The treatment choice for metastatic breast cancer should consider the appropriate balance between efficacy and toxicity of the therapy. We discuss a clinical case with an early response and prolonged ...to liposomal anthracyclines-based chemotherapy, without cardiotoxicity, enhancing the evidence of safety of liposomal formulation to prevent heart damage. Moreover, the case seems to be of interest for the role of 18F-FDG-PET in clinical response assessment: an early decrease of the standardized uptake value value, even before conventional imaging evaluation, is highly predictive for prolonged clinical response.
To the editor We have read the excellent study conducted by Simoneti et al. with considerable interest, which shows that laboratory animal (LA) exposure was associated with atopic sensitization. With ...regard to this, we would like to disagree on the modalities to collect data on "pet ownership" and provide some suggestions on the possible "preventive aspects" of allergic sensitization to LA based on our clinical and scientific experiences. It is indubitable that the presence of a persistent exposure to LA increases the amounts of allergens reaching the airways and, consequently, the risk of developing allergic sensitization and bronchial asthma. However, only this aspect should not be considered as the exclusive risk factor for the development of occupational asthma to LA.
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CEKLJ, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Most oilseed crushing industries use solvent extraction with commercial hexane to produce crude oils. Desolventization with steam in a desolventizer-toaster (DT) is used to remove the residual ...solvent from oilseed meals. In this study, a mathematical model is developed to simulate the desolventizing process and analyze the influence of operating variables in continuous equipment.
Mass transfer phenomena are outlined to take into account different retention and transport mechanisms. Solvent diffusion through pores from the solid to the vapor phase is analyzed and the contribution of axial dispersion along the bed is evaluated. The final equations describing solvent flow in meal particles and through the desolventizer are solved by numerical techniques.
The influence of processing variables such as desolventizing temperature and residence time as well as the effect of some process parameters, like particle size, oil content and void fraction in the bed, on the meal residual solvent is simulated by the model.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Cancer of supernumerary breast or ectopic breast tissue has haigher incidence than the cancer on ortotopic breast. This finding puts some problems about the diagnosis and therapy of ectopic breast ...cancer. The Authors describe their personal experience in three patients surgically treated and discuss about problems and solutions of this pathology.
We report a case of eosinophilic cystitis (EC) in a 65-year-old man with urethral stricture disease from blunt pelvic traumatic event. EC is a rare condition characterized by eosinophilic ...infiltration of the bladder wall, that usually presents with irritative voiding symptoms, suprapubic pain and hematuria. Etiology is still not clear although a review of the literature suggests that pathogenetic mechanisms probably engage an altered immune response in the bladder, with the inflammatory reaction caused by factors such as exogenous allergens and previous bladder injury or surgery to the bladder or the prostate. The diagnosis of EC has to be confirmed by biopsy, since in some cases it may manifest as other inflammatory and malignant bladder disorders. A conservative medical management is indicated initially, since this disease may be self-limited, with a benign course especially in children and young patients. In adults EC is more often a chronic recurrent condition that requires close follow-up since it may lead to serious progressive bladder and/or upper urinary tract disease. More invasive therapies (including transurethral resection, partial or total cystectomy) may also be required when conservative therapy fails.
Balloon brachytherapy with the MammoSite system (Hologic Inc., Bedford, MA) is a widely used approach for accelerated partial breast irradiation. Inherent to this approach, high skin doses can occur ...if the balloon to skin distance is small. This has been associated with late skin toxicity, particularly telangiectasia. The Xoft Axxent electronic brachytherapy balloon applicator (Xoft, Fremont, CA) is a novel device for accelerated partial breast irradiation. It is unique in that it uses an electronic 50-kV source. This source has a pronounced anisotropy with constriction of isodose distribution at the proximal end of the catheter. This anisotropy can be considered as an advantage to optimize skin dose when the cavity to skin distance is small. In this study, we simulated various balloon-insertion orientations to optimized skin surface dose.
Breast phantoms were constructed of tissue-equivalent material. Xoft Axxent balloon catheters were inserted at a distance of 6mm from the surface. The catheter was placed at three different catheter to surface orientations: (1) perpendicular to the surface, (2) oblique to the surface (45 degrees), and (3) parallel to the surface. Three-dimensional treatment planning was then performed using Nucletron's Plato planning system (Nucletron, Columbia, MD). Multiple dwell positions were used, and the dose was optimized to the target volume. The target volume was defined as volume from the balloon surface to 1-cm distance from the balloon surface or to the phantom surface (if less then 1cm from the balloon surface). Target volume coverage was compared between plans using dose-volume histograms. Surface doses were compared using isodose line distribution and surface point doses. Plato planned surface doses were then verified by direct measurement using Landauer Dot InLight dosimeters (Landauer, Glenwood, IL).
Excellent target coverage was obtained for all three catheter orientations with a D(95) of > or =95%. Surface dose was lowest for the perpendicular orientation with a calculated dose of 99%. The parallel orientation had the highest surface dose of 164%. The oblique orientation showed intermediate results with a surface dose of 117%. Measured surface doses were reproducible and correlated well with calculated values.
Optimized Xoft Axxent balloon catheter orientation using source anisotropy and multiple dwell positions can be used to minimize excessive skin dose and yet maintain optimal tumor cavity coverage when the cavity to skin distance is small. This has the potential to decrease skin late effects and improve cosmetic outcome. Further clinical study is warranted.
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