Whole brain radiotherapy with a conformational external beam radiation boost for lung cancer patients with 1-3 brain metastasis: a multi institutional study.

BACKGROUND: To determine the outcome of patients with brain metastasis (BM) from lung cancer treated with an external beam radiotherapy boost (RTB) after whole brain radiotherapy (WBRT). METHODS: A total of 53 BM patients with lung cancer were treated sequentially with WBRT and RTB between 1996 and 2008 according to our institutional protocol. Mean age was 58.8 years. The median KPS was 90. Median recursive partitioning analysis (RPA) and graded prognostic assessment (GPA) grouping were 2 and 2.5, respectively. Surgery was performed on 38 (71%) patients. The median number of BM was 1 (range, 1-3). Median WBRT and RTB combined dose was 39 Gy (range, 37.5-54). Median follow-up was 12.0 months. RESULTS: During the period of follow-up, 37 (70%) patients died. The median overall survival (OS) was 14.5 months. Only 13 patients failed in the brain. The majority of patients (n = 29) failed distantly. The 1-year OS, -local control, extracranial failure rates were 61.2%, 75.2% and 60.8%, respectively. On univariate analysis, improved OS was found to be significantly associated with total dose (< or = 39 Gy vs. > 39 Gy; p < 0.01), age < 65 (p < 0.01), absence of extracranial metastasis (p < 0.01), GPA > or = 2.5 (p = 0.01), KPS > or = 90 (p = 0.01), and RPA < 2 (p = 0.04). On multivariate analysis, total dose (p < 0.01) and the absence of extracranial metastasis (p = 0.03) retained statistical significance. CONCLUSIONS: The majority of lung cancer patients treated with WBRT and RTB progressed extracranially. There might be a subgroup of younger patients with good performance status and no extracranial disease who may benefit from dose escalation after WBRT to the metastatic site.

External beam radiotherapy ± chemotherapy in the treatment of anal canal cancer: a single-institute long-term experience on 100 patients.

One-hundred patients treated with curative radiotherapy (RT) ± chemotherapy (CT) for an anal canal carcinoma (T1-4N0-3M0) were retrospectively analyzed. Five- and 10-year local control (LC) rates were 73% and 67%, respectively. Acute and late G3-G4 toxicity rates were 32% and 12%, respectively. Two patients underwent a colostomy for a G4 anal toxicity. This study confirms the outcomes of RT ± CT in the treatment of anal canal cancer. Concomitant CT and LC statistically influenced Overall Survival and Colostomy-Free Survival. CT also statistically reduced the risk of nodal relapse. High rates of acute skin toxicity impose tailored volumes and techniques of irradiation.

Radiothérapie « flash » à très haut débit de dose : un moyen d'augmenter l'indice thérapeutique par minimisation des dommages aux tissus sains [Ultrahigh dose-rate, "flash" irradiation minimizes the side-effects of radiotherapy].

PURPOSE: Pencil beam scanning and filter free techniques may involve dose-rates considerably higher than those used in conventional external-beam radiotherapy. Our purpose was to investigate normal tissue and tumour responses in vivo to short pulses of radiation. MATERIAL AND METHODS: C57BL/6J mice were exposed to bilateral thorax irradiation using pulsed (at least 40Gy/s, flash) or conventional dose-rate irradiation (0.03Gy/s or less) in single dose. Immunohistochemical and histological methods were used to compare early radio-induced apoptosis and the development of lung fibrosis in the two situations. The response of two human (HBCx-12A, HEp-2) tumour xenografts in nude mice and one syngeneic, orthotopic lung carcinoma in C57BL/6J mice (TC-1 Luc+), was monitored in both radiation modes. RESULTS: A 17Gy conventional irradiation induced pulmonary fibrosis and activation of the TGF-beta cascade in 100% of the animals 24-36 weeks post-treatment, as expected, whereas no animal developed complications below 23Gy flash irradiation, and a 30Gy flash irradiation was required to induce the same extent of fibrosis as 17Gy conventional irradiation. Cutaneous lesions were also reduced in severity. Flash irradiation protected vascular and bronchial smooth muscle cells as well as epithelial cells of bronchi against acute apoptosis as shown by analysis of caspase-3 activation and TUNEL staining. In contrast, the antitumour effectiveness of flash irradiation was maintained and not different from that of conventional irradiation. CONCLUSION: Flash irradiation shifted by a large factor the threshold dose required to initiate lung fibrosis without loss of the antitumour efficiency, suggesting that the method might be used to advantage to minimize the complications of radiotherapy.

Tailoring Magnetic Properties of Co-Fe Thin Films by Topographical Modifications Using Thermal Annealing and Swift Heavy Ion Irradiation and Fabrication of Magnetoelectric Multilayers for Device Applications

Magnetism and magnetic materials have been playing a lead role in improving the quality of life. They are increasingly being used in a wide variety of applications ranging from compasses to modern technological devices. Metallic glasses occupy an important position among magnetic materials. They assume importance both from a scientific and an application point of view since they represent an amorphous form of condensed matter with significant deviation from thermodynamic equilibrium. Metallic glasses having good soft magnetic properties are widely used in tape recorder heads, cores of high-power transformers and metallic shields. Superconducting metallic glasses are being used to produce high magnetic fields and magnetic levitation effect. Upon heat treatment, they undergo structural relaxation leading to subtle rearrangements of constituent atoms. This leads to densification of amorphous phase and subsequent nanocrystallisation. The short-range structural relaxation phenomenon gives rise to significant variations in physical, mechanical and magnetic properties. Magnetic amorphous alloys of Co-Fe exhibit excellent soft magnetic properties which make them promising candidates for applications as transformer cores, sensors, and actuators. With the advent of microminiaturization and nanotechnology, thin film forms of these alloys are sought after for soft under layers for perpendicular recording media. The thin film forms of these alloys can also be used for fabrication of magnetic micro electro mechanical systems (magnetic MEMS). In bulk, they are drawn in the form of ribbons, often by melt spinning. The main constituents of these alloys are Co, Fe, Ni, Si, Mo and B. Mo acts as the grain growth inhibitor and Si and B facilitate the amorphous nature in the alloy structure. The ferromagnetic phases such as Co-Fe and Fe-Ni in the alloy composition determine the soft magnetic properties. The grain correlation length, a measure of the grain size, often determines the soft magnetic properties of these alloys. Amorphous alloys could be restructured in to their nanocrystalline counterparts by different techniques. The structure of nanocrystalline material consists of nanosized ferromagnetic crystallites embedded in an amorphous matrix. When the amorphous phase is ferromagnetic, they facilitate exchange coupling between nanocrystallites. This exchange coupling results in the vanishing of magnetocrystalline anisotropy which improves the soft magnetic properties. From a fundamental perspective, exchange correlation length and grain size are the deciding factors that determine the magnetic properties of these nanocrystalline materials. In thin films, surfaces and interfaces predominantly decides the bulk property and hence tailoring the surface roughness and morphology of the film could result in modified magnetic properties. Surface modifications can be achieved by thermal annealing at various temperatures. Ion irradiation is an alternative tool to modify the surface/structural properties. The surface evolution of a thin film under swift heavy ion (SHI) irradiation is an outcome of different competing mechanism. It could be sputtering induced by SHI followed by surface roughening process and the material transport induced smoothening process. The impingement of ions with different fluence on the alloy is bound to produce systematic microstructural changes and this could effectively be used for tailoring magnetic parameters namely coercivity, saturation magnetization, magnetic permeability and remanence of these materials. Swift heavy ion irradiation is a novel and an ingenious tool for surface modification which eventually will lead to changes in the bulk as well as surface magnetic property. SHI has been widely used as a method for the creation of latent tracks in thin films. The bombardment of SHI modifies the surfaces or interfaces or creates defects, which induces strain in the film. These changes will have profound influence on the magnetic anisotropy and the magnetisation of the specimen. Thus inducing structural and morphological changes by thermal annealing and swift heavy ion irradiation, which in turn induce changes in the magnetic properties of these alloys, is one of the motivation of this study. Multiferroic and magneto-electrics is a class of functional materials with wide application potential and are of great interest to material scientists and engineers. Magnetoelectric materials combine both magnetic as well as ferroelectric properties in a single specimen. The dielectric properties of such materials can be controlled by the application of an external magnetic field and the magnetic properties by an electric field. Composites with magnetic and piezo/ferroelectric individual phases are found to have strong magnetoelectric (ME) response at room temperature and hence are preferred to single phasic multiferroic materials. Currently research in this class of materials is towards optimization of the ME coupling by tailoring the piezoelectric and magnetostrictive properties of the two individual components of ME composites. The magnetoelectric coupling constant (MECC) (_ ME) is the parameter that decides the extent of interdependence of magnetic and electric response of the composite structure. Extensive investigates have been carried out in bulk composites possessing on giant ME coupling. These materials are fabricated by either gluing the individual components to each other or mixing the magnetic material to a piezoelectric matrix. The most extensively investigated material combinations are Lead Zirconate Titanate (PZT) or Lead Magnesium Niobate-Lead Titanate (PMNPT) as the piezoelectric, and Terfenol-D as the magnetostrictive phase and the coupling is measured in different configurations like transverse, longitudinal and inplane longitudinal. Fabrication of a lead free multiferroic composite with a strong ME response is the need of the hour from a device application point of view. The multilayer structure is expected to be far superior to bulk composites in terms of ME coupling since the piezoelectric (PE) layer can easily be poled electrically to enhance the piezoelectricity and hence the ME effect. The giant magnetostriction reported in the Co-Fe thin films makes it an ideal candidate for the ferromagnetic component and BaTiO3 which is a well known ferroelectric material with improved piezoelectric properties as the ferroelectric component. The multilayer structure of BaTiO3- CoFe- BaTiO3 is an ideal system to understand the underlying fundamental physics behind the ME coupling mechanism. Giant magnetoelectric coupling coefficient is anticipated for these multilayer structures of BaTiO3-CoFe-BaTiO3. This makes it an ideal candidate for cantilever applications in magnetic MEMS/NEMS devices. SrTiO3 is an incipient ferroelectric material which is paraelectric up to 0K in its pure unstressed form. Recently few studies showed that ferroelectricity can be induced by application of stress or by chemical / isotopic substitution. The search for room temperature magnetoelectric coupling in SrTiO3-CoFe-SrTiO3 multilayer structures is of fundamental interest. Yet another motivation of the present work is to fabricate multilayer structures consisting of CoFe/ BaTiO3 and CoFe/ SrTiO3 for possible giant ME coupling coefficient (MECC) values. These are lead free and hence promising candidates for MEMS applications. The elucidation of mechanism for the giant MECC also will be the part of the objective of this investigation.

Proper evaluation of the external convective heat transfer for the thermal analysis of cool roofs

Cool materials are characterized by high solar reflectance and high thermal emittance; when applied to the external surface of a roof, they make it possible to limit the amount of solar irradiance absorbed by the roof, and to increase the rate of heat flux emitted by irradiation to the environment, especially during nighttime. However, a roof also releases heat by convection on its external surface; this mechanism is not negligible, and an incorrect evaluation of its entity might introduce significant inaccuracy in the assessment of the thermal performance of a cool roof, in terms of surface temperature and rate of heat flux transferred to the indoors. This issue is particularly relevant in numerical simulations, which are essential in the design stage, therefore it deserves adequate attention. In the present paper, a review of the most common algorithms used for the calculation of the convective heat transfer coefficient due to wind on horizontal building surfaces is presented. Then, with reference to a case study in Italy, the simulated results are compared to the outcomes of a measurement campaign. Hence, the most appropriate algorithms for the convective coefficient are identified, and the errors deriving by an incorrect selection of this coefficient are discussed.

The effect of an Er,Cr:YSGG laser on external adaptation of healthy and decayed cavities

The aim of this study was to evaluate the influence of chlorhexidine and Er, Cr:YSGG laser irradiation on the bond strength and external adaptation in mixed healthy and caries-affected class V cavities before and after thermal cycling. Thirty-six cavity preparations were made in mixed class V buccal human molars, half of them being artificially caries-induced. Any remaining affected dentin was removed from the cavity with a round burr at low speed. The teeth were divided into six groups, according to cleaning agent for both healthy and caries-induced dentin: no treatment, chlorhexidine and erbium, chromium-doped: yttrium, scandium, gallium, garnet (Er,Cr:YSGG) laser irradiation. A Filtek P90 (3M ESPE, St Paul, MN, USA) silorane adhesive restorative system was used. The specimens were subjected to 5000 thermal cycles (5-55 degrees C 60 min). Epoxy replicas were obtained to characterize the external adaptation under scanning electron microscopy. The average percentages of non-continuous margins were 5.41% and 6.49% in enamel dentin before thermal cycling and 25% and 33.7% after thermal cycling, respectively. The caries-affected and laser irradiated cavities showed higher non-continuous margins. Thermal cycling was able to raise the percentage of non-continuous margin for all groups. Chlorhexidine did not affect the marginal adaptation results, and the Er,Cr:YSGG laser irradiation showed significantly worse results compared with the control group.

Comparative assessment of global irradiation from a satellite estimate model (CM SAF) and on-ground measurements (SIAR): a Spanish case study

An analysis and comparison of daily and yearly solar irradiation from the satellite CM SAF database and a set of 301 stations from the Spanish SIAR network is performed using data of 2010 and 2011. This analysis is completed with the comparison of the estimations of effective irradiation incident on three different tilted planes (fixed, two axis tracking, north-south hori- zontal axis) using irradiation from these two data sources. Finally, a new map of yearly values of irradiation both on the horizontal plane and on inclined planes is produced mixing both sources with geostatistical techniques (kriging with external drift, KED) The Mean Absolute Difference (MAD) between CM SAF and SIAR is approximately 4% for the irradiation on the horizontal plane and is comprised between 5% and 6% for the irradiation incident on the inclined planes. The MAD between KED and SIAR, and KED and CM SAF is approximately 3% for the irradiation on the horizontal plane and is comprised between 3% and 4% for the irradiation incident on the inclined planes. The methods have been implemented using free software, available as supplementary ma- terial, and the data sources are freely available without restrictions.

Comparative assessment of global irradiation from a satellite estimate model (CM SAF) and on-ground measurements (SIAR): a Spanish case study

An analysis and comparison of daily and yearly solar irradiation from the satellite CM SAF database and a set of 301 stations from the Spanish SIAR network is performed using data of 2010 and 2011. This analysis is completed with the comparison of the estimations of effective irradiation incident on three different tilted planes (fixed, two axis tracking, north-south hori- zontal axis) using irradiation from these two data sources. Finally, a new map of yearly values of irradiation both on the horizontal plane and on inclined planes is produced mixing both sources with geostatistical techniques (kriging with external drift, KED) The Mean Absolute Difference (MAD) between CM SAF and SIAR is approximately 4% for the irradiation on the horizontal plane and is comprised between 5% and 6% for the irradiation incident on the inclined planes. The MAD between KED and SIAR, and KED and CM SAF is approximately 3% for the irradiation on the horizontal plane and is comprised between 3% and 4% for the irradiation incident on the inclined planes. The methods have been implemented using free software, available as supplementary ma- terial, and the data sources are freely available without restrictions.

Downscaling of global solar irradiation in R

A methodology for downscaling solar irradiation from satellite-derived databases is described using R software. Different packages such as raster, parallel, solaR, gstat, sp and rasterVis are considered in this study for improving solar resource estimation in areas with complex topography, in which downscaling is a very useful tool for reducing inherent deviations in satellite-derived irradiation databases, which lack of high global spatial resolution. A topographical analysis of horizon blocking and sky-view is developed with a digital elevation model to determine what fraction of hourly solar irradiation reaches the Earth's surface. Eventually, kriging with external drift is applied for a better estimation of solar irradiation throughout the region analyzed. This methodology has been implemented as an example within the region of La Rioja in northern Spain, and the mean absolute error found is a striking 25.5% lower than with the original database.

Intensification Of Bioactive Compounds Extraction From Medicinal Plants Using Ultrasonic Irradiation.

Extraction processes are largely used in many chemical, biotechnological and pharmaceutical industries for recovery of bioactive compounds from medicinal plants. To replace the conventional extraction techniques, new techniques as high-pressure extraction processes that use environment friendly solvents have been developed. However, these techniques, sometimes, are associated with low extraction rate. The ultrasound can be effectively used to improve the extraction rate by the increasing the mass transfer and possible rupture of cell wall due the formation of microcavities leading to higher product yields with reduced processing time and solvent consumption. This review presents a brief survey about the mechanism and aspects that affecting the ultrasound assisted extraction focusing on the use of ultrasound irradiation for high-pressure extraction processes intensification.

Preservation Of The External Jugular Vein In Bilateral Radical Neck Dissections: Technique In Two Cases And Review Of The Literature.

Context. The possibility of cephalic venous hypertension with the resultant facial edema and elevated cerebrospinal fluid pressure continues to challenge head and neck surgeons who perform bilateral radical neck dissections during simultaneous or staged procedures. Case Report. The staged procedure in patients who require bilateral neck dissections allows collateral venous drainage to develop, mainly through the internal and external vertebral plexuses, thereby minimizing the risks of deleterious consequences. Nevertheless, this procedure has disadvantages, such as a delay in definitive therapy, the need for a second hospitalization and anesthesia, and the risk of cutting lymphatic vessels and spreading viable cancer cells. In this paper, we discuss the rationale and feasibility of preserving the external jugular vein. Considering the limited number of similar reports in the literature, two cases in which this procedure was accomplished are described. The relevant anatomy and technique are reviewed and the patients' outcomes are discussed. Conclusion. Preservation of the EJV during bilateral neck dissections is technically feasible, fast, and safe, with clinically and radiologically demonstrated patency.

Combined External Pressure And Cu-substitution Studies On Bafe2as2 Single Crystals.

We report a combined study of external pressure and Cu-substitution on BaFe2As2 single crystals grown by the in-flux technique. At ambient pressure, the Cu-substitution is known to suppress the spin density wave (SDW) phase in pure BaFe2As2(TSDW ≈ 140 K) and to induce a superconducting (SC) dome with a maximum transition temperature [Formula: see text]. This [Formula: see text] is much lower than the Tc ∼ 15-28 K achieved in the case of Ru, Ni and Co substitutions. Such a lower Tc is attributed to a Cu(2+) magnetic pair-breaking effect. The latter is strongly suppressed by applied pressure, as shown herein, Tc can be significantly enhanced by applying high pressures. In this work, we investigated the pressure effects on Cu(2+) magnetic pair-breaking in the BaFe2-xCuxAs2 series. Around the optimal concentration (xopd = 0.11), all samples showed a substantial increase of Tc as a function of pressure. Yet for those samples with a slightly higher doping level (over-doped regime), Tc presented a dome-like shape with maximum Tc ≃ 8 K. Remarkably interesting, the under-doped samples, e.g. x = 0.02 display a maximum pressure induced Tc ≃ 30 K which is comparable to the maximum Tc's found for the pure compound under external pressures. Furthermore, the magnetoresistance effect as a function of pressure in the normal state of the x = 0.02 sample also presented an evolution consistent with the screening of the Cu(2+) local moments. These findings demonstrate that the Cu(2+) magnetic pair-breaking effect is completely suppressed by applying pressure in the low concentration regime of Cu(2+) substituted BaFe2As2.

Intrapupal temperature variation during Er,Cr: YSGG enamel irradiation on carries prevention

Studies have shown the cariostatic effect of Er,Cr:YSGG (2.78 mm) laser irradiation on human enamel and have suggested its use on caries prevention. However there are still no reports on the intrapulpal temperature increase during enamel irradiation using parameters for caries prevention. The aim of this in vitro study was to evaluate the temperature variation in the pulp chamber during human enamel irradiation with Er,Cr:YSGG laser at different energy densities. Fifteen enamel blocks obtained from third molars (3 x 3 x 3 mm) were randomly assigned to 3 groups (n=5): G1 - Er,Cr:YSGG laser 0.25 W, 20 Hz, 2.84 J/cm², G2 - Er,Cr:YSGG laser 0.50 W, 20 Hz, 5.68 J/cm², G3 - Er,Cr:YSGG laser 0.75 W, 20 Hz, 8.52 J/cm². During enamel irradiation, two thermocouples were fixed in the inner surface of the specimens and a thermal conducting paste was used. One-way ANOVA did not show statistically significant difference among the experimental groups (a=0.05). There was intrapulpal temperature variation <0.1ºC for all irradiation parameters. In conclusion, under the tested conditions, the use of Er,Cr:YSGG laser with parameters set for caries prevention lead to an acceptable temperature increase in the pulp chamber.

Nd:YAG laser irradiation effect on apical intracanal dentin - a microleakage and SEM evaluation

The purpose of this in vitro study was to evaluate the effect of neodymium:yttrium-aluminum-garnet (Nd:YAG) laser irradiation on intracanal dentin surface by SEM analysis and its interference in the apical seal of filled canals. After endodontic treatment procedures, 34 maxillary human incisors were randomly assigned to 2 groups. In the negative control group (n=17), no additional treatment was performed and teeth were filled with vertically condensed gutta-percha; in the laser-treated group (n=17), the root canals were irradiated with Nd:YAG laser (1.5 W, 100 mJ, 15 Hz) before filling as described for the control group. Two specimens of each group were prepared for SEM analysis to evaluate the presence and extent of morphological changes and removal of debris; the other specimens were immersed in 0.5% methylene blue dye (pH 7.2) for 24 h for evaluation of the linear dye leakage at the apical third. SEM analysis of the laser-treated group showed dentin fusion and resolidification without smear layer or debris. The Student’s t-test showed that the laser-treated group had significantly less leakage in apical third than the control group. Within the limitations of this study, it may be concluded that the morphological changes on the apical intraradicular dentin surface caused by Nd:YAG laser resulted in less linear dye apical leakage.

Temperature of denture base resin under different protocols of microwave irradiation

This in vitro study evaluated the temperature of dentures after different microwave irradiation protocols. Two complete dentures (one maxillary and one mandibular denture) were irradiated separately 4 times for each of the following 5 protocols: dentures immersed in water (G1- 6 min, G2- 3 min); dentures kept dry (G3- 6 min); dentures placed in the steam sterilizer (G4- 6 min, G5- 3 min). The final temperature of the dentures was gauged in a thin and in a thick area of each denture with an infrared thermometer. All groups presented an increase in the resin base temperature. The thin areas of the dentures underwent greater heating than the thick areas. There was no significant difference (p>0.05) between the final mean temperatures of dentures immersed in water for 6 (G1) and 3 min (G2). However, the final mean temperatures recorded in G1 and G2 exceeded 71°C and were significantly higher (<0.001) than the final mean temperatures recorded in the other groups. It may be concluded that denture base resins subjected to microwave irradiation immersed in water may be exposed to deleterious temperatures.