이 작품은 비디오 설명서의 지원 정돈하기 위해 NIH NINDS 부여 R01 NS074388 581 (CL Limoli), 재생 의료에 대한 캘리포니아 연구소 (CIRM) 부여 RS1 - 00413 (CLL)과 CIRM 그랜트에 의해 지원되었다. 우리는 또한 행동 테스트에 사용되는 모든 사용자 정의 - 만든 재료의 준비 자신의 조언, 지원 및 탁월한 기술 능력에 대한 루디 림부르흐과 캘리포니아 대학, 얼바인의 생물학 기계 공장의 에드워드 라우 감사드립니다.

<ol>
	<li>Abayomi, O. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pathogenesis+of+irradiation-induced+cognitive+dysfunction.">Pathogenesis of irradiation-induced cognitive dysfunction.</a> Acta. Oncol. 35, 659-663 (1996).</li><li>Anderson, V. A., Godber, T., Smibert, E., Weiskop, S., Ekert, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cognitive+and+academic+outcome+following+cranial+irradiation+and+chemotherapy+in+children:+a+longitudinal+study.">Cognitive and academic outcome following cranial irradiation and chemotherapy in children: a longitudinal study.</a> Br. J. Cancer. 82, 255-262 (2000).</li><li>Acharya, M. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Rescue+of+radiation-induced+cognitive+impairment+through+cranial+transplantation+of+human+embryonic+stem+cells.">Rescue of radiation-induced cognitive impairment through cranial transplantation of human embryonic stem cells.</a> Proc. Natl. Acad. Sci. U. S. A. 106, 19150-19155 (2009).</li><li>Mumby, D. G., Gaskin, S., Glenn, M. J., Schramek, T. E., Lehmann, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hippocampal+damage+and+exploratory+preferences+in+rats:+memory+for+objects,+places,+and+contexts.">Hippocampal damage and exploratory preferences in rats: memory for objects, places, and contexts.</a> Learn. Mem. 9, 49-57 (2002).</li><li>Walf, A. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+use+of+the+elevated+plus+maze+as+an+assay+of+anxiety-related+behavior+in+rodents.">The use of the elevated plus maze as an assay of anxiety-related behavior in rodents.</a> Nat. Protoc. 2, 322-328 (2007).</li><li>Macleod, J. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cancer+chemotherapy+impairs+contextual+but+not+cue-specific+fear+memory.">Cancer chemotherapy impairs contextual but not cue-specific fear memory.</a> Behav Brain Res. 181, 168-172 (2007).</li><li>Schafe, G. E., Nadel, N. V., Sullivan, G. M., Harris, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Memory+consolidation+for+contextual+and+auditory+fear+conditioning+is+dependent+on+protein+synthesis,+PKA,+and+MAP+kinase.">Memory consolidation for contextual and auditory fear conditioning is dependent on protein synthesis, PKA, and MAP kinase.</a> Learn. Mem. 6, 97-110 (1999).</li><li>Winocur, G., Wojtowicz, J. M., Sekeres, M., Snyder, J. S., Wang, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Inhibition+of+neurogenesis+interferes+with+hippocampus-dependent+memory+function.">Inhibition of neurogenesis interferes with hippocampus-dependent memory function.</a> Hippocampus. 16, 296-304 (2006).</li><li>Phillips, R. G., LeDoux, J. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Differential+contribution+of+amygdala+and+hippocampus+to+cued+and+contextual+fear+conditioning.">Differential contribution of amygdala and hippocampus to cued and contextual fear conditioning.</a> Behav. Neurosci. 106, 274-285 (1992).</li><li>D'Hooge, R., De Deyn, P. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Applications+of+the+Morris+water+maze+in+the+study+of+learning+and+memory.">Applications of the Morris water maze in the study of learning and memory.</a> Brain. Res. Brain. Res. Rev. 36, 60-90 (2001).</li><li>Morris, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Developments+of+a+water-maze+procedure+for+studying+spatial+learning+in+the+rat.">Developments of a water-maze procedure for studying spatial learning in the rat.</a> J. Neurosci. Methods. 11, 47-60 (1984).</li><li>Meyers, C. A., Brown, P. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Role+and+relevance+of+neurocognitive+assessment+in+clinical+trials+of+patients+with+CNS+tumors.">Role and relevance of neurocognitive assessment in clinical trials of patients with CNS tumors.</a> J. Clin. Oncol. 24, 1305-1309 (2006).</li><li>de Ruiter, M. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cerebral+hyporesponsiveness+and+cognitive+impairment+10+years+after+chemotherapy+for+breast+cancer.">Cerebral hyporesponsiveness and cognitive impairment 10 years after chemotherapy for breast cancer.</a> Hum. Brain. Mapp. , (2010).</li><li>Hess, D. C., Borlongan, C. V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cell-based+therapy+in+ischemic+stroke.">Cell-based therapy in ischemic stroke.</a> Expert. Rev. Neurother. 8, 1193-1201 (2008).</li></ol>

관심 없음 충돌 선언하지 않습니다.

암 생존자 12,13에서 점점 일반적되고있다인지 장애의 발전을 막아보기 위해 설계된 장기적인 전략에 대한 누르면 필요가있다. 그들은 세포 독성 암치료 14 손실되거나 손상된 세포 교체에 대한 기회를 제공하는 등 셀 요법은 CNS에서 정상 조직 sequelae의 범위를 ameliorating위한 수단을 제공할 수 있습니다 줄기. 이러한 노력의 실현을 촉진하기 위해, 우리는 기능 CNS 3의 조사 조직 침대 내에서 인식을 복원하는 cranially engrafted hNSCs의 능력을 확인 교장 실험 증명 일련의 실시했습니다. 이 노력에 중요한 안정적으로 재현할 방식으로 신중하게 통제인지 일련의 테스트를 실시하는 기능되었습니다. 우리는 병원에서 줄기 세포 요법의 translational 잠재력을 신속하게하기 위해 노력이 중요한 절차를 상세있다. 아르 추가 고려 사항데이터의 품질 상당한 영향을 미칠 가능성이 아래에 강조 표시됩니다. 인지 테스트는 세부 사항에 세심한주의를 요구하고 특정 표준 관행을 준수하는 것은 결과의 해석을 복잡하게 유물을 최소화하는 데 도움이됩니다. 동물 지주 객실과 경험에서 별도의 전용 행동 테스트 룸의 사용이 바람직합니다. 또한 손에 작업에서 동물주의를 분산시킬 수 동물 시설에서 외부 소음을 차단 &quot;백색 잡음&quot;을 사용하는 신중한 있습니다. 그들이 이전 작업을 관리하는 행동 테스트를 수행합니다 경험을 잘 알고 있어야하는인지 테스트 향하는 동물 스트레스를 최소화하기 위해서는 중요합니다. 여성과 남성을 테스트하는 경우 일반적으로, 그것은 그들이 남자 냄새 단서는 시험 무대에 남아있다면 시험 기간 동안 더 걱정하는 경향이로 첫번째 여자를 테스트하는 것이 좋습니다. 작업의 일련 배터리를 관리하면 레아에게 동물을 노출하는 것이 중요합니다첫 번째 (EPM 같은 NPR)와 (FC, MWM 등) 대부분의 스트레스 작업을 마지막으로 성 스트레스 작업.

quantifying cognitive decrements caused by cranial radiotherapy

생존의를 제​​외하고, 암의 임상 관리의 형태소인지 장애는 치료 결과를 작성하는데 중요한 요소입니다. CNS 및 비 - CNS의 malignancies 시달리다 많은 환자, 방사선 치료 및 화학 요법은 질병 제어를위한 최고의 옵션을 제공합니다. 이 트리 트먼트 그러나 비용에 와서, 그리고 거의 모든 암 생존자 (미국 ~ 11000000 혼자 일 현재) 두개골 방사선 치료 (~ 200000 / YR의 대상 환자에서 발견되는 가장 심각한 사건,인지 장애를 개발하기위한 몇 가지 위험을 초래 ) 기본 및 전이성 뇌종양 1의 제어를위한. 특히 문제가 누구의 장기적인 생존 상당한 사회 경제적 부담이 표시된인지 감소 결과 퍼진 소아 가지 경우입니다. 지금까지이 중요한 임상 문제에 더 만족스러운 해결책은 아직 없습니다. 우리는 이식 줄기 CE를 사용하여이 심각한 건강 관심사를 해결했습니다두개골 조사 3 받게 athymic 쥐의 방사선 유발인지 하락을 방지하기 위해 재편. 시험 관내 culturing과 인간의 신경 줄기 세포 (hNSCs)의 이식에 stereotaxic 레이저의 세부 사항은 우리의 동반자 종이 (Acharya 외., 주피터 참조)에서 찾을 수 있습니다. 조사 및 이식 수술 후, 쥐가 그 다음 인식의 변화, 이식할 세포 생존과 조사 후 분화 특정 마커 1과 4 개월의 표현에 대한 평가입니다. 비판적으로 방사선 - 유발인지 sequelae, 엄격한 양적인지 작업의 일련의 수행되어야 개량하다하도록 설계 잠재적인 개입의 성공 또는 실패를 평가합니다. 이것을 달성하기 위해, 우리는 hippocampal와 비 hippocampal 학습과 기억을 계량하기 위해, 새로운 장소 인식, 물 미로, 고가 플러스 미로와 공포 컨디셔닝을 포함한인지 테스트 패러다임의 스위트룸으로 우리의 동물을 주제. 우리의 유틸리티를 보여준조사 동물인지 감소의 특정 종류를 quantifying하고, hNSCs와 engrafted 동물인지 기능 3 상당한 개선을 전시 것을 보여주기 위해 그들을 사용하는 이러한 테스트합니다. engrafted 인간의 줄기 세포에서 파생된인지 장점과 유사한 전략 언젠가 장애인 인식으로 고통받는 암 생존자에 많이 필요한 임상 수단을 제공할 수 있습니다하는 것이 좋습니다. 따라서, 우리는 병원에 우리의 유망한 결과의 번역을 촉진하기 위해인지 테스트 패러다임에 사용되는 중요한 단계 서면 및 비주얼 문서를 제공합니다.

Watch this Scientific Journal Video about Quantifying Cognitive Decrements Caused by Cranial Radiotherapy at JoVE.com

Quantifying Cognitive Decrements Caused by Cranial Radiotherapy

뇌 종양의 radiotherapeutic 관리로 인한인지 장애에 부정적인 삶의 질을 영향 임상 처치하기 어려운 상태를 나타냅니다. 비판적으로 방사선 - 유발인지 감소를 ameliorating에 대한 잠재적인 개입을 평가하는 능력은 궁극적으로인지의 엄격한 양적 평가를 수행하는 기능에 따라 달라집니다.

두개골 방사선 치료에 의한인지 감소를 Quantifying

With the exception of survival, cognitive impairment stemming from the clinical management of cancer is a major factor dictating therapeutic outcome. For ...

quantifying-cognitive-decrements-caused-by-cranial-radiotherapy

Universidad de Cartagena UDEC

Research

JoVE Journal

Medicine

12.6K 조회수.  University of California Irvine. 뇌 종양의 radiotherapeutic 관리로 인한인지 장애에 부정적인 삶의 질을 영향 임상 처치하기 어려운 상태를 나타냅니다. 비판적으로 방사선 - 유발인지 감소를 ameliorating에 대한 잠재적인 개입을 평가하는 능력은 궁극적으로인지의 엄격한 양적 평가를 수행하는 기능에 따라 달라집니다.

비디오: Quantifying Cognitive Decrements Caused by Cranial Radiotherapy

Stem Cell Transplantation Strategies for the Restoration of Cognitive Dysfunction Caused by Cranial Radiotherapy

Radiotherapy often provides the only clinical recourse for those afflicted with primary or metastatic brain tumors. While beneficial, cranial irradiation can induce a progressive and debilitating decline in cognition that may, in part, be caused by the depletion of neural stem cells. Given the increased survival of patients diagnosed with brain cancer, quality of life in terms of cognitive health has become an increasing concern, especially in the absence of any satisfactory long-term treatments.
To address this serious health concern we have used stem cell replacement as a strategy to combat radiation-induced cognitive decline. Our model utilizes athymic nude rats subjected to cranial irradiation. The ionizing radiation is delivered as either whole brain or as a highly focused beam to the hippocampus via linear accelerator (LINAC) based stereotaxic radiosurgery. Two days following irradiation, human neural stem cells (hNSCs) were stereotaxically transplanted into the hippocampus. Rats were then assessed for changes in cognition, grafted cell survival and for the expression of differentiation-specific markers 1 and 4-months after irradiation. Our cognitive testing paradigms have demonstrated that animals engrafted with hNSCs exhibit significant improvements in cognitive function. Unbiased stereology reveals significant survival (10-40%) of the engrafted cells at 1 and 4-months after transplantation, dependent on the amount and type of cells grafted. Engrafted cells migrate extensively, differentiate along glial and neuronal lineages, and express a range of immature and mature phenotypic markers.
Our data demonstrate direct cognitive benefits derived from engrafted human stem cells, suggesting that this procedure may one day afford a promising strategy for the long-term functional restoration of cognition in individuals subjected to cranial radiotherapy. To promote the dissemination of the critical procedures necessary to replicate and extend our studies, we have provided written and visual documentation of several key steps in our experimental plan, with an emphasis on stereotaxic radiosurgey and transplantation.

Brain tumor patients routinely undergo cranial radiotherapy, and while beneficial, this treatment often results in debilitating cognitive dysfunction. This serious unresolved problem has at present, no clinical recourse, and has driven our efforts to devise stem cell based therapies for the recovery of radiation-induced cognitive decrements.

두개골 방사선 치료에 의한인지 기능 장애의 회복을위한 세포 이식 전략을 줄기

Radiotherapy often provides the only clinical recourse for those afflicted with primary or metastatic brain tumors. While beneficial, cranial irradiation ...

연구

의학

Combination Radiotherapy in an Orthotopic Mouse Brain Tumor Model

Glioblastoma multiforme (GBM) are the most common and aggressive adult primary brain tumors1. In recent years there has been substantial progress in the understanding of the mechanics of tumor invasion, and direct intracerebral inoculation of tumor provides the opportunity of observing the invasive process in a physiologically appropriate environment2. As far as human brain tumors are concerned, the orthotopic models currently available are established either by stereotaxic injection of cell suspensions or implantation of a solid piece of tumor through a complicated craniotomy procedure3. In our technique we harvest cells from tissue culture to create a cell suspension used to implant directly into the brain. The duration of the surgery is approximately 30 minutes, and as the mouse needs to be in a constant surgical plane, an injectable anesthetic is used. The mouse is placed in a stereotaxic jig made by Stoetling (figure 1). After the surgical area is cleaned and prepared, an incision is made; and the bregma is located to determine the location of the craniotomy. The location of the craniotomy is 2 mm to the right and 1 mm rostral to the bregma. The depth is 3 mm from the surface of the skull, and cells are injected at a rate of 2 &mu;l every 2 minutes. The skin is sutured with 5-0 PDS, and the mouse is allowed to wake up on a heating pad. From our experience, depending on the cell line, treatment can take place from 7-10 days after surgery. Drug delivery is dependent on the drug composition. For radiation treatment the mice are anesthetized, and put into a custom made jig. Lead covers the mouse's body and exposes only the brain of the mouse. The study of tumorigenesis and the evaluation of new therapies for GBM require accurate and reproducible brain tumor animal models. Thus we use this orthotopic brain model to study the interaction of the microenvironment of the brain and the tumor, to test the effectiveness of different therapeutic agents with and without radiation.

The purpose of this article is to describe the use of an orthotopic glioblastoma model for chemoradiation studies. This article will go though cell processing, implanting, and radiotherapy of the mouse using an intracranial model.

Orthotopic 마우스 뇌종양 모델의 조합 방사선 치료

Glioblastoma multiforme (GBM) are the most common and aggressive adult primary brain tumors1. In recent years there has been substantial progress in the ...

High Content Screening in Neurodegenerative Diseases

The functional annotation of genomes, construction of molecular networks and novel drug target identification, are important challenges that need to be addressed as a matter of great urgency1-4. Multiple complementary 'omics' approaches have provided clues as to the genetic risk factors and pathogenic mechanisms underlying numerous neurodegenerative diseases, but most findings still require functional validation5. For example, a recent genome wide association study for Parkinson's Disease (PD), identified many new loci as risk factors for the disease, but the underlying causative variant(s) or pathogenic mechanism is not known6, 7. As each associated region can contain several genes, the functional evaluation of each of the genes on phenotypes associated with the disease, using traditional cell biology techniques would take too long. 
	There is also a need to understand the molecular networks that link genetic mutations to the phenotypes they cause. It is expected that disease phenotypes are the result of multiple interactions that have been disrupted. Reconstruction of these networks using traditional molecular methods would be time consuming. Moreover, network predictions from independent studies of individual components, the reductionism approach, will probably underestimate the network complexity8. This underestimation could, in part, explain the low success rate of drug approval due to undesirable or toxic side effects. Gaining a network perspective of disease related pathways using HT/HC cellular screening approaches, and identifying key nodes within these pathways, could lead to the identification of targets that are more suited for therapeutic intervention.
	High-throughput screening (HTS) is an ideal methodology to address these issues9-12. but traditional methods were one dimensional whole-well cell assays, that used simplistic readouts for complex biological processes. They were unable to simultaneously quantify the many phenotypes observed in neurodegenerative diseases such as axonal transport deficits or alterations in morphology properties13, 14. This approach could not be used to investigate the dynamic nature of cellular processes or pathogenic events that occur in a subset of cells. To quantify such features one has to move to multi-dimensional phenotypes termed high-content screening (HCS)4, 15-17. HCS is the cell-based quantification of several processes simultaneously, which provides a more detailed representation of the cellular response to various perturbations compared to HTS. 
	HCS has many advantages over HTS18, 19, but conducting a high-throughput (HT)-high-content (HC) screen in neuronal models is problematic due to high cost, environmental variation and human error. In order to detect cellular responses on a 'phenomics' scale using HC imaging one has to reduce variation and error, while increasing sensitivity and reproducibility. 
	Herein we describe a method to accurately and reliably conduct shRNA screens using automated cell culturing20 and HC imaging in neuronal cellular models. We describe how we have used this methodology to identify modulators for one particular protein, DJ1, which when mutated causes autosomal recessive parkinsonism21. 
	Combining the versatility of HC imaging with HT methods, it is possible to accurately quantify a plethora of phenotypes. This could subsequently be utilized to advance our understanding of the genome, the pathways involved in disease pathogenesis as well as identify potential therapeutic targets.

We describe a methodology combining automated cell culturing with high-content imaging to visualize and quantify multiple cellular processes and structures, in a high-throughput manner. Such methods can aid in the further functional annotation of genomes as well as identify disease gene networks and potential drug targets.

Neurodegenerative 질병 높은 콘텐츠 심사

The functional annotation of genomes, construction of molecular networks and novel drug target identification, are important challenges that need to be ...

Imaging Glioma Initiation In Vivo Through a Polished and Reinforced Thin-skull Cranial Window

Glioma is the one of the most lethal forms of human cancer. The most effective glioma therapy to date-surgery followed by radiation treatment-offers patients only modest benefits, as most patients do not survive more than five years following diagnosis due to glioma relapse 1,2. The discovery of cancer stem cells in human brain tumors holds promise for having an enormous impact on the development of novel therapeutic strategies for glioma 3. Cancer stem cells are defined by their ability both to self-renew and to differentiate, and are thought to be the only cells in a tumor that have the capacity to initiate new tumors 4. Glioma relapse following radiation therapy is thought to arise from resistance of glioma stem cells (GSCs) to therapy 5-10. In vivo, GSCs are shown to reside in a perivascular niche that is important for maintaining their stem cell-like characteristics 11-14. Central to the organization of the GSC niche are vascular endothelial cells 12. Existing evidence suggests that GSCs and their interaction with the vascular endothelial cells are important for tumor development, and identify GSCs and their interaction with endothelial cells as important therapeutic targets for glioma. The presence of GSCs is determined experimentally by their capability to initiate new tumors upon orthotopic transplantation 15. This is typically achieved by injecting a specific number of GBM cells isolated from human tumors into the brains of severely immuno-deficient mice, or of mouse GBM cells into the brains of congenic host mice. Assays for tumor growth are then performed following sufficient time to allow GSCs among the injected GBM cells to give rise to new tumors-typically several weeks or months. Hence, existing assays do not allow examination of the important pathological process of tumor initiation from single GSCs in vivo. Consequently, essential insights into the specific roles of GSCs and their interaction with the vascular endothelial cells in the early stages of tumor initiation are lacking. Such insights are critical for developing novel therapeutic strategies for glioma, and will have great implications for preventing glioma relapse in patients. Here we have adapted the PoRTS cranial window procedure 16and in vivo two-photon microscopy to allow visualization of tumor initiation from injected GBM cells in the brain of a live mouse. Our technique will pave the way for future efforts to elucidate the key signaling mechanisms between GSCs and vascular endothelial cells during glioma initiation.

Imaging Glioma Initiation In Vivo Through a Polished and Reinforced Thin-skull Cranial Window

By combining a polished and reinforced thin-skull (PoRTS) cranial window and glioblastoma (GBM) cell injection, we can observe glioma initiation and growth from injected GBM cells in the brain of a live mouse longitudinally.

이미징 Glioma 개시<em&gt; 생체 내</em&gt; 연마하고 강화 얇은 두개골 두개골 창을 통해

Glioma is the one of the most lethal forms of human cancer. The most effective glioma therapy to date-surgery followed by radiation treatment-offers ...

Voluntary Breath-hold Technique for Reducing Heart Dose in Left Breast Radiotherapy

Breath-holding techniques reduce the amount of radiation received by cardiac structures during tangential-field left breast radiotherapy. With these techniques, patients hold their breath while radiotherapy is delivered, pushing the heart down and away from the radiotherapy field. Despite clear dosimetric benefits, these techniques are not yet in widespread use. One reason for this is that commercially available solutions require specialist equipment, necessitating not only significant capital investment, but often also incurring ongoing costs such as a need for daily disposable mouthpieces. The voluntary breath-hold technique described here does not require any additional specialist equipment. All breath-holding techniques require a surrogate to monitor breath-hold consistency and whether breath-hold is maintained. Voluntary breath-hold uses the distance moved by the anterior and lateral reference marks (tattoos) away from the treatment room lasers in breath-hold to monitor consistency at CT-planning and treatment setup. Light fields are then used to monitor breath-hold consistency prior to and during radiotherapy delivery.

The current priority in breast cancer radiotherapy is to reduce cardiac doses without compromising target tissue coverage. The voluntary breath-hold technique described here is a simple, inexpensive solution to this problem and capable of being instituted widely without the need for specialized equipment.

왼쪽 유방 방사선 치료에 심장 선량 감소를위한 자발적 호흡 홀드 기술

Breath-holding techniques reduce the amount of radiation received by cardiac structures during tangential-field left breast radiotherapy. With these ...

State of the Art Cranial Ultrasound Imaging in Neonates

Cranial ultrasound (CUS) is a reputable tool for brain imaging in critically ill neonates. It is safe, relatively cheap and easy to use, even when a patient is unstable. In addition it is radiation-free and allows serial imaging. CUS possibilities have steadily expanded. However, in many neonatal intensive care units, these possibilities are not optimally used. We present a comprehensive approach for neonatal CUS, focusing on optimal settings, different probes, multiple acoustic windows and Doppler techniques. This approach is suited for both routine clinical practice and research purposes. In a live demonstration, we show how this technique is performed in the neonatal intensive care unit. Using optimal settings and probes allows for better imaging quality and improves the diagnostic value of CUS in experienced hands. Traditionally, images are obtained through the anterior fontanel. Use of supplemental acoustic windows (lambdoid, mastoid, and lateral fontanels) improves detection of brain injury. Adding Doppler studies allows screening of patency of large intracranial arteries and veins. Flow velocities and indices can be obtained. Doppler CUS offers the possibility of detecting cerebral sinovenous thrombosis at an early stage, creating a window for therapeutic intervention prior to thrombosis-induced tissue damage. Equipment, data storage and safety aspects are also addressed.

Cranial ultrasound (CUS) is a valuable tool for brain imaging in critically ill neonates. This video shows a comprehensive approach for neonatal (Doppler) CUS for both clinical and research purposes, including a bedside demonstration of the technique.

신생아의 예술 두개골 초음파 이미징의 주

Cranial ultrasound (CUS) is a reputable tool for brain imaging in critically ill neonates. It is safe, relatively cheap and easy to use, even when a ...

A Mouse Model of Orthopedic Surgery to Study Postoperative Cognitive Dysfunction and Tissue Regeneration

Surgery is commonly used to improve and maintain quality of life. Unfortunately, in vulnerable patients such as the elderly, complications may occur and significantly diminish the outcome. Indeed, after routine orthopedic surgery to repair a fracture, as many as 50% of elderly patients suffer from neurologic complications like delirium. Also, the capacity to heal and regenerate tissue after surgery decreases with age, and can impact the quality of fracture repair and even osseous integration of implants. Thus, a better understanding of mechanisms that drive these age-dependent changes could provide strategic targets to minimize risk for such complications and optimize outcomes. Here, we introduce a clinically relevant mouse model of tibial fracture. The postoperative changes in these mice mimic some of the cognitive impairments commonly observed after routine orthopedic surgery in humans. Briefly, an incision is performed in the right hind limb under strictly aseptic conditions. Muscles are disassociated, and a 0.38-mm stainless steel pin is inserted into the upper crest of the tibia, inside the intramedullary canal. Osteotomy is then performed, and the wound is stapled. We have used this model to investigate the effects of surgical trauma on postoperative neuroinflammation and behavioral changes. By applying this fracture model in combination with parabiosis, a surgical model in which 2 mice are anastomosed, we have studied cells and secreted factors that systemically rejuvenate organ function and tissue regeneration after injury. By following our step-by-step protocol, these models can be reproduced with high fidelity, and can be adapted to interrogate many biologic pathways that are altered by surgical trauma.

This protocol describes a mouse model of orthopedic surgery that has been used to study mechanisms of postoperative neuroinflammation and behavioral changes, and when combined with parabiosis, to study tissue regeneration during aging.

정형 외과 수술 후 인지 기능 장애 및 조직 재생 연구의 마우스 모델

Surgery is commonly used to improve and maintain quality of life. Unfortunately, in vulnerable patients such as the elderly, complications may occur and ...

Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy

The prognosis of patients with metastatic cancers has improved in the past decades due to effective chemotherapy and oligometastatic surgery. For inoperable patients, local ablation therapies, such as stereotactic body radiotherapy (SBRT), can provide effective local tumor control with minimal toxicity. Because of its high precision and accuracy, SBRT delivers a higher radiation dose per fraction, is more effective, and targets smaller irradiation volumes than does conventional radiotherapy. In addition, steep dose gradients from target lesions to surrounding normal tissues are achieved using SBRT; thus, SBRT provides more effective tumor control and exhibits fewer side effects than conventional radiotherapy. The use of SBRT is prevalent for treating intracranial lesions (known as stereotactic radiosurgery); however, it is now also used for treating spinal and adrenal metastases. Because of advancements in image-guided assistance and respiratory motion management, several studies have investigated the use of SBRT for treating lung or liver tumors, which move as a patient breathes. The results of these studies have suggested that SBRT favorably controls tumors in the case of moving lesions.
Four-dimensional computed tomography (4D-CT) with an abdominal compressor (AC) is clinically convenient for effective respiratory motion management. Because this method is noninvasive and allows free breathing, its use reduces complications. Furthermore, patients consider this method convenient. Moreover, it is considered more efficient than other methods of respiratory motion management by physicians and therapists. The use of 4D-CT with an AC for treating pulmonary lesions has also been widely investigated, and the technique is gaining acceptance for treating hepatic lesions. However, the protocols for using 4D-CT with an AC for treating hepatic lesions are different from those used for treating pulmonary lesions. In this article, we describe a new protocol for SBRT with 4D-CT and an AC for treating liver metastases.

Stereotactic body radiotherapy (SBRT) requires rigorous accuracy and precision for delivering high radiation doses per fraction to small treatment volumes to improve tumor control and simultaneously reduce toxicity. Herein, we present a noninvasive and clinically convenient respiratory motion management protocol for SBRT for liver metastases.

몸 정위 적 방사선 치료에 대 한 내부 대상 볼륨 메서드를 사용 하 여 간 전이의 치료

The prognosis of patients with metastatic cancers has improved in the past decades due to effective chemotherapy and oligometastatic surgery. For ...

Radiation Planning Assistant - A Streamlined, Fully Automated Radiotherapy Treatment Planning System

The Radiation Planning Assistant (RPA) is a system developed for the fully automated creation of radiotherapy treatment plans, including volume-modulated arc therapy (VMAT) plans for patients with head/neck cancer and 4-field box plans for patients with cervical cancer. It is a combination of specially developed in-house software that uses an application programming interface to communicate with a commercial radiotherapy treatment planning system. It also interfaces with a commercial secondary dose verification software. The necessary inputs to the system are a Treatment Plan Order, approved by the radiation oncologist, and a simulation computed tomography (CT) image, approved by the radiographer. The RPA then generates a complete radiotherapy treatment plan. For the cervical cancer treatment plans, no additional user intervention is necessary until the plan is complete. For head/neck treatment plans, after the normal tissue and some of the target structures are automatically delineated on the CT image, the radiation oncologist must review the contours, making edits if necessary. They also delineate the gross tumor volume. The RPA then completes the treatment planning process, creating a VMAT plan. Finally, the completed plan must be reviewed by qualified clinical staff.

Radiation therapy is a highly complex cancer treatment that requires multiple specialists to create a treatment plan and provide quality assurance (QA) prior to delivery to a patient. This protocol describes the use of a fully automated system, the Radiation Planning Assistant (RPA), to create high-quality radiation treatment plans.

방사선 계획 도우미-유선형된, 완전 자동화 된 방사선 치료 계획 시스템

The Radiation Planning Assistant (RPA) is a system developed for the fully automated creation of radiotherapy treatment plans, including volume-modulated ...

Assessment of Static Graviceptive Perception in the Roll-Plane using the Subjective Visual Vertical Paradigm

Vestibular disorders are among the most common syndromes in medicine. In recent years, new vestibular diagnostic systems have been introduced that allow the examination of all semicircular canals in the clinical setting. Assessment methods of the otolithic system, which is responsible for the perception of linear acceleration and perception of gravity, are far less in clinical use. There are several experimental approaches for measuring the perception of gravity. The most frequently used method is the determination of the subjective visual vertical. This is usually measured with the head in an upright position. We present here an assessment method for testing otolith function in the roll plane. The subjective visual vertical is measured in the head upright position as well as with head inclination of &#177; 15&#176; and &#177; 30&#176; in the roll plane. This extended functional paradigm is an easy-to-perform clinical test of otolith function and ensures increased information content for the detection of impaired graviceptive perception.

The perception of gravity is commonly determined by the subjective visual vertical in the head upright position. The additional assessment at head tilts of &#177; 15&#176; and &#177; 30&#176; in the roll plane ensures increased information content for the detection of impaired graviceptive perception.

주관적인 시각적 수직 패러다임을 사용하여 롤 플레인에서 정적 중력 지각의 평가

Vestibular disorders are among the most common syndromes in medicine. In recent years, new vestibular diagnostic systems have been introduced that allow ...