58 research outputs found
Lymph Node Oligometastasis from Rectal Cancer in Contact with the Bowel Treated with High-Dose Planned Adaptive Radiotherapy
Full text linkThe efficacy of stereotactic ablative radiotherapy for oligometastases has been reported. However, there are no reports of oligometastatic lymph nodes in contact with the bowel being successfully treated with high-dose adaptive radiotherapy. A 61-year-old woman with oligometastatic pelvic lymph node after resection of rectal cancer was treated with high-dose planned adaptive radiotherapy using helical tomotherapy. Because the lymph node was in contact with the bowel, high-dose conventionally fractionated planned adaptive radiotherapy was used instead of stereotactic ablative radiotherapy to avoid bowel side effects such as perforation. Five years after radiotherapy, there is no recurrence and no adverse events. High-dose adaptive planned radiotherapy may become an alternative curative treatment for oligometastases in lymph nodes in contact with the bowel
MRI-guided stereotactic ablative radiation therapy for metachronously recurrent pulmonary oligometastases from hepatocellular carcinoma after failure of systemic therapy
Full text linkObjectives. This article aims to evaluate the feasibility and effectiveness of MRI-guided stereotactic ablative radiotherapy (SABR) for metachronously recurrent pulmonary oligometastases from hepatocellular carcinoma (HCC) when systemic
therapies prove ineffective. Case Presentation. A 47-year-old male with metastatic HCC underwent unsuccessful chemotherapy, targeted therapy,
and immunotherapy. The patient had a history of 14 lung metastases, previously treated with respiratory non-gated SABR. However, five new lung metastases emerged, raising concerns about potential pulmonary toxicity. After administering oral capecitabine, tumor growth persisted. To address this, the patient received MRI-guided respiratory-gated SABR using a recently installed system. Outcome. MRI-guided respiratory-gated SABR was well-tolerated, with no radiation-induced adverse events reported during treatment and a six-month follow-up period. Imaging follow-up demonstrated complete tumor regression, and no new recurrences were observed. Conclusions. This case report suggests that MRI-guided SABR could be a viable option for managing metachronously recurrent pulmonary oligometastases from HCC, particularly after failed systemic therapies. The precise targeting achieved with minimal toxicity, utilizing a 1 mm margin without an internal target volume, showcases the potential of this approach. However, further scientific investigation is warranted to validate these findings, given the limited scope of this single case report. Nonetheless, MRI-guided SABR holds promise as a safe and effective local treatment modality for lung metastases in HCC patients
High-Dose Radiotherapy for Locally Advanced Pancreatic Cancer: Prioritizing Organ-at-Risk Dose Limitation
Full text linkBackground: Locally advanced pancreatic cancer presents major treatment challenges.
Objective: This report highlights high-dose radiotherapy as a palliative option, aiming to relieve symptoms and minimize damage to surrounding organs while enhancing antitumor effects.
Case: An 87-year-old woman with a history of type 2 diabetes was referred for palliative radiotherapy due to unresectable, locally advanced pancreatic cancer that had spread to the head of the pancreas. To provide symptomatic relief, including relief from epigastric pain and a feeling of fullness, she received high-dose volumetric modulated arc therapy (66-92 Gy /33 fractions) with an emphasis on limiting the radiation exposure of organs at risk. The radiotherapy plan was designed to administer a dose of 66 Gy to the planning target volume (PTV), ensuring that at least 95% of the PTV received this dose. Concurrently, the maximum permissible dose to a 0.1-ml volume of the small intestine and stomach was strictly limited to less than 66 Gy. The mean dose to these organs was set at 46 Gy. The treatment plan was modified midway through by adapting the PTV after the patient had received 46 Gy.
Results: At the six-month follow-up, complete tumor remission was observed, and her symptoms were alleviated. No adverse events were reported during or within six months after radiotherapy.
Conclusion: A high-dose adaptive radiation therapy strategy that prioritizes dose constraints to critical organs may serve as an alternative treatment option for elderly patients and those with comorbidities among patients with locally advanced pancreatic cancer
Hipofrakcionirana terapija zračenjem moduliranog intenziteta vođena MRI-om nakon simultane integrirane pojačane radioterapije cijele dojke u ranom raku dojke: nekirurški pristup
No full textRadical radiotherapy is a novel non-surgical approach to the treatment of early breast cancer. In order to administer a sufficient dose of radiation to the tumor while minimizing the side effects, the exposure to the surrounding normal tissues must be minimized. A 46-year-old woman with early-stage triple-negative breast cancer was treated curatively with MRI-guided hypofractionated intensity-modulated radiation therapy after a whole-breast integrated boost radiation, because the patient refused surgery and chemotherapy. Six months after treatment, the tumor disappeared completely without adjuvant chemotherapy, and there were no recurrences or adverse events two years after treatment. In conclusion, MRI-guided hypofractionated intensity-modulated radiation therapy following simultaneous whole-breast integrated boost radiotherapy may be a feasible alternative treatment for early breast cancer.Radikalna radioterapija je novi nekirurški pristup liječenja ranog raka dojke. Kako bi se primijenila dovoljna doza zračenja na tumor a smanjile nuspojave, izloženost okolnih normalnih tkiva mora biti minimalizirana. Prikazujemo slučaj 46-godišnje žene s trostruko-negativnim rakom dojke u ranom stadiju koja je liječena kurativno magnetskom rezonancijom vođenom terapijom zračenja hipofrakcijskog intenziteta, i integriranom pojačanom radioterapijom cijele dojke, nakon što je bolesnica odbila kirurški zahvat i kemoterapiju. Šest mjeseci nakon liječenja tumor je potpuno nestao bez adjuvantne kemoterapije, a dvije godine nakon liječenja nema znakova recidiva niti nuspojava. Zaključno, MRI-om vođena hipofrakcionirana terapija zračenjem moduliranog intenziteta nakon simultane integrirane pojačane radioterapije cijele dojke može biti izvedivo alternativno liječenje ranog raka dojke
DTI-Guided Hypofractionated IMRT for Large Brain Metastasis in Small Cell Lung Cancer: A Case Report
Full text linkBackground: The utilization of diffusion tensor imaging (DTI)-guided radiotherapy represents an innovative approach for detecting tumor invasion while minimizing radiation exposure to critical white matter tracts.
Objective Diffusion tensor imaging (DTI) is a useful technique for visualizing white matter tracts adjacent to the tumor. The application of DTI in conjunction with radiotherapy for large brain metastases has not been reported. Therefore the current case report is discussing this health issue.
Method: This case report discussing a 62-year-old female patient underwent DTI-guided hypofractionated intensity-modulated radiation therapy for a metastasis measuring 4.5 centimeters from small-cell lung cancer in the left frontal lobe.
Results: The tumor showed complete radiological remission with no observed neurological sequelae or treatment-related toxicity.
Conclusion: DTI-guided radiotherapy has the potential to become a safe and effective treatment for large brain metastasis that are adjacent to matter tracts
Dual-energy spectral CT for the evaluation of cancellous bone metastasis treated by stereotactic ablative radiotherapy
No full textAcoustic and perceptual analyses of politeness in Japanese speech
Full text linkIn order to examine potential acoustic cues for politeness in Japanese speech, fO and temporal aspects of polite and casual utterances of two question sentences spoken by
six male native speakers were acoustically analysed. The analysis showed that fO movement of the final part of utterances and speech rate of utterance were consistently differently used in these different speaking styles (i.e., 'polite' and 'casual')across all the speakers. Perceptual experiments with listeners using a rating scale
method confirmed that these acoustic variables, which were manipulated using digital resynthesis, had an impact on politeness perception. It was showed that the duration
and fO direction of the final vowel of utterances were so influential that the overall impression of utterance politeness was changed. An experiment which used speech
rate variations of a polite utterance showed the important role of this variable in perceived politeness. Politeness ratings showed an inverted-U shape as a function of speech rate, but differed according to particular speakers. The speech rate of listeners was found to affect their utterance rate preference; listeners clearly preferred rates
close to their own, i.e., rates they perceived as 'natural' or comfortable. A final experiment, using speech rate variations of a polite utterance as stimuli and a two alternative forced-choice procedure, showed a very high correlation between perceived politenesss cores and naturalness scores. This suggests the importance of
listener characteristics in politeness research
PSD-95 regulates synaptic kainate receptors at mouse hippocampal mossy fiber-CA3 synapses
Full text linkKainate-type glutamate receptors (KARs) are the third class of ionotropic glutamate receptors whose activation leads to the unique roles in regulating synaptic transmission and circuit functions. In contrast to AMPA receptors (AMPARs), little is known about the mechanism of synaptic localization of KARs. PSD-95, a major scaffold protein of the postsynaptic density, is a candidate molecule that regulates the synaptic KARs. Although PSD-95 was shown to bind directly to KARs subunits, it has not been tested whether PSD-95 regulates synaptic KARs in intact synapses. Using PSD-95 knockout mice, we directly investigated the role of PSD-95 in the KARs-mediated components of synaptic transmission at hippocampal mossy fiber-CA3 synapse, one of the synapses with the highest density of KARs. Mossy fiber EPSCs consist of AMPA receptor (AMPAR)-mediated fast component and KAR-mediated slower component, and the ratio was significantly reduced in PSD-95 knockout mice. The size of KARs-mediated field EPSP reduced in comparison with the size of the fiber volley. Analysis of KARs-mediated miniature EPSCs also suggested reduced synaptic KARs. All the evidence supports critical roles of PSD-95 in regulating synaptic KARs
SOCIAL WELL-BEING OF MINORITY CHILDREN: SOCIAL WORK PRACTICE WITH CHILDREN OF JAPANESE ORIGIN IN A CHANGING WORLD
No full textThis dissertation was developed from the standpoint of social work practice with children from a minority background. Such children are often stereotyped, misunderstood and misled by others in society. The children tend, then, to be insecure, confused and lacking in self-respect and self-confidence. The problem studied was how a practice should be structured or created which assists such children develop personalities that allow them to be at ease with their minority status and to socialize constructively in society. The author\u27s thesis is that such a practice must be concerned with the children\u27s development of a positive self-identity that assists their socialization in the setting in which they find themselves. A descriptive and inductive method was used. This included an analysis of the objectives and operation of a summer camp the author organized primarily for 6-14 year old boys and girls of Japanese origin. The key points of that model practice are isolated and used in presenting a framework valid for the approach to practice with all minority children. Recognizing that the social worker has internalized knowledge, skills and values, the dissertation related those three elements to work with minorities. Knowledge must reflect a thorough understanding of the client\u27s total environment. In the case of Japanese origin children, the author presents the broad environment of the historical, political, economical and social situation of the Japanese in the U.S. This has included, at times, severe racial discrimination. The immediate environment of the Japanese family is presented through a selection of the findings of prominent Japanese scholars and through close observation of cases met with in practice. The author stresses the fact that the environmental pressures affect children in a minority in different ways, and that each minority has its own environment. This emphasizes the care the practitioner must exercise in work, and the respect toward the client that is required. The environmental study of the Japanese child\u27s setting is followed by the description of the numerous skills, methods, and techniques involved in the establishment and operation of the summer camp--in reality a created environment. Methods included continuous needs surveys through parent interviews and direct contact with children. Methods used to respond to needs are curriculum and program planning, use of manpower and community resources, management, supervision, case work and group work. The practice is designed to deal with the identified developmental goals of the children served. Values for work with minority children are stated in terms of love and respect for each child served along with an acceptance of individual and cultural difference. The model practice has operated for eight seasons. Follow-up with former campers and strong community acceptance indicates that most of the goals are being reached. The children observed are functioning well, accepting and respecting the positive values of the majority and their minority culture. The last portion of the dissertation conceptualizes the elements and principles of the social work practice framework exemplified earlier. The practice framework is viewed as including (1) a complex environment creating numerous tensions for (2) the unit served, the center of attention of practice and (3) the practitioner interacting with the unit from a traditional or created agency setting. Finally, implications are noted for further study and practice with the Japanese minority, other minorities and even majority children
The analysis of literary space in a contemporary Japanese literary text, Kurai Tabi (The dark journey)
No full textThis thesis was scanned from the print manuscript for digital preservation and is copyright the author.
Researchers can access this thesis by asking their local university, institution or public library to
make a request on their behalf. Monash staff and postgraduate students can use the link in the References field
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