Dosimetric evaluation of four whole brain radiation therapy approaches with hippocampus and inner ear avoidance and simultaneous integrated boost for limited brain metastases.

AIMS: To perform a dosimetric evaluation of four different simultaneous integrated boost whole brain radiotherapy modalities with hippocampus and inner ear avoidance in the treatment of limited brain metastases. METHODS: Computed tomography/magnetic resonance imaging data of 10 patients with limited (1-5) brain metastases were used to replan step-and-shoot intensity-modulated radiotherapy (sIMRT), dynamic intensity-modulated radiation therapy (dIMRT), volumetric-modulated arc therapy (VMAT), and helical tomotherapy (Tomo). The prescribed doses of 40-50 Gy in 10 fractions and 30 Gy in 10 fractions were simultaneously delivered to the metastatic lesions and the whole-brain volume, respectively. The hippocampal dose met the RTOG 0933 criteria for hippocampal avoidance (Dmax ≤17 Gy, D100% ≤10 Gy). The inner ear dose was restrained to Dmean ≤15 Gy. Target coverage (TC), homogeneity index (HI), conformity index (CI), maximum dose (Dmax), minimum dose (Dmin) and dose to organs at risk (OARs) were compared. RESULTS: All plans met the indicated dose restrictions. The mean percentage of planning target volume of metastases (PTVmets) coverage ranged from 97.1 to 99.4%. For planning target volume of brain (PTVbrain), Tomo provided the lowest average D2% (37.5 ± 2.8 Gy), the highest average D98% (25.2 ± 2.0 Gy), and the best TC (92.6% ± 2.1%) and CI (0.79 ± 0.06). The two fixed gantry IMRT modalities (step and shot, dynamic) provided similar PTVbrain dose homogeneity (both 0.76). Significant differences across the four approaches were observed for the maximum and minimum doses to the hippocampus and the maximum doses to the eyes, lens and optic nerves. CONCLUSION: All four radiotherapy modalities produced acceptable treatment plans with good avoidance of the hippocampus and inner ear. Tomo obtained satisfactory PTVbrain coverage and the best homogeneity index. TRIAL REGISTRATION: Clinicaltrials.gov, NCT03414944 . Registered 29 January 2018.

Performance enhancement of single layer organic light-emitting diodes using chlorinated indium tin oxide as the anode.

Effective green single-layer organic light-emitting diodes (OLEDs) are reported with fac-tris(2-phenylpyridine)iridium [Ir(ppy)3] as a dopant and chlorinated indium tin oxide (Cl-ITO) as a transparent anode. The work function of the chlorinated ITO is manipulated to be ∼5.3 eV from ∼4.7 eV for bared ITO. The improvement in anode workfunction allows the direct hole injection into the HOMO of the phosphorescent dopant. As a result, the green phosphorescent OLEDs with simple single layers can deliver a current efficiency (CE) and external quantum efficiency (EQE) as high as 33.48 cd A-1 and 10.1%, respectively.

The protective effect of curcumin against the 19­kDa Mycobacterium tuberculosis protein-induced inflammation and apoptosis in human macrophages.

The Mycobacterium tuberculosis 19-kDa lipoprotein (P19) is both cell wall-associated and secreted and is a candidate virulence factor that could cause the apoptosis of human macrophages infected with M. tuberculosis. P19 induces TLR2 activation, resulting in the upregulation of death receptors and ligands, followed by a death-receptor signaling cascade. The mechanisms by which P19 induces macrophage apoptosis are not fully characterized. Curcumin, a natural polyphenol, exhibits a variety of pharmacological effects such as antioxidant, anti-inflammatory and antitumor properties. In the present study, we investigated the effect of curcumin on P19-induced apoptosis in human macrophage cells and the underlying mechanisms. The results showed that both P19 and curcumin inhibit the growth of macrophages in a dose- and time-dependent manner. A low dose of curcumin (10 or 20 µM) attenuated both the macrophage cell growth inhibition and the increase in the expression of IL-6 and TNF-α induced by P19. Curcumin also decreased the phosphorylation of JNK and p38 that were induced by P19. However, JNK but not p38 inhibitors reversed the effect of P19 on the growth inhibition of macrophages. These data suggest that curcumin may protect macrophages from P19-induced cell apoptosis via a TLR2-mediated JNK-dependent pathway.

A case of tuberculous peritonitis.

This study aimed to provide the initial laparoscopy results as well as the results after a 16-month follow-up of a 78-year-old patient with tuberculous peritonitis. Imaging and laboratory examinations were performed for preliminary diagnosis, and laparoscopy and Gram staining were used for definitive diagnosis. The initial laparoscopy results showed the presence of typical yellow-white nodules on the liver surface and a biopsy demonstrated caseous necrotic granuloma. After 16 months, laparoscopy results showed that yellow-white nodules were reduced after antituberculous drug treatment and adhesions formed by fibrin networks were clearly visible. Laparoscopy and biopsy contributed to the rapid diagnosis of tuberculous peritonitis.