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Purpose: H3K27M- and H3G34R-mutant gliomas are recently-classified subgroups of high-grade gliomas (HGGs) affecting younger adults. This study aimed to describe patterns of infiltration and failure, and the volumetric response of these tumours to radiotherapy. Methods: Patients with histone-mutant gliomas aged 16–50 years, managed from 2009 to 2021 were identified and clinical, radiological and histopathological characteristics collected. Tumour volume was assessed on MRI at diagnosis, pre-radiotherapy, month + 1, + 3 and + 5 post-radiation and at relapse. Results: Of 538 IDH1/2 wild-type HGGs, 18(15%) had a histone alteration. Eleven were H3K27M- and 7 H3G34R-mutant respectively. Median age at diagnosis was 20 years (range17-48 years). Median overall survival was 20 months (95%CI 14-29 months). Both H3K27M- and H3G34R-mutant tumours exhibited extensive T2F infiltration involving a median of 4 neuroanatomical subsites at diagnosis. Median volume of disease pre-radiotherapy on T1gd and T2F respectively was 0.5cm3 (IQR:0–1.7cm3) and 11.9 cm3 (IQR:7.5–29.6cm3) for H3K27M and 0.9cm3 (IQR:0–8.4cm3) and 43.8cm3 (IQR:25.2–86.6 cm3) for H3G34R tumours. T2F volume reduction > 50% was observed 3-months post-IMRT in 7(64%) patients with H3K27M and 1(14%) with H3G34R tumours. Fourteen patients had relapsed. Relapse was local-only, distant-only and both in 4(44%), 3(33%) and 2(22%) H3K27M-mutant and 1(20%), 2(40%), and 2(40%) H3G34R-mutant tumours. On last scan before death, leptomeningeal spread was present in 4/8(50%) and 1/5(20%) and subependymal spread in 4/8 (50%) and 0/5 H3K27M- and G34R-mutant cases respectively. Conclusion: H3K27M-mutant gliomas are highly responsive to radiotherapy but exhibit high propensity for subsequent leptomeningeal and subependymal spread. H3G34R-mutant tumours exhibit lesser early volumetric response to radiotherapy and propensity for distant in-brain failure. [ABSTRACT FROM AUTHOR]

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Experiments were conducted to determine the extent of Fusarium langsethiae infection in wheat, barley and oats grown under identical experimental conditions. In total, four experiments were conducted with both winter and spring sown experiments at two locations. The amount of F. langsethiae infection was determined by quantifying F. langsethiae DNA and quantifying the combined concentration of the trichothecene mycotoxins HT-2 and T-2 (HT-2 + T-2) in cereal head fractions (grain and rest of the head) after threshing at harvest. Results of the study showed that under identical experimental conditions, oats had the highest F. langsethiae DNA and HT-2 + T-2 concentrations compared to wheat and barley. This indicates that the high levels detected on UK oats compared to wheat and barley from surveys of commercial crops is a consequence of genetic differences rather than differences in agronomy applied to the cereal species. The concentration of HT-2 and T-2 per unit of F. langsethiae DNA in oats compared to wheat and barley was also significantly higher indicating host differences in either the stimulation of HT-2 and T-2 production or in the metabolism of HT-2 and T-2. The study also showed that the proportion of F. langsethiae DNA in threshed grains was significantly lower than that in the rest of the cereal head. [ABSTRACT FROM AUTHOR]

To determine the outcome of elderly patients with glioblastoma managed with hypofractionated [40 Gray (Gy)] or long-course (60 Gy) radiation therapy (RT). Patients aged >60 years diagnosed with WHO grade IV glioma managed with RT between October 2006 and July 2012 were retrospectively identified. Baseline data including ECOG performance status, RT dose and use of temozolomide (TMZ) were recorded. Overall survival was calculated in months from date of diagnosis. 109 patients were included with age distribution from 61 to 88 years (13 % <65, 63 % 65-75, and 24 % >75). Median survival (MS) of total group was 12 months (95 % CI 11-13) with 12 % surviving beyond 2 years. For age groups <65, 65-75, >75 the survival was 17, 12, and 9 months respectively ( p = 0.001). Near total resection ( p = 0.027), but not ECOG 0-1 ( p = 0.34) was associated with improved MS. For the 69 patients aged 65-75, 55 % were managed with 40 Gy and 45 % 60 Gy. Longer survival was associated with the use of 60 Gy (15 vs. 9 months, p < 0.0001), and use of TMZ (13 vs. 7 months, p < 0.0001). In the 48 patients (70 %) managed with TMZ, the MS was 15 months with 60 Gy (95 % CI 13-17) compared with 11 months (95 % CI 9-13) in those with 40 Gy. Performance status with ECOG 0-1 was not associated with improved survival ( p = 0.25). Within the limitations of a retrospective study, we demonstrate improved MS in the elderly population when TMZ is added to RT. Those in the age group 65-75 may benefit from long-course RT with TMZ. [ABSTRACT FROM AUTHOR]

Purpose: Radiotherapy (RT) and temozolomide (TMZ) for glioblastoma (GBM) has resulted in longer survival. Uncertainties exist regarding quality of survival. This study aims to determine the rate of patients returning to previous employment (EM) following treatment. Methods: Eligible patients were diagnosed with GBM, aged 18-70 years, and treated with intensity-modulated radiotherapy to 60 Gray and TMZ (EORTC Protocol) between July 2007 and July 2011. EM was defined as paid work. Exclusion criteria included patients without histological confirmation of WHO grade IV glioblastoma, those not in paid employment in the 2-month period prior to diagnosis, or mothers of pre-school aged children not working. Data were collected on EM prior (EM pre) and after RT at 6 and 12 months (EM 6 m, EM 12 m). Rate of EM was analysed in regards to baseline performance status (ECOG), neurological deficits (MRC scale) and median survival. Results: One hundred twelve patients were identified with median follow-up of 15.5 months and median survival 18 months (95%CI, 15-21 months). Seventy-one patients were working prior to diagnosis and eligible for analysis. Twenty patients returned to work (28 %) by EM 6 months and 19 patients (27 %) by EM 12 months. EM 6 months was strongly associated with ECOG and MRC status, with only 1 of 37 patients (3 %) with neurological deficit returning to work compared with 21 of 36 (58 %) intact patients. Of good performance status patients not returning to work, factors included presence of income insurance, family financial support or treatment-related symptoms. Conclusion: A modest proportion of patients with GBM return back to work at 6 and 12 months following radiotherapy with the majority demonstrating the lowest level of neurological deficit prior to RT. Implications for Cancer Survivors: Return to work following treatment does occur but it is not a common outcome. [ABSTRACT FROM AUTHOR]

Tb and Eu co-doped YO nanoparticles with a volume-weighted average size of about 30 nm were synthesized via simple Pechini-type sol-gel process. The growth of monocrystalline nanoparticles is investigated via XRD and TEM analysis. The study of energy transfer between Tb and Eu ions was carried out by means of PL, PLE, and photoluminescence decay analyses. The energy transfer from Tb to Eu is efficient and we show how a resonant type via a dipole-dipole interaction is the most probable mechanism. We compared the energy-transfer efficiencies calculated from the intensities and from the lifetimes of $${}^5\hbox{D}_4 \longrightarrow ^7\hbox{F}_5$$ transition of Tb, showing the presence of two populations of Tb, with different local surroundings, in the matrix. Furthermore, the critical distance between Tb and Eu ions has been calculated by means of different theories, from a new probabilistic approach based on the discretization of the theory of Chandrasekhar about the distribution of the nearest neighbors in a random distribution of particles, and from the PL data, suggesting a value of about 7 Å. [ABSTRACT FROM AUTHOR]

A field survey was performed to study the infection and development of Fusarium langsethiae in the growing season of wheat, barley, oats and triticale under commercial (2009 - 2011) production. Sampling was completed over three years from fields within the counties of Shropshire and Staffordshire in the UK. Plants sampled (from tillering to harvest) were divided into roots, leaves, lower stem, upper stem and inflorescence/head sub-samples depending on the growth stage of the cereal. DNA was extracted and F. langsethiae DNA quantified using real-time PCR. Fusarium mycotoxins HT-2 and T-2 were quantified from head samples at harvest. Three years of data showed oat to contain the highest levels of both F. langsethiae biomass and HT-2 + T-2 mycotoxins in harvested heads of the cereals studied. The development of F. langsethiae in all three cereals appeared to be similar. Fusarium langsethiae DNA was not detected in the roots and seedlings of all three cereals suggesting F. langsethiae is not a seedling pathogen of cereals. Head infection if it occurs, is at head emergence but before flowering. Seemingly symptomless heads had high levels of F. langsethiae DNA and HT-2 + T-2, confirming previous suggestions that F. langsethiae is a symptomless pathogen of oats. [ABSTRACT FROM AUTHOR]

We report an optical study of Tb-doped YO nanocrystals synthesized by Pechini-type sol-gel method. The particles are investigated in terms of size and morphology by means of X-ray diffraction and transmission electron microscopy analysis. It is shown how the simple Pechini method allows for the growth of monocrystalline nanoparticles with a volume-weighted average size of about 30 nm. The optical properties of Tb in the host lattice are studied in terms of PL, PLE, and lifetimes. Moreover, a correlation between the type of decay curves, the emission and excitation bands' shapes, and the site location of the emitting Tb in the host material YOis proposed. [ABSTRACT FROM AUTHOR]

Single-port access surgery (SPA), the most recent development in laparoscopic surgery allows operations to be carried out through only a single incision using special multichannel ports. By the use of a smaller access tissue trauma and access-related complications, such as wound infections, adhesions and incisional hernias can be decreased considerably. Because of less postoperative pain earlier mobilization of patients can also be achieved. By placing the access transumbilically, e.g. in SPA cholecystectomy (SPA-CHE), the scar is perfectly covered achieving an optimal cosmetic result. Meanwhile various so-called single ports and camera systems have been developed. Great importance is attached to the development of special (double) bended and/or articulating instruments because with these instrument triangulation is possible through only one incision. Nevertheless the stereoscopic situation in SPA-CHE implicates some factors related to retraction, exposition and release of the gallbladder but some difficult situations can be managed safely with some tips and tricks. Because of the already worldwide spread of SPA-CHE this technique will soon become an established minimally invasive technique. However, appropriate studies confirming the clear advantages of the technique are still lacking. [ABSTRACT FROM AUTHOR]

The decomposition of ethylene by pulsed, unfocussed CO-laser radiation has been studied at pressures from 500 to 3000 Torr, using the P(14) line of the 10.6μm band ( v=949.48cm) at incident fluences from about 0.1 to 1.0J/cm. Major products in order of decreasing importance were 1,3-butadiene, acetylene, ethane, propane, 1-butene and methane. These are known products of the thermal free-radical chain decomposition, and it is concluded that the laser-induced decomposition under our conditions is a transient bulk thermal reaction occurring in a thin disc of heated gas close to the entrance window of the reaction vessel at temperatures ranging from about 1000 to 1500K. As in the thermal decomposition, cyclobutane was observed to be a minor product, which in a sequence of laser pulses approached a final constant concentration. The possibility that this corresponded to an equilibrium concentration at some 'effective' reaction temperature was explored. Computer simulation was used to model the accumulation of cyclobutane in the system, both in a single pulse and in a sequence of pulses, and predictions of this model were compared with experiment. It was concluded that cyclobutane could be used in this way as an approximate internal thermometer, within certain limits. Mechanisms of formation of the free-radical chain products are discussed. It is concluded that the chains are initiated by the bimolecular disproportionation reaction, 2CH → CH+CH, and that secondary initiation by dissociation of the product, 1-butene, becomes increasingly important as the reaction proceeds, leading to autocatalysis. It is further concluded that the radical chain decomposition in this system is a transient process occurring in a brief time interval following the short laser pulse (FWHM=110ns), and is far from steady-state conditions. [ABSTRACT FROM AUTHOR]

The absorption of pulsed CO-laser radiation by ethylene has been measured at total pressures from 25 to 3000 Torr, using the P(12) and P(14) lines in the 10.6 μm band, with incident fluences from 0.1 to 0.7 J/cm. Marked deviations from the Beer-Lambert absorption law were observed, with the effective absorption coefficient varying with pressure, fluence, absorption path-length and the addition of non-absorbing gas. Pressure broadening of the rotational lines of the ethylene absorption spectrum was shown to be the major cause of these deviations, together with lesser effects which can be attributed to the rise in temperature of the absorbing gas during the laser pulse. [ABSTRACT FROM AUTHOR]

Extraneural metastases of intracranial germinomas, although infrequent, are associated with a generally poor prognosis despite the high radiosensitivity of localized primary tumors. Ventriculoperitoneal shunts have been implicated in facilitating metastatic spread of primary intracranial germinomas. We present a case of a successfully irradiated suprasellar germinoma recurring after 13 months as an intra-abdominal yolk-sac tumor in a young man. The tumor was eradicated with a combination of systemic chemotherapy and local irradiation, with no residual viable tumor cells confirmed at final surgical extirpation. The role of cerebrospinal fluid (CSF) shunts in metastases, mixed germ-cell tumor histology, and tumor markers in recurrences as well as radiation doses and volumes for treating primary tumors are discussed. Systemic chemotherapy may be utilized as prophylaxis against shunt metastases when CSF drainage is necessary. [ABSTRACT FROM AUTHOR]

Digital imaging system integration is a complex process. A project team and a defined process for system planning, evaluation, and implementation can improve the chance for success. In this presentation, our project team relates their experiences. Copyright © 2001 by W.B. Saunders Company [ABSTRACT FROM AUTHOR]

Preoperative imaging studies and operative inspection may provide insufficient information to appropriately manage certain complex pancreatic pseudocysts. Intraoperative ultrasound accurately identifies and localizes peripancreatic fluid collections, cyst wall thickness, parenchymal and ductal anatomy, and relationships to adjacent visceral and vascular structures. Adjunctive use of intraoperative ultrasonography altered the surgical management in the clinical case described herein and is advocated for assessment of problematic pancreatic pseudocysts. [ABSTRACT FROM AUTHOR]