Stereotactic body radiotherapy with helical TomoTherapy for medically inoperable early stage primary and second-primary non-small-cell lung neoplasm: 1-year outcome and toxicity analysis.

OBJECTIVE: This study investigated the effectiveness of stereotactic body radiotherapy with helical TomoTherapy (T-SBRT) for treating medically inoperable primary and second-primary early stage non-small-cell lung neoplasm (SPLN) and evaluated whether the movement of organizing pneumonia (OP) within the irradiation field (IF) can be detected via analysis of radiological changes. METHODS: Patients (n = 16) treated for 1 year (2011-12) at our hospital by T-SBRT at a total dose of 60 Gy in five fractions were examined retrospectively. Outcome and toxicity were recorded and were separately described for SPLN. CT scans were reviewed by a single radiologist. RESULTS: Of the 16 patients, 5 (31.3%) had primary lung malignancies, 10 (62.5%) had SPLN, and 1 case (6.3%) had isolated mediastinal metastasis of lung neoplasm. Pathological evidence was obtained for 72.2% of all lesions. The median radiological follow-up was 11 months (10.5 months for SPLN). For all cases, the 6- and 12-month survival rates were 100% and 77.7% (100% and 71.4%, respectively, for SPLN), and the 6- and 12-month locoregional control rates were 100% in all cases. 2 (12.5%) of 16 patients developed grade 3 late transient radiation pneumonitis following steroid therapy and 1 (6.3%) presented asymptomatic infiltrates comparable to OP opacities. CONCLUSION: T-SBRT seems to be safe and effective. ADVANCES IN KNOWLEDGE: Mild OP is likely associated with radiation-induced anomalies in the IF, identification of migrating opacities can help discern relapse of radiation-induced opacities.

Computed tomography findings in patients with H1N1 influenza A infection

The present study aimed to review high resolution computed tomography findings in patients with H1N1 influenza A infection. The most common tomographic findings include ground-glass opacities, areas of consolidation or a combination of both patterns. Some patients may also present bronchial wall thickening, airspace nodules, crazy-paving pattern, perilobular opacity, air trapping and findings related to organizing pneumonia. These abnormalities are frequently bilateral, with subpleural distribution. Despite their nonspecificity, it is important to recognize the main tomographic findings in patients affected by H1N1 virus in order to include this possibility in the differential diagnosis, characterize complications and contribute in the follow-up, particularly in cases of severe disease.

Can chest high-resolution computed tomography findings diagnose pulmonary alveolar microlithiasis?

AbstractObjective:The present study was aimed at retrospectively reviewing high-resolution computed tomography (HRCT) findings in patients with pulmonary alveolar microlithiasis in order to evaluate the frequency of tomographic findings and their distribution in the lung parenchyma.Materials and Methods:Thirteen patients (9 females and 4 males; age, 9 to 59 years; mean age, 34.5 years) were included in the present study. The HRCT images were independently evaluated by two observers whose decisions were made by consensus. The inclusion criterion was the presence of abnormalities typical of pulmonary alveolar microlithiasis at HRCT, which precludes lung biopsy. However, in 6 cases lung biopsy was performed.Results:Ground-glass opacities and small parenchymal nodules were the predominant tomographic findings, present in 100% of cases, followed by small subpleural nodules (92.3%), subpleural cysts (84.6%), subpleural linear calcifications (69.2%), crazy-paving pattern (69.2%), fissure nodularity (53.8%), calcification along interlobular septa (46.2%) and dense consolidation (46.2%).Conclusion:As regards distribution of the lesions, there was preferential involvement of the lower third of the lungs. No predominance of distribution in axial and anteroposterior directions was observed.

High-resolution computed tomography and histopathological findings in hypersensitivity pneumonitis: a pictorial essay

Abstract Hypersensitivity pneumonitis is a diffuse interstitial and granulomatous lung disease caused by the inhalation of any one of a number of antigens. The objective of this study was to illustrate the spectrum of abnormalities in high-resolution computed tomography and histopathological findings related to hypersensitivity pneumonitis. We retrospectively evaluated patients who had been diagnosed with hypersensitivity pneumonitis (on the basis of clinical-radiological or clinical-radiological-pathological correlations) and had undergone lung biopsy. Hypersensitivity pneumonitis is clinically divided into acute, subacute, and chronic forms; high-resolution computed tomography findings correlate with the time of exposure; and the two occasionally overlap. In the subacute form, centrilobular micronodules, ground-glass opacities, and air trapping are characteristic high-resolution computed tomography findings, whereas histopathology shows lymphocytic inflammatory infiltrates, bronchiolitis, variable degrees of organizing pneumonia, and giant cells. In the chronic form, high-resolution computed tomography shows traction bronchiectasis, honeycombing, and lung fibrosis, the last also being seen in the biopsy sample. A definitive diagnosis of hypersensitivity pneumonitis can be made only through a multidisciplinary approach, by correlating clinical findings, exposure history, high-resolution computed tomography findings, and lung biopsy findings.

Leptogenesis as the origin of matter-antimatter asymmetry in extra dimensional and supersymmetric models

The Standard Model of particle physics is currently the best description of fundamental particles and their interactions. All particles save the Higgs boson have been observed in particle accelerator experiments over the years. Despite the predictive power the Standard Model there are many phenomena that the scenario does not predict or explain. Among the most prominent dilemmas is matter-antimatter asymmetry, and much effort has been made in formulating scenarios that accurately predict the correct amount of matter-antimatter asymmetry in the universe. One of the most appealing explanations is baryogenesis via leptogenesis which not only serves as a mechanism of producing excess matter over antimatter but can also explain why neutrinos have very small non-zero masses. Interesting leptogenesis scenarios arise when other possible candidates of theories beyond the Standard Model are brought into the picture. In this thesis, we have studied leptogenesis in an extra dimensional framework and in a modified version of supersymmetric Standard Model. The first chapters of this thesis introduce the standard cosmological model, observations made on the photon to baryon ratio and necessary preconditions for successful baryogenesis. Baryogenesis via leptogenesis is then introduced and its connection to neutrino physics is illuminated. The final chapters concentrate on extra dimensional theories and supersymmetric models and their ability to accommodate leptogenesis. There, the results of our research are also presented.

Trachoma among the Yanomami Indians

The Yanomami are one of the last primitive groups of Indians living in Brazil. They have almost no contact with other cultures. The epidemiology of eye disease among Yanomami is virtually unknown. For the first time, a trachoma survey was conducted among Yanomami Indians in the State of Amazonas near the Venezuelan border of the Brazilian rain forest. Ophthalmic examination was carried out on a total of 613 individuals (338 males and 275 females) from eight Yanomami villages along the Marauiá River located in the upper Rio Negro Basin. Age was classified into three categories (children, adults, and elderly) and trachoma was classified into five grades: follicular, inflammatory intense, cicatricial, trichiasis, and corneal opacity. Trachoma was endemic in all villages visited. Overall, 30.3% of the subjects had trachoma. Females were significantly more affected (37.4%) than males (23.9%). The inflammatory trachoma rate reached 24.9% in children and the cicatricial form increased with age, reaching 13.9% among adults and 35.21% among the elderly. Trichiasis or corneal opacities were not detected and treatment of the entire population was initiated with 1 g azithromycin. The detection of endemic trachoma among the Yanomami is relevant for the understanding of the epidemiology of this disease in the Brazilian rain forest and underscores the necessity for a program of trachoma control in this region.

Déficit familial de la LCAT au Québec : description d’une première mutation et contribution du génotype de l’APO E sur le phénotype lipoprotéique

Le déficit familial de LCAT (FLD) est une maladie caractérisée par un défaut de l’activité de l’enzyme lecithin:cholesterol acyltransferase (LCAT). Ce défaut résulte en une concentration plasmatique de C-HDL extrêmement basse, des opacités cornéennes prématurées, la présence d’anémie, de protéinurie et d’insuffisance rénale. Nous avons identifié les premiers patients canadiens-français atteints de déficit familial de LCAT. Deux frères, présentant les signes classiques de FLD étaient homozygotes pour une nouvelle mutation du gène de la LCAT: la mutation c.102delG. Cette mutation se traduit au niveau protéique par un changement du cadre de lecture au niveau du codon His35 et l’insertion d’un codon stop en position 61 entraînant une abolition de l’activité LCAT in vitro et in vivo. La présence de cette mutation cause une réduction importante du C-HDL chez les hétérozygotes (22%) et les homozygotes (88%) ainsi qu’une baisse du C-LDL chez les hétérozygotes (35%) et les homozygotes (58%). De plus, le profil lipidique différait de manière importante entre les deux frères atteints de FLD qui présentaient des génotypes APOE différents. Nous suggérons que APOE est un gène qui modifie le phénotype du FLD et pourrait expliquer l’hétérogénéité des profils lipidiques chez les patients atteints de FLD. Nos résultats suggèrent également que l’association du génotype LCAT-/- a un allèle APOE ε2 est un nouveau mécanisme conduisant à la dysbétalipoproteinemie. Finalement nous avons montré des différences importantes dans les sous-populations des HDL chez les deux sujets atteints de FLD. Le porteur de l’allèle APOE ε2 présentait une proportion beaucoup plus importante de HDL immatures (preβ discoïdaux) par rapport a son frère (77.9% vs. 31.0%).

Mesure du rapport d'embranchement des désintégrations B^0--> pi^- l^+v et B^+--> êta^(') l^+v, du spectre des facteurs de forme des désintégrations B^0--> pi^- l^+v et B^+--> êta l^+v, et extraction de |V_ub| dans l'expérience BABAR

Nous rapportons les résultats d'une étude des désintégrations semileptoniques non-charmées B^+--> êta^(') l^+v et B^0--> pi^- l^+v, mesurés par le détecteur BABAR avec une production d'environ 464 millions de paires de mésons BBbar issues des collisions e^+e^- à la résonance Upsilon(4S). L'analyse reconstruit les événements avec une technique relâchée des neutrinos. Nous obtenons les rapports d'embranchement partiels pour les désintégrations B^+--> êta l^+v et B^0--> pi^- l^+v en trois et douze intervalles de q^2, respectivement, à partir desquels nous extrayons les facteurs de forme f_+(q^2) et les rapports d'embranchement totaux B(B^+--> êta l^+v) = (3.39 +/- 0.46_stat +/- 0.47_syst) x 10^-5 et B(B^0--> pi^- l^+v) = (1.42 +/- 0.05_stat +/- 0.08_syst) x 10^-4. Nous mesurons aussi B(B^+--> êta' l^+v) = (2.43 +/- 0.80_stat +/- 0.34_syst) x 10^-5. Nous obtenons les valeurs de la norme de l'élément |V_ub| de la matrice CKM en utilisant trois calculs différents de la CDQ.

Some Efficient Representations of 3D Information based on Octress

The thesis introduced the octree and addressed the complete nature of problems encountered, while building and imaging system based on octrees. An efficient Bottom-up recursive algorithm and its iterative counterpart for the raster to octree conversion of CAT scan slices, to improve the speed of generating the octree from the slices, the possibility of utilizing the inherent parallesism in the conversion programme is explored in this thesis. The octree node, which stores the volume information in cube often stores the average density information could lead to “patchy”distribution of density during the image reconstruction. In an attempt to alleviate this problem and explored the possibility of using VQ to represent the imformation contained within a cube. Considering the ease of accommodating the process of compressing the information during the generation of octrees from CAT scan slices, proposed use of wavelet transforms to generate the compressed information in a cube. The modified algorithm for generating octrees from the slices is shown to accommodate the eavelet compression easily. Rendering the stored information in the form of octree is a complex task, necessarily because of the requirement to display the volumetric information. The reys traced from each cube in the octree, sum up the density en-route, accounting for the opacities and transparencies produced due to variations in density.

Isospin-rich nuclei in neutron star matter

Stability of nuclei beyond the drip lines in the presence of an enveloping gas of nucleons and electrons, as prevailing in the inner crust of a neutron star, is studied in the temperature-dependent Thomas-Fermi framework. A limiting asymmetry in the isospin space beyond which nuclei cannot exist emerges from the calculations. The ambient conditions such as temperature, baryon density, and neutrino concentration under which these exotic nuclear systems can be formed are studied in some detail.

Cambios maculares y de capa de fibras nerviosas ganglionares posterior a la vitrectomía pars plana y sus factores pronósticos en la fundación oftalmológica nacional

OBJETIVOS: Determinar los factores pronóstico, cambios maculares morfológicos y de capa de fibras nerviosas ganglionares posterior a vitrectomía pars plana, en la Fundación Oftalmológica Nacional. MATERIALES Y MÉTODOS: Estudio longitudinal de antes y después (3y6 meses) de la vitrectomía pars plana (VPP) en pacientes con membrana epirretiniana, agujero macular, síndrome de tracción vítreo macular y opacidades vítreas no-inflamatorias. Se realizó seguimiento clínico y con tomografía de coherencia óptica. RESULTADOS: Grupo de 60 pacientes (mujeres 65.0%), edad promedio 65.45+9.49años y tiempo de enfermedad promedio 23+29.79meses. Las indicaciones de VPP (n=60ojos) fueron agujero macular (38.3%) y membrana epirretiniana (36.7%). Se encontró diferencia significativa entre grosor del complejo capa de células ganglionares (CCG)+capa plexiforme interna (CPI) inicial y 3 meses (p=0.039), correlación entre grosor del complejo CCG+CPI al tercer y sexto mes (r=0.704,p<0.001) y grosor del complejo CCG+CPI al tercer mes con grosor foveal central (CFT) al tercer y sexto mes (r=–0.594,p<0.001 y r=–0.595,p=0.001). Mayores de 65años tenían menor grosor de CFNG a 6meses (r=-0.528,p=0.007). El grosor de CFNG promedio y la presencia de la zona elipsoide inicial fueron factores pronósticos de buena agudeza visual al tercer mes de VPP (r2=0.414,p=0.018, y r2=0.414,p=0.010). CONCLUSIÓN: El grosor de CFNG y la presencia de la zona elipsoide inicial tienen alta capacidad predictiva de buena agudeza visual al tercer mes de VPP, y, correlación inversa entre grosor del complejo CCG+CPI con CFT al tercer y sexto mes de VPP.

Comportamiento del desprendimiento del vítreo posterior en los pacientes expuestos a cirugía de catarata

Objetivo: Describir el comportamiento del desprendimiento del vítreo posterior (DVP) en pacientes expuestos a cirugía de catarata mediante la biomicroscopia, la ecografía ocular y la tomografía de coherencia óptica macular. Materiales y métodos: Se realizó un estudio descriptivo, una serie de casos clínicos de 13 pacientes expuestos a cirugía de catarata en la Fundación Oftalmológica Nacional entre febrero a julio de 2015, con seguimiento a 12 meses. Durante 6 visitas se les realizó toma de agudeza visual mejor corregida y biomicroscopía. Tambíen se les realizó ecografia ocular y tomografia de coherencia óptica macular. Resultados: El porcentaje de DVP por biomicroscopia cambió desde un 7.7% a un 38.4%. El porcentaje de DVP por ecografía en el área nasal cambió de 92.3% a 76.9%. En el área temporal la tasa de DVP cambió de 84.6% y a 76.9%. En al área superior se mantuvo en un 61.5%. En el área inferior varió de un 69.2% a un 76.9%. Y por último, en el área macular de un 53.8% a un 76.9%. El porcentaje de DVP por OCT cambio desde un 69.2% a un 76.9%, en la visita cero y la visita cuatro, respectivamente. Conclusiones: La cirugía de catarata acelera el proceso del DVP. Hubo una progresión del DVP según la biomicroscopia y el OCT, la ecografía no la consideramos una herramiento eficaz para describir la progresión del DVP. 


Relación entre los hallazgos radiográficos y la sintomatología respiratoria en trabajadores expuestos a polvo de carbón en minería de socavón en el departamento de Boyacá, Colombia 2015

Introducción: La inhalación de polvo de carbón favorece el desarrollo de neumoconiosis, causa daños irreversibles al pulmón que se identifican radiológicamente. Los síntomas son tardíos y la patología se puede desarrollar tras varios años de exposición. Objetivo: Caracterizar los hallazgos radiográficos según la metodología de la Organización Internacional del Trabajo (OIT) 2000 y relacionarlos con la sintomatología respiratoria en trabajadores expuestos a polvo de carbón en las labores de minería de socavón en el departamento de Boyacá, Colombia, 2015. Materiales y métodos: Estudio de corte transversal realizado en 232 mineros, se indagó características sociodemográficas, signos y síntomas del sistema respiratorio. Se realizó radiografías de tórax y se aplicó la metodología OIT para describir los hallazgos. Se estableció asociación estadística a través de la prueba Chi cuadrado de Pearson. Para el procesamiento de la información se utilizó el programa SPSS statistics 2.3 Resultados: Toda la población fue de sexo masculino, con una edad promedio de 40,8 años. El cargo de picador fue el más frecuente en 72,4% de los trabajadores. Las radiografías mostraron opacidades pequeñas redondeadas (q/q) en 42%. La expectoración fue el síntoma más frecuente 66,4%. Se encontró una relación estadísticamente significativa entre el tabaquismo con las anomalía parenquimatosas (p=0,002).Conclusión: La prevalencia de neumoconiosis para el departamento de Boyacá fue de 29.7% entre los trabajadores valorados según los criterios OIT para lectura de radiografías de tórax, por lo que se requiere poner en práctica medidas de control a fin de reducir al mínimo la exposición de los trabajadores.

Methane in the atmosphere of the transiting hot Neptune GJ436b?

We present an analysis of seven primary transit observations of the hot Neptune GJ436b at 3.6, 4.5, and 8 μm obtained with the Infrared Array Camera on the Spitzer Space Telescope. After correcting for systematic effects, we fitted the light curves using the Markov Chain Monte Carlo technique. Combining these new data with the EPOXI, Hubble Space Telescope, and ground-based V, I, H, and Ks published observations, the range 0.5-10 μm can be covered. Due to the low level of activity of GJ436, the effect of starspots on the combination of transits at different epochs is negligible at the accuracy of the data set. Representative climate models were calculated by using a three-dimensional, pseudospectral general circulation model with idealized thermal forcing. Simulated transit spectra of GJ436b were generated using line-by-line radiative transfer models including the opacities of the molecular species expected to be present in such a planetary atmosphere. A new, ab-initio-calculated, line list for hot ammonia has been used for the first time. The photometric data observed at multiple wavelengths can be interpreted with methane being the dominant absorption after molecular hydrogen, possibly with minor contributions from ammonia, water, and other molecules. No clear evidence of carbon monoxide and carbon dioxide is found from transit photometry. We discuss this result in the light of a recent paper where photochemical disequilibrium is hypothesized to interpret secondary transit photometric data. We show that the emission photometric data are not incompatible with the presence of abundant methane, but further spectroscopic data are desirable to confirm this scenario.