A comparison of conformal and intensity-modulated techniques for oesophageal radiotherapy.

Background and purpose: To investigate the potential of intensity-modulated radiotherapy (IMRT) to reduce lung irradiation in the treatment of oesophageal carcinoma with radical radiotherapy.Materials and methods: A treatment planning study was performed to compare two-phase conformal radiotherapy (CFRT) with IMRT in five patients. The CFRT plans consisted of anterior, posterior and bilateral posterior oblique fields, while the IMRT plans consisted of either nine equispaced fields (9F), or four fields (4F) with orientations equal to the CFRT plans. IMRT plans with seven, five or three equispaced fields were also investigated in one patient. Treatment plans were compared using dose-volume histograms and normal tissue complication probabilities.Results: The 9F IMRT plan was unable to improve on the homogeneity of dose to the planning target volume (PTV), compared with the CFRT plan (dose range, 16.9+/-4.5 (1 SD) vs. 12.4+/-3.9%; P=0.06). Similarly, the 9F IMRT plan was unable to reduce the mean lung dose (11.7+/-3.2 vs. 11.0+/-2.9 Gy; P=0.2). Similar results were obtained for seven, five and three equispaced fields in the single patient studied. The 4F IMRT plan provided comparable PTV dose homogeneity with the CFRT plan (11.8+/-3.3 vs. 12.4+/-3.9%; P=0.6), with reduced mean lung dose (9.5+/-2.3 vs 11.0+/-2.9 Gy; P=0.001).Conclusions: IMRT using nine equispaced fields provided no improvement over CFRT. This was because the larger number of fields in the IMRT plan distributed a low dose over the entire lung. In contrast, IMRT using four fields equal to the CFRT fields offered an improvement in lung sparing. Thus, IMRT with a few carefully chosen field directions may lead to a modest reduction in pneumonitis, or allow tumour dose escalation within the currently accepted lung toxicity.

Optimisation of radiotherapy for carcinoma of the parotid gland: a comparison of conventional, three-dimensional conformal, and intensity-modulated techniques

Background and purpose: To compare external beam radiotherapy techniques for parotid gland tumours using conventional radiotherapy (RT), three-dimensional conformal radiotherapy (3DCRT), and intensity-modulated radiotherapy (IMRT). To optimise the IMRT techniques, and to produce an IMRT class solution.Materials and methods: The planning target volume (PTV), contra-lateral parotid gland, oral cavity, brain-stem, brain and cochlea were outlined on CT planning scans of six patients with parotid gland tumours. Optimised conventional RT and 3DCRT plans were created and compared with inverse-planned IMRT dose distributions using dose-volume histograms. The aim was to reduce the radiation dose to organs at risk and improve the PTV dose distribution. A beam-direction optimisation algorithm was used to improve the dose distribution of the IMRT plans, and a class solution for parotid gland IMRT was investigated.Results: 3DCRT plans produced an equivalent PTV irradiation and reduced the dose to the cochlea, oral cavity, brain, and other normal tissues compared with conventional RT. IMRT further reduced the radiation dose to the cochlea and oral cavity compared with 3DCRT. For nine- and seven-field IMRT techniques, there was an increase in low-dose radiation to non-target tissue and the contra-lateral parotid gland. IMRT plans produced using three to five optimised intensity-modulated beam directions maintained the advantages of the more complex IMRT plans, and reduced the contra-lateral parotid gland dose to acceptable levels. Three- and four-field non-coplanar beam arrangements increased the volume of brain irradiated, and increased PTV dose inhomogeneity. A four-field class solution consisting of paired ipsilateral coplanar anterior and posterior oblique beams (15, 45, 145 and 170o from the anterior plane) was developed which maintained the benefits without the complexity of individual patient optimisation.Conclusions: For patients with parotid gland tumours, reduction in the radiation dose to critical normal tissues was demonstrated with 3DCRT compared with conventional RT. IMRT produced a further reduction in the dose to the cochlea and oral cavity. With nine and seven fields, the dose to the contra-lateral parotid gland was increased, but this was avoided by optimisation of the beam directions. The benefits of IMRT were maintained with three or four fields when the beam angles were optimised, but were also achieved using a four-field class solution. Clinical trials are required to confirm the clinical benefits of these improved dose distributions.

Presentism and ontological symmetry

In this paper, I argue that there is an inconsistency between two presentist doctrines: that of ontological symmetry and asymmetry of fixity. The former refers to the presentist belief that the past and future are equally unreal. The latter refers to the A-Theoretic intuition that the past is closed or actual, and the future is open or potential. My position in this paper is that the presentist is unable to account for the temporal asymmetry that is so fundamentally a part of her theory. In Section I, I briefly outline a recent defence of presentism due to Craig, and argue that a flaw in this defence highlights the tension between the presentist's doctrines of ontological symmetry and asymmetry of fixity. In Section II, I undertake an investigation, on the presentist's behalf, in order to determine whether she is capable of reconciling these two doctrines. In the course of the investigation, I consider different asymmetries, other than that of ontology, which might be said fundamentally to constitute temporal asymmetry, and the asymmetry of fixity in particular. In Section III, I also consider whether the presentist is able to avail herself of some of the standard B-Theoretic accounts of the asymmetry of fixity, and argue that she cannot. Finally, I conclude that temporal asymmetry cannot be accounted for (or explained) other than through the postulation of an ontological asymmetry.

Comparison of mechanical and electrical activity and interstitial cells of Cajal in urinary bladders from wild-type and W/W-v mice

Background and purpose: W/Wv and wild-type murine bladders were studied to determine whether the W/Wv phenotype, which causes a reduction in, but not abolition of, tyrosine kinase activity, is a useful tool to study the function of bladder interstitial cells of Cajal (ICC).

Experimental approach: Immunohistochemistry, tension recordings and microelectrode recordings of membrane potential were performed on wild-type and mutant bladders.

Key results: Wild-type and W/Wv detrusors contained c-Kit- and vimentin-immunopositive cells in comparable quantities, distribution and morphology. Electrical field stimulation evoked tetrodotoxin-sensitive contractions in wild-type and W/Wv detrusor strips. Atropine reduced wild-type responses by 50% whereas a 25% reduction occurred in W/Wv strips. The atropine-insensitive component was blocked by pyridoxal-5-phosphate-6-azophenyl-2',4'-disulphonic acid in both tissue types. Wild-type and W/Wv detrusors had similar resting membrane potentials of -48 mV. Spontaneous electrical activity in both tissue types comprised action potentials and unitary potentials. Action potentials were nifedipine-sensitive whereas unitary potentials were not. Excitatory junction potentials were evoked by single pulses in both tissues. These were reduced by atropine in wild-type tissues but not in W/Wv preparations. The atropine-insensitive component was abolished by pyridoxal-5-phosphate-6-azophenyl-2',4'-disulphonic acid in both preparations.

Conclusions and implications: Bladders from W/Wv mice contain c-Kit- and vimentin-immunopositive ICC. There are similarities in the electrical and contractile properties of W/Wv and wild-type detrusors. However, significant differences were found in the pharmacology of the responses to neurogenic stimulation with an apparent up-regulation of the purinergic component. These findings indicate that the W/Wv strain may not be the best model to study ICC function in the bladder.

Review of The New Punitiveness: Trends, Theories, Perspectives , edited by J Pratt, D Brown, M Brown, S Hallsworth and W Morrison

Book Review

Electron-impact excitation of W 44+ and W 45+

Plans to employ tungsten in the divertor region of the International Thermonuclear Experimental Reactor require radiative and collisional data for modelling x-ray emissions of highly ionized stages of tungsten. In an earlier paper, we reported on the results of fully relativistic R -matrix calculations for W 46+ that included the effects of radiation damping on the resonance contributions. In this paper, we present the results of similar fully relativistic, radiatively damped R -matrix calculations for W 44+ and W 45+ . Radiation damping is found to be small for W 45+ , but is appreciable for many of the excitations from the ground and metastable levels of W 44+ . Rates from the present calculations will be combined with those from the calculations for W 46+ and employed for collisional-radiative modelling for these ions.

A New ROV Design: Issues on Low Drag and Mechanical Symmetry

This paper reports the design of a new remotely operated underwater vehicle (ROV), which has been developed at the Underwater Systems and Technology Laboratory (USTL) - University of Porto. This design is contextualized on the KOS project (Kits for underwater operations). The main issues addressed here concern directional drag minimization, symmetry, optimized thruster positioning, stability and layout of ROV components. This design is aimed at optimizing ROV performance for a set of different operational scenarios. This is achieved through modular configurations which are optimized for each different scenario.

Letter to S.D. Woodruff from Thomas Steers and W. M. Kelly

Letter to S.D. Woodruff from Thomas Steers and W. M. Kelly regarding the patent for Mrs. Clement. The writer says that he will write to Mr. Woodruff fully respecting the claim of the younger Clement, May 14, 1847.

Letter to Samuel D. Woodruff from Thomas Steers and W.M. Kelly

Letter to Samuel D. Woodruff from Thomas Steers and W.M. Kelly stating that they have been successful in getting the patent through for Mrs. Clement for Lot no.30, Concession 2 in Enniskillen. James Clement is not of age and he cannot transfer his right to his brother Joseph. There is no obstacle of the patent being issued in Richard’s name. There are some notes in pencil on this document. The document is torn, and stained, but text is not affected. The postmark on the outside is Montreal, June 26, 1847, June 25, 1847.