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Biomedical subjects

C Cotrutz

Publications and source records attributed to C Cotrutz.

At least 19 recordsLinked to original sources
PubMed2005

Quantitation of the a priori dosimetric capabilities of spatial points in inverse planning and its significant implication in defining IMRT solution space.

In inverse planning, the likelihood for the points in a target or sensitive structure to meet their dosimetric goals is generally heterogeneous and represents the a priori knowledge of the system once the patient and beam configuration are chosen. Because of this intrinsic heterogeneity, in some extreme cases, a region in a target may never meet the prescribed dose without seriously deteriorating the doses in other areas. Conversely, the prescription in a region may be easily met without violating the tolerance of any sensitive structure. In this work, we introduce the concept of dosimetric capability to quantify the a priori information and develop a strategy to integrate the data into the inverse planning process. An iterative algorithm is implemented to numerically compute the capability distribution on a case specific basis. A method of incorporating the capability data into inverse planning is developed by heuristically modulating the importance of the individual voxels according to the a priori capability distribution. The formalism is applied to a few specific examples to illustrate the technical details of the new inverse planning technique. Our study indicates that the dosimetric capability is a useful concept to better understand the complex inverse planning problem and an effective use of the information allows us to construct a clinically more meaningful objective function to improve IMRT dose optimization techniques.

Algorithms↗
PubMed2001

A multiobjective gradient-based dose optimization algorithm for external beam conformal radiotherapy.

A multiobjective gradient-based algorithm has been developed for the purpose of dose distribution optimization in external beam conformal radiotherapy. This algorithm is based on the concept of gathering the values of all objectives into a single value. The weighting factors of the composite objective values are varied in different steps, allowing the reconstruction of the trade-off surfaces (three or more objectives) or curves (two objectives) which define the boundary between the feasible and non-feasible domain regions. The analysis of these curves allows the decision-maker to select the solution that best fits the clinical goals. In contrast to all the other algorithms, our method provides not a single solution but a sample of solutions representing all possible clinical importance factors (weights) for the objectives used. The application of this algorithm to two test cases shows that a correct selection for the importance factors to multiply the individual objectives in the global objective value is not trivial and that the location and shape of the boundary region between the feasible and non-feasible solution regions are case dependent. Provided that the individual objective functions are analytically differentiable and that the number of objectives is the range of two to three, the computation times are acceptable for clinical use. Furthermore, the optimization for a unique combination of importance factors within the aggregate objective function is performed in less than 1 min.

Algorithms↗
PubMed2000

Intensity modulated arc therapy (IMAT) with centrally blocked rotational fields.

A new technique for intensity-modulated beam (IMB) delivery that combines the features of intensity modulated arc therapy (IMAT) with the use of 'classical blocks' is proposed. The role of the blocks is to realize the high-gradient modulation of the intensity profile corresponding to the region to be protected within the body contour, while the MLC leaves or the secondary collimator defines the rest of the field and delivers intensity-modulated multiple rotational segments. The centrally blocked radiation fields are applied sequentially, in several rotations. Each rotation of the gantry is responsible for delivering one segment of the optimal intensity profile. The new IMAT technique is applied for a treatment geometry represented by an annular target volume centrally located within a circular body contour. The annulus encompasses a circular critical structure, which is to be protected. The beam opening and corresponding weight of each segment are determined in two ways. The first method applies a linear optimization algorithm to precalculated centrally blocked radial dose profiles. These radial profiles are calculated for a set of beam openings, ranging from the largest field that covers the whole planning target volume (PTV) to the smallest, which is 1 cm larger than the width of the central block. The optimization is subjected to dose homogeneity constraints imposed on a linear combination of these profiles and finally delivers the dimensions and weights of the rotational beams to be used in combination. The second method decomposes into several subfields the fluence profile of a rotational beam known to deliver a constant dose level to PTV. This fluence profile is determined by using the analytical method proposed by Brahme for the case of the annular PTV and the concentric organ at risk (OAR). The proper segmentation of this intensity profile provides the field sizes and corresponding weights of the subfields to be used in combination. Both methods show that for this particular treatment geometry, three to seven segments are sufficient to cover the PTV with the 95% dose level and to keep the dose level to the central critical structure under 30% of the maximum dose. These results were verified by experimentally delivering the calculated segments to radiotherapy verification films sandwiched between two cylindrical pieces of a pressed-wood phantom. The total beam time for a three-field irradiation was 77 s. The predicted and experimental dose profiles along the radius of the phantom agreed to within 5%. Generalization of this technique to real-patient treatment geometry and advantages over other conformal radiotherapy techniques are also discussed.

Algorithms↗
PubMed1998

Development in a Windows environment of a radiation treatment planning system for personal computers.

A new personal computer (PC) radiotherapy treatment planning system (RTPS) is presented. The PC-based RTPS is designed to run in the Microsoft Windows 3.11 environment (and later versions), for computers equipped with 486 or Pentium processors. The algorithm used by the new PC-based program for dose calculation belongs to the 'radiological pathlength' category and it was previously implemented on VAX 711 computers at Memorial Sloan-Kettering Cancer Center (MSKCC) in New York, NY, within EXTREP-III RTPS. The EXTREP-III program is a two-dimensional RTPS (with restricted three-dimensional capabilities), developed and used in clinical practice at MSKCC during the 1980s. The PC-based program is implemented in the Visual Basic (version 3.0) language and supports features commonly available in most photon-mode RTPSs: dose calculation for fixed, isocentric and rotational irradiation techniques, dose corrections for both internal inhomogeneities and external inhomogeneities (boluses and compensators), association of machine-specific beams with various wedges and blocks, etc. The graphic interface of the PC-based RTPS is completely new and is designed to meet the requirements of fast and accurate planning. The user interface consists of an event-oriented button-based console which allows users to perform planning and to have isodose charts overlaid on patient computed tomography images initially loaded in the program. The PC-based RTPS tests, performed in order to assess its accuracy and speed of computation, show good results. The acceptable computation times obtained, the good accuracy in dose computation and the user-friendly interface of the program are sufficient reasons to consider the PC-based RTPS a good quality-price ratio tool for radiation treatment planning in cancer therapy.

Algorithms↗
PubMed1978

[Phlebectasia of the internal jugular vein post injury (author's transl)].

The authors present the case of a 14 year-old girl having the cervical deformity developed on the background of influenza and sore throat and was caused by an apparently minor sports injury, with vertebrocervical lesion and rupture of the inner wall of the jugular vein. The painful onset symptomatology, initially attributed to exacerbation of the anginous process and cervical adenitis, evolved towards phonation, deglutition, nervous and final respiratory disturbances. The progressive evolution and gravity of the clinical picture imposed craniocervical surgery, with exclusion of the lateral intramastoid sinus and resection of the extensive ectatic cervicoprevertebral pouch. The authors discuss the mechanism of the vascular lesion, the clinical picture, evolution, diagnosis and therapy, which totaly differed from classical descriptions of phlebectasia of the jugular vein.

Adolescent↗
PubMedDate not supplied

TLC--a rapid method for liposome characterization.

One of the most important problems for the use of liposomes as a drug delivery system is the modification of the vesicle induced by the liquid medium in which they are introduced (blood plasma for in vivo studies and the saline buffer solution for in vitro studies). Using thin-layer chromatography (TLC) we compared the behaviour of phosphatidylcholine (used for liposomes preparation) to that of the following unfilled liposomes: multilamellar liposomes (MLV); small unilamellar vesicles (SUV); and reverse phase evaporation vesicles (REV), before and after storage for 15 min in Krebs-Henseleit solution (37 degrees C, pH 7.4, aerated continuously with 95% O2 + 5% CO2). All variants contained the same amount of phosphatidylcholine. Thin-layer chromatography was performed on silica gel 60 as adsorbent. Two types of solvents were tested: one based on chloroform/alcohol (n-butanol or n-propanol or methanol)/water mixture (in different ratios) and another based on alcohol/alcohol/water mixture (n-butanol/n-propanol/water in 4/3/3 volume ratio). In all variants of chloroform containing solvents no differences were found between phosphatidylcholine and all types of liposomes. When using as solvent n-butanol/n-propanol/water significant differences were found between all types of liposomes before and after storage in Krebs-Henseleit solution. Their presence, after TLC treatment, was shown in electron microscopy studies.

Chromatography, Thin Layer↗
PubMedDate not supplied

Ultrastructural aspects of the alveolar wall in SIDS.

The aim of this study is to make a comparative analyse between light and ultrastructural lesions of the alveolar wall in SIDS. The study was made on lung specimens collected from autopsy of infants with sudden unexplained death. There were studied histopathologically 10 cases of sudden death. Only in 3 cases were made electron microscopically studies. At light microscope, there were put in evidence interstitial and intra-alveolar oedema and the presence of many parietal and intra-alveolar macrophages. There is a good correlation between light and ultrastructural aspects.

Humans↗
PubMedDate not supplied

[Periodontitis, a risk factor for cardiovascular diseases?].

Exist a statistically significant association between a diagnosis of coronary heart disease and certain oral health parameters. These parameters are independent and more strongly associated with coronary heart disease than were recognized risk factors, such as serum cholesterol levels, body mass index, diabetes and smoking status. The correlation between serum and salivary cholesterol concentration and the role of salivary lipids in oral health have been poorly characterized. Lipids in saliva are mostly glandular in origin, through some may diffuse diffuse directly from the serum. The surface of the enamel (in case of dietary fat which have an cariostatic effect) is protected against demineralization by a mixture of salivary lipids and proteins. Salivary lipids may have anucleating role in the early mineralization of the dental plaque. The prevalence of periodontal disease may be increased in patients with atherosclerosis, and dental and periodontal infections have been shown to be associated with occurrence of acute and chronic coronary heart disease. Among the known risk factors of atherosclerosis, high serum lipid levels, especially cholesterol may be important with regard to periodontal health.

Adult↗
PubMedDate not supplied

[Physiological and pathological roles of apoptosis].

An understanding of the cellular events leading to apoptosis is important for the design of new chemotherapeutic agents directed against the types of leukemias and lymphomas that are resistant to currently used chemotherapeutic protocols. Malignant cell proliferation and accumulation depend on an imbalance between the rate of cell production and the rate of cell death. Apoptosis has been demonstrated to be involved not only in the regulation of normal tissues but also in the development and control of tumour cells. The relationship between oncogenes, apoptosis and growth factors is very important in determining prognosis when analysing the potential benefits of different treatment regimens.

Animals↗
PubMedDate not supplied

[Gelatinases in peri-implantation stage].

The periimplantation stage in mice is marked around the 5th day after mating by blastocyst presence in the emdometrium. The events that are marking the implantation event are focused on the evolution of the extracellular matrix around the mezenchime cells that undergoes decidualization. The inductive process is guided by gelatinases and the purpose of our study is to demonstrate their presence at this level.

Animals↗