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Purpose: The purpose of the study was to establish the efficacy and safety of breast intensity-modulated radiation therapy (IMRT) compared with non-IMRT standard wedge radiation therapy (RT) for the treatment of adjuvant breast cancer., Methods: A systematic review and meta-analysis were completed using STATA and a random effects model. A total of 1,499 citations were identified from the literature search. Of those, 1,475 were excluded based on abstract review. Full texts of 24 remaining articles were reviewed and 11 articles were included in the final analysis. Side effects were analysed as the primary outcomes of interest. We calculated individual odds ratios and 95% confidence intervals for 17 classifications of side effects reported. The data for eight classifications of side effects were then pooled for meta-analyses to obtain more precise estimates of the relationships between adjuvant RT and a particular side effect., Results: The pooled analyses revealed potential protective associations between adjuvant IMRT and two acute side effects: dermatitis and moist desquamation. The remaining pooled estimates suggest that the odds of developing edema, hyperpigmentation, fat necrosis, pain, induration were no worse, nor better among those treated with IMRT compared with those treated with non-IMRT standard wedge RT., Conclusion: The pooled estimates from this meta-analysis are in line with the existing evidence. When the outcome of interest is reduction of the acute side effects: dermatitis and moist desquamation IMRT is a viable treatment option for women undergoing external beam RT after breast-conserving surgery., (Copyright © 2017 Canadian Association of Medical Radiation Technologists. Published by Elsevier Inc. All rights reserved.)

Objectives: To compare 1) temporomandibular joint (TMJ) mobility between patients with and without reduced upper cervical spine (UCS) mobility and with and without TMJ osseous osteoarthritic-like changes, and 2) UCS osseous changes between patients with and without TMJ osseous osteoarthritic-like changes and with and without reduced UCS mobility., Study Design: The study comprised 39 patients without pain from TMJ or UCS and with obstructive sleep apnea, 15 women (age range 26-72 years, mean 56.0) and 24 men (age range 27-71 years, mean 49.8). The range of motion (ROM) of the mandible and UCS was assessed clinically. Osseous changes of the TMJ and UCS were assessed by cone beam computed tomography. Differences were tested and adjusted for age and gender by multiple linear and logistic regression analyses., Results: The mandibular ROM was within normal range (45-64 mm) but the UCS ROM was reduced in 15 patients. Osseous TMJ and UCS changes were both found in 38.5% of the patients. Osseous UCS changes were found more frequently in patients with than without TMJ changes (P = .0003; odds ratio 21.9). No other significant results were found., Conclusions: The present findings of comorbid osseous changes in patients with obstructive sleep apnea support a possible biomechanical relationship between the TMJ and the UCS., (Copyright © 2016 Elsevier Inc. All rights reserved.)

A total of eight girls with Rett syndrome were examined, by 31phosphorous magnetic resonance spectroscopy (31P MRS) (4 girls), proton MRS (1H MRS) (4 girls), muscle biopsying (2 girls), and determination of pyruvate and lactate in plasma (5 girls), to investigate the hypothesis of a mitochondrial malfunction as the etiology for this neurologic disorder. Almost all examinations, including electron microscopy in search of structural mitochondrial abnormalities, gave normal results, the only exception being the not unexpected finding of slight neurogenic atrophy in the muscle biopsy specimen from a 15-year-old girl.

The accuracy of relaxation time measurements of spectroscopic inversion recovery and CPMG multi-echo pulse sequences together with ISIS and stimulated echo-pulse methods have been tested on a reference phantom (test object no. 5, of the EEC Concerted Research Project). For the measurements a Siemens Magnetom wholebody magnetic resonance scanner operating at 1.5 Tesla was used. For comparison six imaging pulse sequences for relaxation time measurements were tested on the same phantom. The spectroscopic pulse sequences all had an accuracy better than 10% of the reference values.

Volume selective magnetic resonance (MR) proton spectroscopy was used to investigate changes in the haemopoietic bone marrow in patients with end-stage renal disease undergoing treatment with recombinant human erythropoietin (rHuEPO). Significant changes could be detected in the spectra 14 days after the beginning of treatment, before any response was seen in the haemoglobin concentration of peripheral blood. The spectral changes indicate an alteration in cellular composition of haemopoietic bone marrow with an increase in the amount of haemopoietic active tissue. One patient showed a major change in the spectrum four days after treatment began, indicating that MR spectroscopy may detect early changes in the cellular composition of the bone marrow. This noninvasive method may be useful in evaluating treatment effects of recombinant human haemopoietic growth factors in the bone marrow, as well as investigating bone marrow response from different modes of rHuEPO administration.

Volume selective magnetic resonance (MR) proton spectroscopy was used to investigate the haemopoietic (iliac bone) and fatty bone marrow (tibia) in patients with leukemia and polycythaemia vera. Selective measurements of the relaxation times T1 and T2 for the "water" and "fat" resonances in the bone marrow spectra were performed. Nine patients with acute leukemia and three patients with chronic leukemia were examined at diagnosis. Three patients with acute leukemia in remission were also examined. Five of the leukemic patients had follow-up examinations performed in relation to chemotherapeutic treatment. Nine patients with polycythaemia vera and 21 normal control subjects were examined with identical methods for comparison. All patients had bone marrow biopsies performed prior to every MR examination. Significant differences could be detected in the spectral patterns from iliac bone marrow in patients with leukemia at diagnosis compared to the healthy normal controls. The "relative water content" was increased in the iliac bone marrow spectra of the leukemic patients compared to the normal subjects, which indicates an increase in the amount of haemopoietic tissue and a corresponding decrease in marrow fat content. The T1 relaxation times of the "water" resonance in the spectra from the iliac bone marrow of the leukemic patients were significantly prolonged at diagnosis, compared to the normal controls and the patients with polycythaemia vera. After chemotherapeutic induction of remission, the spectra from the iliac bone marrow in the patients with leukemia resembled normal spectra. Four leukemic patients had abnormal spectra from the tibial bone marrow and one patient showed early changes in tibial marrow during chemotherapeutic treatment, before any major changes could be detected in the iliac bone marrow.

In vitro as well as in vivo studies have shown prolonged T1 relaxation times in patients with acute leukemia. The mechanism behind this finding is not known. In order to evaluate if this was specific for leukemia we examined eight patients with polycythemia vera, representing a condition with a rather benign bone marrow neoplasia. In this group of patients we found prolonged T1 relaxation times but normal T2 relaxation times. This may indicate that the prolonged T1 relaxation time seen in leukemic bone marrow is not due to the malignant cell per se.

The T1 relaxation times were estimated for 31P-metabolites in human skeletal muscle. Five healthy volunteers were examined in a 1.5 Tesla wholebody imaging system using an inversion recovery pulse sequence. The calculated T1 relaxation times ranged from 5.517 sec for phosphocreatine to 3.603 sec for -ATP.

Two patients with closed pancreatic transection, were treated by Roux-en-Y pancreaticojejunostomy. The management of closed isolated pancreatic transection is discussed.