Demonstration of a high-intensity neutron source based on a liquid-lithium target for Accelerator based Boron Neutron Capture Therapy.

A free surface liquid-lithium jet target is operating routinely at Soreq Applied Research Accelerator Facility (SARAF), bombarded with a ~1.91 MeV, ~1.2 mA continuous-wave narrow proton beam. The experiments demonstrate the liquid lithium target (LiLiT) capability to constitute an intense source of epithermal neutrons, for Accelerator based Boron Neutron Capture Therapy (BNCT). The target dissipates extremely high ion beam power densities (>3 kW/cm(2), >0.5 MW/cm(3)) for long periods of time, while maintaining stable conditions and localized residual activity. LiLiT generates ~3×10(10) n/s, which is more than one order of magnitude larger than conventional (7)Li(p,n)-based near threshold neutron sources. A shield and moderator assembly for BNCT, with LiLiT irradiated with protons at 1.91 MeV, was designed based on Monte Carlo (MCNP) simulations of BNCT-doses produced in a phantom. According to these simulations it was found that a ~15 mA near threshold proton current will apply the therapeutic doses in ~1h treatment duration. According to our present results, such high current beams can be dissipated in a liquid-lithium target, hence the target design is readily applicable for accelerator-based BNCT.

Note: Proton irradiation at kilowatt-power and neutron production from a free-surface liquid-lithium target.

The free-surface Liquid-Lithium Target, recently developed at Soreq Applied Research Accelerator Facility (SARAF), was successfully used with a 1.9 MeV, 1.2 mA (2.3 kW) continuous-wave proton beam. Neutrons (~2 × 10(10) n/s having a peak energy of ~27 keV) from the (7)Li(p,n)(7)Be reaction were detected with a fission-chamber detector and by gold activation targets positioned in the forward direction. The setup is being used for nuclear astrophysics experiments to study neutron-induced reactions at stellar energies and to demonstrate the feasibility of accelerator-based boron neutron capture therapy.

High-power liquid-lithium jet target for neutron production.

A compact liquid-lithium target (LiLiT) was built and tested with a high-power electron gun at the Soreq Nuclear Research Center. The lithium target, to be bombarded by the high-intensity proton beam of the Soreq Applied Research Accelerator Facility (SARAF), will constitute an intense source of neutrons produced by the (7)Li(p,n)(7)Be reaction for nuclear astrophysics research and as a pilot setup for accelerator-based Boron Neutron Capture Therapy. The liquid-lithium jet target acts both as neutron-producing target and beam dump by removing the beam thermal power (>5 kW, >1 MW/cm(3)) with fast transport. The target was designed based on a thermal model, accompanied by a detailed calculation of the (7)Li(p,n) neutron yield, energy distribution, and angular distribution. Liquid lithium is circulated through the target loop at ~200 °C and generates a stable 1.5 mm-thick film flowing at a velocity up to 7 m/s onto a concave supporting wall. Electron beam irradiation demonstrated that the liquid-lithium target can dissipate electron power areal densities of >4 kW/cm(2) and volume power density of ~2 MW/cm(3) at a lithium flow of ~4 m/s while maintaining stable temperature and vacuum conditions. The LiLiT setup is presently in online commissioning stage for high-intensity proton beam irradiation (1.91-2.5 MeV, 1-2 mA) at SARAF.

High-power liquid-lithium target prototype for accelerator-based boron neutron capture therapy.

A prototype of a compact Liquid-Lithium Target (LiLiT), which will possibly constitute an accelerator-based intense neutron source for Boron Neutron Capture Therapy (BNCT) in hospitals, was built. The LiLiT setup is presently being commissioned at Soreq Nuclear Research Center (SNRC). The liquid-lithium target will produce neutrons through the (7)Li(p,n)(7)Be reaction and it will overcome the major problem of removing the thermal power generated using a high-intensity proton beam (>10 kW), necessary for sufficient neutron flux. In off-line circulation tests, the liquid-lithium loop generated a stable lithium jet at high velocity, on a concave supporting wall; the concept will first be tested using a high-power electron beam impinging on the lithium jet. High intensity proton beam irradiation (1.91-2.5 MeV, 2-4 mA) will take place at Soreq Applied Research Accelerator Facility (SARAF) superconducting linear accelerator currently in construction at SNRC. Radiological risks due to the (7)Be produced in the reaction were studied and will be handled through a proper design, including a cold trap and appropriate shielding. A moderator/reflector assembly is planned according to a Monte Carlo simulation, to create a neutron spectrum and intensity maximally effective to the treatment and to reduce prompt gamma radiation dose risks.

Job stress reduction therapies.

BACKGROUND: Job stress among healthcare workers has received more attention in recent years, perhaps because these professionals are prime candidates for high stress levels. METHOD: The immediate effects of brief massage therapy, music relaxation with visual imagery, muscle relaxation, and social support group sessions were assessed in 100 hospital employees at a major public hospital. DESIGN: The effects of the therapies were assessed using a within-subjects pre-post test design and by comparisons across groups. RESULTS: Groups reported decreases in anxiety, depression, fatigue, and confusion, as well as increased vigor following the sessions. CONCLUSION: That the groups did not differ on these variables suggests that these particular therapies, when applied for short periods of time, are equally effective for reducing stress among hospital employees.

The use of methotrexate in polymyalgia rheumatica.

OBJECTIVE: To examine the efficacy and steroid sparing potential of methotrexate (MTX) in the treatment of polymyalgia rheumatica (PMR) without giant cell arteritis. METHODS: 43 patients with PMR were treated with MTX 7.5 mg/wk for 3 months. This dose was raised to 10 and finally 12.5 mg/wk MTX if the desired response was not obtained. RESULTS: No patient benefitted clinically or statistically from treatment with MTX. CONCLUSION: MTX is of no benefit in the treatment of PMR.

Rapid onset of action of levocabastine eye-drops in histamine-induced conjunctivitis.

Levocabastine is a recently developed, potent H1-receptor blocker intended for topical application. Seventeen healthy non-atopic volunteers participated in this randomized, double-blind, placebo-controlled study undertaken to investigate the speed of onset of action, efficacy and tolerability of levocabastine eye-drops after a histamine challenge. The degree of histamine-induced ocular inflammation was found to be significantly less after administration of levocabastine compared with placebo. Furthermore, levocabastine was shown to be rapidly effective with an onset of action within 10 min. Levocabastine eye-drops were well-tolerated and no adverse reactions to the study drug were reported. Levocabastine eye-drops appear to be a valuable therapeutic approach for the treatment of histamine-mediated ocular allergies.

Case report: cystic duct carcinoma.

The authors present the 26th reported case of cystic duct carcinoma. Cystic duct carcinoma is more prevalent in males and is associated with right upper quadrant abdominal pain. Survival can be extended with surgery.

Implementation of product-line management in a hospital pharmacy department.

The development and implementation of product-line management (PLM) in a pharmacy department is reviewed. The PLM system of hospital organization shifts the emphasis from function to product. The pharmacy department at a 737-bed nonprofit hospital adopted PLM in an effort to reach more directly the physician and patient markets, enhance the image of pharmacy, and help meet requirements of the Joint Commission on Accreditation of Healthcare Organizations. The department surveyed physicians and administrators to identify their product and service needs and surveyed pharmacy staff members to identify the perceived benefits and risks of a PLM system. A strategic-planning session was held to decide how best to match the pharmacy department's product lines with market needs. The team leaders were renamed clinical supervisors and were no longer responsible for defined physical areas but rather for clinical matters relating to patients in the product line assigned. Pharmacy's chosen product lines were oncology services, neuropsychiatry, maternal and child care, cardiovascular, operating room-anesthesia-pain clinic, and general medical. The transition is being accomplished one product line at a time; interested team leaders transfer into clinical supervisor positions by achieving clinical expertise within the relevant product lines. Despite some initial confusion, PLM contributed to job satisfaction and morale and allowed the pharmacy department to provide increased clinical consultation and intervention services. PLM enhanced the clinical pharmacy program and focused clinical services on the physician and ultimately the patient.

Blocking of histamine-induced conjunctivitis by the oral antihistamine, astemizole.

When histamine is applied topically to the eye it produces stinging and inflammation of the caruncle and bulbar and palpebral conjunctiva. This model has been employed in the present study to assess the ability of an oral antihistamine, astemizole, to attenuate the irritation and inflammatory signs. Astemizole 30 mg, taken orally once daily for 1 week, considerably lessened the stinging and significantly lowered the signs of inflammation caused by topically applied histamines.