PubMed · 10254619
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PURPOSE: The increasing complexity of radiotherapy highlights the need for accurate setup. This paper assesses the potential of position corrections, derived from the three-dimensional (3D) surface of the patient, in reducing positioning errors in patients undergoing conformal radiation therapy of the prostate. METHODS AND MATERIALS: Twenty patients undergoing conformal radiation therapy for prostate cancer had planning computed tomography (CT) scans and then weekly treatment CT scans over the course of their treatment. Patients were positioned on the CT table using three coplanar tattoo marks used for patient setup on the accelerator. Surfaces were computed from the planning CT (planning surface), and the treatment CT (treatment surfaces). Using a surface matching utility, the planning and treatment 3D surfaces were compared. The prostate was implicitly localized based on surface matching of the external contour and by matching the bony anatomy. The resultant prostate displacement after correction was assessed for the two localization methods. RESULTS: Correcting patient position via the surface comparisons reduced the standard deviation of prostate displacement with respect to the patient isocenter in the lateral and anterior/posterior directions. In the lateral direction, prostate and surface motion was highly correlated (r = 0.96). In the anterior/posterior direction the corrections from the surface data were as effective as those derived from the bony anatomy. CONCLUSION: Detailed surface data can aid the positioning of patients receiving conformal radiation therapy to the prostate by reducing the displacement of the target from the intended treatment position. This study shows that surface corrections can be as effective as those derived from bony anatomy, and may be exploited where definition of bony anatomy is difficult.
Atypical hemolytic uremic syndrome (HUS) is a heterogeneous group of disorders, the pathogenesis of which is unclear. Plasma transfusions and plasmapheresis are widely used modes of therapy for adults with this life-threatening syndrome. There is very limited experience in using plasmapheresis therapy in children and infants with atypical HUS. Plasmapheresis, which is considered a relatively safe procedure in adults and older children, may be hazardous in neonates and very young infants and can result in severe complications. We report a 2-month-old infant with idiopathic atypical HUS, who was successfully treated with a 1-month course of plasmapheresis during the acute phase of the disease. Appropriate preparations as well as several adjustments were made in order to meet the special needs of this very young infant who, to the best of our knowledge, is the youngest reported patient with atypical HUS to undergo plasmapheresis. Plasmapheresis therapy of the infant was not associated with any complications of the procedure and resulted in marked clinical improvement. We conclude that plasmapheresis in neonates and in very small infants is technically feasible, can be performed without major complications, and may be of benefit in individual cases.
Fe0-mediated reductive destruction of hazardous organic compounds such as chlorinated organic compounds (COCs) and nitroaromatic compounds (NACs) in the aqueous phase is one of the latest innovative technologies. In this paper, rapid reductive degradation of COCs and NACs by synthesized nanoscale Fe0 in anaerobic batch systems was presented. The nanoscale Fe0, characterized by high specific surface area and high reactivity, rapidly transformed trichloroethylene (TCE), chloroform (CF), nitrobenzene (NB), nitrotoluene (NT), dinitrobenzene (DNB) and dinitrotoluene (DNT) under ambient conditions, which results in complete disappearance of the parent compounds from the aqueous phase within a few minutes. GC analysis reported that the main products of the dechlorination of TCE and CF were ethane and methane as well as that most of the nitro groups in NACs were reductively transformed to amine groups. These results suggest that the rapid reductive destruction by nanoscale Fe0 is potentially a viable in situ or aboveground treatment of groundwater contaminated with hazardous organic compounds including COCs and NACs.