Endocavitary contact radiation therapy for ultrasonographically staged T1 N0 and T2 N0 rectal cancer.

BACKGROUND: The purpose of this study was to determine the long-term outcomes of patients undergoing endocavitary contact radiation therapy (ECR) for stage I rectal cancer. METHODS: A database of patients treated with ECR for biopsy-proven rectal adenocarcinoma from July 1986 to June 2006 was reviewed retrospectively. Only patients with primary, non-metastatic, ultrasonographically staged T1 N0 and T2 N0 cancer who had no adjuvant treatment were included. Patients received a median of 90 (range 60-190) Gy contact radiation, delivered transanally by a 50-kV X-ray tube in two to five fractions. RESULTS: Of 149 patients, 77 (40 T1, 37 T2) met the inclusion criteria. Median age was 74 (range 38-104) years, and median follow-up 69 (range 10-219) months. ECR failed in 21 patients (27 per cent) (persistent disease, four; recurrence, 17), of whom ten remained disease free after salvage therapy. The estimated 5-year disease-free survival rate was 74 (95 per cent confidence interval 63 to 83) per cent after ECR alone, and 87 (76 to 93) per cent when survival after salvage therapy for recurrence was included. CONCLUSION: ECR is a minimally invasive treatment option for early-stage rectal cancer. However, similar to other local therapies, ECR has a worse oncological outcome than radical surgery.

Changes in leg spring behaviour, plantar loading and foot mobility magnitude induced by an exhaustive treadmill run in adolescent middle-distance runners.

OBJECTIVES: This study aimed to determine adjustments in spring-mass model characteristics, plantar loading and foot mobility induced by an exhaustive run. DESIGN: Within-participants repeated measures. METHODS: Eleven highly-trained adolescent middle-distance runners ran to exhaustion on a treadmill at a constant velocity corresponding to 95% of velocity associated with VO₂max (17.8 ± 1.4 kmh(-1), time to exhaustion=8.8 ± 3.4 min). Contact time obtained from plantar pressure sensors was used to estimate spring-mass model characteristics, which were recorded (during 30 s) 1 min after the start and prior to exhaustion using pressure insoles. Foot mobility magnitude (a composite measure of vertical and medial-lateral mobility of the midfoot) was measured before and after the run. RESULTS: Mean contact area (foot to ground), contact time, peak vertical ground reaction force, centre of mass vertical displacement and leg compression increased significantly with fatigue, while flight time, leg stiffness and mean pressure decreased. Leg stiffness decreased because leg compression increased to a larger extent than peak vertical ground reaction forces. Step length, step frequency and foot mobility magnitude did not change at exhaustion. CONCLUSIONS: The stride pattern of adolescents when running on a treadmill at high constant velocity deteriorates near exhaustion, as evidenced by impaired leg-spring behaviour (leg stiffness) and altered plantar loading.

Gas collisions and pressure quenching of the photoluminescence of silicon nanopowder grown by plasma-enhanced chemical vapor deposition

The quenching of the photoluminescence of Si nanopowder grown by plasma-enhanced chemical vapor deposition due to pressure was measured for various gases ( H2, O2, N2, He, Ne, Ar, and Kr) and at different temperatures. The characteristic pressure, P0, of the general dependence I(P) = I0¿exp(¿P/P0) is gas and temperature dependent. However, when the number of gas collisions is taken as the variable instead of pressure, then the quenching is the same within a gas family (mono- or diatomic) and it is temperature independent. So it is concluded that the effect depends on the number of gas collisions irrespective of the nature of the gas or its temperature.

Influence of pressure and radio frequency power on deposition rate and structural properties of hydrogenated amorphous silicon thin films prepared by plasma deposition

The influence of radio frequency (rf) power and pressure on deposition rate and structural properties of hydrogenated amorphous silicon (a-Si:H) thin films, prepared by rf glow discharge decomposition of silane, have been studied by phase modulated ellipsometry and Fourier transform infrared spectroscopy. It has been found two pressure regions separated by a threshold value around 20 Pa where the deposition rate increases suddenly. This behavior is more marked as rf power rises and reflects the transition between two rf discharges regimes. The best quality films have been obtained at low pressure and at low rf power but with deposition rates below 0.2 nm/s. In the high pressure region, the enhancement of deposition rate as rf power increases first gives rise to a reduction of film density and an increase of content of hydrogen bonded in polyhydride form because of plasma polymerization reactions. Further rise of rf power leads to a decrease of polyhydride bonding and the material density remains unchanged, thus allowing the growth of a-Si:H films at deposition rates above 1 nm/s without any important detriment of material quality. This overcoming of deposition rate limitation has been ascribed to the beneficial effects of ion bombardment on the a-Si:H growing surface by enhancing the surface mobility of adsorbed reactive species and by eliminating hydrogen bonded in polyhydride configurations.

Habitat selection in zones of parapatric contact between the Common shrew Sorex araneus and Millet's shrew S. coronatus

(1) The common shrew Sorex araneus and Millet's shrew S. coronatus are sibling species.They are morphologically and genetically very similar but do not hybridize. Their parapatric distribution throughout south-western Europe, with a few narrow zones of distributional overlap, suggests that they are in competitive parapatry. (2) Two of these contact zones were studied; there was evidence of coexistence over periods of 2 years as well as habitat segregation. In both zones, the species segregated on litter thickness and humidity variables. (3) A simple analysis of spatial distribution showed that habitats visible in the field corresponded to the habitats selected by the species. Habitat selection was found throughout the annual life-cycle of the shrews. (4) In one contact zone, a removal experiment was performed to test whether habitat segregation is induced by interspecific interactions. The experiment showed that the species select habitats differentially when both are present and abandon habitat selection when their competitor is removed. (5) These results confirm the role of resource partitioning in promoting narrow rangesof distributional overlap between such parapatric species and qualitatively support the prediction of habitat selection theory that, in a two-species system, coexistence may be achieved by differential habitat selection to avoid competition. The results also support the view that the common shrew and Millet's shrew are in competitive parapatry.

Pulmonary-artery pressure and exhaled nitric oxide in bolivian and caucasian high altitude dwellers

Rapport de synthèse : Plusieurs études suggèrent que les populations vivant en haute altitude sont mieux protégées contre l'hypertension pulmonaire hypoxique que celles originaires de la plaine. Cependant, les mécanismes sous jacents ne sont pas bien compris. Chez les Tibétains, la synthèse augmentée par le système respiratoire de monoxyde d'azote (NO) atténue l'hypertension pulmonaire hypoxique. Il a été spéculé que ce mécanisme pourrait représenter un mode généralisé d'adaptation à la haute altitude, mais il n'existe pas de preuve directe qui consume cette hypothèse. Nous avons donc mesuré la pression artérielle pulmonaire (par échocardiographie Doppler) ainsi que la concentration du NO dans l'air exhalé chez 34 Boliviens en bonne santé, nés et ayant toujours vécus en haute altitude (3600 m) et chez 34 Caucasiens apparentés pour l'âge et le sexe, nés en basse altitude mais vivant depuis de nombreuses années à cette même haute altitude (3600 mètres). La pression artérielle pulmonaire (24.3±5.9 vs. 24.7±4.9 mm Hg) et le NO exhalé (19.2±7.2 vs. 22.5±9.5 ppb) étaient similaires chez les Boliviens et les Caucasiens. Il n'y avait aucune corrélation entre la pression artérielle pulmonaire et le NO respiratoire dans les deux groupes. Ces résultats ne fournissent donc aucune évidence que les Boliviens nés en haute altitude sont mieux protégés contre l'hypertension pulmonaire hypoxique que les Caucasiens nés à basse altitude. Cela suggère que l'atténuation de l'hypertension pulmonaire par une synthèse accrue de NO respiratoire ne représente pas un mode universel d'adaptation des populations à la haute altitude. Abstract : There is evidence that high altitude populations may be better protected from hypoxic pulmonary hypertension than low altitude natives, but the underlying mechanism is incompletely understood. In Tibetans, increased pulmonary respiratory NO synthesis attenuates hypoxic pulmonary hypertension. It has been speculated that this mechanism may represent a generalized high altitude adaptation pattern, but direct evidence for this speculation is lacking. We therefore measured systolic pulmonary-artery pressure (Doppler echocardiography) and exhaled nitric oxide (NO) in 34 healthy, middle-aged Bolivian high altitude natives and in 34 age- and sex-matched, well-acclimatized Caucasian low altitude natives living at high altitude (3600 m). The mean ± SD systolic right ventricular to right arterial pressure gradient (24.3 ± 5.9 vs. 24.7 ± 4.9 mmHg) and exhaled NO (19.2 ± 7.2 vs. 22.5 ± 9.5 ppb) were similar in Bolivians and Caucasians. There was no relationship between ,pulmonary-artery pressure and respiratory NO in the two groups. These findings provide no evidence that Bolivian high altitude natives are better protected from hypoxic pulmonary hypertension than Caucasian low altitude natives and suggest that attenuation of pulmonary hypertension by increased respiratory NO synthesis may not represent a universal adaptation pattern in highaltitude populations.

Polyimide/SU-8 catheter-tip MEMS gauge pressure sensor.

This paper describes the development of a polyimide/SU-8 catheter-tip MEMS gauge pressure sensor. Finite element analysis was used to investigate critical parameters, impacting on the device design and sensing characteristics. The sensing element of the device was fabricated by polyimide-based micromachining on a flexible membrane, using embedded thin-film metallic wires as piezoresistive elements. A chamber containing this flexible membrane was sealed using an adapted SU-8 bonding technique. The device was evaluated experimentally and its overall performance compared with a commercial silicon-based pressure sensor. Furthermore, the device use was demonstrated by measuring blood pressure and heart rate in vivo.

Pulse wave analysis aortic pressure . distole should also be considered

La rigidité anormalement haute des artères à grande conductance est un marqueur de l'augmentation du risque cardiovasculaire et est typiquement retrouvée chez les patients diabétiques ou hypertendus. Ces vaisseaux deviennent plus rigides avec l'âge, expliquant la haute prévalence d'hypertension systolique chez les personnes âgées. Cette rigidification agit sur la pression sanguine de plusieurs façons. Notamment la fonction windkessel est gênée, menant à l'augmentation de la pression systolique et de la pression puisée, la diminution de la pression diastolique, et ainsi à l'augmentation de la postcharge ventriculaire gauche associée à une probable diminution de la perfusion coronarienne. De plus, la propagation des ondes de pression le long de l'arbre vasculaire est accélérée, de sorte que les ondes réfléchies générées au site de décalage d'impédance atteignent l'aorte ascendante plus tôt par rapport au début de l'éjection ventriculaire, aboutissant à une augmentation de la pression systolique centrale, ce qui n'arriverait pas en présence de vaisseaux moins rigides. Dans ce cas, au contraire, les ondes de pression antérogrades et réfléchies voyages plus lentement, de sorte que les ondes de réflexion tendent à atteindre l'aorte centrale une fois l'éjection terminée, augmentant la pression diastolique et contribuant à la perfusion coronarienne. La tonométrie d'applanation est une méthode non invasive permettant l'évaluation de la forme de l'onde de pression au niveau l'aorte ascendante, basée sur l'enregistrement du pouls périphérique, au niveau radial dans notre étude. Nous pouvons dériver à partir de cette méthode un index d'augmentation systolique (sAIX) qui révèle quel pourcentage de la pression centrale est du aux ondes réfléchies. Plusieurs études ont montré que cet index est corrélé à d'autres mesures de la rigidité artérielle comme la vitesse de l'onde de pouls, qu'il augmente avec l'âge et avec les facteurs de risques cardiovasculaires, et qu'il est capable de préciser le pronostic cardiovasculaire. En revanche, peu d'attention a été portée à l'augmentation de la pression centrale diastolique due aux ondes réfléchies (dAIX). Nous proposons donc de mesurer cet index par un procédé d'analyse développé dans notre laboratoire, et ce dans la même unité que l'index systolique. Etant donné que les modifications de la paroi artérielle modulent d'une part la vitesse de l'onde de pouls (PWV) et d'autre part le temps de voyage aller-retour des ondes de pression réfléchies aux sites de réflexion, toute augmentation de la quantité d'énergie réfléchie atteignant l'aorte pendant la systole devrait être associée à une diminution de l'énergie arrivant au même point pendant la diastole. Notre étude propose de mesurer ces deux index, ainsi que d'étudier la relation de l'index d'augmentation diastolique (dAIX) avec la vitesse de propagation de l'onde de pouls (PWV) et avec le rythme cardiaque (HR), ce dernier étant connu pour influencer l'index d'augmentation systolique (sAIX) . L'influence de la position couchée et assise est aussi étudiée. Les mesures de la PWV et des sAIX et dAIX est réalisée chez 48 hommes et 45 femmes âgées de 18 à 70 ans, classés en 3 groupes d'âges. Les résultats montrent qu'en fonction de l'âge, le genre et la position du corps, il y a une relation inverse entre sAIX et dAIX. Lorsque PWV et HR sont ajoutés comme covariables à un modèle de prédiction comprenant l'âge, le genre et la position du corps comme facteurs principaux, sAIX est directement lié à PWV (p<0.0001) et inversement lié à HR (p<0.0001). Avec la même analyse, dAIX est inversement lié à PWV (p<0.0001) et indépendant du rythme cardiaque (p=0.52). En conclusion, l'index d'augmentation diastolique est lié à la rigidité vasculaire au même degré que l'index d'augmentation systolique, alors qu'il est affranchi de l'effet confondant du rythme cardiaque. La quantification de l'augmentation de la pression aortique diastolique due aux ondes réfléchies pourrait être une partie utile de l'analyse de l'onde de pouls.