A dosimetric comparison of RapidArc and IMRT with hypofractionated simultaneous integrated boost to the prostate for treatment of prostate cancer.

OBJECTIVE: To compare the dosimetric results and treatment delivery efficiency among RapidArc® (Varian Medical Systems, Palo Alto, CA), 7-field intensity-modulated radiotherapy (7-f IMRT) and 9-field IMRT (9-f IMRT) with hypofractionated simultaneous integrated boost to the prostate. METHODS: RapidArc, 7-f IMRT and 9-f IMRT plans were created for 21 consecutive patients treated for high-risk prostate cancer using the Eclipse™ treatment planning system (Varian Medical Systems). All plans were designed to deliver 70.0 Gy in 28 fractions to the prostate planning target volume (PTV) while simultaneously delivering 50.4 Gy in 28 fractions to the pelvic nodal PTV. Target coverage and sparing of organs at risk (OARs) were compared across techniques. The total number of monitor units (MUs) and the treatment time were used to assess treatment delivery efficiency. RESULTS: RapidArc resulted in slightly superior conformity and homogeneity of prostate PTV, whereas all plans were comparable with respect to dose to the nodal PTV. Although OARs sparing for RapidArc and 7-f IMRT plans were almost equivalent, 9-f IMRT achieved better sparing of the rectum and bladder than RapidArc and 7-f IMRT. RapidArc provided the highest treatment delivery efficiency with the lowest MUs and shortest treatment time. CONCLUSION: RapidArc resulted in similar OAR sparing to 7-f IMRT, whereas 9-f IMRT provided the best OAR sparing. Treatment delivery efficiency is significantly higher for RapidArc. ADVANCES IN KNOWLEDGE: This study validated the feasibility and limitations of RapidArc in the treatment of high-risk prostate cancer with complex pelvic target volumes.

[Successful emergency surgery for acute mitral regurgitation due to total rupture in the anterior papillary muscle after acute myocardial infarction; report of a case].

A 32-year-old male was admitted with dyspnea Severe dyspnea and hypoxemia developed the next day and blood examination indicated acute myocardial infarction. Echocardiogram revealed massive mitral regurgitation with prolapse of the anterior mitral leaflet due to rupture in the papillary muscle. Percutaneous coronary intervention for total occlusion in the right coronary artery was successfully performed, but progressive heart failure continued to develop. Surgery for the papillary muscle rupture was performed on the 3rd day. Complete head rupture of the anterior papillary muscle was found and the mitral valve was replaced with a prosthetic valve (St. Jude Medical valve: #31). Pathological findings showed necrosis in the papillary muscle with inflammatory changes. The postoperative course was uneventful and the patient was discharged on the 43rd day after surgery.

[Immunoglobulins and sheep red cell receptors in human lymphoblastoid cell lines simultaneously carrying Epstein-Barr virus and cytomegalovirus genomes]. / Présence d'immunoglobulines et de récepteurs pour les globules rouges de mouton dans les lignées lymphoblastiques humaines simultanément porteuses du génome du virus d'Epstein-Barr et du cytomégalovirus

In this communication we attempt to characterize the principal immunological properties of 3 human lymphoblastoid cell lines (LCL) established in our laboratory which carry both the EBV and CMV genomes. The data obtained suggests that two LCL are representative of B lymphocytes while the other LCL has a mixed cell population with the majority being of the B type. The reasons for this heterogeneity are discussed. It is suggested that CMV may also transform thymus-independent (B) lymphocytes.

Some comparative observations on the relative contributions of alternate pathways in the metabolism of glucose by Candida utilis.

Candida utilis was grown in batch, chemostat, and continuously synchronised (phased) culture on a nitrogen-limited glucose mineral salts medium: phosphorus- and carbon-limited phased cultures were also used. The 14CO2 evolved from [G-1-14c]and [G-6-14c] was used, as a simple C1/C6 ratio, to observe the relative changes in EMP and HMP contributions during growth of the cultures. The ratio varied during the cell cycle, and changed with growth rate, and with nutrient limitation. The changes generally indicated that the HMP predominated, most notably in the early part of the batch-growth sequence and early in the cell cycle. The overall results reflected the relative merits of the different cultivation techniques for examining microbial metabolism: the advantage of a greater resolution by the synchronised method, based upon the unit performance rather than the randomised mean performance of the cell population...