ABSTRACT
INTRODUCTION: Transcranial magnetic stimulation or repetitive transcranial magnetic stimulation (TMS/rTMS) are currently used in research and treatments of diseases of the central nervous system, such as recurring depression. Strong electric pulses are used to produce strong pulsed magnetic fields that are directed to the patient's cerebral cortex where the fields induce electric pulses. The pulses may be causing unnecessary exposure of the staff. METHOD: The MagVenture TMS/rTMS system was investigated, without patient presence, through measurements of magnetic field pulses at varying distances from the emitting coil and different power settings (94-127â A/s). RESULTS: Fourteen measurements were done which displayed exposures exceeding the given guidelines up until a distance of 40â cm from the transmitting coil. DISCUSSION: The study shows that the exposure of staff in this type of treatment may exceed the given guidelines for occupational exposure, thus confirming previous findings. This necessitates good routines in information and treatment procedures to avoid this exposure.
Subject(s)
Magnetic Fields , Occupational Exposure/analysis , Radiology , Transcranial Magnetic Stimulation/instrumentation , Humans , Personnel, Hospital , Radiation MonitoringABSTRACT
BACKGROUND: OK-432, penicillin-killed Streptococcus pyogenes, is used in treating lymphangiomas and carcinomas. We have studied in vitro the role of mononuclear phagocytes (MNPs), including purified monocytes (MOs), in the immune response to OK-432. MIP-1alpha/beta and MCP-1 secretions were assessed in whole blood (WB), peripheral blood mononuclear cells (PBMCs) and purified MOs, after in vitro stimulation with OK-432 with or without adherence for 24 hours. RESULTS: OK-432 stimulated MNPs to secrete MCP-1 and MIP-1alpha/beta in healthy individuals and in head and neck squamous cell carcinoma (HNSCC) patients, except for OK-432 stimulation of WB giving a minimal MIP-1alpha/beta response. Upon culture on low-attachment wells, a spontaneous chemokine secretion was observed, with an unchanged secretion following OK-432 stimulation. Inhibition of Syk kinase and/or PI-3 kinase did not significantly change the chemokine response to OK-432, except for MIP-1alpha production being increased upon Syk inhibitor addition and an increased MCP-1 response upon addition of both inhibitors. Adhesion may possibly involve beta1 and/or beta3 integrins, not beta2, whereas beta(1-3) integrins may act as co-stimulatory receptors for OK-432. Based on direct blockage of CD36 or CD18 by antibodies, MCP-1 production may be mediated by CD18 while MIP-1beta and MCP-1 production may occur upon binding to CD36. CONCLUSION: Adherent human MOs produce MCP-1 and MIP-1alpha/beta upon stimulation with OK-432. CD36 modulates MIP-1beta and MCP-1 response. Thus, to some extent OK-432 acts as a substance whereby only MOs adhered to surfaces secrete MCP-1 and MIP-1alpha/beta, in part explaining why OK-432 is suited as a biological response modifying drug.
Subject(s)
Carcinoma, Squamous Cell/blood , Carcinoma, Squamous Cell/therapy , Chemokine CCL2/metabolism , Chemokine CCL3/metabolism , Chemokine CCL4/metabolism , Chemokines/metabolism , Head and Neck Neoplasms/blood , Head and Neck Neoplasms/therapy , Monocytes/metabolism , Picibanil/pharmacology , Antineoplastic Agents/immunology , Antineoplastic Agents/pharmacology , CD18 Antigens/metabolism , CD36 Antigens/metabolism , Carcinoma, Squamous Cell/immunology , Cell Adhesion/drug effects , Head and Neck Neoplasms/immunology , Humans , Immunotherapy , Intracellular Signaling Peptides and Proteins/metabolism , Lymphocyte Activation , Male , Middle Aged , Monocytes/immunology , Monocytes/pathology , Phosphatidylinositol 3-Kinases/metabolism , Phosphorylation/drug effects , Picibanil/immunology , Protein Binding/drug effects , Protein-Tyrosine Kinases/metabolism , Signal Transduction/drug effects , Streptococcus pyogenes/immunology , Syk KinaseABSTRACT
Highly active antiretroviral therapy (HAART) can effectively suppress HIV-1 replication but, as soon as the drugs are withdrawn, there is a rapid rebound of replicating virus. Severe metabolic toxicities and therapy failures due to the appearance of resistant virus are becoming an increasing problem that precludes long-term continuous medication. Therapeutic immunizations represent a feasible and attractive means of supplementing or, alternatively, replacing current therapies, thereby reducing the potential for emergence of drug-resistant HIV-1 strains. We have performed an open, single-center, phase I safety study of a candidate therapeutic HIV-1 vaccine, Vacc-4x, given to 11 HIV-1-infected individuals with or without antiretroviral therapy. The immunogen consists of four synthetic peptides based on the major core protein p24. To ensure optimal exposure of the immunogen to the antigen-presenting cells (APCs), the vaccine was given intradermally together with granulocyte-macrophage colony-stimulating factor (GM-CSF). Responses to the immunization protocol were determined by delayed-type hypersensitivity (DTH) reaction, interferon gamma-secreting cells in the enzyme-linked immunospot (ELISpot) assay, and antibody production to the p24 protein and the peptides. The vaccine was safe and in general well tolerated. Plasma HIV RNA levels and CD4(+) cell counts did not change appreciably during the study. All patients showed a positive DTH response. For two of the patients, the immunization protocol induced responses to one or two of the tested peptides whereas a third patient showed reactivity to one of the peptides before immunization. A weak antibody response in the peptide-specific enzyme-linked immunosorbent assay could be seen in seven patients.
