Poster - Thur Eve - 02: Regulatory oversight of the robotic radiosurgery facilities.

Following a recent review of the Class II Nuclear Facilities and Prescribed Equipment Regulations and regulatory oversight of particle accelerators, the Canadian Nuclear Safety Commission (CNSC) has changed its policy concerning the regulation of particle accelerators. In November 2011, the CNSC began to exercise its regulatory authority with respect to all particle accelerators operating at a beam energy of 1 (one) MeV or greater. The CNSC already licences and inspects particle accelerators capable of operating at or above 10 MeV. The decision to now include low energy particle accelerators (i.e., those operating at or above 1 MeV) ensures adequate, uniform and consistent regulatory oversight for all Class II accelerators. The CNSC expects these facilities to comply with CNSC requirements by December 2013. Besides conventional linear accelerators of lower energy (6 MeV or below) typically found in cancer clinics, two types of equipment now fall under the CNSC's regulatory oversight as a result of the above change: robotic radiosurgery and tomotherapy equipment and facilities. A number of clinics in Canada already operates these types of equipment and facilities. The safety aspects of radiosurgery equipment differ slightly from those for conventional linear accelerators. This poster aims to present an approach taken by the CNSC to regulate robotic radiosurgery equipment and facilities. The presentation will explain how to meet regulatory requirements of the Class II Nuclear Facilities and Prescribed Equipment Regulations by licensees operating or planning to acquire these types of equipment and facilities.

[The clinical course of end stage heart disease in 152 patients qualified for heart transplantation in a four year observation]. / Przebieg krancowej choroby serca u 152 chorych zakwalifikowanych do transplantacji serca w obserwacji czteroletniej.

UNLABELLED: The aim of the study was to analyse the clinical course of pts with end stage disease (ESD) in the period of four years. The study population consisted of 152 pts (132 males, 20 females) at the age of 17-66 years (mean = 48.8 year SD = 9.1) primarily qualified to the heart transplantation (HTX). We analysed the ethiology of cardiac failure, the NYHA class of circulation insufficiency, frequency of occurrence of cardiac arrhythmias and conduction system disturbances in 24-hour ecg monitoring, and the pharmacotherapy efficacy. An ischemic ethiology of cardiac failure we found in 102 pts, cardiomyopathy (idiopathic, hypertrophic or postinfectious) in 46 and unoperable valvular disease--in 4. Ten pts were in II NYHA class, 112 in III, and 30 in IV. Left ventricular ejection fraction (echo assessed) ranged from 11% to 40%(mean = 24.9%), LVEDd = 46-111 mm (mean = 80.9 mm), LVESd = 34-83.5 mm(mean = 63 mm). We found IVa class by Lown ventricular arrhythmias (in Holter monitoring) in 38 pts and IVb in 78. Fifty six pts were treated with amiodarone, 10--with beta-blockers and 11 with sotalol. 19 pts were treated by permanent cardiac pacing during the waiting period, 2 ones--by PTCA, 2--by CABG, three ones--by dynamic cardiomyoplasty, and one--by partial aneurysmectomy. One pt was treated by CABG and automatic cardioverter-defibrilator implantation. In 5 cases HTX was delayed because of the positive effect of pharmacotherapy. In assessed period HTX were performed in 64 cases, 31 pts died and 43 are still waiting for the procedure. CONCLUSIONS: During the 4-year period HTX were performed in 42% of waiting pts. Mortality in this group was 38.2%. In 9 pts (5.9%) the alternative methods of surgical treatment were applicable. In 5 pts (3.9) the decision about HTX was delayed because of the positive change of the clinical status. This fact confirms the necessity of the waiting list verification.

[Severity of angina pectoris and coronary angiographic imaging]. / Nasilenie dusznicy bolesnej a obraz koronariograficzny naczyn wiencowych.

The aim of the study was to evaluate commonly accepted assumption that more extensive coronary lesions correspond to more severe coronary symptoms. 300 consecutive patients with coronary artery disease (74 women and 226 men) admitted to Department of Coronary Disease in 1993/94 were studied. Coronary symptoms were assessed according to the Canadian Cardiovascular Society (CCS) classification of angina pectoris. Anatomic lesions revealed by angiography were classified as one, two or three vessel disease and also with use of Califfs jeopardy score (0-12 points) which is the simple and more precise method of estimating the amount of myocardium at risk. We found significant but rather weak correlation between severity of coronary symptoms (CCS) and angiographic findings (jeopardy score): (r = 0.16, p = 0.07). It was shown that there is the significant correlation between symptoms severity and anatomic lesions revealed by angiography. 17% of patients in spite of the extensive coronary atherosclerosis (10-12 points according to Califf) were almost asymptomatic (I class CCS). It is emphasized that one third of the patients had no critical stenosis however 51% of them presented severe coronary symptoms (III, IV class CCS).

Comparative study of the structure of glyceraldehyde-3-phosphate dehydrogenase from bovine heart muscle.

Glyceraldehyde-3-phosphate dehydrogenase with a specific activity of 153 units/mg protein was isolated from bovine heart muscle. Its relative molecular mass was found to be 144,000. The tryptic peptide map and amino acid analysis were obtained. The N-terminal sequence was established as Val-Lys-Val-Gly-Val-Asn-Gly-... and C-terminal as ...-Ala-Ser-Lys-Glu. Fluorescence and optimal rotation dispersion measurements were performed. The data were compared with other glyceraldehyde-3-phosphate dehydrogenases.

Pathologists' assistant training programs: a report.

This report describes the training of pathologists' assistants in three training programs: at Duke University, at Quinnipiac College associated with Yale University, and at the University of Maryland School of Medicine. The role of this new health profession is described as well as the job situation, experience, and current status of accreditation.

The development of the upper end of the femur, with special reference to its internal architecture.

The development of the upper end of the femur was determined from radiographic analysis of the hips in 191 children and a small series of cadaver specimens from young subjects, with special attention directed to the internal architecture. At birth, linearly arranged trabeculae are present but not visible on conventional radiographs. During the latter part of the first year, trabeculae are seen on conventional studies in an apparently random orientation. Although the principal medial and lateral groups of trabeculae can be shown on coronal slab sections before the end of the first year, they cannot usually be seen on conventional radiographs until 12 to 24 months. The trabecular pattern is well established by the fifth year, although the secondary lateral and linearly oriented trochanteric trabeculae are not easily seen before adolescence. The relevance of these findings in relation to diseases of the hip and upper femur is examined.

The effects of l-norepinephrine on myocardial zonal lesions in dogs in hemorrhagic shock.

Intravenous l-norepinephrine was given to dogs in hemorrhagic shock to determine the effect on myocardial zonal lesions which are characteristically seen in hypovolemic shock. Zonal lesions produced by hemorrhagic shock in drug-treated and nondrug-treated groups were quantitatively compared both at the light microscopic and ultrastructural levels. A significantly greater percentage of myocardium was found to be involved with zonal lesions in animals treated with l-norepinephrine following shock as compared to that found in nondrug-treated animals. The effect was greater for the right ventricle than for the left ventricle. The average size of zonal lesions was slightly smaller in the drug-treated group, indicating that there must have been a greater total number of zonal lesions produced in the treated group. Zonal lesions were not present in "sham shock" animals nor in animals given l-norepinephrine alone. The results indicate that the treatment of hemorrhagic shock with l-norepinephrine can be anatomically deleterious to the heart.