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Biomedical subjects

S Teague

Publications and source records attributed to S Teague.

7 recordsLinked to original sources

Design and dosimetric characteristics of a high dose rate remotely afterloaded endocavitary applicator system.

PURPOSE: An applicator is described for endocavitary treatment of rectal cancers using a high dose rate (HDR) remote afterloading system with a single high-intensity 192Ir source as an alternative to the 50 kVp x-ray therapy contact unit most frequently used in this application. METHODS AND MATERIALS: The applicator consists of a tungsten-alloy collimator with a 45 degree beveled end, placed in a protoscope with an elliptical cross-section. The resultant 3 cm diameter circular treatment aperture, located in the beveled face of the proctoscope, is irradiated by circular array of dwell positions located about 6.5 mm from the applicator surface. This beveled end allows patients with posterior wall tumors to be treated in the dorsal lithotomy position. The dose-rate distributions about the applicator were determined using a combination of thermoluminescent dosimetry (TLD-100 detectors) and radiochromic film dose measurement techniques along with Monte Carlo dosimetry calculations. TLD-100 (3 x 3 x 0.9 mm3 chips) measurements were used to measure the distribution of dose over the proctoscope surface as well as the central axis dose-rate distribution. Relative radiochromic film measurements were used to measure off-axis ratios (flatness and penumbra width) within the treatment aperture. These data were combined with Monte Carlo simulation results to obtain the final dose distribution. RESULTS: The tungsten collimator successfully limits the dose to the tissue in contact with the proctoscope walls to less than 12% of the prescribed dose. These results indicate that the HDR applicator system has slightly more penetrating depth-dose characteristics than the most widely used contact therapy x-ray machine. Flatness characteristics of the two treatment delivery systems are comparable, although the HDR endocavitary applicator has a significantly wider penumbra. Finally, the HDR applicator has a lower surface dose rate (1.5-4 Gy/min of dwell time) compared to 9-10 Gy/min for the x-ray unit. CONCLUSIONS: An applicator system has been developed for endocavitary treatment of early stage rectal carcinoma that uses a single-stepping source HDR remote afterloading system as a radiation source. The advantages of the HDR-based system over x-ray therapy contact units currently used in this clinical application are (a) enhanced flexibility in applicator design and (b) widespread availability of single-stepping source HDR remote afterloading systems.

Brachytherapy↗

Effect of anomalous pathway location on rate of canine experimental A-V reentrant tachycardia.

The effect of anomalous pathway (AP) location and conduction time on the cycle length (CL) and sustainability of paroxysmal A-V reentrant tachycardia was studied in 15 dogs, using an anomalous pathway simulator (APS). The APS was a programmable digital electronic circuit with ability for unidirectional conduction, ventricular sensing, adjustable delay, and atrial stimulation. Contiguous pairs of ventricular sensing electrodes were placed along the A-V ring in each dog at the following sites: anterior, posterior, and lateral right (AR, PR, and LR) and anterior, posterior, and lateral left (AL, PL, and LL) and septal (S). There were significant differences in the CL of tachycardias among the tested sites (P less than 0.01). The CL of tachycardias from the LL site was significantly longer and from the PR site significantly shorter than that from the other sites (P less than 0.05). These differences in CL of tachycardias in relation to the AP location were explicable in terms of corresponding variation in conduction times of the various components of the tachycardia circuit (e.g., intra-atrial, A-V nodal, intraventricular conduction times). The differences in magnitude of the CL of tachycardias, although significant, were small. It was also found that all sites allowed maintenance of tachycardias up to an AP conduction time of 10 ms. In 27% of experiments, atrial refractoriness prevented sustained tachycardias at pathway delays of 1 ms. The relationship between AP conduction time and CL of tachycardias was exponential.

Animals↗

A quantitative description of normal AV nodal conduction curve in man.

The AV nodal conduction curve generated by the atrial extrastimulus technique has been described only qualitatively in man, making clinical comparison of known normal curves with those of suspected AV nodal dysfunction difficult. Also, the effects of physiological and pharmacological interventions have not been quantifiable. In 50 patients with normal AV conduction as defined by normal AH (less than 130 ms), normal AV nodal effective and functional refractory periods (less than 380 and less than 500 ms), and absence of demonstrable dual AV nodal pathways, we found that conduction curves (at sinus rhythm or longest paced cycle length) can be described by an exponential equation of the form delta = Ae-Bx. In this equation, delta is the increase in AV nodal conduction time of an extrastimulus compared to that of a regular beat and x is extrastimulus interval. The natural logarithm of this equation is linear in the semilogarithmic plane, thus permitting the constants A and B to be easily determined by a least-squares regression analysis with a hand calculator.

Adult↗