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Objective To evaluate the dosimetric difference between fixed-field static intensity-modulated radiotherapy (IMRT), fixed-field dynamic multileaf collimator (DMLC), and volumetric modulated arc therapy (VMAT), all of which involve supraclavicular and infraclavicular regions, in breast cancer patients after breast-conserving surgery.Methods This study included 14 female patients with breast cancer who received radiotherapy after breast-conserving surgery in our hospital from October 2012 to April 2016.The radiation field included the chest wall and supraclavicular and infraclavicular regions.IMRT, DMLC, and VMAT plans were generated for each patient while using identical optimization conditions.The doses to planning target volume (PTV) and organs at risk (OARs) were compared based on dose-volume histogram (DVH);one-way analysis of variance or nonparametric Wilcoxon rank test was used for comparison.Results For the dose distribution of PTV, VMAT achieved the best V95, V98, CI, and HI (P<0.009).Concerning the doses to OARs, VMAT achieved the best V5, V20, and Dmean of the ipsilateral lung and the best V5 and Dmean of the contralateral lung (P<0.022).Dmean of the spinal cord was significantly lower in VMAT than in IMRT and DMLC (P=0.004).Conclusions VMAT is preferred for the patients with breast cancer to be treated with radiotherapy involving supraclavicular and infraclavicular regions after breast-conserving surgery.It can improve the dose distribution of target and reduce the doses to organs at risk and radiotherapy toxicities.
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Objective To explore the changes of tumor necrosis factor-α (TNF-α),nuclear factor kappa B (NF-κB),free radical in brain tissue in newborn rats with hypoxic-ischemic brain damage(HIBD),to clarify the role of TNF-α,NF-κB,free radical in HIBD.Methods The 56 SD neonatal rats were randomly divided into control group and hypoxic-ischemic 6 h,12 h,24 h,48 h,72 h,7 d groups.The conventional method was used to establish HIBD model.The level of TNF-α was measured by enzyme-linked immumosorbent assay,NF-κB was detected by electrophoretic mobility shift assay.The neuron apoptosis was identified by flow cytometry.Superoxide dismutase(SOD),molondialdehyde (MDA),glutathione peroxidase(GSH-Px) were identified by spectrophotography.Results The rate of neuron apoptosis,the contents of TNF-α,NF-κB,MDA in brain tissue were significantly higher in 6 h,12 h,24 h,48 h,72 h groups than those in contral group(all P ＜0.05),and the apoptosis,MDA reached the peak at the 24 h after hypoxia,TNF-α reached the peak at the 12 h after hypoxia,NF-κB reached the peak at the 48 h after hypoxia.But the content of SOD and the activity of GSH-Px in hypoxic-ischemic group were significantly lower than those in control group at 6 h,12 h,24 h,48 h,72 h after hypoxia.And the rate of neuronal apoptosis was positively correlated with TNF-α,NF-κB and MAD (all P ＜ 0.05),negatively correlated with GSH-Px and SOD (all P ＜ 0.05),the contents of TNF-α,NF-κB were positively correlated with MAD (all P ＜ 0.05),negatively correlated with the content of SOD and the activity of GSH-Px (all P ＜ 0.05).Conclusions TNF-α,NF-κB,free radical are early changed after HIBD,So they play an important role in HIBD,inflammation and free radical can promote brain damage.
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<p><b>BACKGROUND</b>The vertebral artery (VA) and atlantoaxial joint (AAJ), with complicated structures, are located in the depths of the head-neck boundary area, the regional anatomy of which cannot be shown globally and directly. This study aims to evaluate three-dimensional CT angiography (3DCTA) in displaying the AAJ, atlantoaxial segment of the vertebral artery (ASVA) and the identification of their interrelations.</p><p><b>METHODS</b>Sixty-eight subjects without pathology of the ASVA and AAJ were selected from head-neck CTA examination. All the 3D images were formed with volume rendering (VR) together with techniques of separating, fusing, opacifying and false-coloring (SFOF). On the 3D images, the ASVA and AAJ were observed, and their interrelations were measured.</p><p><b>RESULTS</b>All the 3DCTA images were of high quality and up to our requirements. They could clearly and directly show the ASVA, ascending along the AAJ. There were 5 curves in the course of the ASVA, of which 2 curves were away from the atlantoaxial joint, one in the 2nd curve of 0.0 mm - 5.4 mm, the other in the 4th of 2.6 mm - 9.2 mm. There was no significant difference in the measurements between left and right (P > 0.05). The curved parts of the ASVA slightly expanded, with the biggest diameter of 5.6 mm in the 4th curve. Statistical comparison shows that the left ASVA is larger than the right (P < 0.05). Variations of the ASVA were found in 8 cases and of the AAJ in 12.</p><p><b>CONCLUSIONS</b>3DCTA can globally and directly demonstrate the structures of the AAJ, ASVA and their interrelations. The 3D imaging data make up and enrich the research contents of regional anatomy and lay the foundation for related study and applications.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Atlanto-Axial Joint , Diagnostic Imaging , Imaging, Three-Dimensional , Methods , Tomography, X-Ray Computed , Methods , Vertebral Artery , Diagnostic ImagingABSTRACT
<p><b>OBJECTIVE</b>To evaluate and compare the diagnostic value in atlantoaxial subluxation by CT three-dimensional (3D) reconstruction.</p><p><b>METHODS</b>3D reconstruction findings of 41 patients with atlantoaxial subluxation were retrospectively analyzed, and comparisons were made among images of transverse section, multiplanar reformorting (MPR), surface shade display (SSD), maximum intensity project (MIP), and volume rendering (VR).</p><p><b>RESULTS</b>Of 41 patients with atlantoaxial subluxation, 31 belonged to rotary dislocation, 5 antedislocation, and 5 hind dislocation. All the cases showed the dislocated joint panel of atlantoaxial articulation. Fifteen cases showed deviation of the odontoid process and 8 cases widened distance between the dens and anterior arch of the atlas. The dislocated joint panel of atlantoaxial articulation was more clearly seen with SSD-3D imaging than any other methods.</p><p><b>CONCLUSIONS</b>Atlantoaxial subluxation can well be diagnosed by CT 3D reconstruction, in which SSD-3D imaging is optimal.</p>
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Atlanto-Axial Joint , Wounds and Injuries , Imaging, Three-Dimensional , Joint Dislocations , Diagnostic Imaging , Retrospective Studies , Tomography, X-Ray Computed , MethodsABSTRACT
@#ObjectiveTo explore pathogenesis of headache after subarachnoid hemorrhage (SAH) whether related with immune inflammatory reaction in subarachnoid and observe the effect of immunosuppressive action of dexamethasone on headache.Methods80 patients who was consciousness and complained headache after SAH were randomly divided into four groups, treated only with mannitol, mannitol plus cerebrospinal fluid (CSF) replacement, intrathecal and vein injection with dexamethasone. Effects of four groups were observed.ResultsEfficiencies of four groups were respectively the mannitol group 27.27%, the permutation group 66.67%, the intrathecal group 92.36% and the vein group 30.00%. There was a significantly difference between the intrathecal group and other three groups, and the time of headache remission for intrathecal group was also longer than that of other three groups (P<0.01).ConclusionThe wide immune inflammatory responses in subarachnoid induced by degenerative and hemic CSF is likely main cause of headache after SAH and intrathecal injection with dexamethasone has an obviously effect.