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Alfuraih A, Kadri O, Fakhouri F. On the gamma radiation response of commercially available 3D printing materials for medical dosimetry. Appl Radiat Isot 2024; 207:111256. [PMID: 38432035 DOI: 10.1016/j.apradiso.2024.111256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 12/17/2023] [Accepted: 02/24/2024] [Indexed: 03/05/2024]
Abstract
3D printing technology has rapidly spread for decades, allowing the fabrication of medical implants and human phantoms and revolutionizing healthcare. The objective of this study is to evaluate some radiological properties of commercially available 3D printing materials as potential tissue mimicking materials. Among fifteen materials, we compared their properties with nine human tissues. In all materials and tissues, exposure and energy absorption buildup factors were calculated for photon energies between 0.015 and 15 MeV and penetration depths up to 40 mean free path. Furthermore, the Geant4 Monte Carlo toolkit (version 10.5) was used to simulate their percentage depth dose distributions. In addition, equivalent atomic numbers, effective atomic numbers, attenuation coefficients, and CT numbers have been examined. All parameters were considered in calculating the average relative error (σ), which was used as a statistical comparison tool. With σ between 6 and 7, we found that Polylactic Acid (PLA) was capable of simulating eye lenses, blood, soft tissue, lung, muscle, and brain tissues. Moreover, Polymethacrylic Acid (PMAA) material has a σ value of 4 when modeling adipose and breast tissues, respectively. Aside from that, variations in 3D printing materials' infilling percentage can affect their CT numbers. We therefore suggest the PLA for mimicking soft tissue, muscle, brain, eye lens, lung and blood tissues, with an infill of between 92.7 and 94.3 percent. We also suggest an 89 percent infill when simulating breast tissue. Furthermore, with a 96.7 percent infill, the PMAA faithfully replicates adipose tissue. Additionally, we found that a 59 percent infill of Fe-PLA material is comparable to cortical bone. Due to the benefits of creating individualized medical phantoms and equipment, the results might be seen as an added value for both patients and clinicians.
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Affiliation(s)
- A Alfuraih
- Department of Radiological Sciences. College of Applied Medical Sciences. King Saud University, PO Box 10219, Riyadh 11433, Saudi Arabia
| | - O Kadri
- Research Laboratory on Energy and Matter for Nuclear Science Development (LR16CNSTN02), National Center for Nuclear Science and Technologies, Sidi Thabet Technopark 2020, Tunis, Tunisia.
| | - F Fakhouri
- Department of Biomedical Technology, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia
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Gebreamlak WT, Alkhatib HH. Planar Dose Calculation of Electron Therapy. Biomed Phys Eng Express 2024. [PMID: 38688251 DOI: 10.1088/2057-1976/ad4552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
PURPOSE
The purpose of this study is to compute the planar dose distribution of irregularly shaped electron beams at their maximum dose depth (zmax) using the modified lateral build-up-ratio (LBR) and curve-fitting methods.
Methods:
Circular and irregular cutouts were created using Cerrobend alloy for a 14×14 cm2 applicator. Percentage depth dose (PDD) at the standard source-surface-distance (SSD = 100 cm) and point dose at different SSD were measured for each cutout. Orthogonal profiles of the cutouts were measured at zmax. The data were collected for 6, 9, 12, and 15 MeV electron beam energies on a VERSA HDTM LINAC using the iba Blue Phantom2 3D water phantom system. The planar dose distributions of the cutouts were also measured at zmax in solid water using EDR2 films.
Results:
The measured PDD curves were normalized to a normalization depth (d0) of 1 mm. Each cutout's lateral-buildup-ratio (LBR), lateral spread parameter (σR(z)), and effective SSD (SSDeff) were calculated using the PDD of the open applicator as the reference field. The modified LBR method was then used to calculate the planar dose distribution of the irregular cutouts inside the field at least 5 mm from the edge. A simple curve-fitting model was developed based on the profile shapes of the circular cutouts around the field edge. This model was used to calculate the planar dose distribution of irregular cutouts in the region from 3 mm outside to 5 mm inside the field edge. Finally, the calculated dose distribution was compared with the film measurement.
Conclusions:
The planar dose distribution of electron therapy for irregular cutouts at zmax was calculated using the improved LBR method and a simple curve-fitting model. The calculated profiles were within 3% of the measured. The gamma passing rate with 3%/3mm was more than 96%.
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Affiliation(s)
- Wondesen T Gebreamlak
- South Carolina Oncology Associates, 166 Stoneridge Dr, Columbia, South Carolina, 29210, UNITED STATES
| | - Hassaan H Alkhatib
- South Carolina Oncology Associates, 166 Stoneridge Dr, Columbia, South Carolina, 29210, UNITED STATES
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3
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Koenig HG. Psychological symptoms in patients with physical health problems. Int J Psychiatry Med 2024; 59:3-5. [PMID: 37921003 DOI: 10.1177/00912174231214043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Affiliation(s)
- Harold G Koenig
- Professor of Psychiatry and Behavioral Sciences & Associate Professor of Medicine Duke University Medical Center, Durham, NC, USA
- Adjunct Professor, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Visiting Professor, Department of Psychiatry, Shiraz University of Medical Sciences, Iran
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Quispe-Huillcara B, de-la-Rosa KM, Reyes U, Cerón PV, Vega HR, Sosa MA. Characterization of the radiation beam of a tomotherapy equipment with MCNP. Appl Radiat Isot 2023; 200:110978. [PMID: 37603966 DOI: 10.1016/j.apradiso.2023.110978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 07/18/2023] [Accepted: 08/08/2023] [Indexed: 08/23/2023]
Abstract
This work aims to model and characterize the radiation beam of one Accuray tomotherapy equipment using the Monte Carlo Code MCNP5 (Monte Carlo N-Particle). This tomotherapy equipment is used for delivering high doses of radiation in tumor regions to kill cancer cells and shrink the tumor during radiation therapy of cancer patients, however, the radiation can damage surrounding areas and nearby organs at risk (OAR) if the radiation field is not well delimited. In particular, intensity-modulated radiotherapy treatments (IMRT) with tomotherapy equipment offer great benefits to patients allowing treatment of tumor regions without affecting surrounding areas and OAR. Nowadays, it is well known that a correct simulation of transport of radiation in tomotherapy equipment facilitates considerably the estimation of ideal doses in the tumor, surrounding regions, and OAR. For that reason, in this work, we simulated the geometry of the 6 MV ACCURAY Tomotherapy equipment of the CECAN using the MCNP5. The model includes a TomoLINAC consisting of an electron source that emits Gaussian distribution particles with an average energy of 5.7 MeV and width of 0.3 MeV. The emitted particles impact the tungsten target and pass through primary collimators and jaws that define the irradiation field in the isocenter. To validate the geometry and radiation transport in the TomoLINAC the curves of depth dose percentage (PDD) estimated by simulation and the curves measured experimentally were tuned. In the same way, the simulated transverse and longitudinal profiles were compared with the experimental results. In addition, a comparison between the qualities of the radiation beam characterized with MCNP and measured experimentally in CECAN showed a deviation of 1%. For the simulations, cylindrical detectors located inside a water phantom were considered and it was employed the tally *F8. A good agreement was observed between the PDD's curves obtained from the simulation and those measured experimentally for a field of 5 × 10 cm2 in the isocenter and SSD (distance from the source to the surface) of 85 cm. Also, the comparison between the simulated and experimental transverse profiles obtained at 1.5 cm, 10 cm and 15 cm depth with a radiation field of 5 × 40 cm2 showed very good agreement. The longitudinal profiles were estimated with the same depths as the transverse ones, but for each of them, the openings of the jaws were 5.0 cm, 2.5 cm and 1.0 cm in the longitudinal direction, which corresponds to the direction in which the patient's table moves. The comparison between the simulated and experimental longitudinal profiles showed good concordance too. Once the radiation beam of the ACCURAY tomotherapy equipment had been characterized, experimental dose measurements were made using a Cheese phantom and two A1SL ionization chambers. These results obtained experimentally were compared with those estimated with MCNP for a field of 5 × 40 cm2 at the isocenter and SAD of 85 cm and, it was concluded that both results were similar considering the regions of uncertainty. Finally, we must highlight that the modeling and characterization of the radiation beam of CECAN's ACCURAY tomotherapy equipment can be a key tool for dose estimations in different cancer treatment plans and future research.
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Affiliation(s)
| | | | - Uvaldo Reyes
- State Center of Cancerology, Durango Health Services, 34000, Durango, Dgo., Mexico
| | - Pablo V Cerón
- Department of Environmental Sciences, DCIyT, University of Quintana Roo, 77019, Chetumal, QRoo, Mexico
| | - Héctor R Vega
- Academic Unit of Nuclear Studies, Autonomous University of Zacatecas, 98000, Zacatecas, Zac., Mexico
| | - Modesto A Sosa
- Department of Physical Engineering, DCI, University of Guanajuato, 37150, Leon, Gto., Mexico.
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Giannouli V, Tsolaki M. What Do Arithmetic Errors in the Financial Context Reveal? A Preliminary Study of Individuals with Neurocognitive Disorders. Neurol Int 2023; 15:743-749. [PMID: 37368330 DOI: 10.3390/neurolint15020046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/22/2023] [Accepted: 05/30/2023] [Indexed: 06/28/2023] Open
Abstract
OBJECTIVES Arithmetic errors in the financial context have been investigated mainly in cognitively normal Parkinson's disease (PD) patients and mildly impaired PD (PD-MCI) individuals. The aim of this study was to examine arithmetic errors in the financial context across neurocognitive disorders. METHODS Four hundred and twenty older adults from Greece were divided into four groups (110 patients with a diagnosis of Alzheimer's disease (AD), 107 patients with a diagnosis of mild cognitive impairment (MCI), 109 healthy controls and 94 Parkinson's disease dementia (PDD) patients). Their ages ranged from 65 to 98 years (M = 73.96, SD = 6.68), and the sample had a mean of 8.67 (SD = 4.08) years of education. For each of the AD patients, a counterpart matched by age, educational attainment and gender was selected from a larger group of participants. RESULTS Overall, the results reveal that healthy older adults did not commit arithmetic errors, but AD patients reported procedural errors in their responses to both questions. A high frequency of procedural errors was found in MCI patients' responses to the first question, while the errors in their responses to the second question cannot be categorized. Finally, in PDD patients, place value errors were reported for the first question, while more magnitude errors were made when responding to the second question. CONCLUSIONS These findings support that arithmetic errors within financial contexts are not the same across neurocognitive disorders, and numerical representations are not impaired not only in PDD, but also in AD and MCI. This information could be useful in cognitive assessments performed by neurologists and neuropsychologists as these types of errors may be indicators of specific brain pathologies.
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Affiliation(s)
- Vaitsa Giannouli
- School of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Magdalini Tsolaki
- School of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
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Shrestha R, Lee HJ, Lim J, Gurung P, Thapa Magar TB, Kim YT, Lee K, Bae S, Kim YW. Effect of Photodynamic Therapy with Chlorin e6 on Canine Tumors. Life (Basel) 2022; 12. [PMID: 36556469 DOI: 10.3390/life12122102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/05/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
This work aims to prepare pure Chlorin e6 (Ce6) and establish Ce6-mediated photodynamic therapy (Ce6-PDT) as a better therapy option for canine tumors as well as mouse tumor models. Five dogs suffering from various cancers were treated with Ce6-PDT from one to several times. After receiving the Ce6 (2.5 mg/kg) for 3 h, tumors were illuminated superficially or interstitially with 660 nm light. Two dogs underwent Ce6-guided fluorescence imaging by photodynamic diagnosis (PDD). Cell proliferation and apoptosis were detected by the 4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay and western blot assay, respectively. Ce6-PDT efficacy was also determined using melanoma and pancreatic cancer mouse models. Two veterinary patients with mammary carcinoma and histiocytic sarcoma had their tumors significantly diminished and showed improved health after receiving Ce6-PDT. Moreover, in the cases of canine tumors, the adjunctive use of Ce6-PDD revealed cancers that were not visible with white light viewing and provided a visual contrast from surrounding tissues. Also, in vivo, Ce6-PDT remarkably reduced melanoma and pancreatic tumors in the mouse model. These findings could pave the way for a better understanding of the underlying processes of Ce6-PDT, making it an effective and safe candidate for use in human and veterinary applications to abolish various cancers.
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Russo GI, Sholklapper TN, Cocci A, Broggi G, Caltabiano R, Smith AB, Lotan Y, Morgia G, Kamat AM, Witjes JA, Daneshmand S, Desai MM, Gill IS, Cacciamani GE. Performance of Narrow Band Imaging (NBI) and Photodynamic Diagnosis ( PDD) Fluorescence Imaging Compared to White Light Cystoscopy (WLC) in Detecting Non-Muscle Invasive Bladder Cancer: A Systematic Review and Lesion-Level Diagnostic Meta-Analysis. Cancers (Basel) 2021; 13:4378. [PMID: 34503188 PMCID: PMC8431313 DOI: 10.3390/cancers13174378] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/11/2021] [Accepted: 08/17/2021] [Indexed: 11/16/2022] Open
Abstract
Despite early detection and regular surveillance of non-muscle invasive bladder cancer (NMIBC), recurrence and progression rates remain exceedingly high for this highly prevalent malignancy. Limited visualization of malignant lesions with standard cystoscopy and associated false-negative biopsy rates have been the driving force for investigating alternative and adjunctive technologies for improved cystoscopy. The aim of our systematic review and meta-analysis was to compare the sensitivity, specificity, and oncologic outcomes of photodynamic diagnosis (PDD) fluorescence, narrow band imaging (NBI), and conventional white light cystoscopy (WLC) in detecting NMIBC. Out of 1,087 studies reviewed, 17 prospective non-randomized and randomized controlled trials met inclusion criteria for the study. We demonstrated that tumor resection with either PDD and NBI exhibited lower recurrence rates and greater diagnostic sensitivity compared to WLC alone. NBI demonstrated superior disease sensitivity and specificity as compared to WLC and an overall greater hierarchical summary receiver operative characteristic. Our findings are consistent with emerging guidelines and underscore the value of integrating these enhanced technologies as a part of the standard care for patients with suspected or confirmed NMIBC.
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Affiliation(s)
- Giorgio I. Russo
- Urology Section, Department of Surgery, University of Catania, 95123 Catania, Italy;
| | - Tamir N. Sholklapper
- Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; (T.N.S.); (S.D.); (M.M.D.); (I.S.G.)
| | - Andrea Cocci
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, University of Florence, 50100 Florence, Italy;
| | - Giuseppe Broggi
- Department of Medical and Surgical Sciences and Advanced Technologies, G.F. Ingrassia, Anatomic Pathology, University of Catania, 95123 Catania, Italy; (G.B.); (R.C.)
| | - Rosario Caltabiano
- Department of Medical and Surgical Sciences and Advanced Technologies, G.F. Ingrassia, Anatomic Pathology, University of Catania, 95123 Catania, Italy; (G.B.); (R.C.)
| | - Angela B. Smith
- Department of Urology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;
| | - Yair Lotan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Giuseppe Morgia
- Urology Section, Department of Surgery, University of Catania, 95123 Catania, Italy;
- Department of Experimental Oncology, Mediterranean Institute of Oncology (IOM), 95029 Catania, Italy
| | - Ashish M. Kamat
- Department of Urology, University of Texas MD Anderson Cancer Center, 1515 Pressler, Unit 1373, Houston, TX 77030, USA;
| | - J. Alfred Witjes
- Department of Urology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands;
| | - Siamak Daneshmand
- Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; (T.N.S.); (S.D.); (M.M.D.); (I.S.G.)
| | - Mihir M. Desai
- Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; (T.N.S.); (S.D.); (M.M.D.); (I.S.G.)
| | - Indebir S. Gill
- Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; (T.N.S.); (S.D.); (M.M.D.); (I.S.G.)
| | - Giovanni E. Cacciamani
- Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; (T.N.S.); (S.D.); (M.M.D.); (I.S.G.)
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Reisener MJ, Okano I, Zhu J, Salzmann SN, Miller CO, Shue J, Sama AA, Cammisa FP, Girardi FP, Hughes AP. Workers' Compensation Status in Association with a High NDI Score Negatively Impacts Post-Operative Dysphagia and Dysphonia Following Anterior Cervical Fusion. World Neurosurg 2021; 154:e39-e45. [PMID: 34242831 DOI: 10.1016/j.wneu.2021.06.100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/20/2021] [Accepted: 06/21/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Anterior cervical discectomy and fusion (ACDF) is a safe and effective procedure but has approach-related complications like postoperative dysphagia and dysphonia (PDD). Patient-reported outcome measures including the Hospital for Special Surgery Dysphagia and Dysphonia Inventory (HSS-DDI) have been used for the assessment of PDD. Various factors have been described that affect ACDF outcomes, and our aim was to investigate the effect of workers' compensation (WC) status. METHODS We included patients who underwent ACDF from 2015 to 2018 stratified according to insurance status: WC/non-WC. PDDs were assessed using the HSS-DDI score. We conducted logistic regression analyses. Statistical significance was set at P < 0.05. RESULTS We included 287 patients, 44 (15.33%) WC and 243 (84.67%) non-WC. A statistical comparison revealed a clinically relevant difference in the HSS-DDI total score and both subdomains (P = 0.015; dysphagia P = 0.021; dysphonia P = 0.002). Additional logistic regression analysis adjusting for preoperative Neck Disability Index scores resulted in no clinically relevant differences in the HSS-DDI total score and both subdomains (total score P = 0.420; dysphagia P = 0.531; dysphonia 0.315). CONCLUSIONS WC status was associated with a worse HSS-DDI score but could not be shown to be an independent risk factor for PDD. The preoperative NDI score was a strong predictor for PDD with a clinically relevant difference in the HSS DDI score (P < 0.0001). Surgeon awareness of risk factors for PDD such as WC status, even if it could not be shown as independent, is important as it may influence surgical decision making and managing patient expectations.
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Affiliation(s)
- Marie-Jacqueline Reisener
- Department of Orthopedic Surgery, Spine Service, Hospital for Special Surgery, New York, New York, USA
| | - Ichiro Okano
- Department of Orthopedic Surgery, Spine Service, Hospital for Special Surgery, New York, New York, USA
| | - Jiaqi Zhu
- Department of Epidemiology and Biostatistics, Hospital for Special Surgery, New York, New York, USA
| | - Stephan N Salzmann
- Department of Orthopedic Surgery, Spine Service, Hospital for Special Surgery, New York, New York, USA
| | - Courtney Ortiz Miller
- Department of Orthopedic Surgery, Spine Service, Hospital for Special Surgery, New York, New York, USA
| | - Jennifer Shue
- Department of Orthopedic Surgery, Spine Service, Hospital for Special Surgery, New York, New York, USA
| | - Andrew A Sama
- Department of Orthopedic Surgery, Spine Service, Hospital for Special Surgery, New York, New York, USA
| | - Frank P Cammisa
- Department of Orthopedic Surgery, Spine Service, Hospital for Special Surgery, New York, New York, USA
| | - Federico P Girardi
- Department of Orthopedic Surgery, Spine Service, Hospital for Special Surgery, New York, New York, USA
| | - Alexander P Hughes
- Department of Orthopedic Surgery, Spine Service, Hospital for Special Surgery, New York, New York, USA.
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Andersson M, Berger M, Zieger K, Malmström PU, Bläckberg M. The diagnostic challenge of suspicious or positive malignant urine cytology findings when cystoscopy findings are normal: an outpatient blue-light flexible cystoscopy may solve the problem. Scand J Urol 2021; 55:263-267. [PMID: 34037496 DOI: 10.1080/21681805.2021.1928746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To investigate whether outpatient blue-light flexible cystoscopy could solve the diagnostic challenge of positive or suspicious urine cytology findings despite normal white-light flexible cystoscopy results and normal findings on computerized tomography urography, in patients investigated for urothelial cancer. MATERIAL AND METHODS In a multicentre study, a total of 70 examinations were performed with the use of blue-light flexible cystoscopy (photodynamic diagnosis) after intravesical instillation of the fluorescence agent hexaminolevulinate. The examination started with a conventional white-light flexible cystoscopy and then the settings were switched to use blue light. Suspicious lesions were biopsied. Afterwards, the patients were interviewed regarding their experience of the examinations. RESULTS Bladder cancer was diagnosed in 29 out of 70 (41%) cases, among them 14/29 (48%) had malignant lesions seen only in blue light. The majority had carcinoma in situ (21/29). Normal findings were seen in 41 cases that underwent BLFC. During the further course, malignancy of the bladder was detected in six cases (9%) and malignancy of the upper urinary tract was detected in one case (1%). The majority of patients (93%) preferred the blue-light flexible cystoscopy performed at the outpatient clinic instead of the transurethral resection under general anaesthesia. CONCLUSION Blue-light flexible cystoscopy at the outpatient clinic may be a useful tool to solve unclear cases of a malignant or suspicious urinary cytology suggestive of bladder cancer. The procedure was well tolerated by the patients.
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Affiliation(s)
- Marie Andersson
- Department of Urology, Helsingborg Hospital, Helsingborg, Sweden
| | - Marthe Berger
- Department of Urology, Lillebelt Hospital, Vejle, Denmark
| | - Karsten Zieger
- Department of Urology, Lillebelt Hospital, Vejle, Denmark
| | - Per-Uno Malmström
- Department of Urology, Institute of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden
| | - Mats Bläckberg
- Department of Urology, Helsingborg Hospital, Helsingborg, Sweden
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Hao Y, Cai B, Green O, Knutson N, Yaddanapudi S, Zhao T, Rodriguez V, Schmidt M, Mutic S, Sun B. Technical Note: An alternative approach to verify 6FFF beam dosimetry for Ethos and MR Linac without using a 3D water tank. Med Phys 2021; 48:1533-1539. [PMID: 33547684 DOI: 10.1002/mp.14757] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/17/2020] [Accepted: 01/29/2021] [Indexed: 12/24/2022] Open
Abstract
PURPOSE The current approach to Linac beam dosimetry verification is typically performed utilizing a three-dimensional (3D) water tank system. The 3D beam scanning process is cumbersome, labor intensive, error-prone, and costly. This is especially challenging for the new Ethos system and MR Linacs with a ring gantry. This work proposes an alternative approach to verify 6FFF beam dosimetry for Ethos, ViewRay MRIdian® Linac, and other Linacs with 6FFF beam quality using two-dimensional (2D) ion chamber arrays. METHODS Percentage depth dose (PDD) and profiles of an Ethos, an MRIdian® Linac, and several Linacs with 6FFF beams were measured at the nominal beam current. The beam energy was detuned by changing the bending magnet current on one TrueBeam. PDDs and profiles were measured for detuned beam energies. The peak shape of the 6FFF profile was defined by a "slope" parameter and unflatness. Correlations between peak slope and unflatness metrics vs PDDs were used to evaluate the sensitivity of beam energy to beam profile changes at different field sizes and depths. RESULTS Strong correlations were found between peak slope and PDDs for all Linacs with 6FFF beam. The R-squared values in the linear regression fitting between PDD and peak slope and unflatness were 0.99 and 0.84, respectively. Both profile slope and unflatness were proportional to PDD at the 10 cm depth and the peak slope was 4.3 times more sensitive than PDD. We have identified that measurements with a shallow depth are preferred to quantify the beam energy consistency. CONCLUSIONS Our work shows the feasibility of verifying 6FFF beam quality of Ethos, MR Linac, and other Linacs by defining a profile slope measured from 2D ionization chambers array devices. This new approach provides a simplified method for performing a routine beam quality check without using a 3D water tank system while maximizing cost effectiveness and efficiency.
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Affiliation(s)
- Yao Hao
- Department of Radiation Oncology, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA
| | - Bin Cai
- Department of Radiation Oncology, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA
| | - Olga Green
- Department of Radiation Oncology, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA
| | - Nels Knutson
- Department of Radiation Oncology, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA
| | - Sridhar Yaddanapudi
- Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, LL-W Pomerantz Family Pavilion, Iowa City, IA, 52242-1089, USA
| | - Tianyu Zhao
- Department of Radiation Oncology, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA
| | - Vivian Rodriguez
- Department of Radiation Oncology, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA
| | - Matthew Schmidt
- Department of Radiation Oncology, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA
| | - Sasa Mutic
- Department of Radiation Oncology, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA
| | - Baozhou Sun
- Department of Radiation Oncology, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA
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Kwan K, Sears S, Callen J, Rady P, Tyring S, Bahrami S, Huelsman M, Malone J. Keratotic spines in a patient with pruritic and dyskeratotic dermatosis: A new clinical finding. JAAD Case Rep 2021; 7:103-6. [PMID: 33364280 DOI: 10.1016/j.jdcr.2020.11.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Abstract
There is a great need for innovative new medicines to treat unmet medical needs. The discovery and development of innovative new medicines is extremely difficult, costly, and inefficient. In the last decade, phenotypic drug discovery (PDD) was reintroduced as a strategy to provide first-in-class medicines. PDD uses empirical, target-agnostic lead generation to identify pharmacologically active molecules and novel therapeutics which work through unprecedented drug mechanisms. The economic and scientific value of PDD is exemplified through game-changing medicines for hepatitis C virus, spinal muscular atrophy, and cystic fibrosis. In this short review, recent advances are noted for the implementation and de-risking of PDD (for compound library selection, biomarker development, mechanism identification, and safety studies) and the potential for artificial intelligence. A significant barrier in the decision to implement PDD is balancing the potential impact of a novel mechanism of drug action with an under-defined scientific path forward, with the desire to provide infrastructure and metrics to optimize return on investment, which a known mechanism provides. A means to address this knowledge gap in the future is to empower precompetitive research utilizing the empirical concepts of PDD to identify new mechanisms and pharmacologically active compounds.
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Bhushan M, Tripathi D, Yadav G, Kumar L, Dewan A, Kumar G. Effect of Hip Prosthesis on Photon Beam Characteristics in Radiological Physics. Asian Pac J Cancer Prev 2020; 21:1731-1738. [PMID: 32592371 PMCID: PMC7568891 DOI: 10.31557/apjcp.2020.21.6.1731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Indexed: 11/25/2022] Open
Abstract
Introduction: Aim of study is to investigate the effect of hip prosthesis on 6 and 15 MV photon beam energies. Materials and Methods: Prosthesis was kept at the level of tray position. The measurements were done on Varian Clinac-iX linac. Customized prosthesis, termed as Prosthetic Metal Implant (PMI) was made up of wrought austenitic stainless steel rod and covered with paraffin-wax. ‘Standard prosthesis’ was made up of wrought titanium alloy. The dose profiles were measured for three field sizes i.e. 5, 10 and 20 cm at 100 cm SSD for 6 and 15 MV energies. The perturbation index (PI) was also calculated. Results: Perturbation caused by standard prosthesis was approximately 50% higher than that of PMI. This result may be due to difference in dimension and not because of material composition. Variation of central axis dose might be due to the dimensions of PMI used for experiment which gave intermediate response (e.g. 102.1%, 141.0% and 117.7% for Open, Standard and PMI respectively for 10x10 cm2 field size, 10 cm depth and 15MV photon beam setup )as compared to the ‘open’ and ‘standard’ prosthesis. Percentage dose at 10 cm for 6MV photon increased rapidly with field-size for PMI. But, for 15MV photon, difference was not significant. Surface dose (Ds) for PMI remains significantly higher for smaller field. Conclusion: The perturbation index varied from 0.05 to 0.22 for the measured energies and gave an idea to the planner to assess the behavior of the prosthesis. This range is applicable for both type of implants and for all clinical field-sizes. The attenuation caused by the prosthesis was significant and this effect should be considered in the treatment planning calculations.
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Affiliation(s)
- Manindra Bhushan
- Division of Medical Physics and Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi (India)-110085, India.,Amity School of Applied Sciences, Amity University (AUUP), NOIDA, India
| | - Deepak Tripathi
- Amity School of Applied Sciences, Amity University (AUUP), NOIDA, India
| | - Girigesh Yadav
- Division of Medical Physics and Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi (India)-110085, India
| | - Lalit Kumar
- Division of Medical Physics and Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi (India)-110085, India.,Dr. APJ Abdul Kalam Technical University, Lucknow (UP), India
| | - Abhinav Dewan
- Division of Medical Physics and Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi (India)-110085, India
| | - Gourav Kumar
- Division of Medical Physics and Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi (India)-110085, India
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14
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Xu P, Xia Y, Wang Y, Qi Y, Qi C, He Y, Chang J. The conjugation of targeted therapy and image-guided phototdynamic therapy of cancer in vitro and in vivo. Bioorg Chem 2020; 100:103822. [PMID: 32446121 DOI: 10.1016/j.bioorg.2020.103822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/29/2020] [Accepted: 04/03/2020] [Indexed: 11/17/2022]
Abstract
Integration of multi-functional diagnosis and treatment competencies can improve effect of the drug and its visual distribution to the location of tumor focus site, and play a pivotal role by visualizing the tumor size in the assessment of chemotherapy. With the objective of developing integrated multi-therapeutic and diagnostic agent that could target the kinase receptor with high expression in tumor cells, herein, a biologically releasable drug-drug conjugate compound 9 with dual therapeutic and diagnostic effects was designed, synthesized and evaluated for pharmacodynamics and diagnostic functions in vitro and in vivo. The results of antitumor effects evaluations and compound 9 visual imaging indicated that compound 9 not only improved the anti-proliferative activity of chemotherapy and photodynamic treatment (PDT) in vitro and in vivo compared with those of compound 8 and PpIX but also allowed the photodynamic diagnosis (PDD). The present study verified a facile and effective strategy using a drug-drug conjugate to integrate diagnosis and multi-therapies, showing its potential a candidate clinical drug.
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Affiliation(s)
- Peng Xu
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, PR China; Experimental Chemistry Center, College of Chemistry, Beijing Normal University, Beijing 100875, PR China
| | - Yanhui Xia
- Peking University Third Hospital, Beijing 100083, PR China; Experimental Chemistry Center, College of Chemistry, Beijing Normal University, Beijing 100875, PR China
| | - Yaping Wang
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, PR China; Experimental Chemistry Center, College of Chemistry, Beijing Normal University, Beijing 100875, PR China
| | - Yue Qi
- Experimental Chemistry Center, College of Chemistry, Beijing Normal University, Beijing 100875, PR China.
| | - Chuanmin Qi
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, PR China; Chinese Academy of Medical Science, Beijing 100041, PR China; Experimental Chemistry Center, College of Chemistry, Beijing Normal University, Beijing 100875, PR China.
| | - Yong He
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, PR China.
| | - Jin Chang
- Beijing National Laboratory for Molecular Science, CAS Research/Education Center for Excellence in Molecule Science. Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, PR China.
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15
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Oka T, Matsuoka KI, Utsunomiya A. Sensitive Photodynamic Detection of Adult T-cell Leukemia/Lymphoma and Specific Leukemic Cell Death Induced by Photodynamic Therapy: Current Status in Hematopoietic Malignancies. Cancers (Basel) 2020; 12:E335. [PMID: 32024297 DOI: 10.3390/cancers12020335] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 01/27/2020] [Accepted: 01/30/2020] [Indexed: 01/10/2023] Open
Abstract
Adult T-cell leukemia/lymphoma (ATL), an aggressive type of T-cell malignancy, is caused by the human T-cell leukemia virus type I (HTLV-1) infections. The outcomes, following therapeutic interventions for ATL, have not been satisfactory. Photodynamic therapy (PDT) exerts selective cytotoxic activity against malignant cells, as it is considered a minimally invasive therapeutic procedure. In PDT, photosensitizing agent administration is followed by irradiation at an absorbance wavelength of the sensitizer in the presence of oxygen, with ultimate direct tumor cell death, microvasculature injury, and induced local inflammatory reaction. This review provides an overview of the present status and state-of-the-art ATL treatments. It also focuses on the photodynamic detection (PDD) of hematopoietic malignancies and the recent progress of 5-Aminolevulinic acid (ALA)-PDT/PDD, which can efficiently induce ATL leukemic cell-specific death with minor influence on normal lymphocytes. Further consideration of the ALA-PDT/PDD system along with the circulatory system regarding the clinical application in ATL and others will be discussed. ALA-PDT/PDD can be promising as a novel treatment modality that overcomes unmet medical needs with the optimization of PDT parameters to increase the effectiveness of the tumor-killing activity and enhance the innate and adaptive anti-tumor immune responses by the optimized immunogenic cell death.
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16
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Anusionwu PC, Alpuche Aviles JE, Pistorius S. The use of 0.5r cav as an effective point of measurement for cylindrical chambers may result in a systematic shift of electron percentage depth doses. J Appl Clin Med Phys 2020; 21:117-126. [PMID: 31898872 PMCID: PMC6964751 DOI: 10.1002/acm2.12797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 10/29/2019] [Accepted: 11/22/2019] [Indexed: 11/29/2022] Open
Abstract
Electron dosimetry can be performed using cylindrical chambers, plane‐parallel chambers, and diode detectors. The finite volume of these detectors results in a displacement effect which is taken into account using an effective point of measurement (EPOM). Dosimetry protocols have recommended a shift of 0.5 rcav for cylindrical chambers; however, various studies have shown that the optimal shift may deviate from this recommended value. This study investigated the effect that the selection of EPOM shift for cylindrical chamber has on percentage depth dose (PDD) curves. Depth dose curves were measured in a water phantom for electron beams with energies ranging from 6 to 18 MeV. The detectors investigated were of three different types: diodes (Diode‐E PTW 60017 and SFD IBA), cylindrical (Semiflex PTW 31010, PinPoint PTW 31015, and A12 Exradin), and parallel plate ionization chambers (Advanced Markus PTW 34045 and Markus PTW 23343). Depth dose curves measured with Diode‐E and Advanced Markus agreed within 0.2 mm at R50 except for 18 MeV and extremely large field size. The PDDs measured with the Semiflex chamber and Exradin A12 were about 1.1 mm (with respect to the Advanced Markus chamber) shallower than those measured with the other detectors using a 0.5 rcav shift. The difference between the PDDs decreased when a Pinpoint chamber, with a smaller cavity radius, was used. Agreement improved at lower energies, with the use of previously published EPOM corrections (0.3 rcav). Therefore, the use of 0.5 rcav as an EPOM may result in a systematic shift of the therapeutic portion of the PDD (distances < R90). Our results suggest that a 0.1 rcav shift is more appropriate for one chamber model (Semiflex PTW 31010).
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Affiliation(s)
- Princess C Anusionwu
- CancerCare Manitoba, Winnipeg, Canada.,Department of Physics & Astronomy, University of Manitoba, Winnipeg, Canada
| | - Jorge E Alpuche Aviles
- CancerCare Manitoba, Winnipeg, Canada.,Department of Physics & Astronomy, University of Manitoba, Winnipeg, Canada.,Department of Radiology, University of Manitoba, Winnipeg, Canada
| | - Stephen Pistorius
- CancerCare Manitoba, Winnipeg, Canada.,Department of Physics & Astronomy, University of Manitoba, Winnipeg, Canada.,Department of Radiology, University of Manitoba, Winnipeg, Canada
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17
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Guo X, Pan F, Wang B, Li W, Xia C, Ju Z. Effect of electroacupuncture on mice model of permenopausal depressive disorder. Saudi J Biol Sci 2019; 26:2030-2036. [PMID: 31885488 PMCID: PMC6921301 DOI: 10.1016/j.sjbs.2019.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 08/05/2019] [Accepted: 08/08/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Study the effect of electroacupuncture on permenopausal depressive disorder (PDD) model through the peri-menopausal depression model mice. METHODS KM female mice were selected. Except for the blank group (BG), the other groups of mice were removed by castration method. The mice of PDD was prepared by combining chronic unpredictable stimulation. Mice in the model group (MG) were not treated and fed normally. The western medicine group (WG) was given the corresponding drug for treatment. The electroacupuncture group (EAG) was given the electroacupuncture for treatment, and consecutive for 28 days. The levels of T, E2, FSH and LH in serum of mice were measured, and the brain tissue of 5-HT, DA and NE level were measured. Through the HE staining observed the morphological changes of mice hypothalamus. RESULTS Compared with MG, EAG could increase the number of spontaneous activities of PDD model mice, the level of T, E2 in serum and the level of 5-HT, DA, NE in brain tissue was improved, and the level of FSH, LH in serum was reduced, and the hypothalamic lesions was improved. CONCLUSION Electroacupuncture could improve the activity and memory of PDD mice, adjust the disorder of sex hormone, and increased the levels of monoamine transmitters (5-HT, NE, DA), and it could effectively improve the behavior and related biochemical indexes of PDD, and thus play an important therapeutic role.
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Affiliation(s)
- Xianhui Guo
- Institute of Acupuncture and Massage, Henan University of Chinese Medicine, Zhengzhou 450046, China
- Department of Massage, Third Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450004, China
| | - Fuwei Pan
- Department of Massage, Third Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450004, China
| | - Baoying Wang
- Laboratory Center, Henan University of Traditional Medicine, Zhengzhou 450046, China
| | - Weibiao Li
- Institute of Acupuncture and Massage, Henan University of Chinese Medicine, Zhengzhou 450046, China
| | - Chunyang Xia
- Institute of Acupuncture and Massage, Henan University of Chinese Medicine, Zhengzhou 450046, China
| | - Ziyong Ju
- Institute of Acupuncture and Massage, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
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18
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Konecki T, Kutwin P, Łowicki R, Juszczak AB, Jabłonowski Z. Hexaminolevulinate in the Management of Nonmuscle Invasive Bladder Cancer: A Meta-Analysis. Photobiomodul Photomed Laser Surg 2019; 37:551-558. [PMID: 31339825 DOI: 10.1089/photob.2019.4634] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: The objective of this study was to assess the effect of photodynamic diagnosis (PDD) using hexaminolevulinate on the diagnostic and therapeutic outcomes in nonmuscle invasive bladder cancer (NMIBC) patients. Methods: PubMed, Embase, and the Cochrane Library databases together with conference proceedings were searched. Results: Recurrence-free survival was significantly higher at 3, 6, 9, and 12 months in the PDD groups than in the white light cystoscopy (WLC) groups with the cumulative values of differences in recurrence rates at different follow-up intervals ranging from 8% to 11%. PDD identified additional tumors in 25% of all NMIBC patients and in 35% of carcinoma in situ (CIS) patients. In a patient-based analysis mean sensitivity of PDD versus WLC for all tumor detection was 94% and 84%, respectively. The assessed patient-based specificity was comparable for PDD and WLC in all types of tumors (55-56%); however, in CIS it was higher for PDD (82% vs. 72%). Conclusions: The meta-analysis confirms that PDD in conjunction with WLC detects significantly more tumors than WLC alone. Better diagnostic abilities of PDD transpose to significantly lower short-term recurrence rates after transurethral resection procedure and may improve treatment of NMIBC patients.
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Affiliation(s)
- Tomasz Konecki
- 1st Department of Urology, Medical University of Lodz, Lodz, Poland
| | - Piotr Kutwin
- 1st Department of Urology, Medical University of Lodz, Lodz, Poland
| | - Roman Łowicki
- 1st Department of Urology, Medical University of Lodz, Lodz, Poland
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19
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Sa-Ardta P, Rinder M, Sanyathitiseree P, Weerakhun S, Lertwatcharasarakul P, Lorsunyaluck B, Schmitz A, Korbel R. First detection and characterization of Psittaciform bornaviruses in naturally infected and diseased birds in Thailand. Vet Microbiol 2019; 230:62-71. [PMID: 30827406 DOI: 10.1016/j.vetmic.2019.01.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 01/11/2019] [Accepted: 01/11/2019] [Indexed: 10/27/2022]
Abstract
In Thailand a proventricular dilation disease (PDD)-like syndrome commonly occurs in captive psittacine birds. The etiology, however, has been unknown to date and studies to detect parrot bornaviruses have never been performed in Southeastern Asia. Therefore, 111 psittacines (22 different species) including birds with suspected PDD based on clinical examination results (n = 65), cage mates of PDD suspected parrots without any clinical signs (n = 39) and dead birds with previous clinic suspicious for PDD (n = 7) were tested for bornaviruses using various reverse transcription polymerase chain reaction (RT-PCR) and realtime RT-PCR protocols, an enzyme-linked immunosorbent assay (ELISA), immunohistochemistry, and genome sequencing. Bornaviral infections, indicated by the presence of RNA or antibody positive reactions were detected in 60 birds (54.1%) belonging to 15 psittaciform species and originating from 41 owners. Occurrence of Psittaciform 1 orthobornavirus was confirmed by sequencing of PCR products in 24 of these birds. Parrot bornavirus (PaBV)-5, belonging to the species Psittaciform 2 orthobornavirus and found only in single birds in the United States of America, Japan and Hungary until now, was identified in a macaw. Full genome sequencing revealed features shared with other strains of this virus. PaBV-4 was the prevalent virus type and the viruses grouped in two of the five genetic PaBV-4 subclusters known so far while PaBV-2 was found in a single patient. Forty-five psittacines of the group of PDD-suspected birds (69.2%), 4 dead birds and 11 clinically healthy cage mates were positive in at least one test the latter suggesting inefficient horizontal transmission in natural infections. Lymphoplasmacytic infiltrations (non-purulent inflammation, ganglioneuritis) and bornavirus antigen were detected in diverse tissues confirming PDD as the disease involved. These results may have a major impact on conservation projects including the five near-threatened parrot species living in the wild in Thailand.
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Affiliation(s)
- Phirawich Sa-Ardta
- Clinic for Birds, Small Mammals, Reptiles and Ornamental Fish, Centre for Clinical Veterinary Medicine, LMU Munich, Oberschleißheim, Germany; Department of Veterinary Medicine, Faculty of Veterinary Science, Prince of Songkla University, Songkhla, Thailand.
| | - Monika Rinder
- Clinic for Birds, Small Mammals, Reptiles and Ornamental Fish, Centre for Clinical Veterinary Medicine, LMU Munich, Oberschleißheim, Germany
| | - Pornchai Sanyathitiseree
- Department of Large Animal and Wildlife Clinical Science, Faculty of Veterinary Medicine, Kasetsart University, Kamphaeng Saen Campus, Nakhon Pathom, Thailand
| | - Sompoth Weerakhun
- Department of Veterinary Medicine, Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Preeda Lertwatcharasarakul
- Department of Veterinary Pathology, Faculty of Veterinary Medicine, Kasetsart University, Kamphaeng Saen Campus, Nakhon Pathom, Thailand
| | - Benchapol Lorsunyaluck
- Exotic Pet Clinic, Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Kasetsart University, Kamphaeng Saen Campus, Nakhon Pathom, Thailand
| | - Anna Schmitz
- Clinic for Birds, Small Mammals, Reptiles and Ornamental Fish, Centre for Clinical Veterinary Medicine, LMU Munich, Oberschleißheim, Germany
| | - Rüdiger Korbel
- Clinic for Birds, Small Mammals, Reptiles and Ornamental Fish, Centre for Clinical Veterinary Medicine, LMU Munich, Oberschleißheim, Germany
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20
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Abstract
High Content Screening (HCS) platforms can generate large amounts of multidimensional data. To take full advantage of all the rich contextual information provided by these screens, a combination of traditional as well as nontraditional hit identification and prioritization strategies is required. Here, we describe the workflow and analytics of multidimensional high content data to differentiate, group, and prioritize hits.
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Affiliation(s)
| | - Yanhua Hu
- Bristol-Myers Squibb, Hopewell, NJ, USA
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21
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Segatto NV, Remião MH, Schachtschneider KM, Seixas FK, Schook LB, Collares T. The Oncopig Cancer Model as a Complementary Tool for Phenotypic Drug Discovery. Front Pharmacol 2017; 8:894. [PMID: 29259556 PMCID: PMC5723300 DOI: 10.3389/fphar.2017.00894] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 11/22/2017] [Indexed: 12/14/2022] Open
Abstract
The screening of potential therapeutic compounds using phenotypic drug discovery (PDD) is being embraced once again by researchers and pharmaceutical companies as an approach to enhance the development of new effective therapeutics. Before the genomics and molecular biology era and the consecutive emergence of targeted-drug discovery approaches, PDD was the most common platform used for drug discovery. PDD, also known as phenotypic screening, consists of screening potential compounds in either in vitro cellular or in vivo animal models to identify compounds resulting in a desirable phenotypic change. Using this approach, the biological targets of the compounds are not taken into consideration. Suitable animal models are crucial for the continued validation and discovery of new drugs, as compounds displaying promising results in phenotypic in vitro cell-based and in vivo small animal model screenings often fail in clinical trials. Indeed, this is mainly a result of differential anatomy, physiology, metabolism, immunology, and genetics between humans and currently used pre-clinical small animal models. In contrast, pigs are more predictive of therapeutic treatment outcomes in humans than rodents. In addition, pigs provide an ideal platform to study cancer due to their similarities with humans at the anatomical, physiological, metabolic, and genetic levels. Here we provide a mini-review on the reemergence of PDD in drug development, highlighting the potential of porcine cancer models for improving pre-clinical drug discovery and testing. We also present precision medicine based genetically defined swine cancer models developed to date and their potential as biomedical models.
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Affiliation(s)
- Natalia V Segatto
- Biotechnology Graduate Program, Molecular and Cellular Oncology Research Group, Laboratory of Cancer Biotechnology, Technology Development Center, Federal University of Pelotas, Pelotas, Brazil
| | - Mariana H Remião
- Biotechnology Graduate Program, Molecular and Cellular Oncology Research Group, Laboratory of Cancer Biotechnology, Technology Development Center, Federal University of Pelotas, Pelotas, Brazil
| | | | - Fabiana K Seixas
- Biotechnology Graduate Program, Molecular and Cellular Oncology Research Group, Laboratory of Cancer Biotechnology, Technology Development Center, Federal University of Pelotas, Pelotas, Brazil
| | - Lawrence B Schook
- Department of Radiology, University of Illinois at Chicago, Chicago, IL, United States.,Department of Animal Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Tiago Collares
- Biotechnology Graduate Program, Molecular and Cellular Oncology Research Group, Laboratory of Cancer Biotechnology, Technology Development Center, Federal University of Pelotas, Pelotas, Brazil
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22
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Yin C, Fufa T, Chandrasekar G, Aeluri M, Zaky V, Abdelhady S, Rodríguez AB, Jakobsson J, Varnoosfaderani FS, Mahalingam J, Liu J, Larsson O, Hovatta O, Gaunitz F, Göndör A, Andäng M, Kitambi SS. Phenotypic Screen Identifies a Small Molecule Modulating ERK2 and Promoting Stem Cell Proliferation. Front Pharmacol 2017; 8:726. [PMID: 29114221 PMCID: PMC5660848 DOI: 10.3389/fphar.2017.00726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 09/27/2017] [Indexed: 11/20/2022] Open
Abstract
Stem cells display a fundamentally different mechanism of proliferation control when compared to somatic cells. Uncovering these mechanisms would maximize the impact in drug discovery with a higher translational applicability. The unbiased approach used in phenotype-based drug discovery (PDD) programs can offer a unique opportunity to identify such novel biological phenomenon. Here, we describe an integrated phenotypic screening approach, employing a combination of in vitro and in vivo PDD models to identify a small molecule increasing stem cell proliferation. We demonstrate that a combination of both in vitro and in vivo screening models improves hit identification and reproducibility of effects across various PDD models. Using cell viability and colony size phenotype measurement we characterize the structure activity relationship of the lead molecule, and identify that the small molecule inhibits phosphorylation of ERK2 and promotes stem cell proliferation. This study demonstrates a PDD approach that employs combinatorial models to identify compounds promoting stem cell proliferation.
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Affiliation(s)
- Chang Yin
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Temesgen Fufa
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Gayathri Chandrasekar
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - Madhu Aeluri
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Dr. Reddy's Institute of Life Sciences, University of Hyderabad Campus, Hyderabad, India
| | - Verina Zaky
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Shaimaa Abdelhady
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Antonio B Rodríguez
- Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - Johan Jakobsson
- Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Jianping Liu
- Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - Olle Larsson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Outi Hovatta
- Division of Obstetrics and Gynecology, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Frank Gaunitz
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Anita Göndör
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Michael Andäng
- Dr. Reddy's Institute of Life Sciences, University of Hyderabad Campus, Hyderabad, India
| | - Satish S Kitambi
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
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23
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Weil RS, Lashley TL, Bras J, Schrag AE, Schott JM. Current concepts and controversies in the pathogenesis of Parkinson's disease dementia and Dementia with Lewy Bodies. F1000Res 2017; 6:1604. [PMID: 28928962 PMCID: PMC5580419 DOI: 10.12688/f1000research.11725.1] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/31/2017] [Indexed: 02/03/2023] Open
Abstract
Parkinson's disease dementia (PDD) and dementia with Lewy bodies (DLB) are relentlessly progressive neurodegenerative disorders that are likely to represent two ends of a disease spectrum. It is well established that both are characterised pathologically by widespread cortical Lewy body deposition. However, until recently, the pathophysiological mechanisms leading to neuronal damage were not known. It was also not understood why some cells are particularly vulnerable in PDD/DLB, nor why some individuals show more aggressive and rapid dementia than others. Recent studies using animal and cell models as well as human post-mortem analyses have provided important insights into these questions. Here, we review recent developments in the pathophysiology in PDD/DLB. Specifically, we examine the role of pathological proteins other than α-synuclein, consider particular morphological and physiological features that confer vulnerabilities on some neurons rather than others, and finally examine genetic factors that may explain some of the heterogeneity between individuals with PDD/DLB.
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Affiliation(s)
- Rimona S. Weil
- Dementia Research Centre, UCL Institute of Neurology, London, UK
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Tammaryn L. Lashley
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
- Queen Square Brain Bank for Neurological diseases, UCL Institute of Neurology, London, UK
| | - Jose Bras
- Dementia Research Centre, UCL Institute of Neurology, London, UK
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Anette E. Schrag
- Department of Clinical Neurosciences, UCL Institute of Neurology, London, UK
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Sivasubramanian S, Chandrasekar G, Svensson Akusjärvi S, Thangam R, Sathuvan M, Kumar RBS, Hussein H, Vincent S, Madhan B, Gunasekaran P, Kitambi SS. Phenotypic Screening Identifies Synergistically Acting Natural Product Enhancing the Performance of Biomaterial Based Wound Healing. Front Pharmacol 2017; 8:433. [PMID: 28769790 PMCID: PMC5513901 DOI: 10.3389/fphar.2017.00433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 06/16/2017] [Indexed: 11/13/2022] Open
Abstract
The potential of multifunctional wound heal biomaterial relies on the optimal content of therapeutic constituents as well as the desirable physical, chemical, and biological properties to accelerate the healing process. Formulating biomaterials such as amnion or collagen based scaffolds with natural products offer an affordable strategy to develop dressing material with high efficiency in healing wounds. Using image based phenotyping and quantification, we screened natural product derived bioactive compounds for modulators of types I and III collagen production from human foreskin derived fibroblast cells. The identified hit was then formulated with amnion to develop a biomaterial, and its biophysical properties, in vitro and in vivo effects were characterized. In addition, we performed functional profiling analyses by PCR array to understand the effect of individual components of these materials on various genes such as inflammatory mediators including chemokines and cytokines, growth factors, fibroblast stimulating markers for collagen secretion, matrix metalloproteinases, etc., associated with wound healing. FACS based cell cycle analyses were carried out to evaluate the potential of biomaterials for induction of proliferation of fibroblasts. Western blot analyses was done to examine the effect of biomaterial on collagen synthesis by cells and compared to cells grown in the presence of growth factors. This work demonstrated an uncomplicated way of identifying components that synergistically promote healing. Besides, we demonstrated that modulating local wound environment using biomaterials with bioactive compounds could enhance healing. This study finds that the developed biomaterials offer immense scope for healing wounds by means of their skin regenerative features such as anti-inflammatory, fibroblast stimulation for collagen secretion as well as inhibition of enzymes and markers impeding the healing, hydrodynamic properties complemented with other features including non-toxicity, biocompatibility, and safety.
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Affiliation(s)
| | - Gayathri Chandrasekar
- Department of Microbiology, Tumor and Cell Biology, Karolinska InstitutetSolna, Sweden
| | | | - Ramar Thangam
- Department of Virology, King Institute of Preventive Medicine and ResearchChennai, India.,Council of Scientific and Industrial Research - Central Leather Research InstituteChennai, India
| | - Malairaj Sathuvan
- Department of Virology, King Institute of Preventive Medicine and ResearchChennai, India
| | - R B S Kumar
- Department of Virology, King Institute of Preventive Medicine and ResearchChennai, India
| | - Hawraa Hussein
- Department of Microbiology, Tumor and Cell Biology, Karolinska InstitutetSolna, Sweden
| | - Savariar Vincent
- Center for Environmental Research and Development, Loyola Institute of Frontier Energy, Loyola CollegeChennai, India
| | - Balaraman Madhan
- Council of Scientific and Industrial Research - Central Leather Research InstituteChennai, India
| | - Palani Gunasekaran
- Department of Virology, King Institute of Preventive Medicine and ResearchChennai, India
| | - Satish S Kitambi
- Department of Microbiology, Tumor and Cell Biology, Karolinska InstitutetSolna, Sweden
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Szabo M, Svensson Akusjärvi S, Saxena A, Liu J, Chandrasekar G, Kitambi SS. Cell and small animal models for phenotypic drug discovery. Drug Des Devel Ther 2017; 11:1957-1967. [PMID: 28721015 PMCID: PMC5500539 DOI: 10.2147/dddt.s129447] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The phenotype-based drug discovery (PDD) approach is re-emerging as an alternative platform for drug discovery. This review provides an overview of the various model systems and technical advances in imaging and image analyses that strengthen the PDD platform. In PDD screens, compounds of therapeutic value are identified based on the phenotypic perturbations produced irrespective of target(s) or mechanism of action. In this article, examples of phenotypic changes that can be detected and quantified with relative ease in a cell-based setup are discussed. In addition, a higher order of PDD screening setup using small animal models is also explored. As PDD screens integrate physiology and multiple signaling mechanisms during the screening process, the identified hits have higher biomedical applicability. Taken together, this review highlights the advantages gained by adopting a PDD approach in drug discovery. Such a PDD platform can complement target-based systems that are currently in practice to accelerate drug discovery.
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Affiliation(s)
- Mihaly Szabo
- Department of Microbiology Tumor, and Cell Biology
| | | | - Ankur Saxena
- Department of Microbiology Tumor, and Cell Biology
| | - Jianping Liu
- Department of Biochemistry and Biophysics, Karolinska Institutet, Solna, Sweden
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26
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Leal de Araujo J, Tizard I, Guo J, Heatley JJ, Rodrigues Hoffmann A, Rech RR. Are anti-ganglioside antibodies associated with proventricular dilatation disease in birds? PeerJ 2017; 5:e3144. [PMID: 28413724 PMCID: PMC5390765 DOI: 10.7717/peerj.3144] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 03/04/2017] [Indexed: 11/20/2022] Open
Abstract
The identification of Parrot bornaviruses (PaBV) in psittacine birds with proventricular dilatation disease (PDD) has not been sufficient to explain the pathogenesis of this fatal disease, since not all infected birds develop clinical signs. Although the most accepted theory indicates that PaBV directly triggers an inflammatory response in this disease, another hypothesis suggests the disease is triggered by autoantibodies targeting neuronal gangliosides, and PDD might therefore resemble Guillain-Barré Syndrome (GBS) in its pathogenesis. Experimental inoculation of pure gangliosides and brain-derived ganglioside extracts were used in two different immunization studies. The first study was performed on 17 healthy chickens (Gallus gallus domesticus): 11 chickens were inoculated with a brain ganglioside extract in Freund’s complete adjuvant (FCA) and six chickens inoculated with phosphate-buffered saline. A second study was performed five healthy quaker parrots (Myiopsitta monachus) that were divided into three groups: Two quaker parrots received purified gangliosides in FCA, two received a crude brain extract in FCA, and one control quaker parrot received FCA alone. One chicken developed difficult in walking. Histologically, only a mild perivascular and perineural lymphocytic infiltrate in the proventriculus. Two quaker parrots (one from each treatment group) had mild lymphoplasmacytic encephalitis and myelitis. However, none of the quaker parrots developed myenteric ganglioneuritis, suggesting that autoantibodies against gangliosides in birds are not associated with a condition resembling PDD.
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Affiliation(s)
- Jeann Leal de Araujo
- Department of Veterinary Pathobiology, Texas A&M University, College Station, TX, United States
| | - Ian Tizard
- Department of Veterinary Pathobiology, Texas A&M University, College Station, TX, United States
| | - Jianhua Guo
- Department of Veterinary Pathobiology, Texas A&M University, College Station, TX, United States
| | - J Jill Heatley
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, United States
| | | | - Raquel R Rech
- Department of Veterinary Pathobiology, Texas A&M University, College Station, TX, United States
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Garcia-Esparcia P, Koneti A, Rodríguez-Oroz MC, Gago B, Del Rio JA, Ferrer I. Mitochondrial activity in the frontal cortex area 8 and angular gyrus in Parkinson's disease and Parkinson's disease with dementia. Brain Pathol 2017; 28:43-57. [PMID: 27984680 DOI: 10.1111/bpa.12474] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 12/01/2016] [Indexed: 11/30/2022] Open
Abstract
Altered mitochondrial function is characteristic in the substantia nigra in Parkinson's disease (PD). Information about mitochondria in other brain regions such as the cerebral cortex is conflicting mainly because most studies have not contemplated the possibility of variable involvement depending on the region, stage of disease progression and clinical symptoms such as the presence or absence of dementia. RT-qPCR of 18 nuclear mRNAs encoding subunits of mitochondrial complexes and 12 mRNAs encoding energy metabolism-related enzymes; western blotting of mitochondrial proteins; and analysis of enzymatic activities of complexes I, II, II, IV and V of the respiratory chain were assessed in frontal cortex area 8 and the angular gyrus of middle-aged individuals (MA), and those with incidental PD (iPD), long-lasting PD with parkinsonism without dementia (PD) and long-lasting PD with dementia (PDD). Up-regulation of several genes was found in frontal cortex area 8 in PD when compared with MA and in the angular gyrus in iPD when compared with MA. Marked down-regulation of genes encoding mitochondrial subunits and energy metabolism-related enzymes occurs in frontal cortex but only of genes coding for energy metabolism-related enzymes in the angular gyrus in PDD. Significant decrease in the protein expression levels of several mitochondrial subunits encoded by these genes occurs in frontal cortex area 8 and angular gyrus in PDD. Moreover, expression of MT-ND1 which is encoded by mitochondrial DNA is also reduced in PDD. Reduced enzymatic activity of complex III in frontal cortex area 8 and angular gyrus is observed in PD, but dramatic reduction in the activity of complexes I, II, II and IV in both regions characterizes PDD. Dementia in the context of PD is linked to region-specific deregulation of genomic genes encoding subunits of mitochondrial complexes and to marked reduction in the activity of mitochondrial complexes I, II, III and IV.
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Affiliation(s)
- Paula Garcia-Esparcia
- Institute of Neuropathology, Bellvitge University Hospital, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de LLobregat, Catalonia, Spain
| | - Anusha Koneti
- Institute of Neuropathology, Bellvitge University Hospital, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de LLobregat, Catalonia, Spain
| | - M Cruz Rodríguez-Oroz
- University Hospital Donostia, San Sebastián, Spain.,Ikerbasque (Basque Foundation for Science), Bilbao, Spain.,Biodonostia Research Institute, San Sebastián, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Belen Gago
- Biodonostia Research Institute, San Sebastián, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - José Antonio Del Rio
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Molecular and Cellular Neurobiotechnology, Institute of Bioengineering of Catalonia (IBEC), Parc Científic de Barcelona, Department of Cell Biology, University of Barcelona, Barcelona, Spain.,Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Isidro Ferrer
- Institute of Neuropathology, Bellvitge University Hospital, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de LLobregat, Catalonia, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Institute of Neurosciences, University of Barcelona, Barcelona, Spain.,Department of Pathology and Experimental Therapeutics, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain
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Horváth L, Fekete K, Márton S, Fekete I. Correlation between prescribed daily dose, seizure freedom and defined daily dose in antiepileptic drug treatment. Int J Clin Pharm 2017; 39:459-467. [PMID: 28255953 DOI: 10.1007/s11096-017-0447-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 02/23/2017] [Indexed: 11/28/2022]
Abstract
Background Although defined daily doses (DDD) for antiepileptic drugs (AED) have been assigned only in combination therapy, based on the literature, most patients take them in monotherapy. Furthermore, discrepancies between DDD and prescribed daily dose (PDD) were observed. Objective First, to determine PDDs of AEDs and to reveal PDD/DDD ratio among seizure free versus not seizure free patients in everyday clinical practice. Second, to test the applicability of 75% cut-off of DDD to achieve seizure freedom. Furthermore, to find out what factors might influence PDD. Setting Outpatient data files at a Hungarian university hospital were studied. Methods A retrospective, 20-year cross-sectional database was compiled from 1282 epileptic outpatients' files. Main outcome measure Seizure freedom and PDD were used as outcome measures. Results The mean DDD% of all prescribed AEDs increased steadily from monotherapy, through bitherapy towards polytherapy (p < 0.0001). Most seizure free patients took AEDs in doses in the range of ≤75% of DDDs in monotherapy and bitherapy. Older AEDs (carbamazepine and valproate) were given in a significantly higher mean dose in bitherapy in the seizure free group. Among the newer types, only levetiracetam and lamotrigine had a significantly higher DDD% in mono-, bi-, and polytherapy. Confirmed by logistic regression analysis, gender, age, type of epilepsy, and number of AEDs had a significant impact on the value of 75% DDD. Conclusion No significant unfavourable impact of the lower ratio of PDD/DDD on the outcome of achieving seizure freedom has been confirmed. As a measure of seizure freedom, 75% of DDD may be used, although individual therapy must be emphasised. Precisely quantified DDD would provide a more accurate calculation of other derived values.
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Affiliation(s)
- László Horváth
- Department of Pharmaceutical Surveillance and Economy, Faculty of Pharmacy, University of Debrecen, Nagyerdei krt. 98., Debrecen, 4032, Hungary.
| | - Klára Fekete
- Department of Neurology, Faculty of Medicine, University of Debrecen, Móricz Zs. krt. 22., Debrecen, Hungary
| | - Sándor Márton
- Institute of Political Science and Sociology, Faculty of Arts, University of Debrecen, Egyetem tér 1., Debrecen, Hungary
| | - István Fekete
- Department of Neurology, Faculty of Medicine, University of Debrecen, Móricz Zs. krt. 22., Debrecen, Hungary
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Lindqvist D, Prokopenko I, Londos E, Middleton L, Hansson O. Associations between TOMM40 Poly-T Repeat Variants and Dementia in Cases with Parkinsonism. J Parkinsons Dis 2017; 6:99-108. [PMID: 26756745 DOI: 10.3233/jpd-150693] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Mitochondrial dysfunction has been implicated in the pathophysiology of Parkinson's disease (PD)-related pathologies. OBJECTIVE To investigate the role of the Translocase of the Outer Mitochondrial Membrane 40 homolog (TOMM40) variants in PD without dementia (PDND), PD with dementia (PDD) and in Dementia with Lewy bodies (DLB). METHODS 248 individuals, including 92 PDND, 55 PDD, and 101 DLB, were included. The rs10524523 locus in the TOMM40 gene (TOMM40 poly-T repeat) is characterized by a variable number of T residues that were classified into three groups based on length; short (S), long (L), and very long (VL). We tested log-additive genetic model of association with dementia and adjusted for age, sex, and APOEɛ4 carrier status. We analyzed cerebrospinal fluid (CSF) levels of Aβ42 and Tau, biomarkers related to Alzheimer's disease (AD). RESULTS PDD/DBL status and abnormal CSF AD biomarkers (Aβ42 and Aβ42/Tau ratio) were both associated with the APOEɛ4 allele (p < 0.014) and the L allele of TOMM40 poly-T repeat (p < 0.008). The VL allele was less frequently observed in the PDD/DLB group (p = 0.013). In APOE-ɛ4 adjusted analyses, the relationships between the L and VL alleles and dementia status as well as CSF AD biomarkers were not significant. When adjusting for APOE-ɛ4, however, there were associations between S carrier status and PDD/DLB (p = 0.019) and abnormal CSF levels of Aβ42/Tau ratio (p = 0.037) although these were not significant after adjustment for multiple comparisons. CONCLUSION Our results do not support the notion that TOMM40 poly-T repeat variants have independent effects on PDD and DLB pathology. This relationship seems to be driven by APOE-ɛ4.
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Affiliation(s)
- Daniel Lindqvist
- Division of Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden.,Psychiatry Skåne, Lund, Sweden
| | - Inga Prokopenko
- Neuroepidemiology and Ageing Research, School of Public Health, Imperial College London, UK
| | - Elisabet Londos
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Memory Clinic, Skåne University Hospital, Lund, Sweden
| | - Lefkos Middleton
- Neuroepidemiology and Ageing Research, School of Public Health, Imperial College London, UK
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Memory Clinic, Skåne University Hospital, Lund, Sweden
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Morgante F, Barbui C, Tinazzi M; Italian DIP study group. Parkinsonian axial signs in schizophrenia. Parkinsonism Relat Disord 2017; 36:89-92. [PMID: 28038867 DOI: 10.1016/j.parkreldis.2016.12.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 12/15/2016] [Accepted: 12/21/2016] [Indexed: 11/23/2022]
Abstract
INTRODUCTION We have recently demonstrated evidence of nigro-striatal denervation, disease progression and response to levodopa in a subgroup of patients with schizophrenia who developed parkinsonism. OBJECTIVE In the present study, we investigated whether axial parkinsonian signs might be an early manifestation of parkinsonism in schizophrenia not necessarily related to chronic administration of antipsychotic drugs (AP) drugs. METHODS From a baseline cohort of 299 schizophrenic patients who did not satisfy the diagnostic criteria for parkinsonism (presence of at least two of the following appendicular signs: bradykinesia, tremor, rigidity), we identified a group of patients who manifested two out of three axial parkinsonian signs (abnormality of trunk posture, hypomimia and short-step gait). Accordingly, we obtained two sub-groups of patients with schizophrenia, with (Schiz-Axial, N = 26), and without parkinsonian axial signs (Schiz-NO-Axial, N = 273). Clinical and demographical variables were compared between groups. The motor section of the Unified Parkinson's disease rating scale (UPDRS) was employed to measure motor disability. RESULTS Schiz-Axial patients were significantly older (p = 0.007) and had longer disease duration (p = 0.04) compared to Schiz-NO-Axial. The two groups did not differ for variables related to AP treatment. Total UPDRS motor score (p < 0.0001) as well as limb (p < 0.0001) and axial (p < 0.0001) UPDRS sub-scores were increased in Schiz-Axial patients compared to Schiz-NO-Axial. CONCLUSIONS Our findings provide evidence that axial parkinsonian signs might be an early manifestation of parkinsonism in schizophrenia associated to older age and longer disease duration.
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Hillemanns P, Wimberger P, Reif J, Stepp H, Klapdor R. Photodynamic diagnosis with 5-aminolevulinic acid for intraoperative detection of peritoneal metastases of ovarian cancer: A feasibility and dose finding study. Lasers Surg Med 2016; 49:169-176. [PMID: 27859395 DOI: 10.1002/lsm.22613] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2016] [Indexed: 01/26/2023]
Abstract
OBJECTIVE With a prospective feasibility study, we aimed to analyse the effect of different time points for application and dosage of preoperative oral 5-aminolevulinic acid administration for photodynamic diagnosis of peritoneal metastases in ovarian cancer patients. MATERIALS AND METHODS In this prospective cohort study patients were randomly divided into three different groups. 5-Aminolevulinic acid was orally administered 3-14 hours before surgery using a dosage of 1 mg/kg, 4-9 hours using 10 mg/kg, and 9-16 hours using 10 mg/kg, respectively. Fluorescence was recorded intraoperatively using endoscopic equipment. The number and localization, of fluorescing nodules were documented. To analyze sensitivity and specificity samples from fluorescent and non-fluorescent tissues were evaluated histologically. Plasma protoporphyrin concentrations as well as any adverse events were assessed perioperatively. RESULTS In total, 26 patients suspected for ovarian cancer underwent intraoperative photodynamic diagnosis with 5-aminolevulinic acid. Most of them suffered from advanced cancer, 72% from FIGO-Stage IIIc. No severe adverse events were observed. Orally applied 5-aminolevulinic acid with a dosage of 1 mg/kg revealed no detectable fluorescence. However, at a dosage of 10 mg/kg fluorescence of metastatic tissue was significantly stronger than of non-affected tissue. If administered 4-9 hours preoperatively best detection rates for peritoneal metastases were obtained resulting in a sensitivity of 75% and a specificity of 100%. CONCLUSIONS Photodynamic diagnosis with 5-aminolevulinic acid leads to safe and specific fluorescence detection of peritoneal metastases. 5-Aminolevulinic acid should be used at a dosage of at least 10 mg/kg 4-9 hours preoperatively. Further phase I-II studies are recommended. Lasers Surg. Med. 49:169-176, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Peter Hillemanns
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-University Hospital, Munich, Germany.,Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany
| | - Pauline Wimberger
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-University Hospital, Munich, Germany.,Department of Gynecology and Obstetrics, Technische Universität Dresden, Dresden, Germany
| | - Jessica Reif
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-University Hospital, Munich, Germany.,Department of Obstetrics and Gynecology, Klinikum Starnberg, Starnberg, Germany
| | - Herbert Stepp
- LIFE-Center, Hospital of the University of Munich, Munich, Germany
| | - Rüdiger Klapdor
- Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany
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Sassa Y, Bui VN, Saitoh K, Watanabe Y, Koyama S, Endoh D, Horie M, Tomonaga K, Furuya T, Nagai M, Omatsu T, Imai K, Ogawa H, Mizutani T. Parrot bornavirus-2 and -4 RNA detected in wild bird samples in Japan are phylogenetically adjacent to those found in pet birds in Japan. Virus Genes 2015; 51:234-43. [PMID: 26315330 DOI: 10.1007/s11262-015-1240-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 08/19/2015] [Indexed: 10/23/2022]
Abstract
Bornaviruses (family Bornaviridae) are non-segmented negative-strand RNA viruses. Avian bornaviruses (ABVs), which are causative agents of proventricular dilatation disease, are a genetically diverse group with at least 15 genotypes, including parrot bornaviruses (PaBVs) and aquatic bird bornavirus 1(ABBV-1). Borna disease virus 1(BoDV-1), which infects mammals and causes neurological diseases, has also been reported to infect avian species, although the numbers of the cases have been markedly fewer than those of ABVs. In this study, we conducted genetic surveillance to detect ABVs (PaBV-1 to -5 and ABBV-1) and BoDV-1 in wild birds in Japan. A total of 2078 fecal or cloacal swab samples were collected from wild birds in 2006, 2007, 2008, and 2011, in two regions of Japan. The results demonstrated the presence of PaBV-2 and -4 RNA, while no positive results for other PaBVs, ABBV-1, and BoDV-1 were obtained. PaBV-2 and -4 RNA were detected in 18 samples (0.9 %) of the genera Anas, Grus, Larus, Calidris, Haliaeetus, and Emberiza, in which either PaBV-2 RNA or PaBV-4 RNA, or both PaBV-2 and -4 RNA were detected in 15 (0.7 %), 5 (0.2 %), and 2 (0.1 %) samples, respectively. The nucleotide sequences of PaBV-2 and -4 detected in these samples from wild birds are phylogenetically close to those found in samples from pet birds in Japan, with identities ranging from 99.8 to 100 % and from 98.2 to 99.4 %, respectively. To the best of our knowledge, this is the first report on the detection of PaBV-2 and -4 RNA detected in samples from wild birds.
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Petrou M, Dwamena BA, Foerster BR, MacEachern MP, Bohnen NI, Müller ML, Albin RL, Frey KA. Amyloid deposition in Parkinson's disease and cognitive impairment: a systematic review. Mov Disord 2015; 30:928-35. [PMID: 25879534 DOI: 10.1002/mds.26191] [Citation(s) in RCA: 138] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 01/22/2015] [Accepted: 01/26/2015] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Varying degrees of cortical amyloid deposition are reported in the setting of Parkinsonism with cognitive impairment. We performed a systematic review to estimate the prevalence of Alzheimer disease (AD) range cortical amyloid deposition among patients with Parkinson's disease with dementia (PDD), Parkinson's disease with mild cognitive impairment (PD-MCI) and dementia with Lewy bodies (DLB). We included amyloid positron emission tomography (PET) imaging studies using Pittsburgh Compound B (PiB). METHODS We searched the databases Ovid MEDLINE, PubMed, Embase, Scopus, and Web of Science for articles pertaining to amyloid imaging in Parkinsonism and impaired cognition. We identified 11 articles using PiB imaging to quantify cortical amyloid. We used the metan module in Stata, version 11.0, to calculate point prevalence estimates of patients with "PiB-positive" studies, that is, patients showing AD range cortical Aβ-amyloid deposition. Heterogeneity was assessed. A scatterplot was used to assess publication bias. RESULTS Overall pooled prevalence of "PiB-positive" studies across all three entities along the spectrum of Parkinson's disease and impaired cognition (specifically PDD, PD-MCI, and DLB) was 0.41 (95% confidence interval [CI], 0.24-0.57). Prevalence of "PiB-positive" studies was 0.68 (95% CI, 0.55-0.82) in the DLB group, 0.34 (95% CI, 0.13-0.56) in the PDD group, and 0.05 (95% CI, -0.07-0.17) in the PD-MCI group. CONCLUSIONS Substantial variability occurs in the prevalence of "PiB-positive" studies in subjects with Parkinsonism and cognitive impairment. Higher prevalence of PiB-positive studies was encountered among subjects with DLB as opposed to subjects with PDD. The PD-MCI subjects showed overall lower prevalence of PiB-positive studies than reported findings in non-PD-related MCI. © 2015 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Myria Petrou
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.,Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ben A Dwamena
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.,Veterans Administration Healthcare System, Ann Arbor, Michigan, USA
| | - Bradley R Foerster
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.,Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Veterans Administration Healthcare System, Ann Arbor, Michigan, USA
| | - Mark P MacEachern
- Taubman Health Sciences Library, University of Michigan, Ann Arbor, Michigan, USA
| | - Nicolaas I Bohnen
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.,Veterans Administration Healthcare System, Ann Arbor, Michigan, USA.,Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA.,Univerity of Michigan Morris K. Udall Center for Excellence in Parkinson's Disease Research, Ann Arbor, Michigan, USA
| | - Martijn Ltm Müller
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Roger L Albin
- Veterans Administration Healthcare System, Ann Arbor, Michigan, USA.,Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA.,Univerity of Michigan Morris K. Udall Center for Excellence in Parkinson's Disease Research, Ann Arbor, Michigan, USA
| | - Kirk A Frey
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.,Taubman Health Sciences Library, University of Michigan, Ann Arbor, Michigan, USA
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Archer SK, Shirokikh NE, Preiss T. Probe-Directed Degradation ( PDD) for Flexible Removal of Unwanted cDNA Sequences from RNA-Seq Libraries. ACTA ACUST UNITED AC 2015; 85:11.15.1-11.15.36. [PMID: 25827346 DOI: 10.1002/0471142905.hg1115s85] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Most applications for RNA-seq require the depletion of abundant transcripts to gain greater coverage of the underlying transcriptome. The sequences to be targeted for depletion depend on application and species and in many cases may not be supported by commercial depletion kits. This unit describes a method for generating RNA-seq libraries that incorporates probe-directed degradation (PDD), which can deplete any unwanted sequence set, with the low-bias split-adapter method of library generation (although many other library generation methods are in principle compatible). The overall strategy is suitable for applications requiring customized sequence depletion or where faithful representation of fragment ends and lack of sequence bias is paramount. We provide guidelines to rapidly design specific probes against the target sequence, and a detailed protocol for library generation using the split-adapter method including several strategies for streamlining the technique and reducing adapter dimer content.
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Affiliation(s)
- Stuart K Archer
- Genome Biology Department, The John Curtin School of Medical Research (JCSMR), The Australian National University, Acton, Canberra, Australian Capital Territory, Australia.,Present address: Monash Bioinformatics Platform, Monash University, Clayton, Victoria, Australia.,These authors contributed equally to this work
| | - Nikolay E Shirokikh
- Genome Biology Department, The John Curtin School of Medical Research (JCSMR), The Australian National University, Acton, Canberra, Australian Capital Territory, Australia.,Present address: Moscow Regional State Institute of Humanities and Social Studies, Ministry of Education of Moscow Region, Kolomna, Moscow Region, Russia.,These authors contributed equally to this work
| | - Thomas Preiss
- Genome Biology Department, The John Curtin School of Medical Research (JCSMR), The Australian National University, Acton, Canberra, Australian Capital Territory, Australia.,Victor Chang Cardiac Research Institute, Darlinghurst (Sydney), New South Wales, Australia
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Karrasch M, Laatu S, Ellfolk U, Marttila R, Martikainen K. Education-corrected CERAD identifies MCI and dementia in Parkinson's disease. Acta Neurol Scand 2015; 131:219-24. [PMID: 25273524 DOI: 10.1111/ane.12310] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study examined whether controlling for educational background in the CERAD cognitive screening battery would affect the likelihood of patients with Parkinson's disease to fulfill criteria for mild cognitive impairment (PD-MCI) and dementia (PDD). MATERIALS & METHODS One-hundred seventeen patients with PD were studied. Cognitive impairment was determined as two subtest scores falling below either the standard cutoff scores or education-corrected cutoff scores. The presence of dementia was determined by clinical interview or Clinical Dementia Rating. Patients were then classified as PD-MCI and PDD according to cognitive test performance and presence/absence of dementia. RESULTS The number of cognitively impaired patients (PD-MCI or PDD) was significantly higher when education-controlled cutoff scores were used (62.5% vs 38%). Correspondingly, the number of false negatives (demented PD patients performing normally in CERAD) was significantly lower when education-corrected cutoff scores were used (4% vs 10%). CONCLUSIONS Controlling for education increases the sensitivity of the CERAD for PD-MCI and PDD.
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Affiliation(s)
- M. Karrasch
- Department of Psychology and Logopedics; Abo Akademi University; Turku Finland
| | - S. Laatu
- Outpatient Ward of Neuropsychiatry; Turku University Hospital; Turku Finland
| | - U. Ellfolk
- Department of Psychology and Logopedics; Abo Akademi University; Turku Finland
| | - R. Marttila
- Division of Clinical Neurosciences; Turku University Hospital; Turku Finland
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Abstract
Parkinson's disease dementia (PDD) has become an increasing area of research as treatments for the motor features of Parkinson's disease (PD) have improved and the population of patients with PD grows and ages. If predictors could be used to identify a sub-population of patients at risk of developing an early PDD then research into its neuropathological basis and treatment could be more effectively targeted to specific individuals. At present the predictors with the most evidence have arisen from longitudinal studies tracking the development of dementia in populations of incident, newly diagnosed patients with PD. Evidence exists for predictors across multiple domains: clinical, biological, neuroimaging and genetic. Some of the most robust of these suggest that PDD may develop as the result of an age and tau dependent, posterior cortically based process driven in some cases by mutations in the gene for glucocerebrosidase (GBA). It is clear, though, that more research needs to be undertaken into finding reliable predictors of PDD. At present the best approach may be to combine a set of predictors already identified in order to provide a basis for understanding why and how it occurs. Through this, new therapeutic strategies may emerge.
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Affiliation(s)
- Sarah F Moore
- John Van Geest Centre for Brain Repair, University of Cambridge, Cambridge, CB2 0PY, UK.
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Thakkar KB, Jain MM, Billa G, Joshi A, Khobragade AA. A drug utilization study of psychotropic drugs prescribed in the psychiatry outpatient department of a tertiary care hospital. J Clin Diagn Res 2014; 7:2759-64. [PMID: 24551631 DOI: 10.7860/jcdr/2013/6760.3885] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 08/18/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Psychiatric disorders are one of the major causes of morbidity. Development of newer drugs like SSRIs and atypical antipsychotics has altered the treatment paradigms. Various factors like cost of drugs, local paradigms, etc. play a role in the selection of drug therapy and hence, affect the outcome. Keeping this in mind, we conducted a study to delineate the various drugs used in psychiatric disorders, to find discrepancies, if any, between the actual and the ideal prescribing pattern of psychotropic drugs and to conduct a cost analysis. MATERIAL AND METHODS After our institutional ethics committee approved, a retrospective cross sectional drug utilization study of 600 prescriptions was undertaken. Preparation of the protocol and conduct of the study was as per the WHO - DUS and the STROBE guidelines. RESULTS Drug use indicators - In 600 prescriptions, 1074 (88.25%) were psychotropic drugs. The utilization from the National and WHO EML was 100% and 90%, respectively. Average number of psychotropic drugs per prescription was 1.79 ± 1.02 (SD). 22.5% of the prescriptions contained psychotropic FDCs. 76.01% of drugs were prescribed by generic name. Percentage of psychotropic drugs prescribed from the hospital drug schedule and psychotropic drugs actually dispensed from the hospital drug store were 73.1% and 62.3%, respectively. Drug utilization pattern in different psychiatric disorders - Most commonly prescribed drugs for schizophrenia, bipolar disorders, depression and anxiety disorders were trifluoperazine + trihexiphenydyl (63.9%), carbamazepine (17.2%), amitriptyline (34.9%), and diazepam (23.8%), respectively. The least commonly prescribed drugs were levosulpiride (1.7%), lithium (1.3%), bupropion (4.7%) and clozapine (1.9%), respectively. The PDD/DDD ratio of three drugs - haloperidol, pimozide and amitriptyline - was equal to one. The cost borne by the hospital was 116, i.e., 65.2% of the total cost. The cost index of clozapine was 11.2. CONCLUSION Overall, the principles of rational prescribing were followed. The hospital drug schedule should include more SSRIs. The practice of using 1(st) generation/ typical anti-psychotics as the first line was as per current recommendations. Anti-cholinergics should be used only in selected cases of patients on anti-psychotics. The use of diazepam should be curtailed and it should be used for short term only.
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Affiliation(s)
- Karan B Thakkar
- Resident Doctor, Department of Pharmacology, Grant Medical College & Sir JJ Group of Hospitals , Mumbai, India
| | - Mangal M Jain
- Associate Professor, Department of Pharmacology, Grant Medical College & Sir JJ Group of Hospitals , Mumbai, India
| | - Gauri Billa
- Resident Doctor, Department of Pharmacology, Seth GS Medical College & KEM hospital , Mumbai, India
| | - Abhijit Joshi
- Assistant Professor, Department of Pharmacology, Grant Medical College & Sir JJ Group of Hospitals , Mumbai, India
| | - Akash A Khobragade
- Assistant Professor, Department of Pharmacology, Grant Medical College & Sir JJ Group of Hospitals , Mumbai, India
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Polo-Kantola P, Lampi KM, Hinkka-Yli-Salomäki S, Gissler M, Brown AS, Sourander A. Obstetric risk factors and autism spectrum disorders in Finland. J Pediatr 2014; 164:358-65. [PMID: 24183209 DOI: 10.1016/j.jpeds.2013.09.044] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 09/03/2013] [Accepted: 09/19/2013] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To examine the relationship between obstetric risk factors and childhood autism, Asperger syndrome, and other pervasive developmental disorders (PDDs). STUDY DESIGN Registry-based case-control study from all singleton births in Finland from 1990-2005. Cases with childhood autism, Asperger syndrome, or PDD (n = 4713) were identified from the Finnish Hospital Discharge Register. Each case was matched to 4 controls on sex, date of birth, and place of birth. Information on obstetric risk factors was from the Finnish Medical Birth Register. Conditional logistic regression models were used for statistical analyses. RESULTS When adjusted with confounders, childhood autism was associated with maternal high blood pressure (OR 1.49, 95% CI 1.1-2.1, P = .018), Apgar scores less than 7 (1 minute, OR 1.46, 95% CI 1.1-2.0, P = .021), and neonatal treatment with monitoring (OR 1.40, 95% CI 1.02-1.9, P = .038). PDD was associated with induced labor (OR 1.25 95% CI 1.1-1.5, P = .007), planned cesarean delivery (OR 1.34, 95% CI 1.1-1.7, P = .009), 1-minute Apgar scores 7-8 ( OR 1.22, 95% CI 1.1-1.4, P = .008) and less than 7 (OR 1.34, 95% CI 1.03-1.8, P = .032), and neonatal intensive care unit treatment (OR 1.52, 95% CI 1.2-2.0, P = .003). Asperger syndrome was associated only with 1-minute Apgar scores 7-8 (OR 1.19, 95% CI 1.03-1.4, P = .018). CONCLUSIONS Low Apgar scores as well as conditions requiring neonatal special follow-up are important risk factors for childhood autism and PDD. These findings suggest that fetal distress is a potential risk factor for these disorders, but not for Asperger syndrome.
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Affiliation(s)
- Päivi Polo-Kantola
- Department of Obstetrics and Gynecology, University of Turku, Turku, Finland; Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland
| | - Katja M Lampi
- Department of Child Psychiatry, University of Turku, Turku, Finland
| | | | - Mika Gissler
- National Institute of Health and Welfare (THL), Helsinki, Finland; Nordic School of Public Health, Gothenburg, Sweden
| | - Alan S Brown
- Department of Psychiatry, New York State Psychiatric Institute, College of Physicians and Surgeons of Columbia University, New York, NY; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Andre Sourander
- Department of Child Psychiatry, University of Turku, Turku, Finland; Department of Child Psychiatry, Turku University Hospital, Turku, Finland.
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Maxwell BG, Lobato RL, Cason MB, Wong JK. Perioperative morbidity and mortality of cardiothoracic surgery in patients with a do-not-resuscitate order. PeerJ 2014; 2:e245. [PMID: 24498575 PMCID: PMC3912447 DOI: 10.7717/peerj.245] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 12/21/2013] [Indexed: 12/21/2022] Open
Abstract
Background. Do-not-resuscitate (DNR) orders are often active in patients with multiple comorbidities and a short natural life expectancy, but limited information exists as to how often these patients undergo high-risk operations and of the perioperative outcomes in this population. Methods. Using comprehensive inpatient administrative data from the Public Discharge Data file (years 2005 through 2010) of the California Office of Statewide Health Planning and Development, which includes a dedicated variable recording DNR status, we identified cohorts of DNR patients who underwent major cardiac or thoracic operations and compared themto age- and procedure-matched comparison cohorts. The primary study outcome was in-hospital mortality. Results. DNR status was not uncommon in cardiac (n = 2,678, 1.1% of all admissions for cardiac surgery, age 71.6 ± 15.9 years) and thoracic (n = 3,129, 3.7% of all admissions for thoracic surgery, age 73.8 ± 13.6 years) surgical patient populations. Relative to controls, patients who were DNR experienced significantly greater inhospital mortality after cardiac (37.5% vs. 11.2%, p < 0.0001 and thoracic (25.4% vs. 6.4%) operations. DNR status remained an independent predictor of in-hospital mortality onmultivariate analysis after adjustment for baseline and comorbid conditions in both the cardiac (OR 4.78, 95% confidence interval 4.21–5.41, p < 0.0001) and thoracic (OR 6.11, 95% confidence interval 5.37–6.94, p < 0.0001) cohorts. Conclusions. DNR status is associated with worse outcomes of cardiothoracic surgery even when controlling for age, race, insurance status, and serious comorbid disease. DNR status appears to be a marker of substantial perioperative risk, and may warrant substantial consideration when framing discussions of surgical risk and benefit, resource utilization, and biomedical ethics surrounding end-of-life care.
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Affiliation(s)
- Bryan G Maxwell
- Department of Anesthesiology and Critical Care Medicine , Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - Robert L Lobato
- Department of Anesthesia , Cedars-Sinai Medical Center , Los Angeles, CA , USA
| | - Molly B Cason
- Department of Anesthesiology and Critical Care Medicine , Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - Jim K Wong
- Department of Anesthesia , Stanford University School of Medicine , Stanford, CA , USA
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Abstract
Pre-clinical diastolic dysfunction (PDD) has been broadly defined as left ventricular diastolic dysfunction without the diagnosis of congestive heart failure (HF) and with normal systolic function. PDD is an entity that remains poorly understood, yet has definite clinical significance. Although few original studies have focused on PDD, it has been shown that PDD is prevalent, and that there is a clear progression from PDD to symptomatic HF including dyspnea, edema, and fatigue. In diabetic patients and in patients with coronary artery disease or hypertension, it has been shown that patients with PDD have a significantly higher risk of progression to heart failure and death compared with patients without PDD. Because of these findings and the increasing prevalence of the heart failure epidemic, it is clear that an understanding of PDD is essential to decreasing patients' morbidity and mortality. This review will focus on what is known concerning pre-clinical diastolic dysfunction, including definitions, staging, epidemiology, pathophysiology, and the natural history of the disease. In addition, given the paucity of trials focused on PDD treatment, studies targeting risk factors associated with the development of PDD and therapeutic trials for heart failure with preserved ejection fraction will be reviewed.
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Affiliation(s)
- Siu-Hin Wan
- Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, Minnesota
| | - Mark W Vogel
- Division of Cardiovascular Diseases, Washington University, St. Louis, Missouri
| | - Horng H Chen
- Division of Cardiovascular Diseases, Mayo Clinic and Foundation, Rochester, Minnesota.
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Knol RJ, de Bruin K, Opmeer B, Voorn P, Jonker AJ, van Eck-Smit BL, Booij J. Decreased ipsilateral [¹²³I]iododexetimide binding to cortical muscarinic receptors in unilaterally 6-hydroxydopamine lesioned rats. Nucl Med Biol 2014; 41:90-5. [PMID: 24267055 DOI: 10.1016/j.nucmedbio.2013.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 08/22/2013] [Accepted: 10/03/2013] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Dysfunction of the cholinergic neurotransmitter system is present in Parkinson's disease, Parkinson's disease related dementia and dementia with Lewy bodies, and is thought to contribute to cognitive deficits in these patients. In vivo imaging of the cholinergic system in these diseases may be of value to monitor central cholinergic disturbances and to select cases in which treatment with cholinesterase inhibitors could be beneficial. The muscarinic receptor tracer [(123)I]iododexetimide, predominantly reflecting M1 receptor binding, may be an appropriate tool for imaging of the cholinergic system by means of SPECT. In this study, we used [(123)I]iododexetimide to study the effects of a 6-hydroxydopamine lesion (an animal model of Parkinson's disease) on the muscarinic receptor availability in the rat brain. METHODS Rats (n=5) were injected in vivo at 10-13 days after a confirmed unilateral 6-hydroxydopamine lesion. Muscarinic receptor availability was measured bilaterally in multiple brain areas on storage phosphor images by region of interest analysis. RESULTS Autoradiography revealed a consistent and statistically significant lower [(123)I]iododexetimide binding in all examined neocortical areas on the ipsilateral side of the lesion as compared to the contralateral side. In hippocampal and subcortical areas, such asymmetry was not detected. CONCLUSIONS This study suggests that evaluation of muscarinic receptor availability in dopamine depleted brains using [(123)I]iododexetimide is feasible. We conclude that 6-hydroxydopamine lesions induce a decrease of neocortical muscarinic receptor availability. We hypothesize that this arises from down regulation of muscarinic postsynaptic M1 receptors due to hyperactivation of the cortical cholinergic system in response to dopamine depletion. ADVANCES IN KNOWLEDGE In rats, dopamine depletion provokes a decrease in neocortical muscarinic receptor availability, which is evaluable by [(123)I]iododexetimide imaging. IMPLICATIONS FOR PATIENT CARE This study may further underline the role of a dysregulated muscarinic system in patients with Lewy body disorders.
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Huang H, Peng G, Lin M, Zhang K, Wang Y, Yang Y, Zuo Z, Chen R, Wang J. The diagnostic threshold of HbA1c and impact of its use on diabetes prevalence-a population-based survey of 6898 Han participants from southern China. Prev Med 2013; 57:345-50. [PMID: 23777673 DOI: 10.1016/j.ypmed.2013.06.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Revised: 06/01/2013] [Accepted: 06/09/2013] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The objective of this study is to determine the diagnostic threshold of HbA1c for diabetes and the impact of using it on diabetes prevalence. METHODS A population-based stratified study was conducted in 2010 among community-dwelling adults aged ≥35years in southern China. Participants without previously-diagnosed diabetes (PDD) took oral glucose tolerance test (OGTT) and HbA1c assay. HbA1c diagnostic threshold was determined by receiver operating characteristic curve. RESULTS A total of 6989 participants with mean age of 52years were recruited. The area under curve of HbA1c was 0.903 (95% CI: 0.883-0.922), with optimal cut-off value at 6.25% (sensitivity 75.6% and specificity 91.9%). There were 449 (6.42%) patients with PDD and 422 (6.04%), 815 (11.66%) and 918 (13.13%) new cases diagnosed by OGTT, HbA1c ≥6.25% or either, respectively. When either HbA1c or OGTT was used, newly-diagnosed diabetes prevalence increased by 117.4%. CONCLUSIONS Diabetes is prevalent in southern China. Near half of the patients go undetected with current diagnostic criteria. HbA1c ≥6.25% may be the diagnostic threshold value but needs further verification. The introduction of HbA1c threshold into diabetes diagnosis in China will cause a substantial increase in diabetes prevalence and great challenge on the public healthcare system.
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Affiliation(s)
- Hui Huang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510120, China; Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou 510120, China
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Abstract
Innovation and new molecular entity production by the pharmaceutical industry has been below expectations. Surprisingly, more first-in-class small-molecule drugs approved by the U.S. Food and Drug Administration (FDA) between 1999 and 2008 were identified by functional phenotypic lead generation strategies reminiscent of pre-genomics pharmacology than contemporary molecular targeted strategies that encompass the vast majority of lead generation efforts. This observation, in conjunction with the difficulty in validating molecular targets for drug discovery, has diminished the impact of the "genomics revolution" and has led to a growing grassroots movement and now broader trend in pharma to reconsider the use of modern physiology-based or phenotypic drug discovery (PDD) strategies. This "From the Guest Editors" column provides an introduction and overview of the two-part special issues of Journal of Biomolecular Screening on PDD. Terminology and the business case for use of PDD are defined. Key issues such as assay performance, chemical optimization, target identification, and challenges to the organization and implementation of PDD are discussed. Possible solutions for these challenges and a new neoclassic vision for PDD that combines phenotypic and functional approaches with technology innovations resulting from the genomics-driven era of target-based drug discovery (TDD) are also described. Finally, an overview of the manuscripts in this special edition is provided.
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Affiliation(s)
- Jonathan A Lee
- 1Quantitative and Structural Biology, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA
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Bus MTJ, Muller BG, de Bruin DM, Faber DJ, Kamphuis GM, van Leeuwen TG, de Reijke TM, de la Rosette JJMCH. Volumetric in vivo visualization of upper urinary tract tumors using optical coherence tomography: a pilot study. J Urol 2013; 190:2236-42. [PMID: 23954585 DOI: 10.1016/j.juro.2013.08.006] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2013] [Indexed: 11/30/2022]
Abstract
PURPOSE Knowledge of tumor stage and grade is paramount for treatment decision making in cases of upper urinary tract urothelial carcinoma but this condition cannot be accurately assessed by current techniques. Optical coherence tomography can hypothetically provide the urologist with real-time intraoperative information on tumor grade and stage. In this pilot study we report what are to our knowledge the first results of optical coherence tomography for grading and staging upper urinary tract urothelial carcinoma. MATERIALS AND METHODS Eight consecutive patients underwent ureterorenoscopy for suspicion or followup of upper urinary tract urothelial carcinoma. Optical coherence tomography data sets were intraoperatively obtained from the ureter and renal pelvis. All patients eventually underwent nephroureterectomy. Optical coherence tomography staging was done by visual inspection of lesions found on optical coherence tomography images. Optical coherence tomography grading was done by quantifying optical coherence tomography signal attenuation in mm(-1) on lesions and comparing results with the histopathological diagnosis. The Wilcoxon rank sum test was used for statistical analysis. RESULTS For 7 in vivo optical coherence tomography diagnoses staging was in accordance with histology. In patient 8 tumor thickness transcended optical coherence tomography imaging depth range and, therefore, invasiveness findings were inconclusive. For grading the median attenuation coefficient for grade 2 and 3 lesions was 1.97 (IQR 1.57-2.30) and 3.53 mm(-1) (IQR 2.74-3.94), respectively (p<0.001). Healthy urothelium was too thin to reliably determine the attenuation coefficient. CONCLUSIONS Optical coherence tomography is a promising, minimally invasive tool for real-time intraoperative optical diagnosis of tumors in the upper urinary tract. Our results warrant future research in a larger sample size to determine the accuracy of grading and staging by optical coherence tomography, and its possible implementation in the diagnostic algorithm for upper urinary tract urothelial carcinoma.
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Affiliation(s)
- Mieke T J Bus
- Department of Urology, Academic Medical Center, Amsterdam, The Netherlands.
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Fukuhara H, Inoue K, Kurabayashi A, Furihata M, Fujita H, Utsumi K, Sasaki J, Shuin T. The inhibition of ferrochelatase enhances 5-aminolevulinic acid-based photodynamic action for prostate cancer. Photodiagnosis Photodyn Ther 2013; 10:399-409. [PMID: 24284092 DOI: 10.1016/j.pdpdt.2013.03.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 03/15/2013] [Accepted: 03/17/2013] [Indexed: 12/29/2022]
Abstract
BACKGROUND The aim of this study was to clarify the mechanism of accumulation of 5-aminolevulinic acid (ALA)-dependent protoporphyrin IX (PpIX), ALA-photodynamic therapy (PDT)-induced cell death and enhanced efficiency by a ferrochelatase inhibitor in prostate cancer PC-3 cells. METHODS The accumulation of ALA-induced PpIX in PC-3 cells was observed by fluorescence microscopy and measured by flow cytometry analysis. The efficiency of ALA-PDT was analyzed by flow cytometry and assessed by cell death, caspase-3 activity and mitochondrial membrane potential. The ALA-PDT-promoting effects of ferrochelatase inhibitors, such as deferoxamine and NOC-18, were also analyzed. We confirmed the results obtained in vivo with an animal model using nude mice. RESULTS ALA-induced PpIX accumulation increased in time- and ALA concentration-dependent manners. ALA-PDT decreased the levels of mitochondrial membrane potential, and induced cell death occurred by both apoptosis and necrosis. Inhibition of ferrochelatase by deferoxamine and NOC-18 led to increase of PpIX accumulation and enhanced effect of ALA-PDT in PC-3 cells. In vivo, the degeneration of tumor tissue by ALA-PDT was observed within a broader range and led to apoptosis and necrosis. CONCLUSION This study demonstrated ALA-PDT induced PC-3 cell death by the mechanisms of both necrosis and apoptosis through a caspase-independent mitochondrial pathway. Inhibition of ferrochelatase enhanced these effects, suggesting that ferrochelatase played an important role in ALA-PDT. ALA-PDT could be a new modality for focal therapy of prostate cancer.
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Abstract
Background Autism spectrum disorders (ASDs), characterized by impaired social interactions and deficits in verbal and nonverbal communication, are thought to affect 1 in 88 children in the United States. There is much support for the role of growth factors in the etiology of autism. Recent research has shown that epithelial growth factor (EGF) is decreased in young autistic children (2–4 years of age). This study was designed to determine plasma levels of EGF in an older group of autistic children (mean age 10.6 years) and to correlate these EGF levels with putative biomarkers HGF, uPA, uPAR, GAD2, MPO GABA, and HMGB1, as well as symptom severity of 19 different symptoms. Subjects and methods Plasma from 38 autistic children, 11 children with pervasive developmental disorder (PDD-NOS) and 40 neurotypical, age and gender similar controls was assessed for EGF concentration using ELISAs. Severity of 19 symptoms (awareness, expressive language, receptive language, (conversational) pragmatic language, focus/attention, hyperactivity, impulsivity, perseveration, fine motor skills, gross motor skills, hypotonia (low muscle tone), tiptoeing, rocking/pacing, stimming, obsessions/fixations, eye contact, sound sensitivity, light sensitivity, and tactile sensitivity) was assessed and then compared to EGF concentrations. Results In this study, we found EGF levels in autistic children and those with PDD-NOS to be significantly lower when compared with neurotypical controls. EGF levels correlated with HMGB1 levels but not the other tested putative biomarkers, and EGF correlated negatively with hyperactivity, gross motor skills, and tiptoeing but not other symptoms. Conclusions These results suggest an association between decreased plasma EGF levels and selected symptom severity. We also found a strong correlation between plasma EGF and HMGB1, suggesting inflammation is associated with decreased EGF.
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Laxton AW, Lozano AM. Deep brain stimulation for the treatment of Alzheimer disease and dementias. World Neurosurg 2012; 80:S28.e1-8. [PMID: 22722036 DOI: 10.1016/j.wneu.2012.06.028] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2012] [Revised: 04/04/2012] [Accepted: 06/14/2012] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To review the use of deep brain stimulation (DBS) for treatment of dementia. METHODS A PubMed literature search was conducted to identify all studies that have investigated the use of DBS for treatment of dementia. RESULTS Three studies examined the use of DBS for dementia. One study involved fornix DBS for Alzheimer disease (AD), and two studies involved DBS of the nucleus basalis of Meynert, one to treat AD and one to treat Parkinson disease dementia. CONCLUSIONS Evidence for the use of DBS to treat dementia is preliminary and limited. Fornix and nucleus basalis of Meynert DBS can influence activity in the pathologic neural circuits that underlie AD and Parkinson disease dementia. Further investigation into the potential clinical effects of DBS for dementia is warranted.
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Affiliation(s)
- Adrian W Laxton
- Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
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Sroka M, Reguła J, Lobodziec W. The influence of the bolus-surface distance on the dose distribution in the build-up region. Rep Pract Oncol Radiother 2010; 15:161-4. [PMID: 24376943 DOI: 10.1016/j.rpor.2010.09.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Revised: 07/20/2010] [Accepted: 09/29/2010] [Indexed: 11/21/2022] Open
Abstract
AIM The aim of the paper is to examine the relation between the increase of the photon dose in water in the region of electronic disequilibrium - so-called build-up region - and the distance of the bolus from the water surface for the applied parameters of X-ray beams. MATERIALS AND METHODS PDD measurements were carried out using the plane-parallel ionization chamber Markus in the automatic water phantom IBA BluePhantom with OmniPro-Accept V7 (IBA Dosimetry GmbH, Schwarzenbruck, Germany). All measurements were performed for different field sizes and for 6 MV and 15 MV X-ray beams, respectively. A water-equivalent RW3 slab (Goettingen White Water) produced by PTW was used as a bolus. RESULTS Placing a bolus in an irradiated field changes the shape of the PDD curve in the build-up region in comparison with the one obtained for an open field. All results has been inserted in tables and figures. CONCLUSION The closer the bolus is to the water surface, the smaller the depth of the maximum dose in the phantom for all investigated fields and energies. The changes in the build-up region are important, even if the bolus does not touch the surface of the water phantom. The influence of the bolus can be ignored when the bolus-surface distance equals 25 cm for 6MV X-ray beams and 39 cm for 15 MV X-ray beams.
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