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Summation of responses of cat muscle spindles to combined static and dynamic fusimotor stimulation.

This is a study of the process of interaction between the responses of muscle spindles to stimulation of two fusimotor fibres. Combined stimulation of a static and a dynamic fusimotor fibre supplying the same muscle spindle in the soleus muscle of the anaesthetised cat gave a response which was larger than from stimulating each fibre separately, but less than their sum. A similar summation process was observed with pairs of static fusimotor fibres. The mean summation coefficient for the responses to stimulation of 14 pairs of static fusimotor fibres was 0.29 (range 0.14-0.52; S.D. 0.09), while for 42 static:dynamic pairs it was 0.30 (range 0.07-0.89; S.D. 0.20). Mechanisms considered for the summation process were probabilistic mixing of impulse traffic from two or more impulse generators within the terminals of the primary ending of the spindle, the spread of generator current from one encoding site to another and mechanical interactions between contracting intrafusal fibres. In an experiment where single static and dynamic fusimotor fibres were stimulated together, and then stimulation of the static fibre stopped, the size of the continuing dynamic response was larger than when the dynamic fibre had been stimulated alone. This finding suggested some kind of mechanical interaction between the contracting intrafusal fibres and implies that static and dynamic fusimotor effects within a spindle cannot be considered to be entirely independent of one another.

Action Potentials↗

Myometrial invasion of endometrial carcinoma: assessment with dynamic MR and contrast-enhanced T1-weighted images.

AIM: To evaluate the usefulness of dynamic magnetic resonance (MR) imaging in assessing the depth of myometrial invasion, compared with conventional T2-weighted and contrast-enhanced T1-weighted imaging. PATIENTS AND METHODS: Forty patients with endometrial carcinoma were examined with T2-weighted images, dynamic studies and contrast-enhanced T1-weighted images, preoperatively. We evaluated enhancement patterns of myometrium and tumour, and compared MR findings with histological results concerning the depth of myometrial invasion. RESULTS: In assessing the depth of myometrial invasion, the accuracy of T2-weighted images, dynamic studies and contrast-enhanced T1-weighted images was 58%, 85% and 68%, respectively. The tumour-myometrial contrast of dynamic studies was higher than that of other images. In addition, subendometrial enhancement (SEE) was frequently observed in dynamic studies in post-menopausal women, which was an important landmark in detecting myometrial invasion. CONCLUSION: We consider that dynamic MR imaging has greater advantage in assessing myometrial invasion than T2-weighted or contrast-enhanced T1-weighted imaging.

Adult↗

Fast dynamic contrast-enhanced colour-coded MRI in uterine cervix carcinoma: useful for tumour staging?

OBJECTIVE: To quantify first-pass enhancement of cervix carcinoma using fast dynamic MRI. To assess the accuracy of dynamic contrast-enhanced colour-coded MRI for determining tumour invasion into surrounding pelvic tissues. METHODS: Gadolinium enhanced dynamic MRI at one image every 2 s was performed in 47 patients with cervical carcinoma and five controls. First-pass contrast enhancement of cervix carcinoma and surrounding pelvic tissues was quantified. Automated colour-coded images were constructed using the dynamic parameters slope, amplitude and timing of enhancement. Of 47 patients, 28 underwent surgery and colour coded images were correlated with histological findings. RESULTS: First-pass contrast enhancement imaging of cervix carcinoma required a temporal resolution of dynamic MRI of one image every 3-4 s. Cervix carcinoma first-pass was more rapid and intense than that of other pelvic tissues (P<0.001) with the exception of normal myometrium (P>0.05). Binary colour coding, however, was not reliable for tumour delineation or for accurate assessment of tumour invasion into the parametria or the bladder wall. Overestimation of the extent of tumour invasion occurred in 15, 16 and nine out of 28 patients, respectively, using amplitude, slope and timing of enhancement as parameters. CONCLUSION: Dynamic contrast-enhanced colour-coded MRI of cervix carcinoma has limited value for assessing the extent of tumour spread and tumour staging.

Adult↗

Dynamics of surfactant sorption at the air/water interface: continuous-flow tensiometry.

Dynamic interfacial tensiometry, gauged by axisymmetric drop shape analysis of static drops or bubbles, provides useful information on surfactant adsorption kinetics. However, the traditional pendant-drop methodology is not readily amenable to the study of desorption kinetics. Thus, the question of sorption reversibility is difficult to assess by this technique. We extend classical pendant/sessile drop dynamic tensiometry by immersing a sessile bubble in a continuously mixed optical cell. Ideal-mixed conditions are established by stirring and by constant flow through the cell. Aqueous surface-active-agent solutions are either supplied to the cell (loading) or removed from the cell by flushing with water (washout), thereby allowing study of both adsorption and desorption kinetics. Well-mixed conditions and elimination of any mass transfer resistance permit direct identification of sorption kinetic barriers to and from the external aqueous phase with time constants longer than the optical-cell residence time. The monodisperse nonionic surfactant ethoxy dodecyl alcohol (C(12)E(5)), along with cationic cetyltrimethyl ammonium bromide (CTAB) in the presence of added salt, adsorbs and desorbs instantaneously at the air/water interface. In these cases, the experimentally observed dynamic-tension curves follow the local-equilibrium model precisely for both loading and washout. Accordingly, these surfactants below their critical micelle concentrations (CMC) exhibit no detectable sorption-activation barriers on time scales of order a min. However, the sorption dynamics of dilute CTAB in the absence of electrolyte is markedly different from that in the presence of KBr. Here CTAB desorption occurs at local equilibrium, but the adsorption rate is kinetically limited, most likely due to an electrostatic barrier arising as the charged surfactant accumulates at the interface. The commercial, polydisperse nonionic surfactant ethoxy nonylphenol (NP9) loads in good agreement with local-equilibrium theory but shows deviation from the theoretical washout curve, presumably due to slow desorption of solubilized but otherwise water insoluble components. The polymeric nonionic triblock copolymer Pluronic exhibits almost complete irreversible adsorption at the air/water interface over a molecular-weight range from 3 to 14 kDa. Similar irreversible dynamic behavior is observed for adsorption/desorption of the protein bovine serum albumin (BSA) from dilute aqueous solutions at the air/water interface. The new continuous-flow tensiometer (CFT) is a simple, yet powerful, tool to investigate sorption dynamics at fluid/fluid interfaces, especially for larger molecular weight surface-active agents that exhibit significant hindrance to desorption.

Adsorption↗

The dynamics of vortex-like reentry wave filaments in three-dimensional computer models.

Recent studies using computer simulation and biological studies in 2-dimensional excitable media have suggested that spiral wave reentrant activation and its core dynamics are important elements in the mechanism of functional reentrant tachyarrhythmias, such as atrial and ventricular fibrillation. However, vortex-like reentry has been observed in homogeneous 3-dimensional excitable media, and the dynamics of the related "filaments," which have 3-dimensionally connected "cores" in 2 dimensions, have not been clarified. In order to determine whether the filaments of vortex-like reentry waves can be observed in 3-dimensional media using a mathematical ionic current heart model and whether the abnormal ionic currents in myocardium affect the complexity of the filaments, we studied the qualitative features of vortex-like reentry dynamics using mathematical models in computer simulations. We employed the Luo-Rudy Phase I and the FitzHugh-Nagumo models for our heart media, which were cubic and ventricular shaped, and consisted of 8,000,000 and 5,636,654 myocardial units, respectively. Functional reentry, in the form of vortex waves, was induced in the media by the S1-S2 method. The vortex-like reentry waves and their filaments were displayed by computer graphics. Computations were performed on an NEC SX-4 supercomputer (NEC, Tokyo, Japan) using programs written in C language. Computer simulation studies have shown that the filament dynamics of vortex-like reentry in the original Luo-Rudy model is considerably more complex than that in the FitzHugh-Nagumo model. However, when we mathematically modified the L-type calcium current and shortened the action potential duration, just as occurs with sustained rapid ventricular pacing, the dynamics of the vortex-like reentrant wave fronts and the filaments were similar in both models. Our results suggested that the original character of myocardium causes drastic changes in filament shape and location, resulting in intricate functional reentrant waves, and that if the L-type calcium current is depressed, the complexity of the dynamics of the filaments are decreased to some degree.

Calcium↗

Effect of complete dentures on dynamic measurement of changing head position: A pilot study.

STATEMENT OF PROBLEM: Complete dentures contribute significantly to the facial esthetics of edentulous patients. However, information as to the effect of complete dentures on the natural position of the head is limited. PURPOSE: The purpose of this pilot study was to evaluate the immediate and 30-day effect of wearing complete dentures on the dynamic natural head position measured during walking. MATERIALS AND METHODS: The sample consisted of a volunteer group of 16 patients, 8 women and 8 men, who received new complete dentures. The ages of the subjects ranged from 45 to 64 years (mean=52 years). Dynamic measurement of head posture was carried out by a specially constructed inclinometer device. Each subject in turn was fitted with the inclinometer system and instructed to walk in a relaxed manner for 5 minutes. The data, measured as degrees, were stored in a pocket data logger. This procedure was repeated before insertion of dentures (T1), immediately after insertion of dentures (T2), and 30 days after insertion of dentures (T3). Stored dynamic head posture data were transferred to computer for analysis. The means of the measurements were statistically compared with Friedman and following Wilcoxon tests (alpha =.05). RESULTS: Twelve of 16 (75%) subjects showed an average of 4.6 degrees of cranial extension immediately after insertion of dentures. Six (37.5%) subjects showed an average of 6.4 degrees of cranial flexion, and 8 (50%) subjects showed an average of 5.2 degrees of cranial extension at T3 relative to the T1 measurement. Dynamic head posture measurements of the other 2 subjects remained unchanged. There were significant differences between different measurements of dynamic head posture positions (P<.025). However, only the T1 and T2 measurements were significantly different (P<.015). CONCLUSION: The findings indicate that the statistically significant average extension 4.6 degrees in subjects immediately after insertion of complete dentures was not stable after a 30-day evaluation period and did not produce any statistically significant change. The overall effect of wearing dentures was an irregular flexion or extension pattern on dynamic head posture.

Dental Occlusion, Balanced↗

Viscoelasticity of dynamically fixed bioprosthetic valves. II. Effect of glutaraldehyde concentration.

OBJECTIVE: We have previously shown the benefits of dynamic fixation over conventional static fixation of bioprosthetic valves. In an attempt to increase the durability of bioprosthetic heart valves, we explored the benefit of low-concentration glutaraldehyde dynamic fixation. METHODS: Pig aortic valves obtained fresh from the abattoir and excised with the entire root were dynamically fixed in glutaraldehyde phosphate buffer solutions varying in concentration from 0.05% to 2.5%. Denaturation temperatures were measured and mechanical testing was performed at low (3 mm/sec) to high physiologic rates (30 mm/sec) at 37 degrees C in isotonic modified Hanks solution. RESULTS: When fixed dynamically in 0.05% glutaraldehyde solution for 24 hours, the tissue reached a degree of cross-linking (denaturation temperature = 82.8 degrees +/- 0.6 degree C) significantly higher than that obtained for 0.05% static fixation (denaturation temperature = 79.3 degrees +/- 0.9 degree C) (p < 0.05) but similar to that for conventional static fixation in 0.5% glutaraldehyde solution (denaturation temperature = 83.5 degrees +/- 0.3 degree C). After fixation in low-concentration glutaraldehyde (0.05%), final relaxation slopes and moduli in the circumferential direction were significantly higher than those for the statically fixed tissue but similar to those for the fresh tissue. However, both dynamic and static fixation had the effect of increasing tissue extensibility to similar extents in both directions, irrespective of glutaraldehyde concentration. CONCLUSIONS: Dynamic glutaraldehyde fixation of a porcine aortic valve at lower concentrations resulted in a better degree of cross-linking and a material with biomechanical properties that more closely mimic those of natural heart valve tissue.

Animals↗

The characteristics of dynamic overshoots in square-wave jerks, and in congenital and manifest latent nystagmus.

Dynamic overshoots are seen after voluntary re-fixation saccades. They are microsaccadic movements which follow primary saccades and have no delay. The purpose of this study was to examine the prevalence and metrics of the dynamic overshoots seen after involuntary saccades. Using infra-red oculography we demonstrate that dynamic overshoots are a common occurrence in physiological square-wave jerks, congenital nystagmus and manifest latent nystagmus and that these overshoots are saccadic in nature and have the same dynamic characteristics as those seen following voluntary saccades. It is therefore likely that they share common neural commands to those dynamic overshoots seen after a volitional saccade. All dynamic overshoots are postulated to be the unwanted consequence of making a saccade and are simulated in a model of fast oculomotor behaviour which is consistent with known experimental results.

Adolescent↗

Vying for dominance: dynamic interactions control visual fixation and saccadic initiation in the superior colliculus.

By the time you have reached this point, your daily count of alternating saccades and fixations will have increased considerably. So too will have your understanding of the dynamic interactions model. In the superior colliculi, visual fixation and saccadic initiation may be viewed as independent motor plans that compete for dominance across the intermediate layers. Extrinsic input modifies a point location on the retinotopic motor map that is shaped into a motor plan through the intrinsic circuitry of the superior colliculi. Independent motor plans compete for selection in a push-pull fashion and when a saccadic plan ultimately reaches threshold, it produces a strong burst of action potentials that shuts down the remaining regions of the intermediate layers. Modifying the activity of the intermediate layers changes these dynamic interactions in predictable ways. Enhancing the activity of one region facilitates nearby locations and inhibits distant locations. Diminishing the activity of one region inhibits nearby locations and facilitates distant locations. Such effects have been demonstrated in the neurophysiological activity of single cells (Munoz and Istvan, 1998; Olivier et al., 1999) and in behavior (Hikosaka and Wurtz, 1985; Munoz and Wurtz, 1993b). In addition to explaining visual fixation and saccadic initiation during basic saccadic tasks, the dynamic interactions model can explain changes in the timing of saccadic initiation that are observed when this task is modified. Namely, the gap effect, or decreased saccadic reaction times as a consequence of a gap period, occurs because removing fixation decreases the activity of fixation regions and, correspondingly, increases the excitability of saccadic regions. Express saccades, are a special instance of such dynamic interactions, in which decreased fixation activity and heightened motor preparation signals cause the target-related activity to be translated into a saccadic signal immediately. Finally, the slowing of saccadic initiation for antisaccades, can be interpreted as the consequence of multiple competing signals across the intermediate layers. It should be emphasized that the dynamic interactions that we have described in this chapter are not limited to the superior colliculi. On the contrary, similar interactions take place at many levels of the neuraxis (Moschovakis et al., 1996; Leigh and Zee, 1999; Schall and Thompson, 1999; Hikosaka et al., 2000; Munoz et al., 2000; Glimcher, 2001; Scudder et al., 2002). At this juncture, however, the dynamic interactions involved in producing visual fixation and saccadic initiation are better understood in the superior colliculi because of its well-organized motor map and its well-characterized neuronal elements. Although we are a long way from understanding how the brain controls visual fixation and saccadic initiation, we have made substantial progress in understanding these behaviors in the superior colliculi.

Fixation, Ocular↗

Dynamic and static moduli of elasticity of resin-based materials.

OBJECTIVES: The purpose of this study was to assess and compare the elastic moduli of 34 resin-based materials using a dynamic and a static method. The effect of water storage was also studied up to 6 months. METHODS: Five samples of each material were prepared according to ISO-4049. The dynamic moduli were first determined non-destructively from the fundamental period of the vibrating specimen, then the static moduli were determined by a three-point bending test. The percentages of fillers by weight were determined by ashing in air at 900 degrees C. RESULTS: Low values were obtained with flowable composites as well as with two packable resin composites. Correlations were found between the static and the dynamic modulus of elasticity (r = 0.94; p = 0.0001) as well as between the weight percentage of fillers and the moduli of elasticity (r = 0.82; p < 0.05 for static modulus and r = 0.90; p < 0.05 for the dynamic modulus) both at 24h. Water storage significantly affected both static and dynamic moduli of elasticity (ANOVA two factors; p < 0.05). SIGNIFICANCE: The low moduli of the flowable composites do not allow their use in posterior cavities under high stress. However, this does not exclude their use for minimally-invasive Class I cavities when the opposing tooth is stabilized to a large amount on the natural enamel. The Grindosonic method is very useful and simple for determining the dynamic moduli although it gives higher values than the static one. The elastic modulus evolution of resin-based materials after water storage is unpredictable since different patterns were observed as a function of time.

Analysis of Variance↗

Cervical spine instability: clearance using dynamic fluoroscopy.

Cle aring the cervical spine in a multiply injured trauma patient is a dilemma because clinical examination for ligamentous instability cannot be performed, and the standard cervical spine series can miss isolated ligamentous injury. Static flexion/extension views are unsafe, as the obtunded patient has no protective reflexes and cannot complain of pain during the exam. This results in a need for prolonged spinal immobilization and its attendant complications. Dynamic fluoroscopy may be useful in the detection of otherwise occult injuries.We performed a prospective study of a cervical spine clearance algorithm incorporating dynamic fluoroscopy with flexion/extension views. Inpatient records over a 3-year period were reviewed. Patient demographic data, results of cervical spine films and fluoroscopic exams, interventions based on positive results, and missed injuries were recorded.One hundred ten patients with normal spine plain films underwent dynamic fluoroscopy with flexion and extension views of the cervical spine. The average Glasgow Coma Score was 9.2 and the average revised Trauma Score was 9.5. Nine patients had evidence of cervical instability on exam. Six of these were deemed stable by the orthopedic or neurosurgical spine consultants, and these patients had their hard collars removed. One patient with positive findings had cervical immobilization with hard collar continued, a second had halo placement, and a third underwent spinal fusion for atlanto-occipital disassociation. No patients undergoing dynamic fluoroscopy were subsequently found to have missed cervical spine injury.With our protocol, 3 patients had significant cervical instability that would have been missed without dynamic fluoroscopy. Given the significant medical and legal ramifications of missed cervical spine injury and the benefits of early removal of cervical collars, more widespread use of dynamic fluoroscopy of the cervical spine is warranted.

Journal Article↗

Dynamic characterization of recombinant Chinese hamster ovary cells containing an inducible c-fos promoter GFP expression system as a biomarker.

An inducible reporter gene system for Chinese Hamster Ovary (CHO-DHFR(-)) cells has been developed and characterized with respect to its dynamic properties. The reporter gene system consists of the human c-fos promoter and variants of the green fluorescence protein (GFP), either EGFP with enhanced fluorescence or its destabilized form d2EGFP. The expression of wild-type EGFP or its destabilized form was studied in CHO-DHFR(-) cells in response to serum addition or deprivation. It was shown that serum-induced c-fos promoter mediated EGFP expression was considerably higher than expression from the human CMV promoter, a strong, constitutive promoter preferentially used for high-level expression in CHO cells. However, EGFP was less suitable for studying expression dynamics than d2EGFP due to the protein's long half-life in mammalian cells. The use of d2EGFP resulted in a significant improvement in the dynamic characteristics of the biomarker, particularly when the recombinant cells were selected for high-level GFP expression by subcloning or fluorescence activated cell/sorting (FACS). GFP expression in different subclones and cell populations sorted by FACS was characterized with respect to its dynamic responses in the presence or absence of serum in the culture medium. Significant differences in the GFP expression dynamics were observed for the isolated cell populations. The experimental results indicate that cells with high-level GFP expression also have a faster dynamic response and are thus, desirable for practical application of the reporter gene system e.g. in toxicity monitoring.

Animals↗

Dynamic model of the vergence eye movement system: simulations using MATLAB/SIMULINK.

A dynamic model of the vergence eye movement system was developed and simulated using MATLAB/SIMULINK. The model was based on a dual-mode dynamic model previously written in FORTRAN. It consisted of a fast open-loop component and a slow closed-loop component. The new model contained several important modifications. For example, in the fast component, a zero-order hold element replaced the sampler and the target trajectory estimator in the earlier model to provide more stable and accurate responses. Also, a periodicity detector was added to automatically detect periodicity in the stimulus waveform. The stored periodic stimulus, with a reduction in latency, was used to drive the fast component output. Moreover, a connection representing the efference copy signal was added from the fast component output to the disparity input to provide an accurate estimate of the stimulus waveform. Further, Robinson's model of the extraocular muscles replaced the earlier 2nd-order plant to provide more realistic muscle dynamics. The entire model, containing the fast and slow components, was simulated using a variety of stimuli such as pulses, positive and negative ramps, square-wave, and sine-wave. The responses showed dynamic characteristics similar to experimental results. Thus, this new MATLAB/SIMULINK program provides a relatively easy-to-use, versatile, and powerful simulation environment for investigating the basic as well as clinical aspects of vergence dynamics. Moreover, the simulation program has general characteristics that can be modified to represent other oculomotor systems such as the versional and accommodation systems. This provides a framework for future investigation of dynamic interactions between oculomotor systems.

Computer Simulation↗

A role for phosphorylation in the dynamics of keratin intermediate filaments.

Keratins undergo highly dynamic events in the epithelial cells that express them. These dynamic changes have been associated with important cell processes. We have studied the possible role of keratin phosphorylation-dephosphorylation processes in the control of these dynamic events. Drugs that affect the protein phosphorylation metabolism (activators or inhibitors of protein kinases or protein phosphatases) have been used in two different dynamic experimental systems. First, the behaviour of keratins after the formation of cell heterokaryons, and second, the assembly of a newly synthesised keratin after transfection into the pre-existing keratin cytoskeleton. The main difference between these two systems stems on the alteration of the amount of keratin polypeptides present in the cells, since in heterokaryons this amount was unaltered whilst in transfection experiments there is an increase due to the presence of the transfected protein. We observed in both systems that the inhibition of protein kinases led to a delayed dynamic behaviour of the keratin polypeptides. On the contrary, the inhibition of protein phosphatases by okadaic acid or the activation of protein kinases by phorbol esters promoted a substantial increase in the kinetics of these processes. Biochemical studies demonstrate that this behavioural changes can be correlated with changes in the phosphorylation state of the keratin polypeptides. As a whole, present results indicate that the highly dynamic properties of the keratin polypeptides can be modulated by phosphorylation.

Adenine↗

Protein machine model of enzymatic reactions gated by enzyme internal dynamics.

The slow character of conformational transition dynamics in native proteins, recently becoming more and more apparent, makes conventional theories of chemical reactions inapplicable for the description of enzymatic reactions. Any contemporary statistical theory of biochemical processes has to be based on a possibly simple but realistic model of microscopic dynamics of participating biomolecules. In a model considered in this paper the dynamics of enzymatic protein is approximated by a quasi-continuous diffusive motion of its solid-like structural elements relative to each other. The enzymatic reaction is assumed to involve three steps (a covalent tranformation preceded and followed by association-dissociation processes with the substrate and the product), each step being gated by conformational diffusion. In general, the reaction proceeds in three stages: initial, transient and steady-state. Carefully approximated analytical formulae describing the kinetics in each stage are derived. In the limit of the fast internal dynamics of the enzyme, when compared to the local chemical transformations, the initial stage of reaction, dependent on the initial distribution of enzyme conformations, is absent and all the formulae describing the remaining two stages simplify to those provided by the classical theory of Haldane. However, following recent studies, the rule seems to be that it is the conformational dynamics of the enzyme, and not the details of chemical mechanism, that affects the rate of enzymatic reaction. Apart from the possibility of the initial inhomogeneous kinetics, the important result obtained in the limit of slow conformational dynamics is that the kinetic mechanisms of a reaction differ in general between the transient and steady-state stages. Possibilities of carrying out an experimentum crucis directly discrediting the conventional approach are considered.

Journal Article↗

Dynamic myocardial velocity changes between phases of the cardiac cycle.

The purpose of this study was 1. to define relationships between myocardial velocities according to phases and the range of dynamic phasic changes in controls using tissue Doppler echocardiography (TDE); 2. to compare the usefulness of dynamic changes vs. peak velocities alone on controls and patients. Peak velocity changes between phases were studied by colour M-mode TDE in the posterior wall from pre-ejection to systole (ejectional wall velocity increase) and from ejection to early diastole (early diastolic wall velocity increase) in 17 age-matched controls and a group of 30 patients with dilated cardiomyopathies (CMy) consisting of ischaemic (14) and nonischaemic (16) CMy with similar clinical and echocardiographic presentations. Systolic were correlated with early diastolic peak velocities (r = 0.79 p < 0.0001). Velocity values were significantly lower in patients than in controls (p < 0.001) as well as dynamic ejectional (p = 0.02) and early diastolic (0.03) increases. Dynamic changes were closely similar to controls (74 +/- 7%, 46 +/- 14%) in nonischaemic CMy (66 +/- 18%, 39 +/- 10% NS, respectively), but markedly reduced in ischaemic CMy (28 +/- 59%, and 26 +/- 31%, p = 0.005 and p = 0.06 vs. nonischaemic CMy, respectively). Of patients with ischaemic CMy, 78% had an ejectional increase < 40% and/or an early diastolic increase < 25%. Thus, correlation exists between systolic and early diastolic velocities. Normal range of dynamic changes was defined in an elderly population. Results suggest that velocity dynamics might be more informative than peak velocities alone to show left ventricular dysfunction.

Adult↗

Surface and peripheral doses of dynamic and physical wedges.

PURPOSE: The physical and dosimetric differences between three different wedge systems on a multileaf collimator (MLC) equiped linear accelerator are discussed in this report. In particular, the in-field and peripheral surface doses from these wedge systems are measured and their clinical differences discussed. METHODS AND MATERIALS: A parallel-plate chamber was used in a solid water phantom to measure the surface doses of the wedges. Published correction factors were used to convert relative ionization to relative surface dose. Measurements were performed for 6 and 18 MV photon beams for different field sizes, source-surface distances (SSD), and distances outside the field for peripheral dose measurements. Surface-dose profiles across a field in the wedge-gradient direction were measured for the dynamic and upper wedges. Dose profiles in the nonwedge gradient direction were measured for open beam as well as the three wedges using films at depths of maximum dose (d(max)). RESULTS: At 85 cm SSD, surface doses on the central axis under a dynamic wedge or upper wedges are similar to those of an open field, while those of a lower wedged field are as much as 100% higher. Differences in surface doses due to beam energy are relatively minor compared with differences due to SSD or wedge systems. Dynamic and upper wedges produce similar peripheral doses, much lower than those produced by the lower wedges. The surface dose profile across the field under the dynamic wedge has a higher slope than that under the upper wedge, when the difference in wedge angles is compensated for by normalization to the dose profile at d(max). In the nonwedge gradient direction, the dose profiles at d(max) of both the upper and the lower wedges demonstrate a marked effect of oblique filtration of the primary beam, resulting in an off-axis ratio at 80% of the field width of 0.95, in contrast to the off-axis ratio of 1.05 in the open and the dynamic wedged fields. CONCLUSIONS: The three wedge systems produce significantly different surface and peripheral doses that should be considered in properly choosing a wedge system for clinical use. Dynamic wedge and upper wedge systems deliver surface and peripheral doses similar to those of open fields and much lower than the lower wedge system. Both physical wedge systems degrade beam profiles in the nonwedged direction.

Equipment Design↗

A dynamic model for the estimation of optimum timing of computed tomography scan for dose evaluation of 125I or 103Pd seed implant of prostate.

PURPOSE/OBJECTIVE: The dosimetric evaluation of permanent 125I or 103Pd prostate implant is based on the assumption that both prostate and seeds are static throughout the entire treatment time which lasts months. However, the prostate is often edematous after the surgical implantation of seeds. Therefore, both the volume of the prostate and the seed locations change dynamically as the edema resolves. This effect has impact on the validity of postimplant analysis based upon a CT scan. If a CT scan is taken too early after implantation while there is edema in the prostate, the dose delivered by the implant may be underestimated. If the imaging is delayed too long, the dose may be overestimated. The magnitude of this effect depends on both of the half-life of the isotope used and the half-life and magnitude of the edema. This study describes a dynamic biomathematical model which takes edema into account in calculating the dose delivered by the implant and is used to investigate the optimum time to obtain the postimplant CT scan. MATERIALS AND METHODS: The dynamic biomathematical model is a numerical integration of the accumulated dose in which the prostate dimensions, the seed locations, and the source strength are all functions of time. The function which describes the change in prostate dimensions and seed locations as a function of time was determined in a separate study by analysis of serial postimplant CT scans. Dose-volume histograms (DVH) of the prostate for the total dose generated by the dynamic model are compared to DVHs generated by CT scans simulated for postimplant intervals ranging from 0 to 300 days after the implantation for 30 different combinations of the magnitude and duration of edema. RESULTS: DVHs of the prostate calculated by taking edema into account show that the time of obtaining a CT scan for postimplant analysis is critical to the accuracy of dose evaluations. The comparison of the DVHs generated by the dynamic model to those generated by the CT scans simulated for a range of postimplant intervals show that obtaining the CT scan too early tends to underestimate the total dose while obtaining the CT scan after the edema is resolved tends to overestimate it. The results show that the optimum timing of the CT scan depends upon the duration of the edema and the half-life of the radioisotope used. It is almost independent of the magnitude of the edema. Thus, a unique optimum time window for the imaging study cannot be defined for either 125I or 103Pd implants. However, an optimum time window can be identified for which the calculated dose, on the average, will generally differ from the actual dose by less than 5%, with a maximum error not exceeding 15%. Such a window is 4 to 10 weeks after the implantation for an 125I implant, and 2 to 4 weeks for a 103Pd implant. CONCLUSIONS: A dynamic biomathematical model to correct for the effects of edema in calculating the total dose delivered by an 125I or 103Pd seed implant has been developed. The model has been used to investigate the optimum time window during which the postimplant CT scans for analysis should be obtained.

Brachytherapy↗