Accounting for the variation in collision kerma-to-terma ratio in polyenergetic photon beam convolution

In photon beam convolution, the distribution of energy deposition about a primary photon interaction site due to charged particles set in motion at that site is represented by the primary kernel. Energy deposited due to scattered photons, bremsstrahlung, and annihilation photons is represented by the scatter kernel. As the energy deposited in each kernel voxel is normalized to the energy imparted at the interaction site, it is known as a fractional energy distribution. In terma-based convolution, where kernels are normalized to total energy imparted at the interaction site and are convolved with the terma in the dose calculation process, the sum of fractional energies contained in the primary kernel is equal to the ratio of collision kerma (Kc) to terma (T) corresponding to the energy spectrum used to generate the kernel. Since the ratio of collision kerma to terma increases with depth as the beam hardens, the integral fractional energy in a primary kernel formed for the spectrum at the surface is less than the ratio Kc/T at depth. This causes primary dose to be increasingly underestimated with depth and scatter dose to be increasingly overestimated. Single polyenergetic convolution (using polyenergetic primary and scatter kernels formed using a polyenergetic primary photon spectrum) is thus not as rigorous as if a separate convolution is performed for each energy component. The ratio of true primary dose to single polyenergetic primary dose increases almost linearly with depth and is almost equal to the Kc/T ratio. Primary and scatter dose are calculated correctly if a single polyenergetic convolution is performed in terms of Kc (for primary) and T-Kc (for scatter), where the kernels are weighted sums of monoenergetic kernels normalized to Kc and T-Kc. With this method, it is ensured that total primary energy deposited due to primary photon interactions in a unit mass at a point is equal to Kc at that point.     

24-hour shear bond strength of metal orthodontic brackets bonded to porcelain using various adhesion promoters

Clinically, orthodontists are often faced with the difficulties of bonding to porcelain crowns, veneers, or bridges. Traditional methods of dealing with this are often time-consuming and generally esthetically unacceptable to patients. Current interest involves the use of organosilane primers with or without NTG-GMA and BPDM resins to aid in chemically bonding porcelain with traditional orthodontic adhesives. This study compared the bond strength of three types of adhesion promoters: Ormco Porcelain Primer (OR) (Ormco Corp., Glendora, Calif.), All-Bond2 (AB2) (Bisco Dental Products, Inc., Itasca, Ill.), and Scotchprime Ceramic Primer (SP) (3M, St. Paul, Minn.) with two orthodontic adhesives: Phase II (Reliance, Inc., Itasca, Ill.) and Rely-a-bond (Reliance, Inc., Itasca, Ill.). Eighty ceramometal samples were fabricated and hydrated for 1 week in distilled water before bonding. Next, the samples were etched with 2.5 % HF acid for 90 seconds, rinsed and upper central incisor metal orthodontic brackets were bonded with the various primers and adhesives. After 24 hours they were sheared off with an MTS machine at at rate of 0.5 mm/min, and the bond strength was measured. The mean shear bond strengths (MPa) with Phase II were as follows; Control 0.44 (sigma = 0.22), AB2 8.40 (sigma = 3.61), OR 13.31 (sigma = 5.79), SP 13.53 (sigma = 3.34). With Rely-a-bond, the shear bond strengths were Control 0.41 (sigma = 0.67), AB2 4.34 (sigma = 1.88), OR 9.73 (sigma = 4.58), and SP 12.40 (sigma = 3.05).(ABSTRACT TRUNCATED AT 250 WORDS)     

Caspases mediate tumor necrosis factor-alpha-induced neutrophil apoptosis and downregulation of reactive oxygen production

BACKGROUND: Cyclosporine (CSA) has improved patients and organ-graft survival rates, but its chronic nephrotoxicity is still an issue. Although prolonged vasoconstriction could contribute to chronic CsA tubulointerstitial changes by producing chronic ischemia, this relationship has been difficult to demonstrate thus far, and cellular origin and mediators of these structural alterations remain ill-defined. METHODS: As a part of a clinical trial in kidney transplant recipients on triple immunosuppressive therapy (CsA, azathioprine and steroid), which includes renal biopsy as "per protocol," 22 patients enrolled between 12 and 24 months posttransplantation underwent renal hemodynamic evaluation by measuring glomerular filtration rate and renal plasma flow by the plasma clearance of unlabeled iohexol and the renal clearance of para-aminohippuric acid, respectively. In parallel, the CsA pharmacokinetic profile was also determined. A week later, a protocol biopsy of kidney graft was performed. Light microscopy examination and localization of endothelin-1, RANTES, monocyte chemoattractant protein-1 gene expression by in situ hybridization in the graft specimens were evaluated and related to the pattern of histologic lesions. RESULTS: Ten out of 22 kidney transplant recipients who underwent the protocol biopsy had CsA nephrotoxicity, eight had chronic rejection, and four had no lesions at histological examination. The total daily exposure to CsA was higher in patients with CsA nephrotoxicity than in those with chronic rejection or no lesions at biopsy. Renal function was preserved in the CsA toxicity group as compared with the chronic rejection group, despite some degree of renal hypoperfusion. Tubular atrophy and striped interstitial fibrosis were found in all patients with light microscopical evidence of CsA nephrotoxicity, whereas glomerular and arteriolar lesions were less frequent. Intense staining for endothelin-1, RANTES, and monocyte chemoattractant protein-1 mRNAs selectively localized at tubular epithelial cells was found in biopsies taken from patients with CsA nephrotoxicity, but not in the chronic graft rejection group, whose tubuli had only minimal staining for RANTES mRNA on a few occasions. CONCLUSION: Long-term CsA administration to kidney allograft recipients leads to tubulointerstitial injury independently of its vascular effect. The possible contribution to the development of interstitial fibrosis of inflammatory and growth factors released by tubular cells in which CsA accumulates is proposed.     

Open hearts. The origins of direct-vision intracardiac surgery

This study attempts to clarify the drug problem of Japan in terms of images of illegal drugs (stimulants, marijuana, and volatile solvents) by comparing (1) different types of drugs and (2) differences between generations. Another objective of this research was to examine influence by the mass media reports with regard to drug incidents which influence upon image formation of illegal drugs among people. In this study 488 males from the city of Osaka were chosen by a random sampling method and a door to door survey was undertaken utilizing a self-administered questionnaire with a partial interview method. It was revealed that as a whole negative images such as "dangerous" and "terrible" were still widely prevailing and positive image such as "fashionable" was much less prevailing. Specially, stimulants were regarded more dangerous compared to marijuana and volatile solvents. In contrary, marijuana was regarded more fashionable compared to stimulants and volatile solvents. Volatile solvents were considered more "intimate" compared to other drugs. With regard to generation differences, it was the youth who possessed more positive images towards marijuana and more intimate feelings about volatile solvents than other generations. Findings show that with regard to news about illegal drug incidents, respondents' appraisal of the news of mass media primarily make significant influence, as compare to mere cognition, on images of illegal drugs. Furthermore, it was revealed that there was likely to result in positive images of illegal drugs due to lack of adequate information. From the aspects of education, it was suggested that dissemination of information at a vast range and maintenance of negative images might become a crucial task.