RESUMO
For radiotherapy of total skin including sub-cutaneous tissue up to a depth of 3 cm on the entire left leg of an adult [Angiosarcoma skin], a complex treatment with multiple stationary electron fields was planned at our clinic. The details of dosimetry, clinical dose measurements are presented. The treatment planned with 6 overlapping 9 MeV electron fields in Clinac 2300CD linac. With 25x25 cm cone, a cut-out insert provided 56 × 30 cm field at FSD 213 cm, while patient lying on the floor. Dose distributions were checked using Kodak V densitometric film in cylindrical plastic can phantom. The calibration was carried out using solid water phantom, water equivalent IMRT phantom and water can leg phantom. A dose of 45 Gy in 23 fractions at 5 fractions/week was prescribed. 6 field overlapping field factor was measured by the method described for total body electron irradiation [AAPM]. Skin doses were estimated at random selected points using TLD chips and semiconductor diodes. Measured absorbed doses by three methods were 0.174 cGy/MU, 0.166 cGy/MU and 0.162 cGy/MU agreed well with the calculated value 0.163 cGy/MU. 6 field overlap factor was 2.315. Clinical dose estimates of mean skin dose was 246.0 + 14 cGy [n=18], delivering higher dose by 23%. The gonad dose estimate under shield was <5%. The excess dose to skin delivered in first 14 fractions was adjusted in following 9 fractions. It appears that the excess dose in real situation may be due to either floor backscatter or non uniform overlap of dose from adjacent fields
RESUMO
The aim of this work was to evaluate renal blood flow in asphyxiated newborns using Doppler ultrasonography and assess its value and accuracy in the early detection of renal dysfunction in such cases, thus permitting an early management hence a full recovery of any affected kidney. Twenty-six asphyxiated newborns with a mean gestational age of 39.62 +/- 0.94 weeks and a birth weight of 3.29 +/- 0.60 kg were studied. Twenty clinically healthy neonates matched for sex, gestational and birth weight were included as a control group. The studied cases were classified according to the absence or presence of renal involvement into two groups. The findings of this study suggested that the hypoxic ischemic insult was exerting an effect on the kidneys. Therefore, the presence of documented hypoxic-ischemic insult had an impact on the renal Doppler ultrasonographic measurements despite the absence of clinical and laboratory indices. This highlighted the value of renal Doppler US, with the measurement of RI, as a sensitive noninvasive technique for the early detection of renal dysfunction