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The application of echo-tracking methods to endothelium-dependent vasoreactivity and arterial compliance measurements.

Measurements of endothelium-dependent vasoreactivity and arterial compliance are important metrics of vascular pathophysiology which may be used for the development and evaluation of therapeutic methods. The technique of ultrasonic echo tracking is applicable to measurements of endothelium-dependent vasoreactivity and arterial compliance. To evaluate the application of echo tracking to these measurements, we constructed a system based upon analog-to-digital conversion and storage of the radio frequency (RF) ultrasound signals. Off-line analysis of the RF data with various echo-tracking algorithms demonstrated two potential sources of error: tracking drift and RF transition regions. The tracking drift resulted from the slow accumulation of tracking error. The RF transition regions were associated with disparate motions of neighboring reflectors or the insonation of a new series of tissue layers. As a result of these sources of error, the application of echo tracking to endothelium-dependent vasoreactivity measurements is unlikely to outperform duplex ultrasound methods. The application of echo tracking to arterial compliance measurements via the arterial pressure/diameter relationship may produce variable results due to RF transition regions. Finally, the application of echo tracking to arterial compliance measurements via the pulse wave velocity is relatively insensitive to these sources of error because the pulse-wave velocity measurement depends upon the timing of the peak arterial distension, not on the absolute value of the distension.

Algorithms↗

Benzo(a)pyrene diol epoxide-I-DNA adduct formation in the epidermis and lung of SENCAR mice following topical application of crude coal tar.

The levels of benzo[a]pyrene diol epoxide-I-deoxyguanosine (BPDE-I-dG) adduct formation in epidermis and lung of SENCAR mice following the topical application of benzo[a]pyrene (BP) alone, crude coal tar (CCT) alone, and the two combined were determined in an enzyme linked immunosorbent (ELISA) assay using monoclonal antibodies. Topical application of two doses of BP (20 micrograms) at 72-h intervals, with sacrifice 24 h later resulted in the formation of 197 fmol and 205 fmol BPDE-I-dG adducts per mg DNA in epidermis and lung, respectively. Topical application of 0.5 ml CCT alone resulted in the formation of 278 fmol and 410 fmol BPDE-I-dG adducts per mg DNA in epidermis and lung, respectively. Simultaneous topical application of 20 micrograms BP and CCT (0.1-0.5 ml) resulted in substantially lower BPDE-I-dG adducts in the epidermis as well as in the lung. Our results suggest that CCT may contain inhibitors of carcinogen-DNA adduct formation and that topical application of CCT produces greater effects on DNA-adduct formation in lung than in epidermis. Thus the cancer-causing potency of the polycyclic aromatic hydrocarbons (PAHs) in CCT may be reduced by other anticarcinogenic constituents present in CCT and systemic absorption of carcinogenic PAHs in CCT applied to skin might have tumorigenic effects in other tissues.

7,8-Dihydro-7,8-dihydroxybenzo(a)pyrene 9,10-oxide↗

Histamine application to the nasal mucosa induces release of calcitonin gene-related peptide and substance P from peripheral terminals of trigeminal ganglion: a morphological study in the guinea pig.

Short-term effects of application of histamine to the nasal mucosa on trigeminal ganglion neurons containing calcitonin gene-related peptide (CGRP) and substance P (SP) were examined in guinea pig. Immunoreactivities to CGRP and SP in these neurons were decreased 30 min after the histamine application. The decreases were most marked at 1-3 h after application, after which the immunoreactivities began to increase, reaching the base line by 6 h after the application. The immunoreactivities to CGRP and SP in the nerve endings of nasal mucosa were not decreased. The expression of mRNAs for both peptides in the soma of trigeminal neurons was unchanged. The histamine application to the nasal mucosa may cause release of CGRP and SP from terminals of peripheral processes of trigeminal ganglion neurons, and enhance axonal transport of these peptides, but does not affect their biosynthesis in the soma of trigeminal ganglion neurons.

Animals↗

Enhancement of spinothalamic neuron responses to chemical and mechanical stimuli following combined micro-iontophoretic application of N-methyl-D-aspartic acid and substance P.

A role for sensitization of nociceptors in the generation of primary hyperalgesia is well documented. More recent work has begun to define a role of an increased excitability of neurons within the spinal cord in the generation of secondary hyperalgesia. The present study demonstrates increased responses of primate spinothalamic neurons following co-administration of N-methyl-D-aspartic acid (NMDA) and substance P (SP) by micro-iontophoresis. Wide dynamic range and high threshold STT neurons in laminae I-VI showed an increased frequency of discharges following application of NMDA which was characterized by a slow onset to peak discharge rate and a slow return to background levels of discharge. Combined application of NMDA with SP resulted in an enhancement of responses to NMDA that often long outlasted the administration of SP. This increase in response of the cells to NMDA was not produced by repeated application of NMDA alone or following combined application of NMDA with an SP analog. NMDA responses were reduced or prevented in all cases by co-application of an NMDA-receptor antagonist. Finally, long-lasting potentiation of NMDA responses by SP was paralleled by enhanced responses to mechanical stimulation of skin. It is proposed that a mechanism involving the combined synaptic release of excitatory amino acids and peptides leads to secondary hyperalgesia.

Animals↗

A new design of microwave interstitial applicators for hyperthermia with improved treatment volume.

New 915 MHz microwave interstitial applicators with improved treatment volume have been developed for clinical hyperthermia. The applicators are made from semi-rigid miniature coaxial cables by removing sections of the outer copper conductor to create multiple nodes while preserving the integrity of the teflon dielectric insulators. The homogeneity of the temperature distribution along the longitudinal axis is optimized by empirically adjusting the spacing of the gaps between sections of the outer conductor along the length of the applicator. In vitro and in vivo testing of the two-node and three-node microwave applicators show that the treatment volume can be improved by 100% over that of a one-node microwave applicator.

Animals↗

Development of an 241Am applicator for continuous low-dose-rate irradiation of the rat sarcoma BA1112.

An 241Am applicator for continuous low-dose-rate irradiation of the rat sarcoma BA1112 has been developed. The irradiator consists of two disc sources, each containing 800 mCi of 241Am, an isotope which emits primarily 60 keV photons. The disc sources are held in a specially-designed light-weight helmet which surrounds the tumor on the head of the rat. Dose distributions produced by these sources have been measured using an ionization chamber, thermoluminescent dosimeters and Fricke dosimeter. A computerized treatment planning system has been modified to compute dose distributions from 241Am sources, to optimize the design of this applicator. Computed and measured dose distributions for several values of separation between the 241Am discs are presented. A survival curve for cells from tumors irradiated in vivo with this applicator has been determined by an in vitro colony formation technique. The mean lethal dose DO was found to be 720 cGy for an average tumor dose rate of 95 +/- 7 cGy/hr. The major advantages of the 241Am applicator in comparison with the 192Ir applicator used previously for continuous low-dose-rate studies are: a considerably smaller half value layer thickness and the longer half life of the radionuclide. These features make it more suitable for long-term tumor cure studies because of the lower whole body dose to the animal, the availability of relatively constant dose-rate irradiators for many years, the decreased shielding requirements for the animal care facility and the diminished exposure to laboratory personnel involved with the implants on the animals.

Americium↗

Spiral microstrip hyperthermia applicators: technical design and clinical performance.

Spiral microstrip microwave (MW) antennas have been developed and adapted for use as clinical hyperthermia applicators. The design has been configured in a variety of forms including single fixed antenna applicators, multi-element arrays, and mechanically scanned single or paired antennas. The latter three configurations have been used to allow an expansion of the effective heating area. Specific absorption rate (SAR) distributions measured in phantom have been used to estimate the depth and volume of effective heating. The estimates are made using the bioheat equation assuming uniformly perfused tissue. In excess of 500 treatments of patients with advanced or recurrent localized superficial tumors have been performed using this applicator technology. Data from clinical treatments have been analyzed to quantify the heating performance and verify the suitability of these applicators for clinical use. Good microwave coupling efficiency together with the compact applicator size have proved to be valuable clinical assets.

Equipment Design↗

Comparison of 1 vs 2 or more intracavitary brachytherapy applications in the management of carcinoma of the cervix, with irradiation alone.

Four hundred ninety-eight patients treated in the USA in 1978 for cancer of the cervix by external beam and intracavitary irradiation have been studied to determine the effect of using a single intracavitary (IC) application versus more than one. Most of the patients (46%) underwent intracavitary (IC) treatment after external radiation therapy (RT), 40% during external RT, and 14% prior to external RT. Five-year actuarial survival for all stages was 66% for greater than or equal to 2 applications versus 59% for 1 application, p less than .01. When survival was analyzed by stage, there was a trend toward improved survival with greater than or equal to 2 applications in Stage II (p .10). The rate of infield recurrence for all stages was higher in the 1 IC group (30% vs 17%, p less than .01). These were more frequent in the 1 IC group (53% vs 34%, p less than .05), in Stage III patients, but no significant difference was noted in the other stages. Distant metastases were more frequent in the 1 IC group (19% vs 11%, p .01). The incidence of major complications was the same in both groups. An analysis of patient characteristics and other variables that would explain the difference in results revealed that older patients (p .03), worse Karnofsky (p .056), and more parametrial involvement (p less than .01) accrued more in the 1 IC group. Higher paracentral point doses were administered when greater than or equal to 2 IC applications were used (p less than 0.01); this group also received higher bladder and rectal doses and lower whole pelvic doses. The use of two or more intracavitary insertions affords an opportunity to administer higher paracentral point doses, which appear to be related to higher pelvic tumor control, lower rate of distant metastasis, and better survival.

Adult↗

Dosimetry and dose specification for a new gynecological brachytherapy applicator.

A new afterloadable gynecological intracavitary applicator has been designed and is now in use for the treatment of a wide range of vaginal, cervical, and endometrial cancers in a single application, with a dose distribution that more closely matches the prescribed treatment than previous methods. The plexiglass applicator consists of a bulbous section that is inserted up to the vaginal apex and loaded with right and left ovoid sources. The distal portion is cylindrical with a central channel for tandem sources. A straight tandem is used when the target volume extends to the vaginal apex, but an intrauterine tandem can also be used. Extensive dosimetric and radiographic evaluations were performed to guide design refinements and to validate the surface dose predictions of the brachytherapy treatment planning system. The final applicator design delivers 110-120 cGy/hr to the vaginal apex surface and 95-100 cGy/hr to the distal vaginal surfaces when loaded with a 144.6 U (20 mgRaEq) cesium tube in each ovoid channel and 72.3, 72.3, and 144.6 U (10, 10, and 20 mgRaEq) cesium tubes in the vaginal cylinder channel. A system for treatment dose specification has been established that includes dose tables for manually calculating surface doses to reference points. A dose distribution comparison with a sequential colpostat-vaginal cylinder treatment demonstrates that dose delivery is more precise and uniform with this new applicator.

Brachytherapy↗

Design and dose distribution for rectal applicators for the high dose rate remote afterloading iridium-192 brachytherapy system.

A Remote High Dose Rate (HDR) Brachytherapy Iridium-192 System for outpatient brachytherapy procedures necessitates a variety of applicators in order to accomplish the optimal desired treatment for the patient's tumor involved anatomy. The Nucletron Corporation that manufactures the microselection HDR Iridium-192 treatment unit provided us with their standard applicators; however, a rectal applicator system was not available at the time of purchase. In order to provide this treatment to the patient, the physicians and the physicists designed a custom set of rectal applicators that would meet the current and immediate needs of our patients. A description of the clinical rationale and physical aspects of the rectal applicator system, including design and radiation dosimetry will be presented.

Ambulatory Care↗

Spreadsheet application for radiology resident match rank list.

RATIONALE AND OBJECTIVE: Enormous resources are spent on the selection process for radiology residency, yet agreement on criteria, process, and outcome remains elusive. The aim was to develop, implement, and evaluate a spreadsheet application that streamlined the creation of a match list for resident selection. MATERIALS AND METHODS: The Department of Radiology's traditional procedure of screening, interviewing, and rating candidates was left intact because the selection committee could not reach consensus regarding possible improvements in the process or outcome measures. We developed a spreadsheet application that used the ratings of candidate desirability for our program from our preexisting process to create a tentative match list by adding a system of ordinal ranking and weighting. After 4 years of use, the fairness and usefulness of this application were evaluated by members of the selection committee by means of a survey. RESULTS: The spreadsheet application was used to create tentative match lists for 4 years. The system eliminated ties among candidates on the preliminary match list and met the expectations of a majority of the selection committee members for fairness, objectivity, efficiency, and results. CONCLUSION: A spreadsheet application can streamline the process of resident selection without having to resolve underlying conflicts about selection criteria and outcome measures.

Attitude of Health Personnel↗

Potential applications of chitosan in veterinary medicine.

Chitosan is a partially deacetylated polymer obtained from the alkaline deacetylation of chitin which is a glucose-based unbranched polysaccharide widely distributed in nature as the principal component of exoskeletons of crustaceans and insects as well as of cell walls of some bacteria and fungi. Chitosan exhibits a variety of physicochemical and biological properties resulting in numerous applications in fields such as waste and water treatment, agriculture, fabric and textiles, cosmetics, nutritional enhancement, and food processing. In addition to its lack of toxicity and allergenicity, and its biocompatibility, biodegradability and bioactivity make it a very attractive substance for diverse applications as a biomaterial in pharmaceutical and medical fields, where it has been used for systemic and local delivery of drugs and vaccines. It also has bioactive properties in its own right. This paper reviews current veterinary applications for chitosan including wound healing, bone regeneration, analgesic and antimicrobial effects. It also discusses the potential application of chitosan to drug and vaccine delivery in veterinary species. Given the restrictions imposed by financial and animal restraint considerations, especially in farming applications, the veterinary drug delivery areas most likely to benefit from chitosan are the delivery of chemotherapeutics such as antibiotics, antiparasitics, anaesthetics, painkillers and growth promotants to mucosal epithelium for absorption for local or systemic activity, and the delivery of immunomodulatory agents to the mucosal associated lymphoid tissue for induction or modulation of local immune responses. The properties of chitosan expected to enhance these functions are discussed, and the future research directions in this field are indicated.

Analgesia↗

Effect of fluoride application on shear bond strength of brackets bonded with a resin-modified glass-ionomer.

PURPOSE: The purpose of this study was to assess the effect of fluoride application at 3 different steps of the bonding process on the shear bond strength and bond failure site of a resin-modified glass ionomer cement. MATERIAL: Sixty stainless steel brackets were bonded to bovine incisors with Fuji Ortho LC (GC Europe, Leuven, Belgium) under 4 different enamel conditions: (1) uncontaminated enamel, (2) enamel precleaned with fluoride-containing prophylaxis paste, (3) 1.1% acidulated phosphate fluoride (APF) gel applied immediately before conditioning, and (4) 1.1% APF gel applied immediately before bonding. After bonding, all samples were stored in distilled water for 24 hours and subsequently tested in shear mode on a universal testing machine. RESULTS: No significant differences were found between groups 1 (uncontaminated enamel) and 2 (fluoride application during prophylaxis). Both groups showed significantly greater shear bond strength values than groups 3 (fluoride application before conditioning) and 4 (fluoride application before bonding). Groups 3 and 4 did not differ significantly. Moreover, no significant differences in debond locations were found among the 4 groups. CONCLUSIONS: Fluoride application during initial prophylaxis does not affect the bond strength values of Fuji Ortho LC, whereas it significantly lowers bond strength values when applied before both conditioning and bonding.

Acid Etching, Dental↗

Physical properties of root cementum: part 6. A comparative quantitative analysis of the mineral composition of human premolar cementum after the application of orthodontic forces.

INTRODUCTION: The aim of this study was to examine quantitatively with electron probe microanalysis (EPMA) the calcium (Ca), phosphorus (P), and fluoride (F) concentrations in human first premolar cementum after the application of light and heavy orthodontic forces. METHODS: Thirty-six maxillary and mandibular first premolars (18 experimental, 18 control) were extracted from 16 subjects (10 male, 6 female; mean age, 13.9 years; range, 11.7-16.1 years) who were randomly assigned to the light-force or the heavy-force group. In the light-force group, 25 g of buccally directed force was applied to the experimental premolar; in the heavy-force group, 225 g of buccally directed force was applied to the experimental premolar. The contralateral premolar served as the control. The experimental and control premolars were extracted 28 or 29 days after initial force application and prepared for EPMA. The Ca, P, and F concentrations were measured on the buccal and lingual surfaces at the midpoint of the cervical, middle, and apical thirds of the root from the outer to the middle to the inner third of the cementum. RESULTS: Little change was found in the mineral composition of cementum after the application of light forces; however, there was a trend toward an increase in the mineral composition (Ca, P, and F) of cementum at various areas of periodontal ligament compression. The application of heavy forces caused a significant (P = .000) decrease in the Ca concentration of cementum at certain areas of periodontal ligament tension. The application of both light and heavy orthodontic forces did not appear to influence the F concentrations in cementum. CONCLUSIONS: Heavy orthodontic forces cause alterations in the mineral content of cementum; light forces cause little change.

Adolescent↗

Occlusion of dentinal tubules and selective block of pulp innervation prevent the nociceptive behaviour induced in rats by intradental application of irritants.

OBJECTIVES: Application of irritants on the exposed dentine of the incisors has been shown to produce aversive behaviour in awake rats. This study aims to demonstrate that the observed aversion is due to the infiltration of irritants through the dentinal tubules and the activation of capsaicin sensitive fibres in the tooth pulp. METHODS: Different groups of rats were subjected, under anaesthesia, to cutting of the distal 2 mm of their lower incisors and the fixation of an artificial crown that allows the application of 10-15 microl of solution. Several procedures were followed to prevent the action of the irritants including occlusion of the dentinal tubules, local application of lidocaine, selective ablation of the capsaicin sensitive primary afferents (CSPA) or incisor pulpectomy; the reactions to intradental application of either capsaicin (1%) or formalin (2.5%) were tested using a newly designed behavioural score. RESULTS: Occlusion of dentinal tubules produced significant attenuation of the nociceptive behaviour induced by dentinal application of either capsaicin or formalin. Similar results were observed following either local block with lidocaine (2%), selective ablation of capsaicin sensitive afferents or total denervation by pulpectomy. CONCLUSIONS: The present results confirm the hypothesis of infiltration of irritants to the incisor pulp through the dentinal tubules and suggest that the reported inflammatory reaction and hyperalgesia are mediated, to a large extent, by capsaicin sensitive primary afferents.

Anesthetics, Local↗

Brachytherapy management of the retroverted uterus using ultrasound-guided implant applicator placement.

PURPOSE: Patients with a retroverted uterus present a dilemma for brachytherapy in gynecologic malignancies because of the challenges of the procedure and the risk of uterine perforation. The purpose of this study was to evaluate the efficacy and outcome of ultrasound-guided brachytherapy applicator placement and intraoperative uterine anteversion in patients with gynecologic malignancies, who have a retroverted uterus. METHODS AND MATERIALS: Thirty-three brachytherapy insertions were performed in 18 patients with retroverted uterus (cervical cancer, 17; vaginal cancer, 1). The endocervical canal was dilated, the intrauterine Fletcher tandem was inserted in retroverted fashion and then anteverted along with the uterus under continuous ultrasound guidance. The anteverted tandem position was secured with vaginal packing and use of a second and/or third flange on the tandem stem. Treatment was delivered with low-dose-rate brachytherapy using afterloading with 137Cs. Brachytherapy was combined with external beam radiation in all patients. Median post-therapy follow-up was 2.17 years (range, 0.75-9.25 years). RESULTS: Procedure. Ultrasound-guided dilation of the cervix was achieved in all procedures. Sounding of the retroverted uterus up to the fundus was accomplished successfully in all but one procedure (because severe retroflexion of the uterus and fixation of the fundus to the sacrum). Ultrasound-guided anteversion of the inserted tandem and uterus was achieved in all procedures. No ultrasonographic evidence of perforation was seen in any of the procedures. Intraoperative radiographs showed satisfactory position of the applicators in 31 of the 33 procedures; 2 cases were re-packed resulting in acceptable final applicator position. No backward rotation of the tandem was observed over the duration of the low-dose-rate brachytherapy application. The mean ratio between the dose to the rectum and Point A was 73%; the ratio between the dose to the bladder and Point A was 76%. Outcome. In the 17 patients with cervical cancer, 2-year pelvic tumor control rate was 100%, and 2-year actuarial disease-free survival was 73%. The patient with vaginal cancer has no evidence of disease 5 months post-therapy. There was one complication (1/18 patients, 5.5%): a rectal stricture in a patient with stage IVA cervical cancer requiring colostomy. CONCLUSIONS: The use of ultrasound-guided uterine anteversion for brachytherapy applicator placement is feasible and results in acceptable outcome and complication rates in a population otherwise difficult to manage and at high risk for uterine perforation. Based on these results, this method is likely preferable to brachytherapy with a retroverted tandem, or to the omission of brachytherapy.

Brachytherapy↗

Cerebral preconditioning using cortical application of hypertonic salt solutions: upregulation of mRNAs encoding inhibitors of inflammation.

Previous studies have demonstrated that local application of hypertonic KCl or NaCl to the cerebral cortex induces tolerance to a subsequent episode of ischemia. The objective of the present study was to determine whether application of these salts increases the levels of mRNAs encoding inhibitors of inflammation. Hypertonic KCl or NaCl was applied for 2 h to the frontal cortex of Sprague-Dawley rats. After recovery periods up to 24 h, levels of selected mRNAs were measured in samples from frontal and parietal cortex using Northern blots. Application of hypertonic KCl caused a rapid and widespread increase in the levels of mRNA coding for tumor necrosis factor (TNF), tristetraprolin (TTP), suppressor of cytokine signaling-3 (SOCS3), and brain-derived neurotrophic factor (BDNF), and a 24-h delayed induction of ciliary neurotrophic factor (CNTF) mRNA. Application of hypertonic NaCl caused alterations in mRNA levels that were restricted to the frontal cortex. In this region, application of NaCl rapidly increased levels of mRNA encoding TNF, TTP, and SOCS3, but not BDNF, and caused a delayed induction of CNTF mRNA. These results raise the possibility that upregulation of inhibitors of inflammation after preconditioning may contribute to the induction of tolerance to ischemia.

Animals↗

Effects of sewage sludge compost application on crops and cropland in a 3-year field study.

Composted sewage sludge can be applied to cropland to supply nutrients and improve soil physical properties. However, farmers are much concerned about heavy metal accumulation in cropland and heavy metal availability for crops. A 3-year field study was carried out in this study to investigate the effects of sewage sludge compost (SSC) application on the heavy metal accumulation in cropland soil, rapeseed germination and plumelet development, and yields of barley and Chinese cabbage, compared with conventional mineral fertilization. In addition, the availability of heavy metals for barley and Chinese cabbage was examined. Experimental results showed that SSC application produced little effects on rapeseed germination and stimulated the rape plumelet development at lower application rates (<150 ton ha(-1)). Heavy metals (Cu and Zn) were accumulated in the topsoil (0-20 cm), the barley grains and the cabbage leaves. The yields of barley and Chinese cabbage generated positive response to the SSC application. Addition of mineral N-P-K fertilizers into SSC could further increase the crop yield. Considering the heavy metals accumulation in cropland soil and their availability for crops, SSC should be applied to cropland at a limited application rate (<150 ton ha(-1)).

Brassica↗