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1.
Sci Adv ; 10(24): eadi1621, 2024 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-38865462

RESUMO

The function of germ cells in somatic growth and aging has been demonstrated in invertebrate models but remains unclear in vertebrates. We demonstrated sex-dependent somatic regulation by germ cells in the short-lived vertebrate model Nothobranchius furzeri. In females, germ cell removal shortened life span, decreased estrogen, and increased insulin-like growth factor 1 (IGF-1) signaling. In contrast, germ cell removal in males improved their health with increased vitamin D signaling. Body size increased in both sexes but was caused by different signaling pathways, i.e., IGF-1 and vitamin D in females and males, respectively. Thus, vertebrate germ cells regulate somatic growth and aging through different pathways of the endocrine system, depending on the sex, which may underlie the sexual difference in reproductive strategies.


Assuntos
Envelhecimento , Células Germinativas , Fator de Crescimento Insulin-Like I , Animais , Células Germinativas/metabolismo , Células Germinativas/citologia , Masculino , Feminino , Envelhecimento/fisiologia , Fator de Crescimento Insulin-Like I/metabolismo , Vertebrados , Transdução de Sinais , Caracteres Sexuais , Tamanho Corporal , Vitamina D/metabolismo , Estrogênios/metabolismo
2.
Front Oncol ; 14: 1335623, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38800394

RESUMO

Purpose: Differences in the contours created during magnetic resonance imaging-guided online adaptive radiotherapy (MRgOART) affect dose distribution. This study evaluated the interobserver error in delineating the organs at risk (OARs) in patients with pancreatic cancer treated with MRgOART. Moreover, we explored the effectiveness of drugs that could suppress peristalsis in restraining intra-fractional motion by evaluating OAR visualization in multiple patients. Methods: This study enrolled three patients who underwent MRgOART for pancreatic cancer. The study cohort was classified into three conditions based on the MRI sequence and butylscopolamine administration (Buscopan): 1, T2 imaging without butylscopolamine administration; 2, T2 imaging with butylscopolamine administration; and 3, multi-contrast imaging with butylscopolamine administration. Four blinded observers visualized the OARs (stomach, duodenum, small intestine, and large intestine) on MR images acquired during the initial and final MRgOART sessions. The contour was delineated on a slice area of ±2 cm surrounding the planning target volume. The dice similarity coefficient (DSC) was used to evaluate the contour. Moreover, the OARs were visualized on both MR images acquired before and after the contour delineation process during MRgOART to evaluate whether peristalsis could be suppressed. The DSC was calculated for each OAR. Results: Interobserver errors in the OARs (stomach, duodenum, small intestine, large intestine) for the three conditions were 0.636, 0.418, 0.676, and 0.806; 0.725, 0.635, 0.762, and 0.821; and 0.841, 0.677, 0.762, and 0.807, respectively. The DSC was higher in all conditions with butylscopolamine administration compared with those without it, except for the stomach in condition 2, as observed in the last session of MR image. The DSCs for OARs (stomach, duodenum, small intestine, large intestine) extracted before and after contouring were 0.86, 0.78, 0.88, and 0.87; 0.97, 0.94, 0.90, and 0.94; and 0.94, 0.86, 0.89, and 0.91 for conditions 1, 2, and 3, respectively. Conclusion: Butylscopolamine effectively reduced interobserver error and intra-fractional motion during the MRgOART treatment.

3.
BMC Med Imaging ; 23(1): 102, 2023 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-37528392

RESUMO

BACKGROUND: Megavoltage computed tomography (MVCT) images acquired during each radiotherapy session may be useful for delta radiomics. However, no studies have examined whether the MVCT-based radiomics has prognostic power. Therefore, the purpose of this study was to examine the prognostic power of the MVCT-based radiomics for head and neck squamous cell carcinoma (HNSCC) patients. METHODS: 100 HNSCC patients who received definitive radiotherapy were analyzed and divided into two groups: training (n = 70) and test (n = 30) sets. MVCT images obtained using TomoTherapy for the first fraction of radiotherapy and planning kilovoltage CT (kVCT) images obtained using Aquilion LB CT scanner were analyzed. Primary gross tumor volume (GTV) was propagated from kVCT to MVCT images using rigid registration, and 107 radiomic features were extracted from the GTV in MVCT and kVCT images. Least absolute shrinkage and selection operator (LASSO) Cox regression model was used to examine the association between overall survival (OS) and rad score calculated for each patient by weighting the feature value through the coefficient when features were selected. Then, the predictive values of MVCT-based and kVCT-based rad score and patient-, treatment-, and tumor-specific factors were evaluated. RESULTS: C-indices of the rad score for MVCT- and kVCT-based radiomics were 0.667 and 0.685, respectively. The C-indices of 6 clinical factors were 0.538-0.622. The 3-year OS was significantly different between high- and low-risk groups according to the MVCT-based rad score (50% vs. 83%; p < 0.01). CONCLUSIONS: Our results suggested that MVCT-based radiomics had stronger prognostic power than any single clinical factor and was a useful prognostic factor when predicting OS in HNSCC patients.


Assuntos
Neoplasias de Cabeça e Pescoço , Tomografia Computadorizada por Raios X , Humanos , Tomografia Computadorizada por Raios X/métodos , Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico por imagem , Planejamento da Radioterapia Assistida por Computador/métodos , Prognóstico , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem
4.
Acta Radiol ; 64(9): 2627-2635, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37376758

RESUMO

BACKGROUND: Demyelinating peripheral neuropathy is characteristic of both polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes (POEMS) syndrome and chronic inflammatory demyelinating polyneuropathy (CIDP). We hypothesized that the different pathogeneses underlying these entities would affect the sonographic imaging features. PURPOSE: To investigate whether ultrasound (US)-based radiomic analysis could extract features to describe the differences between CIDP and POEMS syndrome. MATERIAL AND METHODS: In this retrospective study, we evaluated nerve US images from 26 with typical CIDP and 34 patients with POEMS syndrome. Cross-sectional area (CSA) and echogenicity of the median and ulnar nerves were evaluated in each US image of the wrist, forearm, elbow, and mid-arm. Radiomic analysis was performed on these US images. All radiomic features were examined using receiver operating characteristic analysis. Optimal features were selected using a three-step feature selection method and were inputted into XGBoost to build predictive machine-learning models. RESULTS: The CSAs were more enlarged in patients with CIDP than in those with POEMS syndrome without significant differences, except for that of the ulnar nerve at the wrist. Nerve echogenicity was significantly more heterogeneous in patients with CIDP than in those with POEMS syndrome. The radiomic analysis yielded four features with the highest area under the curve (AUC) value of 0.83. The machine-learning model showed an AUC of 0.90. CONCLUSION: US-based radiomic analysis has high AUC values in differentiating POEM syndrome from CIDP. Machine-learning algorithms further improved the discriminative ability.


Assuntos
Síndrome POEMS , Polirradiculoneuropatia Desmielinizante Inflamatória Crônica , Humanos , Polirradiculoneuropatia Desmielinizante Inflamatória Crônica/diagnóstico por imagem , Síndrome POEMS/diagnóstico por imagem , Estudos Retrospectivos , Nervos Periféricos , Ultrassonografia
5.
J Appl Clin Med Phys ; 24(7): e14071, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37327042

RESUMO

INTRODUCTION: Dosimetric accuracy is critical when a patient treated with volumetric modulated arc therapy (VMAT) is transferred to another beam-matched linac. To evaluate the performance of Accelerated Go Live (AGL) service, the measured beam characteristics and patient specific quality assurance (QA) results between two AGL-matched linacs were compared. MATERIALS AND METHODS: Two VersaHD linacs were installed using the AGL service. After the installation, the beam data such as percentage depth dose (PDD), lateral profiles and output factors for all photon beams were measured. Relative doses were also measured as a function of the multi-leaf collimator (MLC) leaf gap width. Subsequently, VMAT plans were created for prostate, pelvis, head and neck, liver, lung cancers and multiple brain metastases. Dose distributions and point doses were measured by multi-dimensional detectors and ionization chambers for patient specific quality assurance, and comparisons were made between the two linacs. RESULTS: Dose differences in PDDs were all within ± 1% except the entrance region, and the averaged gamma indices of the lateral profiles were within 0.3. The differences in doses as a function of the MLC leaf gap width between the two linacs were within ±0.5%. For all the plans, gamma passing rates were all higher than 95% with criteria of 2%/2 mm. The average and the SD of dose differences on the multi-dimensional detector between both measurements was 0.06 ± 2.12%, and the average of point dose differences was -0.03 ± 0.33%. CONCLUSION: We have evaluated the AGL performance in the context of beam characteristics and patient specific QA. It was demonstrated that the AGL service provides an accurate VMAT treatment reproducibility for many tumor sites with gamma pass rates greater than 95% under criteria of 2%/2 mm.


Assuntos
Neoplasias Encefálicas , Radioterapia de Intensidade Modulada , Humanos , Aceleradores de Partículas , Radioterapia de Intensidade Modulada/métodos , Reprodutibilidade dos Testes , Planejamento da Radioterapia Assistida por Computador/métodos , Dosagem Radioterapêutica
6.
Jpn J Radiol ; 41(11): 1316-1322, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37354344

RESUMO

PURPOSE: The aim of this study was to develop a new workflow for 1.5-T magnetic resonance (MR)-guided on-line adaptive radiation therapy (MRgART) and assess its feasibility in achieving dose constraints. MATERIALS AND METHODS: We retrospectively evaluated the clinical data of patients who underwent on-line adaptive radiation therapy using a 1.5-T MR linear accelerator (MR-Linac). The workflow in MRgART was established by reviewing the disease site, number of fractions, and re-planning procedures. Five cases of prostate cancer were selected to evaluate the feasibility of the new workflow with respect to achieving dose constraints. RESULTS: Between December 2021 and September 2022, 50 consecutive patients underwent MRgART using a 1.5-T MR-Linac. Of these, 20 had prostate cancer, 10 had hepatocellular carcinoma, 6 had pancreatic cancer, 5 had lymph node oligo-metastasis, 3 had renal cancer, 3 had bone metastasis, 2 had liver metastasis from colon cancer, and 1 had a mediastinal tumor. Among a total of 247 fractions, 235 (95%) were adapt-to-shape (ATS)-based re-planning. The median ATS re-planning time in all 50 cases was 17 min. In the feasibility study, all dose constraint sets were met in all 5 patients by ATS re-planning. Conversely, a total of 14 dose constraints in 5 patients could not be achieved by virtual plan without using adaptive re-planning. These dose constraints included the minimum dose received by the highest irradiated volume of 1 cc in the planning target volume and the maximum dose of the rectal/bladder wall. CONCLUSION: A new workflow of 1.5-T MRgART was established and found to be feasible. Our evaluation of the dose constraint achievement demonstrated the effectiveness of the workflow.


Assuntos
Neoplasias da Próstata , Planejamento da Radioterapia Assistida por Computador , Masculino , Humanos , Planejamento da Radioterapia Assistida por Computador/métodos , Dosagem Radioterapêutica , Fluxo de Trabalho , Estudos Retrospectivos , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/radioterapia , Espectroscopia de Ressonância Magnética
7.
Igaku Butsuri ; 43(4): 107-124, 2023.
Artigo em Japonês | MEDLINE | ID: mdl-38417889

RESUMO

In recent years, MR-Linac, a radiotherapy linear accelerator (linac) equipped with magnetic resonance (MR) imaging, has been deployed in clinical facilities across Japan. Because of the magnetic field of MR-Linac, which can affect the dose distributions and dose response of ionization chambers, conventional reference dosimetry for absorbed dose to water using an ionization chamber becomes impractical. Consequently, the magnetic field effect should be considered in the reference dosimetry for MR-Linac. Although numerous studies have delved into this matter and several magnetic field correction methods have been proposed to extend the conventional formalism, a practical protocol for reference dosimetry for MR-Linac remains elusive.The purpose of this review are as follows: (i) to summarize and evaluate literature and existing datasets as well as identify any gaps that highlight areas for the future research on this topic; (ii) to elucidate dosimetric challenges associated with ionization chamber dosimetry in magnetic fields; and (iii) to propose a formalism for reference dosimetry for MR-Linac based on available literature and datasets. This review focuses on studies based on commercially available MR-Linacs and datasets, specifically tailored for reference-class cylindrical ion chambers.


Assuntos
Aceleradores de Partículas , Radiometria , Radiometria/métodos , Imageamento por Ressonância Magnética/métodos , Campos Magnéticos , Água
8.
Sci Rep ; 12(1): 11628, 2022 07 08.
Artigo em Inglês | MEDLINE | ID: mdl-35804091

RESUMO

The African turquoise killifish Nothobranchius furzeri (N. furzeri) is a useful model organism for studying aging, age-related diseases, and embryonic diapause. CRISPR/Cas9-mediated gene knockout and Tol2 transposon-mediated transgenesis in N. furzeri have been reported previously. However, these methods take time to generate knockout and transgenic fish. In addition, knock-in technology that inserts large DNA fragments as fluorescent reporter constructs into the target gene in N. furzeri has not yet been established. Here, we show that triple-target CRISPR-mediated single gene disruption efficiently produces whole-body biallelic knockout and enables the examination of gene function in the F0 generation. In addition, we developed a method for creating the knock-in reporter N. furzeri without crossing by optimizing the CRISPR/Cas9 system. These methods drastically reduce the duration of experiments, and we think that these advances will accelerate aging and developmental studies using N. furzeri.


Assuntos
Ciprinodontiformes , Genética Reversa , Envelhecimento/genética , Animais , Animais Geneticamente Modificados , Ciprinodontiformes/genética , Técnicas de Transferência de Genes
9.
Front Pediatr ; 9: 625456, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33816399

RESUMO

Multisystem inflammatory syndrome in children (MIS-C) is a severe Kawasaki-like illness that was first linked to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in European countries in the spring of 2020 and has been suggested to have overlap with Kawasaki disease shock syndrome (KDSS). There are few reports of MIS-C from Asia. This observational study aimed to identify the clinical features in children presenting with KDSS in Japan over a 5-year period and to summarize similarities and differences between KDSS and MIS-C. We retrospectively collected data on patient characteristics, clinical signs and symptoms, treatment, and prognosis including coronary artery abnormalities (CAAs), which were compared with data of patients with KDSS worldwide and patients with MIS-C from a review. KDSS was identified in 6 (1.1%) of 552 patients with Kawasaki disease (KD) treated at a single institution in Japan between 2015 and 2020 (1 in 2020). In patients with KDSS in Japan or worldwide vs. patients with MIS-C, KDSS was more likely to have a diagnosis of complete KD (100, 70 vs. 6.3%), a higher incidence of CAAs (50, 65 vs. 11%), and a greater requirement for vasoactive agonists (67, 67 vs. 43%) because of circulatory shock (100, 50 vs. 26%). Both KDSS and MIS-C had good prognosis (mortality 0, 6.7 vs. 1.7%). Although KDSS in Japan and MIS-C show some overlap in clinical symptoms, they are unlikely to be the same disease entity. KDSS is more likely to have a cardiovascular phenotype with CAAs and requires treatment with cardiovascular agents.

10.
Sci Adv ; 7(7)2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33568475

RESUMO

Stem cell (SC) proliferation and differentiation organize tissue homeostasis. However, how SCs regulate coordinate tissue scaling in dynamic organs remain unknown. Here, we delineate SC regulations in dynamic skin. We found that interfollicular epidermal SCs (IFESCs) shape basal epidermal proliferating clusters (EPCs) in expanding abdominal epidermis of pregnant mice and proliferating plantar epidermis. EPCs consist of IFESC-derived Tbx3+-basal cells (Tbx3+-BCs) and their neighboring cells where Adam8-extracellular signal-regulated kinase signaling is activated. Clonal lineage tracing revealed that Tbx3+-BC clones emerge in the abdominal epidermis during pregnancy, followed by differentiation after parturition. In the plantar epidermis, Tbx3+-BCs are sustained as long-lived SCs to maintain EPCs invariably. We showed that Tbx3+-BCs are vasculature-dependent IFESCs and identified mechanical stretch as an external cue for the vasculature-driven EPC formation. Our results uncover vasculature-mediated IFESC regulations, which explain how the epidermis adjusts its size in orchestration with dermal constituents in dynamic skin.

11.
Genet Med ; 23(6): 1050-1057, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33495529

RESUMO

PURPOSE: To expand the recent description of a new neurodevelopmental syndrome related to alterations in CDK19. METHODS: Individuals were identified through international collaboration. Functional studies included autophosphorylation assays for CDK19 Gly28Arg and Tyr32His variants and in vivo zebrafish assays of the CDK19G28R and CDK19Y32H. RESULTS: We describe 11 unrelated individuals (age range: 9 months to 14 years) with de novo missense variants mapped to the kinase domain of CDK19, including two recurrent changes at residues Tyr32 and Gly28. In vitro autophosphorylation and substrate phosphorylation assays revealed that kinase activity of protein was lower for p.Gly28Arg and higher for p.Tyr32His substitutions compared with that of the wild-type protein. Injection of CDK19 messenger RNA (mRNA) with either the Tyr32His or the Gly28Arg variants using in vivo zebrafish model significantly increased fraction of embryos with morphological abnormalities. Overall, the phenotype of the now 14 individuals with CDK19-related disorder includes universal developmental delay and facial dysmorphism, hypotonia (79%), seizures (64%), ophthalmologic anomalies (64%), and autism/autistic traits (56%). CONCLUSION: CDK19 de novo missense variants are responsible for a novel neurodevelopmental disorder. Both kinase assay and zebrafish experiments showed that the pathogenetic mechanism may be more diverse than previously thought.


Assuntos
Deficiência Intelectual , Transtornos do Neurodesenvolvimento , Animais , Quinases Ciclina-Dependentes/genética , Mutação com Ganho de Função , Humanos , Lactente , Mutação de Sentido Incorreto , Peixe-Zebra/genética
13.
Sci Rep ; 10(1): 17575, 2020 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-33067521

RESUMO

Cyclin-dependent kinase 8 (CDK8) is a member of the CDK/Cyclin module of the mediator complex. A recent study reported that heterozygous missense CDK8 mutations cause a neurodevelopmental disorder in humans. The mechanistic basis of CDK8-related disorder has yet to be delineated. Here, we report 2 patients with de novo missense mutations within the kinase domain of CDK8 along with the results of in vitro and in vivo functional analyses using a zebrafish model. Patient 1 and Patient 2 had intellectual disabilities and congenital anomalies. Exome analyses showed that patient 1 had a heterozygous de novo missense p.G28A variant in the CDK8 (NM_001260.3) gene and patient 2 had a heterozygous de novo missense p.N156S variant in the CDK8 gene. We assessed the pathogenicity of these two variants using cultured-cells and zebrafish model. An in vitro kinase assay of human CDK8 showed that enzymes with a p.G28A or p.N156S substitution showed decreased kinase activity. An in vivo assays of zebrafish overexpression analyses also showed that the p.G28A and p.N156S alleles were hypomorphic alleles. Importantly, the inhibition of CDK8 kinase activity in zebrafish embryos using a specific chemical inhibitor induced craniofacial and heart defects similar to the patients' phenotype. Taken together, zebrafish studies showed that non-synonymous variants in the kinase domain of CDK8 act as hypomorphic alleles causing human congenital disorder.


Assuntos
Quinase 8 Dependente de Ciclina/genética , Mutação de Sentido Incorreto , Transtornos do Neurodesenvolvimento/genética , Mutação Puntual , Anormalidades Múltiplas/genética , Animais , Criança , Anormalidades Craniofaciais/genética , Quinase 8 Dependente de Ciclina/antagonistas & inibidores , Quinase 8 Dependente de Ciclina/deficiência , Quinase 8 Dependente de Ciclina/fisiologia , Quinases Ciclina-Dependentes/fisiologia , Embrião não Mamífero/anormalidades , Embrião não Mamífero/enzimologia , Feminino , Cardiopatias Congênitas/genética , Heterozigoto , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Lactente , Deficiência Intelectual/genética , Mutação com Perda de Função , Masculino , Domínios Proteicos , Inibidores de Proteínas Quinases/farmacologia , Quinazolinas/farmacologia , RNA Mensageiro/biossíntese , RNA Mensageiro/genética , Peixe-Zebra/embriologia , Proteínas de Peixe-Zebra/antagonistas & inibidores , Proteínas de Peixe-Zebra/fisiologia
14.
Sci Rep ; 10(1): 14120, 2020 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-32839482

RESUMO

CRISPR/Cas-mediated genome editing is a powerful tool for generating genetically mutated cells and organisms. Linearisation of donor cassettes with this system has been shown to facilitate both transgene donor insertion and targeted knock-in. Here, we developed a donor plasmid that we name pCriMGET (plasmid of synthetic CRISPR coded RNA target sequence-equipped donor plasmid-mediated gene targeting), in which an off-target free synthetic CRISPR coded RNA-target sequence (syn-crRNA-TS) is incorporated with a multi-cloning site, where a donor cassette can be inserted. With co-expression of Cas9 and the syn-crRNA-TS guide RNA (gRNA), pCriMGET provides a linearised donor cassette in vivo, thereby promoting the transgene donor insertion and targeted knock-in. When co-injected with Cas9 protein and gRNA into murine zygotes, pCriMGET yielded around 20% transgene insertion in embryos. This method also achieved more than 25% in-frame knock-in at the mouse Tbx3 gene locus without predicted insertion-deletion mutations using a transgene donor with 400-bp homology arms. pCriMGET is therefore useful as a versatile CRISPR/Cas9-cleavable donor plasmid for efficient integration and targeted knock-in of exogenous DNA in mice.


Assuntos
Sistemas CRISPR-Cas/genética , Edição de Genes/métodos , Técnicas de Introdução de Genes/métodos , Plasmídeos/genética , RNA Guia de Cinetoplastídeos/genética , Proteínas com Domínio T/genética , Animais , Feminino , Marcação de Genes , Engenharia Genética/métodos , Genoma/genética , Células HEK293 , Células HeLa , Humanos , Mutação INDEL/genética , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos ICR , Camundongos Transgênicos , Transgenes/genética
15.
Front Pediatr ; 8: 249, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32478021

RESUMO

Aspirin has been used as a concomitant drug in the treatment of Kawasaki disease (KD). In recent years, there has been discussion concerning whether high-dose aspirin is appropriate for treatment in the acute phase of KD. We retrospectively investigated the incidence of coronary artery abnormalities (CAAs) and the antipyretic effect of 30 to 50 mg/kg/day aspirin, the minimum and the maximum approved doses in Japan. This was a single-center, non-randomized, retrospective, historical cohort study. Patients were routinely treated with 50 mg/kg/day aspirin (50-mg Group) between 2007 and April 2014, and with 30 mg/kg/day aspirin (30-mg Group) between May 2014 and 2016. All patients were given initial and, if necessary, subsequent intravenous immunoglobulin (IVIG) 2.0 g/kg. The primary endpoint was incidence of CAAs defined as a CA diameter with a Z score ≥2.5 at treatment week 4. The secondary endpoint was incidence of further treatment. Incidences were compared using inverse probability weighting analysis adjusting for age, sex, and risk scores. In 587 patients, there was no significant difference in incidence of CAAs (odds ratio in 30-mg Group 0.769, 95% confidence interval (CI): 0.537-1.101, p = 0.151). Risk of further treatment after the first IVIG in the 30-mg Group was significantly higher than that in the 50-mg Group (odds ratio 1.379, 95% CI: 1.051-1.811, p = 0.021). Although this study has some limitations, the findings suggest that aspirin 50 mg/kg/day may have no significant effect on improving incidence of CAAs compared with 30 mg/kg/day but may have a lower rate of further treatment.

16.
Med Phys ; 47(5): 2197-2205, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32096876

RESUMO

PURPOSE: Radiomics is a new technique that enables noninvasive prognostic prediction by extracting features from medical images. Homology is a concept used in many branches of algebra and topology that can quantify the contact degree. In the present study, we developed homology-based radiomic features to predict the prognosis of non-small-cell lung cancer (NSCLC) patients and then evaluated the accuracy of this prediction method. METHODS: Four datasets were used: two to provide training and test data and two for the selection of robust radiomic features. All the datasets were downloaded from The Cancer Imaging Archive (TCIA). In two-dimensional cases, the Betti numbers consist of two values: b0 (zero-dimensional Betti number), which is the number of isolated components, and b1 (one-dimensional Betti number), which is the number of one-dimensional or "circular" holes. For homology-based evaluation, computed tomography (CT) images must be converted to binarized images in which each pixel has two possible values: 0 or 1. All CT slices of the gross tumor volume were used for calculating the homology histogram. First, by changing the threshold of the CT value (range: -150 to 300 HU) for all its slices, we developed homology-based histograms for b0 , b1 , and b1 /b0 using binarized images. All histograms were then summed, and the summed histogram was normalized by the number of slices. 144 homology-based radiomic features were defined from the histogram. To compare the standard radiomic features, 107 radiomic features were calculated using the standard radiomics technique. To clarify the prognostic power, the relationship between the values of the homology-based radiomic features and overall survival was evaluated using LASSO Cox regression model and the Kaplan-Meier method. The retained features with nonzero coefficients calculated by the LASSO Cox regression model were used for fitting the regression model. Moreover, these features were then integrated into a radiomics signature. An individualized rad score was calculated from a linear combination of the selected features, which were weighted by their respective coefficients. RESULTS: When the patients in the training and test datasets were stratified into high-risk and low-risk groups according to the rad scores, the overall survival of the groups was significantly different. The C-index values for the homology-based features (rad score), standard features (rad score), and tumor size were 0.625, 0.603, and 0.607, respectively, for the training datasets and 0.689, 0.668, and 0.667 for the test datasets. This result showed that homology-based radiomic features had slightly higher prediction power than the standard radiomic features. CONCLUSIONS: Prediction performance using homology-based radiomic features had a comparable or slightly higher prediction power than standard radiomic features. These findings suggest that homology-based radiomic features may have great potential for improving the prognostic prediction accuracy of CT-based radiomics. In this result, it is noteworthy that there are some limitations.


Assuntos
Processamento de Imagem Assistida por Computador/métodos , Neoplasias Pulmonares/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Carcinoma Pulmonar de Células não Pequenas/patologia , Humanos , Neoplasias Pulmonares/patologia , Prognóstico , Carga Tumoral
17.
J Infect Chemother ; 26(1): 132-135, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31350185

RESUMO

Aspergillosis is a rare fungal infection in newborns, and its morbidity and mortality are high. Voriconazole (VRCZ) is the first-line antifungal agent for invasive Aspergillus infection, but little data is available about its pharmacokinetics in infants. We report a case of a premature infant who developed ventriculitis due to Aspergillus fumigatus and received combination antifungal therapy including VRCZ. ß-D glucan and Aspergillus antigen index were elevated in the cerebrospinal fluid (CSF). We titrated the dose of VRCZ by monitoring plasma and CSF concentrations. The CSF to plasma concentration ratio of VRCZ ranged from 0.47 to 1.36 (median 0.71). While VRCZ adequately penetrates the blood-brain barrier, its concentration is highly variable in infants.


Assuntos
Antifúngicos , Aspergillus fumigatus , Ventriculite Cerebral/tratamento farmacológico , Neuroaspergilose/tratamento farmacológico , Voriconazol , Antifúngicos/sangue , Antifúngicos/líquido cefalorraquidiano , Antifúngicos/uso terapêutico , Monitoramento de Medicamentos , Humanos , Recém-Nascido , Masculino , Voriconazol/sangue , Voriconazol/líquido cefalorraquidiano , Voriconazol/uso terapêutico
18.
Radiol Phys Technol ; 12(3): 351-356, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31364005

RESUMO

We evaluated an anthropomorphic head and neck phantom with tissue heterogeneity, produced using a personal 3D printer, with quality assurance (QA), specific to patients undergoing intensity-modulated radiation therapy (IMRT). Using semi-automatic segmentation, 3D models of bone, soft tissue, and an air-filled cavity were created based on computed tomography (CT) images from patients with head and neck cancer treated with IMRT. For the 3D printer settings, polylactide was used for soft tissue with 100% infill. Bone was reproduced by pouring plaster into the cavity created by the 3D printer. The average CT values for soft tissue and bone were 13.0 ± 144.3 HU and 439.5 ± 137.0 HU, respectively, for the phantom and 12.1 ± 124.5 HU and 771.5 ± 405.3 HU, respectively, for the patient. The gamma passing rate (3%/3 mm) was 96.1% for a nine-field IMRT plan. Thus, this phantom may be used instead of a standard shape phantom for patient-specific QA in IMRT.


Assuntos
Cabeça , Pescoço , Imagens de Fantasmas , Impressão Tridimensional , Garantia da Qualidade dos Cuidados de Saúde , Radioterapia de Intensidade Modulada/instrumentação , Cabeça/diagnóstico por imagem , Humanos , Pescoço/diagnóstico por imagem , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador , Tomografia Computadorizada por Raios X
19.
Cell Rep ; 27(3): 928-939.e4, 2019 04 16.
Artigo em Inglês | MEDLINE | ID: mdl-30995487

RESUMO

Establishment of robust gene expression boundary is crucial for creating elaborate morphology during development. However, mechanisms underlying boundary formation have been extensively studied only in a few model systems. We examined the establishment of zic1/zic4-expression boundary demarcating dorsoventral boundary of the entire trunk of medaka fish (Oryzias latipes) and identified a subgroup of dermomyotomal cells called horizontal boundary cells (HBCs) as crucial players for the boundary formation. Embryological and genetic analyses demonstrated that HBCs play crucial roles in the two major events of the process, i.e., refinement and maintenance. In the refinement, HBCs could serve as a chemical barrier against Wnts from the neural tube by expressing Hhip. At later stages, HBCs participate in the maintenance of the boundary by differentiating into the horizontal myoseptum physically inhibiting cell mixing across the boundary. These findings reveal the mechanisms underlying the dorsoventral boundary in the teleost trunk by specialized boundary cells.


Assuntos
Proteínas de Peixes/metabolismo , Somitos/metabolismo , Fatores de Transcrição/metabolismo , Animais , Animais Geneticamente Modificados/metabolismo , Padronização Corporal/genética , Diferenciação Celular , Cromossomos Artificiais Bacterianos/genética , Proteínas de Peixes/genética , Regulação da Expressão Gênica no Desenvolvimento , Oryzias/metabolismo , Somitos/citologia , Fatores de Transcrição/genética , Peixe-Zebra/metabolismo
20.
Med Phys ; 46(2): 964-972, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30506576

RESUMO

PURPOSE: We determined correction factors for absorbed dose energy dependence and intrinsic energy dependence for measurements of absorbed dose to water around an 192 Ir source using a radiophotoluminescent glass dosimeter (RPLD) calibrated with a 4-MV photon beam. METHODS: The ratio of the absorbed dose to the water and the average absorbed dose to RPLD for the 192 Ir beam relative to the same ratio in a 4 MV photon beam defines the absorbed dose energy dependence and was determined at distances of 2-10 cm (at intervals of 1 cm) from the 192 Ir source in a water phantom using the egs_chamber user code. The RPLD was calibrated to measure absorbed dose to water, Dw , in a 4 MV photon beam using an ionization chamber, which was also used to measure absorbed dose to water, Dw , in a water phantom using the 192 Ir source. The detector response radiophotoluminescence (RPL signal per average absorbed dose in the detector) in the 192 Ir beam relative to that in the 4 MV photon beam (the relative intrinsic efficiency) was determined experimentally. Finally, the beam quality correction factor was obtained as the quotient between the absorbed dose energy dependence and the relative intrinsic efficiency and corrects for the difference between the beam quality Q0 used at calibration and the beam quality Q used in the measurements. RESULTS: The relative dose ratio of the average absorbed dose to water relative to RPLD ranged from 0.930 to 0.746, and the beam quality correction factor ranged from 0.999 to 0.794 for distances of 2-10 cm from the 192 Ir source. The relative detector response to an 192 Ir source and a 4-MV photon beam was 0.930, and it did not vary significantly with distance. CONCLUSIONS: These results demonstrate that corrections for absorbed dose energy dependence and intrinsic energy dependence are required when using an RPLD to measure with sources different from the reference source providing the primary calibration.


Assuntos
Braquiterapia/instrumentação , Vidro/química , Radioisótopos de Irídio/uso terapêutico , Imagens de Fantasmas , Dosímetros de Radiação , Radiometria/instrumentação , Simulação por Computador , Humanos , Luminescência , Método de Monte Carlo , Doses de Radiação , Radiometria/métodos
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