidogenic response to ovarian microinjection of VIP is asymmetric and varies during the estrous cycle. In the present study, we analyze whether the differential effects of VIP in each ovary are modulated by the neural signals arriving through the SON. Cyclic female rats were submitted on diestrus-1, diestrus-2, proestrus, or estrus to a unilateral section of the SON, and immediately afterward, the denervated ovary was either microinjected or not with VIP. Animals were sacrificed 1 h after treatment. The injection of VIP into the left denervated ovary performed on diestrus-1 decreased progesterone levels in comparison with the left SON sectioning group; similar effects were observed on proestrus when VIP was injected into either of the denervated ovaries. Compared to the left SON sectioning group, VIP treatment into the left denervated ovary on diestrus-2 or proestrus decreased testosterone levels, whereas on diestrus-1, proestrus or estrus, the same treatment resulted in higher estradiol levels. Compared to the right SON sectioning group, VIP injected into the right denervated ovary yielded higher testosterone levels on diestrus-1 and estrus and lower testosterone levels on proestrus. VIP injection into the right denervated ovary increased estradiol levels on diestrus-2 or estrus while decreasing them on proestrus. Our results indicate that in the adult cyclic rat, the set neural signals arriving to the ovaries through the SON asymmetrically modulate the role of VIP on steroid hormone secretion, depending on the endocrine status of the animal. The results also support the hypothesis that the left and right ovary respond differently to the VIPergic stimulus.

Anatomical organization and neural pathways of the ovarian plexus nerve in rats

BACKGROUND

In this work, a detailed anatomical description of the ovarian plexus nerve (OPN) in rats is presented. The distribution of the OPN was analyzed by gross anatomy; the features of the superior mesenteric ganglion (SMG) were determined by histological studies; and the localization of the postganglionic neurons innervating the ovary were identified with retrograde tracer. We studied 19 adult cyclic rats of the CIIZ-V strain.

RESULTS

We found that the right OPN originates from the celiac ganglion, the lumbar ganglion of the sympathetic trunk (LGST) and the SMG. The left OPN originates from the LGST and the anastomotic branch from the splanchnic nerve. The SMG was attached to the inferior vena cava containing sympathetic neurons that innervate the right ovary through the OPN, and which is anatomically single. When the tracer was injected into the right ovary, only the SMG showed positive neurons, while when the tracer was injected into the left ovary, labeled postganglionic neurons were observed in the LGST.

CONCLUSIONS

This is the first time that it is reported that the SMG is attached to the inferior vena cava and it is directly related to the right ovary. The neural pathways and sympathetic ganglia involved in the communication between the ovaries and the preganglionic neurons are different in the left and right side.

Soil radon dynamics in the Amer fault zone: An example of very high seasonal variations

Soil radon levels of the Amer fault zone have been measured for a 4 year-period with the aim of checking seasonal fluctuations obtained in previous studies and to understand radon origin and dynamics. In this manuscript additional results are presented: updated continuous and integrated soil radon measurements, radionuclide content of soil materials and a detailed analysis of an urban profile by means of the electrical resistivity imaging technique and punctual soil radon, thoron and CO2 measurements. Integrated and continuous measurements present a wide range of values, [0.2-151.6] kBq m(-3) for radon, [4.5-39.6] kBq m(-3) for thoron and [4.0-71.2] g m(-2) day(-1) for CO2. The highest soil radon levels in the vicinity of the Amer fault (>40 kBq m(-3)) are found close to the fractured areas and present very important fluctuations repeated every year, with values in summer much higher than in winter, confirming previous studies. The highest radon values, up to 150 kBq m(-3), do not have a local origin because the mean value of radium concentration in this soil (19 ± 5 Bq kg(-1)) could not explain these values. Then soil radon migration through the fractures, influenced by atmospheric parameters, is assumed to account for such a high seasonal fluctuation. As main conclusion, in fractured areas, seasonal variations of soil radon concentration can be very important even in places where average soil radon concentration and radium content are not especially high. In these cases the migration capability of the soil is given not by intrinsic permeability but by the fracture structure. Potential risk estimation based on soil radon concentration and intrinsic permeability must be complemented with geological information in fractured systems.

Asymmetric steroidogenic response by the ovaries to the vasoactive intestinal peptide

In vitro the vasoactive intestinal peptide (VIP) stimulates progesterone, androgens, and estradiol secretion, and the effects are time-dependent. The present study analyzed the acute (1 h) and sub-acute (24 h) effects of unilateral injection of VIP into the ovarian bursa on each day of the estrous cycle on progesterone, testosterone, and estradiol serum levels. Cyclic 60-day-old virgin female rats on diestrus-1, diestrus-2, proestrus, or estrus were injected with saline or VIP 10(-6) M into the left or right ovarian bursa. One hour after saline injection on each day of estrus cycle, progesterone levels were higher than in control animals. The acute effects of saline solution on testosterone and estradiol levels were asymmetric and varied during the estrous cycle. In comparison with saline groups, the effects of VIPergic stimulation on progesterone, testosterone, and estradiol serum levels depend on the time elapsed between treatment and autopsy and vary during the estrous cycle. An acute asymmetric response from the ovaries to the VIP was observed at diestrus-1, diestrus-2, and proestrus on progesterone and estradiol levels. The asymmetries on testosterone levels were observed at diestrus-1, diestrus-2, and estrus days. The present results suggest that in the cyclic rat, each ovary has different sensitivities to VIPergic stimulation which depends on the endocrine status of the animal.

A simple flow cytometry method improves the detection of phosphatidylserine-exposing extracellular vesicles

BACKGROUND

Plasma contains cell-derived extracellular vesicles (EVs), which participate in physiopathological processes and have potential applications as disease biomarker. However, the enumeration of EVs faces major problems, due to their sub-micrometer size and to intrinsic limitations in methods of characterization, mainly flow cytometry (FCM).

OBJECTIVES

Our objective is to enumerate EVs in plasma, by taking as the prototype the population of phosphatidylserine (PS)-exposing EVs, which constitute one of the major EV populations and are responsible for thrombotic disorders.

METHODS

The concentration of PS-exposing EVs in platelet-free plasma (PFP) of healthy subjects was measured by FCM using either light scattering or fluorescence as the trigger and fluorescent Annexin-5 (Anx5) as the specific label. In addition, PS-exposing EVs were enumerated by electron microscopy (EM) after labeling with Anx5 gold nanoparticles and sedimentation on EM grids.

RESULTS

We show that about 50× more Anx5-positive EVs are detected by FCM when detection is triggered on fluorescence as compared with light scattering. By fluorescence triggering, concentrations of 22 000-30 000 Anx5-positive EVs per μL PFP were determined, using two different flow cytometers. The limit of detection of the fluorescence triggering method was estimated at about 1000-2500 Anx5 molecules. Results from EM suggest that EVs down to 100-150 nm diameter are detected by fluorescence triggering.

CONCLUSION

This study presents a simple method for enumerating EVs. We believe that this method is applicable in a general context and will improve our understanding of the roles of EVs in pathophysiological situations, which will open avenues for the development of EV-based diagnosis assays.

MCTP system model based on linear programming optimization of apertures obtained from sequencing patient image data maps

PURPOSE

The authors present a hybrid direct multileaf collimator (MLC) aperture optimization model exclusively based on sequencing of patient imaging data to be implemented on a Monte Carlo treatment planning system (MC-TPS) to allow the explicit radiation transport simulation of advanced radiotherapy treatments with optimal results in efficient times for clinical practice.

METHODS

The planning system (called CARMEN) is a full MC-TPS, controlled through aMATLAB interface, which is based on the sequencing of a novel map, called "biophysical" map, which is generated from enhanced image data of patients to achieve a set of segments actually deliverable. In order to reduce the required computation time, the conventional fluence map has been replaced by the biophysical map which is sequenced to provide direct apertures that will later be weighted by means of an optimization algorithm based on linear programming. A ray-casting algorithm throughout the patient CT assembles information about the found structures, the mass thickness crossed, as well as PET values. Data are recorded to generate a biophysical map for each gantry angle. These maps are the input files for a home-made sequencer developed to take into account the interactions of photons and electrons with the MLC. For each linac (Axesse of Elekta and Primus of Siemens) and energy beam studied (6, 9, 12, 15 MeV and 6 MV), phase space files were simulated with the EGSnrc/BEAMnrc code. The dose calculation in patient was carried out with the BEAMDOSE code. This code is a modified version of EGSnrc/DOSXYZnrc able to calculate the beamlet dose in order to combine them with different weights during the optimization process.

RESULTS

Three complex radiotherapy treatments were selected to check the reliability of CARMEN in situations where the MC calculation can offer an added value: A head-and-neck case (Case I) with three targets delineated on PET/CT images and a demanding dose-escalation; a partial breast irradiation case (Case II) solved with photon and electron modulated beams (IMRT + MERT); and a prostatic bed case (Case III) with a pronounced concave-shaped PTV by using volumetric modulated arc therapy. In the three cases, the required target prescription doses and constraints on organs at risk were fulfilled in a short enough time to allow routine clinical implementation. The quality assurance protocol followed to check CARMEN system showed a high agreement with the experimental measurements.

CONCLUSIONS

A Monte Carlo treatment planning model exclusively based on maps performed from patient imaging data has been presented. The sequencing of these maps allows obtaining deliverable apertures which are weighted for modulation under a linear programming formulation. The model is able to solve complex radiotherapy treatments with high accuracy in an efficient computation time.

A system to measure isomeric state half-lives in the 10 ns to 10 μs range

The Isomeric State Measurement System (SISMEI) was developed to search for isomeric nuclear states produced by fusion-evaporation reactions. The SISMEI consists of 10 plastic phoswich telescopes, two lead shields, one NaI(Tl) scintillation detector, two Compton suppressed HPGe γ-ray detectors, and a cone with a recoil product catcher. The new system was tested at the 8 UD Pelletron tandem accelerator of the University of São Paulo with the measurement of two known isomeric states: (54)Fe, 10(+) state (E = 6527.1 (11) keV, T(1/2) = 364(7) ns) and the 5/2(+) state of (19)F (E = 197.143 (4) keV, T(1/2) = 89.3 (10) ns). The results indicate that the system is capable of identifying delayed transitions, of measuring isomeric state lifetimes, and of identifying the feeding transitions of the isomeric state through the delayed γ-γ coincidence method. The measured half-life for the 10(+) state was T(1/2) = 365(14) ns and for the 5/2(+) state, 100(36) ns.

Extracellular vesicles from blood plasma: determination of their morphology, size, phenotype and concentration

BACKGROUND

Plasma and other body fluids contain membranous extracellular vesicles (EVs), which are considered to derive from activated or apoptotic cells. EVs participate in physiological and pathological processes and have potential applications in diagnostics or therapeutics. Knowledge on EVs is, however, limited, mainly due to their sub-micrometer size and to intrinsic limitations in methods applied for their characterization.

OBJECTIVES

Our aim was to provide a comprehensive description of EVs from plasma of healthy subjects.

METHODS

Cryo-transmission electron microscopy combined with receptor-specific gold labeling was used to reveal the morphology, size and phenotype of EVs. An original approach based on sedimentation on electron microscopy grids was developed for enumerating EVs. A correlation was performed between conventional flow cytometry and electron microscopy results.

RESULTS

We show that platelet-free plasma samples contain spherical EVs, 30 nm to 1 μm in diameter, tubular EVs, 1-5 μm long, and membrane fragments, 1-8 μm large. We show that only a minority of EVs expose the procoagulant lipid phosphatidylserine, in contrast to the classical theory of EV formation. In addition, the concentrations of the main EV sub-populations are determined after sedimentation on EM grids. Finally, we show that conventional flow cytometry, the main method of EV characterization, detects only about 1% of them.

CONCLUSION

This study brings novel insights on EVs from normal plasma and provides a reference for further studies of EVs in disease situations.

Unilateral or bilateral vagotomy induces ovulation in both ovaries of rats with polycystic ovarian syndrome

BACKGROUND

Injecting estradiol valerate (EV) to pre-pubertal or adult female rat results in effects similar to those observed in women with polycystic ovarian syndrome (PCOS). One of the mechanisms involved in PCOS development is the hyperactivity of the sympathetic nervous system. In EV-induced PCOS rats, the unilateral sectioning of the superior ovarian nerve (SON) restores ovulation of the innervated ovary. This suggests that, in addition to the sympathetic innervation, other neural mechanisms are involved in the development/maintenance of PCOS. The aims of present study were analyze if the vagus nerve is one of the neural pathways participating in PCOS development.

METHODS

Ten-day old rats were injected with EV dissolved in corn oil. At 24-days of age sham-surgery, unilateral, or bilateral sectioning of the vagus nerve (vagotomy) was performed on these rats. The animals were sacrificed at 90-92 days of age, when they presented vaginal estrous preceded by a pro-estrus smear.

RESULTS

In EV-induced PCOS rats, unilateral or bilateral vagotomy restored ovulation in both ovaries. Follicle-stimulating hormone (FSH) levels in PCOS rats with unilateral or bilateral vagotomy were lower than in control rats.

CONCLUSIONS

This result suggests that in EV-induced PCOS rats the vagus nerve is a neural pathway participating in maintaining PCOS. The vagus nerve innervates the ovaries directly and indirectly through its synapsis in the celiac-superior-mesenteric ganglion, where the somas of neurons originating in the SON are located. Then, it is possible that vagotomy effects in EV-induced PCOS rats may be explained as a lack of communication between the central nervous system and the ovaries.

Unilateral sectioning of the superior ovarian nerve of rats with polycystic ovarian syndrome restores ovulation in the innervated ovary

The present study tested the hypothesis that if polycystic ovary syndrome (PCOS) results from activating the noradrenergic outflow to the ovary, unilaterally sectioning the superior ovarian nerve (SON) will result in ovulation by the denervated ovary, and the restoration of progesterone (P4), testosterone (T) and estradiol (E2) normal serum level. A single 2 mg dose of estradiol valerate (EV) to adult rats results in the development of a syndrome similar to the human PCOS. Ten-day old rats were injected with EV or vehicle solution (Vh) and were submitted to sham surgery, unilateral or bilateral sectioning of the SON at 24-days of age. The animals were sacrificed at 90 to 92 days of age, when they presented vaginal estrus preceded by a pro-estrus smear. In EV-treated animals, unilateral sectioning of the SON restored ovulation by the innervated ovary and unilateral or bilateral sectioning of the SON normalized testosterone and estradiol levels. These results suggest that aside from an increase in ovarian noradrenergic tone in the ovaries, in the pathogenesis of the PCOS participate other neural influences arriving to the ovaries via the SON, regulating spontaneous ovulation. Changes in P4, T and E2 serum levels induced by EV treatment seem to be controlled by neural signals arising from the abdominal wall and other signals arriving to the ovaries through the SON, and presents asymmetry.

[The pyramidal tract: new pathways]

OBJECTIVE

To review some anatomofunctional aspects of the pyramidal tract which are relevant in clinical practice, especially the newer concepts.

DEVELOPMENT

a) Although the motor function is best known, the pyramidal tract also has sensory functions, modulating the transmission of impulses in the spinal cord. In fact, motor function is a recent acquisition on the evolutionary scale. b) Other descending pathways, such as the cortico reticulospinal path, participate in voluntary movements. However, the pyramidal pathway is necessary for fine movements of the hand. c) Most of the pyramidal fibres control movements of the contralateral side of the body, but there are a few fibres which do not cross to the other side and play a part in ipsilateral body movements. These fibres seem to contribute to motor recovery following a brain lesion. d) Classically it is recognized that the motor cortex and pyramidal fibres follow a somatotopical distribution. Nevertheless territories corresponding to different parts of the body are superimposed to a considerable extent and may be modified on very diverse occasions. e) Experimentally it has been proved that a circumscribed lesion of the pyramidal pathway does not cause hyper reflexia or spasticity. The hyper reflexia and spasticity habitually seen in patients with pyramidal syndrome is due to lesions of other descending pathways.

CONCLUSION

The pyramidal tract is anatomically and functionally related to other nerve structures and its activity is therefore integrated within the nervous system.

[A radiological study of the cervical alterations in Down syndrome. New findings on computerized tomography and three dimensional reconstructions]

OBJECTIVE

We studied a large proportion of the population in our health district who have Down's syndrome to determine the incidence and variety of changes in the spine and to define the guidelines for preventive diagnosis advisable in relation to atlanto-axial instability, a common disorder in these patients.

PATIENTS AND METHODS

First phase: a plain X-ray of the cervical spine in a neutral lateral projection and in flexion in 188 patients, measuring the atlanto-odontoid distance. Second phase: computerized tomography (CT) studies and three dimensional reconstructions in 25 patients (13.3%) chosen at random. The axial cuts from the upper portion of C3 to the occiput were 3 mm in thickness with 3 mm intervals and a standard reconstruction algorithm.

RESULTS

The incidences of atlanto-axial instability with an atlodontoid distance (3)5 mm were not comparable with the published series. There was a lower incidence (4.2%), with no difference between measurements in flexion and in the neutral lateral views. There was a greater incidence of malformations than in other reports, including a rare case of os odontoideum and also constant asymmetry of the occipital condyles (100%) in the patients of the CT series and consequently instability of the atlas (96%) and off-centered odontoides (84%).

CONCLUSIONS

The study showed that there was deficient asymmetrical development of the occipital bone, which caused different heights of the occipital condyles and led to cervico-cranial mal-position. For study of the degree of error of position and congenital anomalies. We recommend replacing plain X-ray studies by CT with three dimensional reconstructions.

The glenolabral articular disruption lesion: MR arthrography with arthroscopic correlation

OBJECTIVE

The purpose of this study was to describe the MR arthrography appearance of the glenolabral articular disruption (GLAD) lesion. Proper diagnosis of this lesion is important because it can be a source of persistent shoulder pain that requires surgical repair and because it is often difficult to diagnose clinically.

MATERIALS AND METHODS

Findings on MR arthrography were retrospectively correlated with the clinical histories and physical examination findings of six patients in whom we saw the typical appearance of the GLAD lesion. Four of these patients underwent follow-up arthroscopy that included surgical proof of GLAD lesions.

RESULTS

Five of the six patients had a documented glenohumeral impaction injury associated with an abducted externally rotated shoulder. All six patients had persistent shoulder pain, but their shoulders were stable during routine examination. In all patients, MR arthrography showed a superficial tear of the anteroinferior labrum with an adjacent articular cartilage injury. The torn labrum remained firmly attached to the anterior scapular periosteum, and contrast material was seen to extend into the labral tear and cartilaginous defect.

CONCLUSION

The MR arthrography findings of GLAD lesions include a nondisplaced tear of the anteroinferior labrum with an adjacent chondral injury. The pattern of chondral injury can range from a cartilaginous flap tear to a depressed osteochondral injury of the articular cartilage and underlying bone.

Rheumatoid nodule of the foot: MRI appearances mimicking an indeterminate soft tissue mass

Subcutaneous rheumatoid nodules occur commonly in advanced cases of rheumatoid arthritis, but only rarely appear in the feet. We present a case of a subcutaneous rheumatoid nodule arising in the heel pad of a 68-year-old man with a long history of rheumatoid arthritis, along with a review of the literature. The appearance of the mass on MRI is illustrated and correlated with the histologic findings. The MRI appearance of a subcutaneous rheumatoid nodule is that of a nonspecific ill-defined mass with long T1- and long T2-relaxation times. A differential diagnosis for similar appearing masses is offered.

Recent advances in magnetic resonance imaging of the musculoskeletal system

Numerous recent technical innovations in magnetic resonance imaging have dramatically improved the imaging evaluation of musculoskeletal disease; however, with the introduction of new techniques comes the risk of inappropriate applications and unanticipated pitfalls in interpretation. Some of the practical and theoretical implications of these recent innovations as well as potential caveats associated with their use are highlighted in the following discussion.

[Deferred repair of surgical ureteral lesions]

Our experience in surgical injuries of the ureter, as well as the therapeutic approach followed to repair them as expounded in this paper. Immediate nephrostomy following diagnosis, and restoration deferred a minimum of three weeks have provided good results, as well as it has allowed us to detect and achieve spontaneous restoration in one case. These reasons, together with the absence of technical difficulties during the second intervention, invite us to consider the reevaluation and deferred restoration--if appropriate--of the surgical ureteral injuries as a therapeutic approach from which a number of patients can profit.

[Pubo-vaginal percutaneous suspension by the Gittes technique for stress incontinence. Initial experience]

The paper presents our initial experience with endoscopic suspension of the vesical neck, as per the modification introduced by Gittes and based on incorporation through the vaginal mucosa of non-absorbable single-filament sutures. In this way it is feasible to use a simple non-incisive vaginal surgery with minimum morbidity. Good results have been obtained so far in six of the seven patients operated on. No complications have presented following tube retrieval on the second day. It is our belief that these initial results can be a reasonable basis to a wider use of this technique and to know its long-term results in treating stress incontinency through urethral hypermobility.

[Incidental carcinoma of the kidney with renal vein thrombosis]

Incidental carcinoma of kidney is an increasingly common pathology as a result of a wider use of high resolution diagnostic methods. The special characteristics of these tumors, usually small and in a low grade or stage, make conservative surgery to be considered as a valid therapeutical option. An incidental carcinoma of kidney with tumoral thrombosis of the renal vein undetected in the pre-surgical study, circumstance which allows to emphasize the malignant potential of these tumors is presented here. Based on this, we believe that a meticulous evaluation of the renal vein condition should be made, in patients considered as possible candidates for conservative surgery. In this sense, selective renal phebography and magnetic resonance could be considered explorative means that play an important role in the introduction of renal preservation surgery, if future studies show that its use allows an early detection of the tumoral condition of renal vein.

Clinical trial of remote radiologist services for a military installation

It is often difficult to provide continuity of professional radiological services at U.S. military facilities located at a distance from major metropolitan areas. To address this problem, we have designed and evaluated a program to send x-ray films from a U.S. Army hospital to a remote site for expert radiological interpretation. Nine hundred and forty-two x-ray studies were sent by U.S. Express Mail from the Radiology Department of a U.S. Army Hospital over a 2-month period. The typed reports were sent back to the hospital through the use of a computer-to-computer telephone link within 72 hours of film transport. No studies were lost and security of all studies was maintained. This program offers a cost-effective, otherwise unavailable means to provide high quality professional radiological services to U.S. military facilities both inside the United States and in foreign countries.