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Objective:To investigate the dosimetric differences between conventional IMRT and electron beam conformal radiotherapy (EBCRT) combined with IMRT for post-mastectomy left-sided breast cancer patients.Methods:A total of 20 post-mastectomy left-sided breast cancer patients who were treated in the Ningbo First Hospital from June 2018 to October 2021 were retrospectively studied. The planning target volume (PTV) included the supra-and infra-clavicular regions(PTV sc)and the ipsilateral chest wall (PTV cw), and the prescribed dose was 50 Gy/25 f. All radiotherapy plans were designed using the Varian Eclipse treatment planning system (TPS). After that, the dose distribution of the target volume and the dose exposure of organs at risk (OARs) were compared and analyzed. Results:All the IMRT plans met the clinical requirements, yet 2/20 of the EBCRT combined with IMRT plans were not clinically accepted. For these two patients, the maximum chest wall thickness was 3.7 cm and 4.4 cm each, and the designed electron beam energy was 12 MeV and 15 MeV, respectively. The dose to the ipsilateral lung of these two patients exceeded the institution-specific dose limit standard. For the remaining 18 patients whose chest wall thickness was 3 cm or less, the designed electron beams were 9 MeV or less. All the EBCRT combined with IMRT plans were clinically accepted. The target dose distribution of the conventional IMRT was better than that of the EBCRT combined with IMRT (uniformity index (HI): PTV sc: t = -10.20, P<0.05; PTV cw: t = -9.24, P<0.05; conformal index (CI): PTV all: t = 10.39, P <0.05). For OARs, the V5 Gy, V20 Gy, and Dmean of the ipsilateral lung of EBCRT combined with IMRT were lower than those of IMRT ( t = 5.98, 6.30, 11.30, P <0.05). Specifically, the V25 Gy and Dmean of heart decreased by 8.3% and 4.79 Gy, respectively ( t = 15.23, 15.76, P<0.05), the Dmean of the left anterior descending coronary artery (LADCA) decreased by 44.03% ( t = 11.69, P <0.05), and the V5 Gy and Dmean of the contralateral breast decreased by 7.9% and 0.8 Gy, respectively ( t = 3.66, 4.93, P<0.05). The dosimetric differences of other OARs were not statistically significant ( P > 0.05). Conclusions:For post-mastectomy left-sided breast cancer patients with a chest wall thickness of less than 3 cm, EBCRT combined IMRT can significantly reduce the exposure dose to the heart, the ipsilateral lung, and the contralateral breast, which is beneficial to reducing the potential risk of long-term complications after radiotherapy and can further improve the long-term overall survival rate of patients. For patients with thick chest wall, IMRT plans are more technologically ideal.
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In order to adapt to different target shapes and protect the surrounding normal tissues, the design of two-dimensional electron beam radiotherapy planning requires additional lead blocks. But the Pinnacle treatment planning system can not directly shape the lead block conformity to the size of the beam field given by the doctor. Every time, physicists need to manually drag the lead block to form the required beam field. When meeting a two-dimensional electron beam treatment planning with the same field parameters as before, physicists need to rearrange the field for dose calculation, which greatly reduces the design efficiency of the two-dimensional electron beam treatment planning. In this study, we independently developed a two-dimensional electron beam radiotherapy planning system based on Qt Creator. The system can quickly design a two-dimensional electron beam radiotherapy plan, which reduces the repeated work of physicists.
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Electrons , Radiotherapy Dosage , Radiotherapy Planning, Computer-AssistedABSTRACT
Objective:Objective To investigate the role of radiotherapy in the treatment of refractory keloids, evaluate the self-assessment degree of satisfaction of patients and compare with the objective outcomes.Methods:A total of 144 patients (290 lesions) with refractory keloids admitted to Peking Union Medical College Hospital from 2013 to 2018 were included in this study. The median age was 28 years old (range: 15-81 years old). All lesions were subjected to electronic radiation at postoperative 24h. The regime of 5 to 7MeV electron beam radiation therapy was adopted. The total dose was ranged from 16 to 18 Gy/2f (at 1-week interval). The median follow-up time was 48 months (range: 35-91 months). Patient and Observer Scar Assessment Scale (POSAS) was used to evaluate the degree of satisfaction. Multivariate analysis was performed by Cox proportional hazards model.Results:Among 290 keloids, 52 keloids (17.9%) relapsed in 3 to 42 months from the end of radiotherapy (median 12 months). The main side effects were hyperpigmentation and local incisional extension. Univariate analysis showed that local incisional color darker than skin, pruritus, pain and young age were associated with recurrence. Multivariate analysis indicated that local incisional color darker than skin and pain were the independent prognostic factors for scar recurrence. Recurrence, hyperpigmentation and local incisional extension were the main reasons for patients′ dissatisfaction.Conclusions:Postoperative electronic radiation can achieve satisfactory efficacy in the treatment of refractory keloids. Local incisional color darker than skin and pain are the independent prognostic factors of keloid recurrence. Patient self-assessment results are not fully consistent with the objective clinical outcomes and recurrence status.
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Background: Postmastectomy radiation (PMRT) to the chest wall using electron beam treatment with uniform bolus was practiced at our institution. The planning target volume (PTV) included the chest wall and the internal mammary nodes (IMN) along with supraclavicular nodal regions. The varying thickness of the postmastectomy chest wall and the varying position of the IMN resulted in dose inhomogeneity in the PTV. In addition, there was the risk of increased lung and cardiac doses. In this prospective study, we report the making of a custom-made bolus using dental wax called “step bolus.” Materials and Methods: From March 2010 to January 2011, 167 patients received PMRT. As conformal photon plans were not acceptable in 48 patients, they were treated with single energy electrons and custom-made bolus. Results: Addition of the step bolus improved dose distribution to the PTV reduced the mean lung dose %, the mean heart dose % and lung dose (D10, D20, D30, D50, and D70). Forty-seven patients had Grade 2, and one patient had Grade 3 skin toxicity. Acute symptomatic radiation pneumonitis was observed in one patient. At 5 years, 29 patients were alive with a median follow-up of 32 months and no local recurrences were observed. One patient died of myocardial infarction unrelated to treatment, one patient did not come for follow-up, 22 patients had systemic metastases, and 24 patients were disease free. Conclusion: A custom-made step bolus using dental wax can be used for tissue compensation in electron beam therapy with resulting good local disease control and acceptable toxicity.
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Context: Low energy electron beam has been being used widely for superficial cancer treatments. In the current study a design for production of very low energy electron beam, by different thickness of Perspex spoilers, is presented that may be used for skin cancer. Aims: MCNPX Monte Carlo code was used for modeling and simulations in the current study. An energy spoiler Perspex was modeled for degrading 4 MeV electron beam of Varian 2300 CD Linac. Materials and Methods: The thicknesses of 3, 7, and 10 mm were applied before electron applicator at a distance of 42 cm from phantom surface. Dosimetric properties of new electron beams including Rp, Dmax, E0, as well as the penumbra of the beam were investigated. Results: For the 3 mm spoiler, the superficial beam output decreased to 77%, and the Dmax, R90, R50, and RP were shifted to the depths of 4, 6, 9, and 12 mm, respectively. While for 10 mm filter the results were 5.2, 3.0 and 5.0 mm for R90, R50, and Rp, respectively. In addition, the surface dose was 93% and the Dmax was shifted to the depth of 1mm for the 10mm Perspex spoiler slab. Conclusions: The presented beam provides a novel surface dose, Dmax, and RP which can be applicable for treatment of skin cancers with minimum dose to the beyond normal tissues
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Aim: The purpose of this study is to measure radiation leakage of Siemens Primus Plus and Siemens Artiste linear accelerators in electron mode and to compare the leakage level with that recommended by the International Electrotechnical Commission (IEC) standard. Materials and Methods: In this assessment, Siemens Primus Plus linear accelerator with 10 cm × 10 cm, 15 cm × 15 cm, and 25 cm × 25 cm applicators was used. The radiation leakage in lateral and vertical directions was measured for Siemens Primus Plus and Siemens Artiste linear accelerators. Results: Data derived from radiation leakage measurement for Siemens Primus Plus and Siemens Artiste linear accelerators in lateral direction from the field edge and in vertical direction from the applicator were reported. The radiation leakage data were then compared with the IEC standard to evaluate in-air field leakage. Conclusion: Comparing the radiation leakage level from fields with the IEC standard for two applicators, the maximum that was occurred for 12 MeV electron beam and applicator size of 10 cm × 10 cm in Siemens Artiste linear accelerator was 2.3%, which is less than the IEC's recommended limit of 10%. It is concluded that the leakage amount is much less than the specified limit and that both of the linear accelerators have high level of safety. Considering the measurement stage, it also needs to be noted that the beam angle affected the radiation leakage level from field edge, and in 25° angle, it is higher than in 0° angle. Comparing radiation leakage from the right side of the field for the two linear accelerators, the amount of leakage for Siemens Primus Plus linear accelerator is more than Siemens Artiste linear accelerator
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Objective To explore the mid-term efficacy of porous titanium trabecular metal ( TTM ) components manufactured by 3D printing for primary total hip arthroplasty ( THA ). Methods Enrolled for this prospective clinical trial were 19 patients ( 20 hips ) who were to receive primary THA from May 2012 to June 2013 at Department of Orthopaedics and Traumatology, Puai Hospital. Of them, 9 patients ( 10 hips) used 3D printing porous TTM for acetabular prosthesis in primary THA while the other 10 patients ( 10 hips ) used Pinnacle acetabular prosthesis. At 5 years after operation, clinical and radiographic evaluations were conducted to assess acetabular component stability, osseointegration in the acetabulum-bone interface, and osteolysis incidence. Harris scores were used to assess the hip functions. Results The follow-up duration for all the patients averaged 5 years. By the Harris scores, 8 cases were excellent and 2 good in the TTM group while 9 excellent and one good in the Pinnacle group. The Harris scores were significantly improved from preoperative 48.2+5.5 to 92.8+3.1 at 5 years after operation in the TTM group and significantly from 46.5 ± 8.7 to 94.6 ± 2.9 in the Pinnacle group ( P ＜0.05 ). There were no significant differences regarding the preoperative Harris scores and those 5 years after operation between the 2 groups ( P ＞ 0.05 ) . Radio-graphic evaluation showed stable acetabular components, fine osseointegration, and no implant loosening or osteolysis. Two hips in the TTM group had a postoperative radiolucent line which disappeared 6 months later. The 5-year survival rate of the acetabular components was 100% for both groups, taking prosthetic loosening or revision as the end point. Conclusion The 3D printing TTM has shown excellent mid-term efficacy but its long-term efficacy needs further follow-up study.
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PURPOSE: We aimed to evaluate clinical outcomes including progression-free survival (PFS), overall survival (OS), partial response, and complete response in patients who underwent radiation therapy (RT) for mycosis fungoides (MF). Also, we sought to find prognostic factors for clinical outcomes. MATERIALS AND METHODS: Total 19 patients confirmed with MF between 1999–2015 were retrospectively reviewed. Clinical and treatment characteristics, clinical outcomes, and and toxicities were analyzed. RESULTS: Eleven patients were treated with total skin electron beam radiotherapy (TSEBT) and 8 patients with involved field radiation therapy (IFRT) with median dose of 30 Gy, respectively. The median time interval from diagnosis to RT was 2.6 months (range, 0.4 to 87.3 months). The overall response rate was 100%; 11 patients (57.9%) had a complete response and 8 patients (42.1%) a partial response. The presence of positive lymph node at the time of consultation of RT was associated with lower OS (p = 0.043). In multivariate analysis, PFS was significantly lower for patients with increased previous therapies experienced following RT (p = 0.019) and for patients showing PR during RT (p = 0.044). There were no reported grade 3 or more skin toxicities related with RT. CONCLUSION: Both IFRT and TSEBT are effective treatment for MF patients. Patients with short disease course before RT or complete response during RT are expected to have longer PFS. Positive lymph node status at the initiation of RT was associated woth poor OS, suggesting other treatment modalities such as low-dose RT for patients with low life-expectancy.
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Humans , Diagnosis , Disease-Free Survival , Lymph Nodes , Lymphoma, T-Cell, Cutaneous , Multivariate Analysis , Mycosis Fungoides , Radiotherapy , Retrospective Studies , SkinABSTRACT
Objective To establish a cranial bone defect model of goat and to study application in craniomaxillo-facial surgery.Methods Electron beam computed tomography (EBCT) scanner was used to scan goat'heads and faces in series and thin layers.Data of EBCT were input in workstation from digital inlet,and then to three-dimensional reconstruction with method of surface shadow.After final data were transformed to the files,the rapid prototyping machine was able to identify and establish the 3D model.Results The EBCT continuous thin-layer (1 mm) scanning data were passed to wave filter,falling coarse,distinguishing and collecting the outline,3D-reconstruction,curved surface reconstruction with CAD and the substance reconstruction.The final data were input into the laser rapid prototyping machine.Three-dimensional bionic cranium models were fabricated by machine in layer by layer manufacturing principle.Conclusions Establishment of the cranial bone defect model in the goat is very useful to the three-dimensional measurement,individualized reconstruction and basic and clinical research for the cranial bone defect.
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Additive manufacturing (AM) is an alternative metal fabrication technology. The outstanding advantage of AM (3D-printing, direct manufacturing), is the ability to form shapes that cannot be formed with any other traditional technology. 3D-printing began as a new method of prototyping in plastics. Nowadays, AM in metals allows to realize not only net-shape geometry, but also high fatigue strength and corrosion resistant parts. This success of AM in metals enables new applications of the technology in important fields, such as production of medical implants. The 3D-printing of medical implants is an extremely rapidly developing application. The success of this development lies in the fact that patient-specific implants can promote patient recovery, as often it is the only alternative to amputation. The production of AM implants provides a relatively fast and effective solution for complex surgical cases. However, there are still numerous challenging open issues in medical 3D-printing. The goal of the current research review is to explain the whole technological and design chain of bio-medical bone implant production from the computed tomography that is performed by the surgeon, to conversion to a computer aided drawing file, to production of implants, including the necessary post-processing procedures and certification. The current work presents examples that were produced by joint work of Polygon Medical Engineering, Russia and by TechMed, the AM Center of Israel Institute of Metals. Polygon provided 3D-planning and 3D-modelling specifically for the implants production. TechMed were in charge of the optimization of models and they manufactured the implants by Electron-Beam Melting (EBM®), using an Arcam EBM® A2X machine.
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Humans , Amputation, Surgical , Certification , Corrosion , Fatigue , Freezing , Israel , Joints , Metals , Methods , Plastics , Russia , TitaniumABSTRACT
Objective To observe the gastric changes in adult male Sprague-Dawly (SD) rats irradiated by the single large dose electron beam,providing animal experimental evidence for intraoperative radiotherapy for gastric cancer.Methods Thirty-eight SD rats were randomly divided into the control and experimental groups.The stomach of the rats in the experimental group were subject to single 6 MeV 20 Gy irridiation by using the patent technology of Accurate Irradiation Experiment Table for Small Animal Radiation.The general conditions,gastric injury and body weight change were observed at different days following irradiation.Results The most severe gastric damage of rats was observed on the 14th d after irradiation.The gastric injury was gradually repaired accompanied with glandular atrophy at 28 d postirradiation,and the gastric injury was manifested as cellulose fibrinous repair on the 56th d after irradiation.Within 1 week post-irradiation,weight loss was noted in the experimental group,which significantly differed from the rats in the control group (P＜0.05).During the 2nd week,the body weight was increased in the experimental group,significantly lower compared with the rats in the control group (P＜ 0.05).The body weight of rats did not significantly differ between two groups at 6 weeks after irradiation (P＞ 0.05).Conclusions The most severe gastric injury is observed at 2 weeks after the single-dose 6 MeV electron beam 20 Gy irradiation,whereas no gastric perforation occurs.The gastric injury can be restored to normal status within 8 weeks following irradiation.
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Background: Reconstruction of customized cranial implants with a mesh structure using computer-assisted design and additive manufacturing improves the implant design, surgical planning, defect evaluation, implant-tissue interaction and surgeon's accuracy. The objective of this study is to design, develop and fabricate cranial implant with mechanical properties closer to that of bone and drastically decreases the implant failure and to improve the esthetic outcome in cranial surgery with precision fitting for a better quality of life. A customized cranial mesh implant is designed digitally, based on the Digital Imaging and Communication in Medicine files and fabricated using state of the Art-Electron Beam Melting an Additive Manufacturing technology. The EBM produced titanium implant was evaluated based on their mechanical strength and structural characterization. Results: The result shows, the produced mesh implants have a high permeability of bone ingrowth with its reduced weight and modulus of elasticity closer to that the natural bone thus reducing the stress shielding effect. Scanning electron microscope and micro-computed tomography (CT) scanning confirms, that the produced cranial implant has a highly regular pattern of the porous structure with interconnected channels without any internal defect and voids. Conclusions: The study reveals that the use of mesh implants in cranial reconstruction satisfies the need of lighter implants with an adequate mechanical strength, thus restoring better functionality and esthetic outcomes for the patients.
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Humans , Prosthesis Design/methods , Skull , Surgical Mesh , Titanium/chemistry , Computer-Aided Design , Plastic Surgery Procedures/instrumentation , Mechanical Phenomena , Prostheses and Implants , Porosity , Imaging, Three-Dimensional , Elasticity , ElectronsABSTRACT
Objective To study the micro-pore architecture and mechanical properties of porous titanium scaffolds with diamond molecule structure produced by 3D print technology,so as to guide the development of 3D-prinited porous titanium orthopedic implants.Methods Selective laser melting (SLM) and electron beam melting (EBM) were used to fabricate porous Ti6Al4V scaffolds with diamond molecule structure.The micro-pore architectures of those scaffolds were observed using optical microscope and scanning electron microscope (SEM),and universal material testing machine was used to conduct compressive test on the scaffolds.Results Both SLM and EBM techniques had machining error and half-melted metal particles were found on the strut surface.The relative error of strut size produced by SLM and EMB was 20.9％-35.8％ and-9.1％-46.8％,respectively.The scaffold with strut width of 0.2 mm could not be produced by EBM.The compressive strength and elastic modulus of the scaffold fabricated by SLM was 99.7-192.6 MPa and 2.43-4.23 GPa,respectively.The compressive strength and elastic modulus of the scaffold fabricated by SLM was 39.5-96.9 MPa and 1.44-2.83 GPa,respectively.Conclusions The manufacturing precision of SLM is higher than that of EBM.Porosity is the main factor that affects the compressive strength and elastic modulus of the scaffolds.In the same process,with the increase of porosity,both the compressive strength and elastic modulus decrease.When the porosities are similar,the scaffolds fabricated by SLM possess higher compressive strength and elastic modulus than those by SLM.
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Objective To study the micro-pore architecture and mechanical properties of porous titanium scaffolds with diamond molecule structure produced by 3D print technology,so as to guide the development of 3D-prinited porous titanium orthopedic implants.Methods Selective laser melting (SLM) and electron beam melting (EBM) were used to fabricate porous Ti6Al4V scaffolds with diamond molecule structure.The micro-pore architectures of those scaffolds were observed using optical microscope and scanning electron microscope (SEM),and universal material testing machine was used to conduct compressive test on the scaffolds.Results Both SLM and EBM techniques had machining error and half-melted metal particles were found on the strut surface.The relative error of strut size produced by SLM and EMB was 20.9％-35.8％ and-9.1％-46.8％,respectively.The scaffold with strut width of 0.2 mm could not be produced by EBM.The compressive strength and elastic modulus of the scaffold fabricated by SLM was 99.7-192.6 MPa and 2.43-4.23 GPa,respectively.The compressive strength and elastic modulus of the scaffold fabricated by SLM was 39.5-96.9 MPa and 1.44-2.83 GPa,respectively.Conclusions The manufacturing precision of SLM is higher than that of EBM.Porosity is the main factor that affects the compressive strength and elastic modulus of the scaffolds.In the same process,with the increase of porosity,both the compressive strength and elastic modulus decrease.When the porosities are similar,the scaffolds fabricated by SLM possess higher compressive strength and elastic modulus than those by SLM.
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Objective To study the micro-pore architecture and mechanical properties of porous titanium scaffolds with diamond molecule structure produced by 3D print technology,so as to guide the development of 3D-prinited porous titanium orthopedic implants.Methods Selective laser melting (SLM) and electron beam melting (EBM) were used to fabricate porous Ti6Al4V scaffolds with diamond molecule structure.The micro-pore architectures of those scaffolds were observed using optical microscope and scanning electron microscope (SEM),and universal material testing machine was used to conduct compressive test on the scaffolds.Results Both SLM and EBM techniques had machining error and half-melted metal particles were found on the strut surface.The relative error of strut size produced by SLM and EMB was 20.9％-35.8％ and-9.1％-46.8％,respectively.The scaffold with strut width of 0.2 mm could not be produced by EBM.The compressive strength and elastic modulus of the scaffold fabricated by SLM was 99.7-192.6 MPa and 2.43-4.23 GPa,respectively.The compressive strength and elastic modulus of the scaffold fabricated by SLM was 39.5-96.9 MPa and 1.44-2.83 GPa,respectively.Conclusions The manufacturing precision of SLM is higher than that of EBM.Porosity is the main factor that affects the compressive strength and elastic modulus of the scaffolds.In the same process,with the increase of porosity,both the compressive strength and elastic modulus decrease.When the porosities are similar,the scaffolds fabricated by SLM possess higher compressive strength and elastic modulus than those by SLM.
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Objective To study the micro-pore architecture and mechanical properties of porous titanium scaffolds with diamond molecule structure produced by 3D print technology, so as to guide the development of 3D-prinited porous titanium orthopedic implants. Methods Selective laser melting (SLM) and electron beam melting (EBM) were used to fabricate porous Ti6Al4V scaffolds with diamond molecule structure. The micro-pore architectures of those scaffolds were observed using optical microscope and scanning electron microscope (SEM), and universal material testing machine was used to conduct compressive test on the scaffolds. Results Both SLM and EBM techniques had machining error and half-melted metal particles were found on the strut surface. The relative error of strut size produced by SLM and EMB was 20.9%-35.8% and －9.1%-46.8%, respectively. The scaffold with strut width of 0.2 mm could not be produced by EBM. The compressive strength and elastic modulus of the scaffold fabricated by SLM was 99.7-192.6 MPa and 2.43-4.23 GPa, respectively. The compressive strength and elastic modulus of the scaffold fabricated by SLM was 39.5-96.9 MPa and 1.44-2.83 GPa, respectively. Conclusions The manufacturing precision of SLM is higher than that of EBM. Porosity is the main factor that affects the compressive strength and elastic modulus of the scaffolds. In the same process, with the increase of porosity, both the compressive strength and elastic modulus decrease. When the porosities are similar, the scaffolds fabricated by SLM possess higher compressive strength and elastic modulus than those by SLM.
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Objective To assess the prognostic benefits of intraoperative radiotherapy (IORT) with electron beam among patients with unresectable locally advanced pancreatic cancer.Methods Between January 2009 and December 2014,167 patients with unresectable locally advanced pancreatic cancer received IORT with electron beam (10-20 Gy) in our hospital.After surgery,12 patients were treated with external beam radiotherapy,56 patients with chemoradiotherapy (CRT),and 17 patients with chemotherapy.Overall survival (OS),local recurrence,and toxicities were retrospectively analyzed.The Kaplan-Meier method was used to calculate survival rates,the log-rank test was used for survival difference analysis and univariate prognostic analysis,and the Cox model was used for multivariate prognostic analysis.Results The follow-up rate was 100％.The median OS time was 10.3 months,and the 2-year OS rate was 22％.The median progression-fiee survival (PFS) time was 6.3 months,and the 2-year PFS rate was 9.9％.The cancer-specific survival (CSS) time was 11.2 months,and the 2-year CSS rate was 23.6％.In the patients treated with IORT alone at doses of＜15 Gy,15 Gy and＞15 Gy,the median OS times were 6.2 months vs.9.1 months vs.22.2 months,and the 1-year OS rates were 10.0％ vs.39.6％ vs.74.4％ (P=0.000).Among the patients receiving postoperative adjuvant therapy,those treated with IORT+CRT had the best survival,with a median OS time of 11.6 months (P=0.033).The univariate analysis showed that IORT dose (P =0.000),tumor size (P =0.006),and IORT applicator diameter (P =0.007) were prognostic factors.The multivariate analysis showed that IORT dose (P=0.000) and IORT combined with CRT (P=0.006) were independent prognostic factors.Conclusions IORT with electron beam is an effective and safe treatment strategy for unresectable locally advanced pancreatic cancer.After protecting surrounding organs,increasing the IORT dose can improve the survival.IORT combined with CRT should be recommended because it improves survival for unresectable locally advanced pancreatic cancer without increasing toxicities.
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Objective To study the clinical efficacy of micro-plasma radiofrequency with joint electron-beam radiation treatment for keloids.Methods A total of 15 patients with keloids over half a year were treated with single time micro-plasma radiofrequency technology by roller tip at 80-100 watts.The hypofractionated electron-beam was used,with 9 Gy dose per time covering the scar with a 1 cm margin,within 24 hours and 1 week after the micro-plasma treatment.The Vancouver Scar Scales (VSS) were assessed before and 6 months after the treatment.Patients' satisfaction and the adverse reactions were evaluated 6 months after the treatment.Results There was astatistically significant difference between the mean VSS of 15 patients pre-and 6 months posttreatment (from 11.73± 1.12 to 3.87±2.53,P＜0.05).The degree of improvement was:excellent in 1 case,good 10 cases,fair 3 cases,and poor 1 case.Patients' assessment was:extremely satisfied in 6 cases,satisfied 6 cases,approximately satisfied 2 cases and dissatisfied 1 case.The adverse reactions included hyperpigmentation within the radiation field on the anterior chest wall in 1 case and delayed healing of 1 patient 's scar wound.Conclusions Micro-plasma radiofrequency combined with electron-beam radiation therapy is highly effective and safe on keloids with good clinical application value.
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Background: Oral health diseases are common in all regions of the world. Mouth rinses are widely used generally by population as a port of daily oral care regimen. In addition to antimicrobial activity, mouth rinses possess certain cytotoxic effects. Electron‑beam (E‑beam) radiation is a form of ionizing energy known to induce structural, physical, and chemical changes in irradiated products. In this study, the modulatory effects of E‑beam in irradiated mouth rinses were evaluated for its biological activities. Materials and Methods: The antimicrobial activities of nonirradiated and irradiated mouth rinses were evaluated for its antimicrobial and antibiofilm activities against oral pathogens, Enterococcus faecalis, Streptococcus mutans, Staphylococcus aureus, and Candida albicans. The antimicrobial activity was evaluated by disc diffusion method and antibiofilm activity was evaluated by O’Toole method. The cytotoxicity was evaluated against human gingival fibroblast (HGF) cells by 3‑(4, 5 Dimethythiazol‑yl)‑2,5‑Diphenyl‑tetrazolium bromide assay. Results: Colgate Plax (CP) exhibited the antimicrobial activity against the tested pathogens, and a significant (P < 0.05) increase was observed against S. aureus at 750 Gy irradiation. Further, CP significantly (P < 0.05) suppressed S. mutans, S. aureus, and C. albicans biofilm. Listerine (LS) inhibited S. mutans and C. albicans biofilm. Whereas irradiated CP and LS significantly (P < 0.05) suppressed the biofilm formed by oral pathogens. The suppression of biofilm by irradiated mouth rinses was dose‑ and species‑dependent. There was no significant (P > 0.05) difference in the cytotoxicity of irradiated and nonirradiated mouth rinses on HGF cells. However, an increased percentage viability of HGF cells was observed by mouth rinses irradiated at 750 Gy. Conclusion: The E‑beam irradiation enhanced the antibiofilm activity of mouth rinses without modifying the cytotoxicity.
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Objective To explore the shielding effects of 1-4 layers of lead aprons (LPs) and body shielding devices (BSDs) against stray radiation (SR) outside the electron beam field of 6-15 MeV.Methods JR-115B LiF TLDs were used to measure the stray radiation doses (SRDs) to the patient undergoing treatment,before and after being shielding,for different distances,different energies,different applicators,variable layers of LPs,and different thickness of body shielding devices (BSDs),respectively,along long calculating and comparing the shielding ratios of LPs and BSDs against SR.Results When the applicator (10 cm × 10 cm) is unchanged,the shielding ratio increased with the increased distance from measuring point (r =0.717,P ＜ 0.05) and decreased with the increased electron energy (r =-0.678,P ＜ 0.05);when the energy was constant,there was no correlation between the shielding ratio and the size of applicator (P ＞ 0.05);For lower energy electron beam of 6 and 9 MeV,the shielding ratio for 1 mm Pb-BSD was slightly higher than that for 2 layers of LA (t =2.519,2 662,P ＜ 0.05),ranging from 81.5％ to 95.3％ and 55.4％ to 84.6％,respectively.For 12 and 15 MeV higher energy electron beam,the shielding ratio for 2 mm Pb-BSD was slightly higher than that for 4 layers of LA (t=3.768,7.934,P＜0.05),ranging from 64.6％ to 93.4％ and 51.1％ to 92.4％,respectively.Conclusions LAs or BSDs are availavle for effectively reducing the doses from stray radiation,and may help reduce the secondary risks from stray radiation.BSDs have more obvious advantages than LPs with regard to shielding effect.