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Biomedical subjects

A Wu

Publications and source records attributed to A Wu.

At least 235 records · Page 13Linked to original sources

EMS providers do not accurately note motor-vehicle crash patients with positive serum alcohol concentrations.

INTRODUCTION: Alcohol use is associated with many motor-vehicle crashes and may increase the severity of injury. Because alcohol use also may mask injury, prehospital emergency care providers (PHECPs) may make inaccurate assessments. To assess and triage crash victims accurately, PHECPs must identify recent alcohol use. STUDY OBJECTIVE: This study examines the accuracy of PHECPs in identifying motor-vehicle crash victims who had positive serum alcohol concentrations. DESIGN: Retrospective cohort study. POPULATION: Included in the study were motor-vehicle crash victims more than 17 years of age who were conveyed directly to a university medical center emergency department by ground ambulance (n = 372). TIME PERIOD: 15 July 1990 to 15 July 1991. METHODS: Data sources included ambulance report forms and hospital records. Variables that were abstracted included the Revised Trauma Score (RTS), the PHECPs' impression of alcohol use, and serum alcohol concentrations. Sensitivity, specificity, predictive-value positive, predictive-value negative, and 0.95 confidence intervals (0.95 CI) were calculated for the PHECPs' ability to identify patients with a serum alcohol concentration > 0. The relationship between the RTS and the impressions of alcohol use was analyzed with chi-square testing: a p-value of < 0.05 was considered statistically significant. CONCLUSION: This study suggests that PHECPs cannot accurately identify crash victims with positive serum alcohol concentrations. Selection bias and retrospective design are significant limitations of this study. Future studies should develop and evaluate methods to improve PHECPs' accuracy in assessing alcohol use in motor-vehicle crash victims.

Accidents, Traffic↗

Subcellular localization of IRS-1 in cell proliferation and differentiation.

The type 1 insulin-like growth factor receptor (IGF-IR) and its docking protein, insulin receptor substrate-1 (IRS-1), play important roles in cell transformation, cell differentiation and aging. IRS-1 and other IRS proteins can, under certain conditions, localize to the nuclei of cells, where they undergo interactions with nuclear and nucleolar proteins. In this study, we confirm and extend these observations, demonstrating that IRS-1 is preferentially nuclear in growing cells. Differentiation and inhibition of ribosomal RNA synthesis cause subcellular redistribution of IRS-1 and other nuclear proteins to the cytoplasm.

Animals↗

Carboxyhemoglobin trend in Chicago blood donors, 1970-1974.

An 18% reduction in the carboxyhemoglobin (HbCO) saturation in nonsmoking Chicago blood donors occurred between 1970 and 1974, indicating that current donors are being exposed to a lower average carbon monoxide (CO) concentration than had been experienced by 1970 donors. In contrast to the situation in 1970, when it was discovered that 74% of the nonsmokers in Chicago were being exposed to CO in excess of the amount permitted by the federal air quality standards, in 1974 only 41% of the nonsmokers were being overexposed. The observed reduction in HbCO correlates well with both the ambient CO levels recorded at the air monitoring stations and the reduction in CO emission from automobiles. If the current trend continues, Chicago should reach compliance with air quality standards for CO by 1985. The measurement of HbCO in a representative urban population is an accurate index of actual CO exposure and supplements the air pollution data provided by air monitoring stations.

Air Pollutants↗

Dosimetry measurements and analyses of 10-MV x rays for Clinac-18.

Radiation parameters for two Varian Clinac-18 10-MV x-ray units were measured and compared with the same parameters for the Toshiba LMR-13 and the Arco Mevatron XII. Comparison of the percentage depth dose, surface dose, and depth of maximum ionization as a function of field size are presented.

Radiotherapy↗

UV-induced second readout of LiF thermoluminescent dosimeters in the therapeutic dose range.

A previously developed technique for reading out LiF thermoluminescent dosimeters (TLD) a second and subsequent time by means of ultraviolet (UV)-induced repopulation of dosimetry traps was studied to determine the feasibility of maintaining a second readout capability in a radiotherapy clinical setting. It was found that with grouping of the TLDs according to second readout sensitivity, the UV-induced readout attained a precision comparable to that of the initial readout. However, the UV-induced TL response retained a strong previous dose memory following a standard high-temperature anneal, and routine calibration before each reuse is recommended.

Fluorides↗

Dosimetry characteristics of large wedges for 4- and 6-MV x rays.

Two sets of newly designed large wedge filters for field sizes up to 20 X 20 cm2 have become commercially available for use with 4- and 6-MV linear accelerators. Such field sizes are sometimes required to ensure adequate coverage in certain treatment techniques. This work reports base line data resulting from an investigation of the dosimetric properties of these wedges. Measurements of wedge angles, transmission factors, and beam hardening effects are described, and comparisons are made with the smaller standard wedges.

Humans↗

Electron contamination due to Lucite in a 45-MV photon beam.

The presence of the Lucite blocking tray in a 45-MV betatron beam leads to a considerable loss in the skin-sparing properties of this unit. Measurements conducted with a parallel-plate chamber show that the surface dose is approximately doubled (up to 58% of the maximum absorbed dose) and the depth of maximum dose is reduced by as much as 1.5 cm by the Lucite. These results suggest that separate dosimetry data should be kept for blocked and unblocked fields. The penetration of the electron contamination to the open field depth of maximum dose can lead to erroneous results if attenuation measurements are made at that depth. Studies of the effect of the lead sheet and leaded acrylic on the surface dose showed that under normal circumstances the presence of high-Z materials increases the surface dose, hence these materials cannot in general be used as electron filters on very high energy x-ray units. A Luciteless blocking tray with universal triangular corner blocks has been designed for use in special cases requiring a reduced surface dose.

Electrons↗

A beam-edge modifier for abutting electron fields.

Abutment of unmodified electron fields to irradiate large areas can lead to significant dose inhomogeneities in the region of junction of the fields. In this paper we describe the design and dosimetric characteristics of a device developed to broaden the electron beam penumbra and thereby to improve the dose uniformity in the overlap region. The device is a high-density triangular-toothed comb capable of reducing the beam intensity without seriously degrading the beam energy. The effect of the comb is such that a single device will generate a beam penumbra which is broad and very nearly linear at all depths for all clinically used beam energies. Results are shown for various field configurations and energies. With a gap of 5.0 cm between the treatment cone and phantom surface the dose "ripple" in the region beneath the teeth was found not to exceed +/- 5% at 0.5-cm depth.

Electrons↗

Effective wedge angles for 6-MV wedges.

Measurements were undertaken with 30 degrees and 45 degrees large wedges on a 6-MV linac to determine the effective wedge angle for various combinations of open and wedged fields. The validity of Tatcher's equation, relating effective wedge angle to maximum dose weightings, was examined over a range of field sizes from 5 X 5 to 20 X 20 cm. An alternative equation involving only central axis quantities was also investigated. The results obtained from an analysis of point dose measurements indicate that, for these wedges, either equation yields sufficient accuracy for clinical purposes.

Animals↗

Tumor dose specification of I-125 seed implants.

A new calculation procedure for interstitial implants with I-125 seeds is presented. The total activity of I-125 seeds required to deliver a net minimum dose of 1 Gy is also given as a function of implant volume for various seed spacings. This will permit clinicians to prescribe a specific dose for patients as a primary or boost treatment. Elongation and shape corrections are studied. Discussions and comparisons with other dosimetric calculations such as "matched" peripheral dose, average minimum dose, and minimum peripheral dose are made. The results indicate that for a fixed total activity the net minimum dose is relatively insensitive to variations in seed spacing and individual seed activity.

Brachytherapy↗

Performance characteristics of a helical microwave interstitial antenna for local hyperthermia.

A helical microwave antenna has been designed to improve heat deposition by interstitial applicators used for clinical hyperthermia. Iso-specific-absorption-rate (SAR) curves of the helical antenna as well as a conventional monopole antenna were measured and compared in both muscle and brain tissue phantoms. The heating pattern of the helical antenna is more uniform along the length of the antenna which has important implications for multiarray implant configurations.

Humans↗

A dose homogeneity index for evaluating 192Ir interstitial breast implants.

To evaluate and optimize dose homogeneity of 192Ir interstitial breast implants, we define a quantity, the dose homogeneity index (DHI), as follows: DHI = [V(TDR)--V(HDR)]/V(TDR), where V(TDR) denotes the total treatment volume enclosed by the prescribed treatment dose rate (TDR) and V(HDR) denotes the volume enclosed by high-dose rate (HDR), which is 1.5 X TDR or greater. We have used the DHI to examine and compare 192Ir double-plane implants of various sizes planned by the Memorial system or the Tufts system. Criteria have been suggested for the number of planes required for implants in a given treatment volume. Anderson's volume-dose histogram with inverse square suppression is adopted for illustration.

Brachytherapy↗

Effect of gold shielding on the dosimetry of an 125I seed at close range.

Radioactive 125I plaques with gold shields have been used for the treatment of choroidal melanoma. The effect of the gold shield on the dosimetry of a single 125I seed (model 6711) has been investigated in this paper. Increases in dose at close range due to the presence of the shield are observed. Such enhancement is in agreement with Williamson's Monte Carlo calculations.

Brachytherapy↗

Separation of dose-gradient effect from beam-hardening effect on wedge factors in photon fields.

It is known experimentally that a wedge transmission factor depends upon the field size and depth of measurement in particular. Dependence of the transmission upon depth has been attributed to a hardening of the incident beam through the filter, which preferentially absorbs the low-energy photon of the bremsstrahlung component of that beam. We have attempted to separate this hardening effect from that of increased phantom scatter due to dose gradient induced by the wedge filter. Using an experimental wedge machined from cerrobend, the filter transmission at depth is measured and redefined relative to an "equally hardened" beam, obtained by filtering through a flat slab of equal thickness at the center of the wedge. Results of the Co-60, 4-, and 8-MV wedged beams indicate that nearly half of the increase in the transmission at depth is due to the effect of dose-gradient scatter in polystyrene phantom. Based on a simple relationship between primary and scattering radiation, an algebraic presentation is indeed in support of the dose gradient resulting in apparent increase in the wedge factors, at depth.

Cobalt Radioisotopes↗

Film dosimetry analyses on the effect of gold shielding for iodine-125 eye plaque therapy for choroidal melanoma.

One of the methods currently being used to treat choroidal melanoma employs an episcleral plaque containing I-125 radioactive seeds. However, comprehensive dosimetry studies on the plaque are scarce and controversial. For this work, we use film to study the dosimetry outside the lip of the gold shield of the eye plaque. This lip around the gold shield was made to protect the critical structures behind and adjacent to the lesion. Since the changes of energy spectrum of I-125 in tissue are negligible, film dosimetry seems to be a logical choice because of high spatial resolution required around the lip of the gold plaque. For this study, we first established an H and D curve with dose expressed in a unit of specific dose rate constant. This avoids absolute dose measurements. All film density measurements are made with a 1-mm aperture scan, normalized to the density at the prescription point for tumor of 3-5-mm apical height, i.e., 5 mm from the interior surface of sclera, and converted to percentage isodose curves. With a gold shield, it is found that when the plaque is placed against the optical nerve, the optical disk and macula, located at 2 mm outside the lip, on the exterior surface of sclera, may receive 85% of the prescription dose for a 12-mm plaque and 58% for a 16-mm plaque. For tumors of 8-mm apical height, the optical nerve would receive more than the prescription dose.

Brachytherapy↗

Comparison of dose calibration by ionometric and chemical dosimetry for 6- and 45-MV x-ray beams.

This work reports the results of an experiment carried out to investigate the compatibility of TG-21 ion chamber calibration with Fricke dosimetry near the extremes of the clinically available megavoltage photon energy range. Doses determined from ion chamber measurements and from chemical dosimetry are compared for a 6-MV linear accelerator x-ray beam and 45-MV betatron beam. The Fricke dosimetry was carried out by the National Institute of Standards and Technology. Agreement within 1% between the two techniques was obtained at both photon energies using a currently accepted G-value.

Calibration↗