The construction and first proton beam tests of a demonstrator dedicated to the beam ballistic control in hadrontherapy cancer treatments are described. This cost-effective demonstrator, called large ...area pixelized detector, is a PET-like detector used for in-beam ballistic control. It was built to test the feasibility of monitoring in real time, during irradiation, the ion range in the patient through the measurement of the beam-induced β + activity distribution. Achieving this goal necessitates to overcome several challenges. One of them is the rejection of the beam-induced background. Another one is the definition of fast event selection and reconstruction techniques so that real time monitoring is possible. Strategies employed to tackle these problems are presented and tested with the 65 MeV Medicyc proton beam of the cancer treatment center in Nice, France. In particular, an original fast reconstruction technique is presented. First performances obtained during irradiation of polymethyl methacrylate targets are described.
Abstract
Background
pericardial diseases during pregnancy are rare. The most common are hydropericardium – typically in the third trimester, with spontaneous resolution – and pericarditis. ...Echocardiogram is the imaging method of first choice for diagnosis.
Clinical case
a 38–year–old woman, at gestational week 24, came to the Emergency Department due to anxiety, shortness of breath, cough, gastroesophageal reflux, inappetence, and sialorrhea, all of which started with the pregnancy and worsened overtime. She underwent cardiological evaluation because of troponin discovered via blood test. The evaluation highlighted mild pericardial effusion. Hence, she was admitted to the Cardiology Department, where a progressive increase of effusion – from mild to severe (in particular in front of apical and posterior segments) without hemodynamic impact – was noted. Corticosteroid therapy was started without clinical improvement and the patient displayed orthopnea, diaphoresis, and oliguria. Through an echographic re–evaluation an hypervascular mass was identified in parasternal view. After a multidisciplinary discussion, a CT scan of thorax and abdomen with contrast (MRI was impracticable due to orthopnea) was carried out with evidence of a mediastinal solid lesion (11,5 x 7 mm) compressing superior vena cava, trachea and principal bronchial branches suggestive of lymphoproliferative disease. A pericardiocentesis was perfomed with evacuation of 400 ml of bloody fluid. The worsening of blood gas test required a tracheal intubation. Therefore, an emergency Cesarean section was executed, and a surgical biopsy of mass was taken with detection of diffuse large B–cell non–Hodgkin‘s lymphoma. Hgh doses of corticosteroids and chemotherapeutic drugs were administered and the patient was extubated after two days. After four therapeutic cycles, a PET–CT scan confirmed remission of the disease.
Conclusion
pregnancy is not a predisposing condition for pericardial diseases. Although pericardial involvement is benign in most cases, the use of corticosteroid therapy after the 20th week of gestation is indicated in suspected pericarditis to avoid fetal complications from NSAIDs. If there is no response, the use of advanced imaging methods (even potentially dangerous to the fetus) should not be procrastinated.
ABSTRACT This study aimed to evaluate the impact of minimally invasive partial pericardiotomy on echocardiographic variables of morphometry and function in healthy horses. Minimally invasive ...pericardiotomy was performed in six healthy horses. Echocardiographic evaluation was executed in different moments: prior to the surgical procedure (M0); 24 hours post procedure (M1); 72 hours post procedure (M2) and 28 days post procedure (M3). The following variables were measured: Right ventricular internal diameter in diastole and systole (RVd and RVs), interventricular septum thickness in diastole and systole (IVSd and IVSs), left ventricular internal diameter in diastole and systole (LVd and LVs), left ventricular free wall thickness in diastole and systole (LVFWd and LVFWs), aortic root diameter (Ao) and left atrial diameter (LA). From this data, the following variables were calculated: fractional shortening (FS%), fractional thickening of the interventricular septum (IVS%), fractional thickening of the left ventricular free wall (LVFW%) and the relationship between left atrial and aortic diameters (LA/Ao). After 28 days, a new thoracoscopy was performed for inspection of the thoracic cavity. In M1 and M2 ECO evaluations, a statistically significant change in LVFW and a decrease in RVd, LVd, LVFWs, LA, LVs, FS% and IVS was documented. Pericardiotomy is a promising technique in horses, with minor postoperative complication. The variations in the echocardiographic parameters were transient and did not cause hemodynamic damage to the animals.
RESUMO O objetivo do presente estudo foi avaliar o impacto da pericardiotomia parcial minimamente invasiva sobre as variáveis ecocardiográficas morfométricas e funcionais em cavalos, visto que não há nenhum trabalho que tenha avaliado o impacto da pericardiotomia na espécie equina. Foram utilizados seis cavalos hígidos, nos quais se realizou pericardiotomia minimamente invasiva. Em todos eles, foi efetuado exame ecocardiográfico em diferentes momentos: previamente ao procedimento cirúrgico (M0); 24 horas após (M1); 72 horas após (M2) e 28 dias após (M3). Foram mensurados: diâmetro interno do ventrículo direito (VDd e VDs), espessura do septo interventricular (SIVd e SIVs), diâmetro interno do ventrículo esquerdo (VEd e VEs), espessura da parede livre do ventrículo esquerdo (PLVEd e PLVEs), diâmetro interno da aorta (Ao) e diâmetro atrial esquerdo (AE). Foram calculadas as variáveis fração de encurtamento (FEC%), espessamento fracional do septo interventricular (SIV%), espessamento fracional da parede livre do ventrículo esquerdo (PLVE%) e relação entre diâmetro do átrio esquerdo e diâmetro aórtico (AE/Ao). Após 28 dias, realizou-se nova toracoscopia para inspeção da cavidade torácica. Nas avaliações do ECO no M1 e no M2, houve alteração estatisticamente significativa no PLVE em diástole (28±5,5 e 31,7±2, respectivamente) e diminuição dos parâmetros VDd,(30,1±11,6 e 31,7± 10,7) VEd (113,3±21 e 121,7±13,7), PLVEs (42±8,2 e 43,9±2,8), AE (78,5±6,1 e 82,7±4,7), VEs (74,1±16 e 71,5±9,3), FEC (34,4±10,2 e 41,2±5,7) e SIV (27,1±8,7 e 42,3±27,9). A técnica de pericardiotomia empregada mostrou-se promissora em equinos. As variações dos parâmetros ecocardiográficos foram transitórias, não causando prejuízos hemodinâmicos aos animais.
We report the observation of the X(3872) in the J/psipi(+)pi(-) channel, with J/psi decaying to mu(+)mu(-), in p (p) over bar collisions at roots=1.96 TeV. Using approximately 230 pb(-1) of data ...collected with the Run II D0 detector, we observe 522+/-100 X(3872) candidates. The mass difference between the X(3872) state and the J/psi is measured to be 774.9+/-3.1(stat)+/-3.0(syst) MeV/c(2). We have investigated the production and decay characteristics of the X(3872) and find them to be similar to those of the psi(2S) state.
We present the first results obtained with a detector, called Large Area Pixelized Detector (LAPD), dedicated to the study the ballistic control of the beam delivered to the patient by in-beam and ...real time detection of secondary particles, emitted during its irradiation in the context of hadrontherapy. These particles are 511keV γ from the annihilation of a positron issued from the β+ emitters induced in the patient tissues along the beam path. The LAPD basic concepts are similar to a conventional PET camera. The 511keV γ are detected and the reconstructed lines of response allow to measure the β+ activity distribution. Nevertheless, when trying to use γ from positron annihilation for the ballistic control in hadrontherapy, the large prompt γ background should be taken into account and properly rejected. First reconstruction results, obtained with a phantom filled with a high intensity FDG source at the cancer research centre of Clermont-Ferrand are shown. We also report results of measurements performed at the Heidelberg Ion-Beam Therapy Centre with one third of the detector, using proton and carbon ion beams.
The D0 Collaboration presents first evidence for the production of single top quarks at the Fermilab Tevatron < p(p)over bar > collider. Using a 0.9 fb(-1) dataset, we apply a multivariate ...analysis to separate signal from background and measure sigma(< p(p)over bar >-> tb+X,tqb+X)=4.9 +/- 1.4 pb. The probability to measure a cross section at this value or higher in the absence of a signal is 0.035%, corresponding to a 3.4 standard deviation significance. We use the cross section measurement to directly determine the Cabibbo-Kobayashi-Maskawa matrix element that describes the Wtb coupling and find 0.68 <vertical bar V-tb vertical bar <= 1 at 95% C.L. within the standard model.
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