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Biomedical subjects

L Greig

Publications and source records attributed to L Greig.

3 recordsLinked to original sources

Linear accelerator output variability.

The Wellington Cancer Centre is equipped with two matched linear accelerators (Varian 2100CD) linear accelerators (identified as SN1027 and SN42). Each morning, before treatments commence, a radiation therapist carries out an output constancy check of the radiation output and every fortnight a physicist measures, in a phantom, the delivered radiation dose to check on the machine calibration. The daily output checks have been recorded into a database (Argus QA for Radiation Oncology) since August 1997 and in June 1998 the fortnightly calibration measurements were added. The information in the database, up to April 2003, has been analysed to consider the quality of the daily constancy checks as compared with the fortnightly calibration measurements and whether the data contains useful information on machine performance. After allowance for the effects of machine recalibration the fortnightly calibration measurements had an average standard deviation of 0.4% and the daily constancy checks 0.8%. The daily constancy checks had a greater number of large deviations than would be expected assuming a normal distribution and were not a good predictor of the need for a recalibration. The fortnightly calibration measurements with a much lower spread give a reliable indication of the need for a recalibration allowing the adoption of a +/- 1% tolerance. Over the period analysed one accelerator (SN42) was relatively stable with the output generally drifting between +/- 1% while the other (SN1027) had a consistent increase in the average output of about 2.5% per year.

Calibration↗

Dosimetry of small electron fields shaped by lead.

Electron radiotherapy fields are commonly used to treat superficial cancers. Field shaping can be achieved by placing lead on the patient surface to minimise the dose to surrounding areas. However, significant dosimetry changes under high density material edges for electron fields have been reported in the literature. This project evaluated the dosimetry of small dimension electron fields shaped with lead placed on the surface. Comparisons were made between circular lead cutouts placed on the skin and low melting point alloy cutouts placed in an applicator. Depth doses, profiles and output factors were measured using a diode detector in a water phantom. Film was also used to determine surface dose delivered when the lead cutouts were placed on the surface. Minimal differences were observed between the different setups for the depth dose curves, although significant differences were seen in the penumbra and the surface doses. The penumbra is smaller for the lead cutouts placed on the surface, however, significant dose increases at the edge of the field were observed for larger fields and energies; this may result in undesirable clinical effects.

Electrons↗

Anti-oxidants-- a protective role in cardiovascular disease?

Established risk factors for cardiovascular disease (CVD), such as hypertension, smoking and diabetes mellitus, explain only some of the observed variation in clinical events. This has maintained interest in other nutritional and biochemical factors that might contribute to the underlying pathophysiology of CVD. All of these risk factors are associated with increased oxidative stress in the vessel wall, which may contribute to CVD by several mechanisms. Studies in animal models of CVD have suggested that natural and synthetic anti-oxidants can prevent the development of clinical end points. These observations have generated the hypothesis that anti-oxidant therapy might also prevent CVD in human populations. This has been supported by epidemiological studies showing a negative correlation between circulating concentrations or dietary intake of natural anti-oxidant vitamins and CVD event rate. Many studies have also demonstrated a beneficial effect of anti-oxidants on surrogate markers of CVD such as endothelial function and lipoprotein oxidation. However, the results of large prospective randomised controlled intervention trials, mostly involving vitamin E in patients at increased risk of CVD, have been disappointing and have failed to demonstrate the anticipated benefits. This paper will critically examine the evidence and try to offer some explanation for the apparent failure of animal and epidemiological data to translate into meaningful clinical benefits.

Animals↗