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Enhancement of electrolaryngeal speech by adaptive filtering.

Artificial larynges provide a means of verbal communication for people who have either lost or are otherwise unable to use their larynges. Although they enable adequate communication, the resulting speech has an unnatural quality and is significantly less intelligible than normal speech. One of the major problems with the widely used Transcutaneous Artificial Larynx (TAL) is the presence of a steady background noise caused by the leakage of acoustic energy from the TAL, its interface with the neck, and the surrounding neck tissue. The severity of the problem varies from speaker to speaker, partly depending upon the characteristics of the individual's neck tissue. The present study tests the hypothesis that TAL speech is enhanced in quality (as assessed through listener preference judgments) and intelligibility by removal of the inherent, directly radiated background signal. In particular, the focus is on the improvement of speech over the telephone or through some other electronic communication medium. A novel adaptive filtering architecture was designed and implemented to remove the background noise. Perceptual tests were conducted to assess speech, from two individuals with a laryngectomy and two normal speakers using the Servox TAL, before and after processing by the adaptive filter. A spectral analysis of the adaptively filtered TAL speech revealed a significant reduction in the amount of background source radiation yet preserved the acoustic characteristics of the vocal output. Results from the perceptual tests indicate a clear preference for the processed speech. In general, there was no significant improvement or degradation in intelligibility. However, the processing did improve the intelligibility of word-initial non-nasal consonants.

Adult↗

Radon survey in the high natural radiation region of Niska Banja, Serbia.

A radon survey has been carried out around the town of Niska Banja (Serbia) in a region partly located over travertine formations, showing an enhanced level of natural radioactivity. Outdoor and indoor radon concentrations were measured seasonally over the whole year, using CR-39 diffusion type radon detectors. Outdoor measurements were performed at 56 points distributed over both travertine and alluvium sediment formations. Indoor radon concentrations were measured in 102 living rooms and bedrooms of 65 family houses. In about 50% of all measurement sites, radon concentration was measured over each season separately, making it possible to estimate seasonal variations, which were then used to correct values measured over different periods, and to estimate annual values. The average annual indoor radon concentration was estimated at over 1500 Bq/m3 and at about 650 Bq/m3 in parts of Niska Banja located over travertine and alluvium sediment formations, respectively, with maximum values exceeding 6000 Bq/m3. The average value of outdoor annual radon concentration was 57 Bq/m3, with a maximum value of 168 Bq/m3. The high values of indoor and outdoor radon concentrations found at Niska Banja make this region a high natural background radiation area. Statistical analysis of our data confirms that the level of indoor radon concentration depends primarily on the underlying soil and building characteristics.

Air Pollutants, Radioactive↗

Radiation recall dermatitis and pneumonitis in a patient treated with paclitaxel.

BACKGROUND: Radiation recall refers to a tissue reaction produced by a chemotherapeutic agent in a previously irradiated field that would not occur in a nonirradiated field. A number of agents have been reported to cause radiation recall. Recently, there have been case reports of recall dermatitis from paclitaxel treatment. METHODS: A patient with metastatic lung cancer received palliative radiation to her mediastinum and ribs. Because of disease progression, she subsequently received paclitaxel. RESULTS: After paclitaxel administration, the patient became acutely dyspneic. A subsequent chest X-ray revealed a parenchymal opacity in a region that corresponded with the patient's radiation portal. She also developed a severe skin reaction in the previously treated electron field. CONCLUSIONS: This is one of few reported cases of recall dermatitis from paclitaxel and is also suggestive of recall pneumonitis, a phenomenon previously unreported to the authors' knowledge. Given paclitaxel's ability to function as a radiosensitizer, this response is not unexpected. As the frequency of paclitaxel administration increases, its potential as a radiation sensitizer and radiation recall should be considered.

Adenocarcinoma↗

Radiation therapy in skin cancer. A historical perspective and current applications.

BACKGROUND: Radiation therapy has been used for skin cancer for nearly a century. During this protracted period, techniques of administering superficial irradiation have developed continuously. More recently, the availability of electron beams for treatment of skin cancer has improved further our ability to treat skin cancer more efficiently and with less toxicity. These include primary skin cancers as well as any metastatic skin lesion. OBJECTIVE: Indications and advantages of modern radiation therapy in skin cancer are confusing at times. In this review, an attempt was made to clarify the role of this discipline in dermatologic use. METHODS: Old literature has been reviewed in order to give an appropriate historical perspective of treatment of skin with irradiation. Literature has also been selected for updating information on current indications and practice of radiation therapy for skin lesions. RESULTS: Radiation therapy is very effective in many situations where other modalities are contraindicated or functionally or cosmetically impairing. With the most efficient methods of fractionation and administration, the control rate of most skin cancers with radiation is as high as 90% or more. CONCLUSION: Modern day radiation therapy is very effective in treatment of skin cancers. Not only the control rate is as good as any other modality, but, with irradiation, cosmetic appearance and function are better preserved under most circumstances.

History, 19th Century↗

[The treatment of cutaneous radiation-induced fibrosis with pentoxifylline and vitamin E. An empirical report].

BACKGROUND: Radiation fibrosis represents a severe complication of radiation therapy; standardized treatment protocols are lacking so far. Surgical excision rarely results in complete healing. PATIENT AND METHODS: We report on a 58-year-old female patient who developed a squamous cell carcinoma within the fibrotic area of the irradiation field on the right chest, resulting from a radiotherapy following mastectomy for breast cancer 17 years ago. After surgical excision of the carcinoma a combined treatment with pentoxifylline tablets (3 x 400 mg/d p.o.) and vitamin-E capsules (1 x 400 mg/d p.o.) was initiated. Skin thickness was quantified by 20 MHz-ultrasound before and during treatment. RESULTS: The patient noted an increasing improvement of the condition of the affected skin starting from 4 months. A continuing decrease of skin thickness as documented by 20 MHz-ultrasound could be demonstrated from the 6th month on. The treatment was tolerated well, no side effects were observed. CONCLUSION: The data indicate a beneficial therapeutic effect of pentoxifylline and vitamin E on radiation-induced fibrosis. Little is known about the mechanism of action of this combined treatment protocol including pentoxifylline and vitamin E. Controlled clinical trials should be performed to confirm this observation.

Breast Neoplasms↗

Geographical distribution of birth places of children with cancer in the UK.

Using birth addresses, we examined the geographical variation in risk for all types of childhood cancers in the UK, on a scale corresponding to the 10-km squares of the National Grid. The effects of socioeconomic and environmental factors, including natural background radiation, were investigated and their relative importance assessed using Poisson regression. Data came from a national collection of all fatal cancers between 1953 and 1980 in children aged 0-15 years and consisted of 9363 children of known place of birth from 12 complete annual cohorts born in the period 1953-64. For solid cancers, as well as for leukaemias and lymphomas, there was marked variation of cumulative mortality according to place of birth. High mortalities were associated with areas characterized as having high social class, higher incomes and good housing conditions, but also with high population densities (births per hectare). Each of these contrasting social indicators operated independently of the other, indicating complex determining mechanisms. Mortalities increased with increased radon exposure, and the relationship operated independently of the socioeconomic factors. At this scale of analysis, we found no increased mortality in industrialized areas. A population-mixing infective hypothesis, which postulates high rates of leukaemia when highly exposed urban populations are introduced to isolated rural areas, was supported by observations of high mortalities in 'growth areas' and New Towns, but was not readily reconcilable with the high rates seen in the high-density areas. If these correlations do indeed represent an infective mechanism, then the outcomes are not limited to malignancies of the immune system alone.

Adolescent↗

Metabolic efficiency in response to environmental agents predicts hormesis and invalidates the linear no-threshold premise: ionizing radiation as a case study.

Hormesis derives from high metabolic efficiency and hence high fitness that evolve in response to single and multiple environmental agents in low to moderate stress habitats. Consequently, nonlinear fitness continua are an evolutionary expectation for all environmental agents, which invalidates the LNT premise. For ionizing radiation, hormesis is interpreted to be adaptation to background radiation exposures, combined with adaptation to higher radiation exposures dependent on metabolic protection from the array of other abiotic stresses in the environment. This model of radiation hormesis renders suggestions of therapeutic radiation supplementation redundant because of similar health effects from other environmental agents. Furthermore, the model is compatible with a return of exposure levels for radiation protection to higher doses than are presently permissible, a deduction with substantial economic benefits.

Adaptation, Physiological↗

Relative biological effectiveness (RBE) of 210Po alpha-particles versus X-rays on lethality in bovine endothelial cells.

PURPOSE: Alpha-radiation from polonium-210 ((210)Po) can elevate background radiation dose by an order of magnitude in people consuming large quantities of meat and seafood, particularly caribou and reindeer. Because up to 50% of the ingested (210)Po body burden is initially found in the blood, a primary target for the short range alpha-particles is the endothelial cells lining the blood vessels. This study examined the relative biological effectiveness (RBE) of (210)Po alpha-particles versus 250 kVp X-rays in producing injury to cultured bovine aortic endothelial cells. MATERIALS AND METHODS: Radiation effects on cells were measured in four different ways: the percentage viable cells by trypan blue dye exclusion, the number of live cells, the lactate dehydrogenase (LDH) release to medium and the ability to form colonies (clonogenic survival). RESULTS: Comparison of dose-response curves yielded RBE values of 13.1+/-2.5 (SEM) for cell viability, 10.3+/-1.0 for live cell number and 11.1+/-3.0 for LDH activity. The RBE values for clonogenic survival were 14.0+/-1.0 based on the ratio of the initial slopes of the dose-response curves and 13.1, 9.9 and 7.7 for 50, 10 and 1% survival rate, respectively. At X-ray doses <0.25 Gy, a pronounced stimulatory effect on proliferation was noted. CONCLUSIONS: Exposure to (210)Po alpha-particles was seven to 14 times more effective than X-ray exposure in causing endothelial cell damage.

Alpha Particles↗

[Adaptation processes in natural Drosophila populations in radiation contaminated Belarus regions before and after radiation exposure removal].

We have shown that natural drosophila populations from the settlement Vetka of Gomel region with increased radiation background are more adapted to mutagenic effect of radiation than drosophila populations from Berezinsky reserve (the control). After the populations were placed into laboratory thermostat adaptation of Vetka population remained within 6-8 generations without irradiation. However the control population became more resistant too. So, the keeping of natural drosophila populations under laboratory conditions was a stress and led to unspecific adaptation the same as a low level of radiocontamination did. These facts should be considered in studying dynamics of the mutation level during radionuclide removal in animals caught in radiocontaminated regions and placed in vivaria conditions.

Adaptation, Physiological↗

The effect of low level ionizing radiation on embryogenesis of silkworm, Bombyx mori L.

The effect of chronic radiation, 100, 1000 and 4000 times exceeding the natural background radiation, on embryogenesis of silkworm, Bombyx mori has been investigated. It is shown that low level ionizing radiation shortens by several hours the period of embryogenesis while the larva mass increases as the development proceeds. A single preincubational exposure of silkworm eggs to a dose of 2 Gy increases the mass of larvae as well as the cocoon shell weight, silk-bearing and the raw silk production.

Animals↗

Radiation-induced versus endogenous DNA damage: possible effect of inducible protective responses in mitigating endogenous damage.

Ionizing radiation (IR) causes damage to DNA that is apparently proportional to absorbed dose. The incidence of radiation-induced cancer in humans unequivocally rises with the value of absorbed doses above about 300 mGy, in a seemingly linear fashion. Extrapolation of this linear correlation down to zero-dose constitutes the linear-no-threshold (LNT) hypothesis of radiation-induced cancer incidence. The corresponding dose-risk correlation, however, is questionable at doses lower than 300 mGy. Non-radiation induced DNA damage and, in consequence, oncogenic transformation in non-irradiated cells arises from a variety of sources, mainly from weak endogenous carcinogens such as reactive oxygen species (ROS) as well as from micronutrient deficiencies and environmental toxins. In order to relate the low probability of radiation-induced cancer to the relatively high incidence of non-radiation carcinogenesis, especially at low-dose irradiation, the quantitative and qualitative differences between the DNA damages from non-radiation and radiation sources need to be addressed and put into context of physiological mechanisms of cellular protection. This paper summarizes a co-operative approach by the authors to answer the questions on the quantitative and qualitative DNA damages from non-radiation sources, largely endogenous ROS, and following exposure to low doses of IR. The analysis relies on published data and justified assumptions and considers the physiological capacity of mammalian cells to protect themselves constantly by preventing and repairing DNA damage. Furthermore, damaged cells are susceptible to removal by apoptosis or the immune system. The results suggest that the various forms of non-radiation DNA damage in tissues far outweigh corresponding DNA damage from low-dose radiation exposure at the level of, and well above, background radiation. These data are examined within the context of low-dose radiation induction of cellular signaling that may stimulate cellular protection systems over hours to weeks against accumulation of DNA damage. The particular focus is the hypothesis that these enhanced and persisting protective responses reduce the steady state level of non-radiation DNA damage, thereby reducing deleterious outcomes such as cancer and aging. The emerging model urgently needs rigorous experimental testing, since it suggests, importantly, that the LNT hypothesis is invalid for complex adaptive systems such as mammalian organisms.

Adaptation, Physiological↗

A practical guide for protecting personnel, pregnant personnel, and patients during diagnostic radiography and fluoroscopy.

The following article presents a comprehensive overview of the practical aspects of radiation protection for diagnostic radiology. The topics discussed include background radiation levels, typical exposure levels for radiologic technologists, risk estimates, the relationship between dose and effect, dose limits, personnel monitoring, protective devices, gonadal shielding, and the immobilization of patients. Special attention has been given to the concerns of pregnant personnel and pregnant patients.

Female↗

Distribution of radiation in synovectomy of the knee with 166Ho-FHMA using image fusion.

BACKGROUND: Radiation synovectomy is an effective technique for the treatment of chronic synovitis in patients with rheumatoid arthritis (RA), and is an alternative for surgical synovectomy. Holmium ferric hydroxide macroaggregates (166Ho-FHMA) is suitable for radiation synovectomy, especially because it emits high-energy beta particles and a smaller proportion of low-energy photons that are suitable for gamma-camera imaging. OBJECTIVE: The aim of this study was to develop a method to fuse 166Ho-FHMA single photon emission computed tomography (SPECT) and magnetic resonance (MRI) images, to show the distribution of 166Ho-FHMA inside the joint with images that localize synovitis. METHODS: The knees of 6 patients with RA were treated with 166Ho-FHMA. (99m)Tc-human immunoglobulin ((99m)Tc-HIG) SPECT images and MRI images were taken before 166Ho-FHMA injections. 166Ho-FHMA SPECT images were taken 4, 28, and 40 hours after injections. SPECT and MRI images were merged using a specific image fusion method, called mutual information algorithm, to study associations between anatomical and metabolic information from these images. RESULTS: Fusion of SPECT and MRI images indicated that intensity of radioactivity was associated with the amount of synovitis. Activity distribution of 166Ho-FHMA could be registered using anatometabolic images. CONCLUSIONS: A new method to fuse the distribution of radiation in the synovectomy of the knee was developed using SPECT/MRI image registration. Image registration of SPECT and MRI can be used to determine the activity distribution of radioisotopes in relation to synovitis.

Female↗

Evaluating the effectiveness of a radiation safety training intervention for oncology nurses: a pretest-intervention-posttest study.

BACKGROUND: Radiation, for either diagnosis or treatment, is used extensively in the field of oncology. An understanding of oncology radiation safety principles and how to apply them in practice is critical for nursing practice. Misconceptions about radiation are common, resulting in undue fears and concerns that may negatively impact patient care. Effectively educating nurses to help overcome these misconceptions is a challenge. Historically, radiation safety training programs for oncology nurses have been compliance-based and behavioral in philosophy. METHODS: A new radiation safety training initiative was developed for Memorial Sloan-Kettering Cancer Center (MSKCC) adapting elements of current adult education theories to address common misconceptions and to enhance knowledge. A research design for evaluating the revised training program was also developed to assess whether the revised training program resulted in a measurable and/or statistically significant change in the knowledge or attitudes of nurses toward working with radiation. An evaluation research design based on a conceptual framework for measuring knowledge and attitude was developed and implemented using a pretest-intervention-posttest approach for 15% of the study population of 750 inpatient registered oncology nurses. RESULTS: As a result of the intervention program, there was a significant difference in nurse's cognitive knowledge as measured with the test instrument from pretest (58.9%) to posttest (71.6%). The evaluation also demonstrated that while positive nursing attitudes increased, the increase was significant for only 5 out of 9 of the areas evaluated. CONCLUSION: The training intervention was effective for increasing cognitive knowledge, but was less effective at improving overall attitudes. This evaluation provided insights into the effectiveness of training interventions on the radiation safety knowledge and attitude of oncology nurses.

Adult↗

Fractionated ionizing radiation exposure induces apoptosis through caspase-3 activation and reactive oxygen species generation.

BACKGROUND: Radiation therapy (RT) is a well established therapeutic modality for the treatment of solid tumors. In particular, post-operative RT is considered the standard treatment adjuvant to surgery since its ability to prolong median survival of patients with malignant astrocytoma has been shown; nevertheless the ionizing radiation (IR) treatment fails in a considerable number of astrocytoma patients. MATERIALS AND METHODS: Using an ADF human astrocytoma cell line the molecular mechanisms involved in the DNA damage induced by fractionated irradiation (FIR) and single IR treatment have been investigated. RESULTS: FIR and single IR treatment inhibited the growth of the ADF human astrocytoma cell line. FACS analysis revealed that FIR treatment, but not single IR treatment, induced growth inhibition associated with the induction of apoptosis. Apoptosis was related to caspase-3 activation and reactive oxygen species (ROS) generation. ROS formation depends on the up-regulation of the cytochrome P450 enzyme gene. On the contrary, 12.5 Gy induced necrotic cell death up-regulating the HSPD1, HSPCB, HSPCA and HSPB1 genes. CONCLUSION: FIR treatment induced cell death through caspase-3 and ROS-mediated apoptosis.

Apoptosis↗

Radiation therapy alone in elderly with early stage non-small cell lung cancer.

BACKGROUND: Radiation therapy (RT) alone is frequently used in elderly patients with medically inoperable early stage (I/II) non-small cell lung cancer (NSCLC). We retrospectively investigated the effectiveness of RT alone in this patient population treated in our institution. MATERIAL AND METHODS: Between 1995 and 1999, a total of 33 patients were treated with RT alone in our institution, all being males. RT doses ranged 66-78 Gy (median, 70 Gy) using standard fractionation (2.0 Gy per fraction). The age range was 71-97 years (median, 75 years) with 11 patients being >or=80 years old. Twenty-two (67%) patients had a squamous cell carcinoma. There were 24 (73%) stage I and nine (27%) stage II patients. RESULTS: Radiographic objective response rate was observed in 23 (70%) patients. The median survival time was 37.4 months and 3-year survival time was 50%, while the median cause-specific survival time was 48.1 months and a 3-year cause-specific survival rate was 55.3%. The median time to local recurrence was 36.8 months and a 3-year local recurrence-free survival rate was 50.2%, while the median time to distant metastasis was not achieved yet, the 3-year distant metastasis-free survival rate being 71.4%. One (3%) patient died of RT-induced acute lung toxicity, while only two (6%) patients experienced late grade 3 lung toxicity. No other high-grade toxicity was observed during this study. CONCLUSIONS: RT alone was effective and low toxic in elderly with early stage (I/II) NSCLC and could be considered as treatment of choice in this patient population.

Aged↗

Noscapine and diltiazem augment taxol and radiation-induced S-phase arrest and clonogenic death of C6 glioma in vitro.

BACKGROUND: Radiation therapy after surgical resection is the approved treatment of gliomas, and survival benefits are reported with taxane-based chemotherapy. We investigated whether these regimes could be augmented with blood-brain barrier permeable drugs, N and D. Noscapine is an opioid antitussive, which acts anti cancer via blocking microtubule dynamics. Diltiazem is a calcium channel-blocking cardiac antiarrythmic, which also blocks tumor growth and P-glycoprotein. METHODS: Effects of N (11.1 micromol/L), D (11.1 micromol/L), and T (11.7 micromol/L) were monitored in C6 glioma cells via S phase, colony formation, and fine structure analysis. RESULTS: Taxol depleted S phase from 35.2% to 12.2%. Both N and D synergistically augmented T-mediated S-phase depletion, and they also effectively reduced colonies, which were more potent by N by 49%. Taxol reduced colonies by 98%, and there were almost no surviving colonies in copresence of T with either N or D. Colony reduction by radiotherapy was increased strongly by T and significantly by N. Taxol and radiation profoundly increased number of mitochondria. Both D and N suppressed this increase via myelinosis and autophagy. CONCLUSION: Noscapine and D should be further tested in animal models because of their potential and already-present clinical applicability.

ATP Binding Cassette Transporter, Subfamily B, Mem↗