Clinical implementation of AAPM Task Group 32 recommendations on brachytherapy source strength specification

Historically the strength of sealed brachytherapy sources has been described by many physical quantities, including true activity, apparent activity, and equivalent mass of radium. Recently, the AAPM Task Group 32 recommended that these quantities be replaced by a single quantity, air-kerma strength, with units of muGy m2h-1. A set of equations has been developed for unambiguously converting source strength estimates and renormalizing published dose-rate tables, which assume traditional quantities and units, into forms consistent with air-kerma strength. For commonly used brachytherapy sources, multiplicative conversion factors for each source-strength formalism and set of units are given. To convert equivalent mass of radium to air-kerma strength requires a single multiplicative factor, 7.23 muGy m2h-1/mgRaEq, applicable to all sources. Based upon a review of vendor source specification practices, the factors for converting source strength of 198Au, 103Pd, and 125I seeds from apparent mCi to air-kerma strength are 2.06, 1.29, and 1.27 muGy m2h-1/mCi(apparent), respectively. These factors are independent of source geometry but depend on the nominal exposure rate constant value selected by the vendor. Conversion factors applicable to mass of radium or true activity depend upon both source geometry and radionuclide identity. Because many of these conversion factors depend upon vendor choices of physical constants and exposure rate constants, readers are cautioned to carefully review vendor source strength specification practices before adopting these values clinically. Finally, the relationships between the various source strength quantities and absorbed dose rate in the medium surrounding the source are elucidated.     

The characterization of Gardnerella vaginalis DNA using non-radioactive DNA probes

DNA restriction profiles of various Gardnerella vaginalis isolates, generated by BamHI, EcoRI, PstI and other restriction enzymes, varied considerably. Only a few DNA fragments were identified as common in ethidium bromide fluorescence profile and Southern-blot hybridization patterns (employing a digoxigenin-labelled G. vaginalis DNA probe and an enzyme-linked immunoassay detection method). While the efficiencies of Southern-blot hybridization appeared inconsistent, in dot-blot assays, DNA from each isolate hybridized readily, enabling the detection of at least 10 ng DNA. A 5.7-kb DNA fragment from G. vaginalis ATCC 14018 genomic library, cloned in the BamHI site of pBR322, could replace the total genomic DNA probe. This specific DNA fragment was present in different sizes in 12 analysed G. vaginalis strains, describing a restriction fragment length polymorphism. In control studies, none of the DNA from bacteria other than G. vaginalis (including some genitourinary tract residents) hybridized with the G. vaginalis total or specific DNA probes. Non-radioactive G. vaginalis DNA probes can thus form the basis of a useful detection method for further studies of this organism.     

Two-dimensional dosimetry in the near field of the model 200 103Pd source for interstitial brachytherapy implants using a thermoluminescent sheet

A large area and highly sensitive thermoluminescent (TL) sheet film was used for two-dimensional dose distribution measurements at millimetre distances from a 103Pd interstitial brachytherapy source. The TL film is made of Teflon homogeneously mixed with small particles of thermoluminescent material (BaSO4: Eu doped). This TL sheet (5 cm x 5 cm) was used to determine the relative dosimetric characteristics (i.e., radial dose function, 2D and 1D anisotropy functions, as defined by the updated AAPM Task Group No 43 report) of the model 200 103Pd source that emits low energy photons (21 keV). The two-dimensional dosimetry data were obtained for distances from the source surface to 15 mm. The radial dose function measured with the TL sheet is in reasonable agreement within 11% with the values recommended in the updated AAPM TG-43 report. All the measured 2D dose distributions showed limited symmetry about the source axes. The differences between the 1D anisotropy function values measured with the TL sheet and the data recommended in the updated AAPM TG-43 report were 10% at 5 mm and 7.5% at 10 mm, respectively, for the model 200 103Pd seed. Our experiments have demonstrated that it is feasible to use the TL sheet as a dosimeter in the determination of the dosimetric characteristics in the immediate vicinity of interstitial brachytherapy sources emitting low energy photons.     

Macrophage-tumour cell interactions: identification of MUC1 on breast cancer cells as a potential counter-receptor for the macrophage-restricted receptor, sialoadhesin

In many carcinomas, infiltrating macrophages are commonly found closely associated with tumour cells but little is known concerning the nature or significance of adhesion molecules involved in these cellular interactions. Here we demonstrate in primary human breast cancers that sialoadhesin (Sn), a macrophage-restricted adhesion molecule, is frequently expressed on infiltrating cells that often make close contact with breast carcinoma cells. To determine whether Sn could act as a specific receptor for ligands on breast cancer cell lines, binding assays were performed with a recombinant form of the protein fused to the Fc portion of human immunoglobulin G1 (IgG1) (Sn-Fc). Sn-Fc was found to bind specifically and in a sialic acid-dependent manner to the breast cancer cell lines MCF-7, T47.D and BT-20 both in solid- and solution-phase binding assays. To investigate the nature of the sialoglycoproteins recognized by Sn on breast cancer cells, MCF-7 cells were labelled with [6-3H]glucosamine. Following precipitation with Sn-Fc, a major band of approximately 240000 MW was revealed, which was shown in reprecipitation and Western blotting experiments to be the epithelial mucin, MUC1.     

Modification of electron-beam dose distributions by transverse magnetic fields

By applying a transverse magnetic field to a dosimetry phantom, an incident high-energy electron beam is made to follow a spiral path in the course of slowing down. Certain levels, determined by the electron energy and the magnetic field strength, will be traversed several times by the same electrons. The net result of this process is an enhancement of the depth dose in relation to the entrance dose, and a more sharply defined depth of penetration. Experiments with 50- and 55-MeV electrons traversing a 20.5-kG field are shown to support the predictions of a detailed Monte Carlo calculation.     

Evaluation of inhibitory effect of diphenhydramine on benzodiazepine dependence in rats

Effect of diphenhydramine was investigated on withdrawal signs in lorazepam dependent rats. Physical dependence was produced by giving lorazepam admixed with the food in the following dose schedule: 10 x 4, 20 x 4, 40 x 4, 80 x 4 and 120 x 7 (mg/kg, daily x days). The parameters observed during the periods of administration of lorazepam and after its withdrawal were spontaneous locomotor activity (SLA), body temperature, reaction time to pain, foot shock aggression (FSA) and audiogenic seizures. Diphenhydramine was administered orally in the dose schedules of once daily (10, 20 and 40 mg/kg) and twice daily (5, 10 and 20 mg/kg) in separate groups during the withdrawal period. The withdrawal signs observed in control group (without diphenhydramine) were hyperkinesia, hyperthermia, hyperaggression and audiogenic seizures. Hyperkinesia and hyperthermia were blocked in all the groups of diphenhydramine-treated rats. FSA was inhibited only by diphenhydramine (10 and 20 mg/kg) given twice daily. Audiogenic seizures were completely blocked by once daily (20 and 40 mg/kg) as well as twice daily (20 mg/kg) doses of diphenhydramine. It may be concluded that diphenhydramine exerts a protective effects on benzodiazepine withdrawal syndrome.     

Synthesis and antimicrobial activity of Schiff and Mannich bases of isatin and its derivatives with pyrimidine.

Isatin and its derivatives have been reacted with 4-(4'-chlorophenyl)-6-(4"-methyl phenyl)-2-aminopyrimidine to form Schiff bases and the N-Mannich bases of these compounds were synthesized by reacting them with formaldehyde and several secondary amines. Investigation of antimicrobial activity of the compounds was made by the agar dilution method against 28 pathogenic bacteria, eight pathogenic fungi and anti-HIV activity against replication of HIV-1 (III B) in MT-4 cells. The compounds are significantly active against bacteria and fungi.     

Buprenorphine pharmacokinetics: relative bioavailability of sublingual tablet and liquid formulations.

Buprenorphine is an effective new treatment for opiate dependence. This study compared the bioavailability of buprenorphine from a tablet to that from a reference solution. Six men experienced with, but not dependent on, opiates (DSM-III-R) were each administered 7.7 mg of buprenorphine in liquid form and 8 mg in tablet form 1 week apart in a balanced crossover design. Plasma levels were measured by electron capture capillary gas chromatography (GC), and concentration-time curves were constructed. Pharmacokinetic data were analyzed by analysis of variance. The bioavailability from the tablet was approximately 50% that from the liquid and was not affected by saliva pH. Lower bioavailability from the tablet may be due to slow dissolution.     

Evidence for central histaminergic mechanism in foot shock aggression

The role of central histaminergic system in foot shock induced aggression was studied in mice. Histamine administered by intracerebral (IC) injection (25–200 g) produced a significant increase in fighting episodes in a dose dependent manner. It was observed that mepyramine (H₁ blocker) given intraperitoneally (IP) significantly increased and metiamide (H₂ blocker) given IC decreased significantly the fighting response. To determine the nature of receptors involved in histamine induced facilitation of aggressive behaviour, histamine was administered IC in mice pretreated with mepyramine or metiamide. Mepyramine pretreatment further increased the facilitatory effect of histamine while metiamide blocked the enhancement of aggressiveness by histamine. Combined pretreatment with metiamide and mepyramine decreased significantly the fighting counts which remained unaffected after histamine. Haloperidol did not block the enhancement of aggression by histamine or mepyramine. However, atropine pretreatment partially inhibited the histamine induced increase in the fighting counts. Results of pretreatment with metiamide and atropine were similar to those obtained with pretreatment of metiamide and mepyramine. Metiamide alone or in combination with atropine failed to affect the facilitatory effect of amphetamine on the foot-shockaggression. It is concluded that central histamine H₂ receptors have a facilitatory role and H₁ receptors an inhibitory role on aggressive behaviour in mice induced by foot-shock. Since histamine per se had a facilitatory effect on foot-shock induced aggression, the central H₂ receptors seem to dominate over the H₁ receptors.     

Microvascular decompression for trigeminal neuralgia: report of outcome in patients over 65 years of age

Microvascular decompression (MVD) is now recognized as an effective operation for the cure of trigeminal neuralgia (TN), and is far superior to the other surgical procedures utilized in the treatment of TN. TN is common in the elderly, but there is debate concerning MVD in 'elderly' patients. Some clinicians have a policy of not offering patients over a certain age the choice of MVD, yet the recurrence rate is inversely related to the age of the patient. Previous failed procedures and a long period of pain before MVD, also affect the outcome negatively. This study is a retrospective review of the outcome in elderly patients following MVD. Forty-two patients over the age of 65 years are reviewed after undergoing MVD for TN. The results indicate that there was no serious morbidity or mortality that could be ascribed to old age and the length of stay in the hospital was not influenced by the age of the patient. The results are compared with the outcome in a younger age group and the literature on MVD for TN reviewed.