The effect of radiation technique and bladder filling on the acute toxicity of pelvic radiotherapy for localized high risk prostate cancer

Purpose: The goal of this project was to see if using IMRT to deliver elective pelvic nodal irradiation (EPNI) for prostate cancer reduced acute treatment toxicity.

Methods: Two hundred and thirty patients were enrolled into prospective trials delivering EPNI with a concomitant hypofractionated IMRT boost to the prostate. During accrual, the method of EPNI delivery changed as new literature emerged. Three methods were used (1) 4FB, (2) IMRT with 2 cm CTV margins around the pelvic vessels as suggested by Shih et al. (2005) [7] (IMRT-Shih), and (3) IMRT with nodal volumes suggested by the RTOG (IMRT-RTOG). Initially patients were treated with an empty bladder, with the remainder treated with bladder full.

Results: Patients in the 4FB group had higher rates of grade 2 acute GI toxicities compared to the IMRT-Shih and IMRT-RTOG groups (31.9% vs 20.8% vs 7.2%, p = 0.0009). Patients in the 4FB group had higher rates of grade 3 urinary frequency compared to the two IMRT groups (8.5% vs 0% vs 0%, p = 0.027). However, multivariate analysis suggested the factor that most influenced toxicity was bladder filling followed by IMRT.

Conclusions: Bladder filling appeared to be the dominant factor which predicted for acute toxicity, followed by the use of IMRT.

IMPROVED POSTFILTERING TECHNIQUE FOR BLOCK QUANTISATION OF SPEECH.

A modified comb filtering technique is proposed which can be used to reduce framing noise generated when speech signals are transform-coded or vector-quantized. Application of this filter to 9. 6 kbit/s speech in a vector transform coder has been found to improve the perceptual quality of the coded speech.

Design, optimization and characterisation of polymeric microneedle arrays prepared by a novel laser-based micromoulding technique

Design and evaluation of a novel laser-based method for micromoulding of microneedle arrays from polymeric materials under ambient conditions. The aim of this study was to optimise polymeric composition and assess the performance of microneedle devices that possess different geometries.

Design technique for mm-wave IC realization of the load network of switched-mode class-EF power amplifier

Analysis and synthesis of the new Class-EF power amplifier (PA) are presented in this paper. The proposed circuit offers means to alleviate some of the major issues faced by existing Class-EF and Class-EF PAs, such as (1) substantial power losses due to parasitic resistance of the large inductor in the Class-EF load network, (2) unpredictable behaviour of practical lumped inductors and capacitors at harmonic frequencies, and (3) deviation from ideal Class-EF operation mode due to detrimental effects of device output inductance at high frequencies. The transmission-line load network of the Class-EF PA topology elaborated in this paper simultaneously satisfies the Class-EF optimum impedance requirements at fundamental frequency, second, and third harmonics as well as simultaneously providing matching to the circuit optimum load resistance for any prescribed system load resistance. Furthermore, an elegant solution using an open and short-circuit stub arrangement is suggested to overcome the problem encountered in the mm-wave IC realizations of the Class-EF PA load network due to lossy quarter-wave line. © 2010 IEICE Institute of Electronics Informati.

Application of a mechanobiological simulation technique to stents used clinically

Many cardiovascular diseases are characterised by the restriction of blood flow through arteries. Stents can be expanded within arteries to remove such restrictions; however, tissue in-growth into the stent can lead to restenosis. In order to predict the long-term efficacy of stenting, a mechanobiological model of the arterial tissue reaction to stress is required. In this study, a computational model of arterial tissue response to stenting is applied to three clinically relevant stent designs. We ask the question whether such a mechanobiological model can differentiate between stents used clinically, and we compare these predictions to a purely mechanical analysis. In doing so, we are testing the hypothesis that a mechanobiological model of arterial tissue response to injury could predict the long-term outcomes of stent design. Finite element analysis of the expansion of three different stent types was performed in an idealised, 3D artery. Injury was calculated in the arterial tissue using a remaining-life damage mechanics approach. The inflammatory response to this initial injury was modelled using equations governing variables which represented tissue-degrading species and growth factors. Three levels of inflammation response were modelled to account for inter-patient variability. A lattice-based model of smooth muscle cell behaviour was implemented, treating cells as discrete agents governed by local rules. The simulations predicted differences between stent designs similar to those found in vivo. It showed that the volume of neointima produced could be quantified, providing a quantitative comparison of stents. In contrast, the differences between stents based on stress alone were highly dependent on the choice of comparison criteria. These results show that the choice of stress criteria for stent comparisons is critical. This study shows that mechanobiological modelling may provide a valuable tool in stent design, allowing predictions of their long-term efficacy. The level of inflammation was shown to affect the sensitivity of the model to stent design. If this finding was verified in patients, this could suggest that high-inflammation patients may require alternative treatments to stenting.

Transcameral suture to prevent tube-corneal touch after glaucoma drainage device implantation: a new surgical technique

PURPOSE: To report a new technique to correct tube position in anterior chamber after glaucoma drainage device implantation.

PATIENT AND METHODS: A patient who underwent a glaucoma drainage device implantation was noted to have the tube touching the corneal endothelium. A 10/0 polypropylene suture with double-armed 3-inch long straight needle was placed transcamerally from limbus to limbus, in the superior part of the eye, passing the needle in front of the tube.

RESULTS: The position of the tube in the anterior chamber was corrected with optimal distance from corneal endothelium and iris surface. The position remained satisfactory after 20 months of follow-up.

CONCLUSIONS: The placement of a transcameral suture offers a safe, quick, and minimal invasive intervention for the correction of the position of a glaucoma drainage device tube in the anterior chamber.

Surgical technique:Complex glaucoma case requiring molteno drainage tube extension

A 42-year-old man has been under long-term follow-up since he was a child for congenital glaucoma and buphthalmos in both eyes. His left eye best corrected visual acuity (BCVA) was counting fingers, due to end-stage glaucoma. He was on maximal medical therapy with an intraocular pressure (IOP) maintained at mid to low twenties. His right eye, the only seeing eye, had a BCVA of 6/9. This eye had undergone multiple glaucoma laser and surgical procedures, including an initial first Molteno drainage device inserted superonasally that failed in April 2003 due to fibrotic membrane over the tube opening. As a result, he subsequently had a second Molteno drainage device inserted inferotemporally. To further maximize his vision he had an uncomplicated cataract extraction and intraocular lens implant in December 2004, after which he developed postoperative cystoid macular edema and corneal endothelial failure. He underwent a penetrating keratoplasty in the right eye thereafter in March 2007. After approximately a year, the second Molteno device developed drainage tube retraction, which was managed surgically to maintain optimum IOP in the right eye. His right eye vision to date is maintained at 6/12. © 2011 Mustafa and Azuara-Blanco.

Refined Magnetoseismological Technique for the Solar Corona

We present a step-by-step guide of a refined magnetoseismological technique for plasma diagnostics in the Sun’s corona. Recently developed MHD wave theory which models a coronal loop as an expanding magnetic flux tube with an arbitrary longitudinal plasma density profile is applied to TRACE observations of fast kink
oscillations. The theory predicts that using the observed ratio of the first overtone and fundamental mode to predict the plasma density scale height and not taking account of loop expansion will lead to an overestimation of scale height. For the first time, the size of this correction is quantified directly from observation and for the particular case study presented here, it is found that the overestimation is approximately by a factor of 2.

An in situ spatially resolved analytical technique to simultaneously probe gas phase reactions and temperature within the packed bed of a plug flow reactor

This paper reports the detailed description and validation of a fully automated, computer controlled analytical method to spatially probe the gas composition and thermal characteristics in packed bed systems. As an exemplar, we have examined a heterogeneously catalysed gas phase reaction within the bed of a powdered oxide supported metal catalyst. The design of the gas sampling and the temperature recording systems are disclosed. A stationary capillary with holes drilled in its wall and a moveable reactor coupled with a mass spectrometer are used to enable sampling and analysis. This method has been designed to limit the invasiveness of the probe on the reactor by using the smallest combination of thermocouple and capillary which can be employed practically. An 80 mu m (O.D.) thermocouple has been inserted in a 250 mu m (O.D.) capillary. The thermocouple is aligned with the sampling holes to enable both the gas composition and temperature profiles to be simultaneously measured at equivalent spatially resolved positions. This analysis technique has been validated by studying CO oxidation over a 1% Pt/Al2O3 catalyst and the spatial resolution profiles of chemical species concentrations and temperature as a function of the axial position within the catalyst bed are reported.