Perspectives in linear accelerator for FLASH VHEE: Study of a compact C-band system

PURPOSE

In order to translate the FLASH effect in clinical use and to treat deep tumors, Very High Electron Energy irradiations could represent a valid technique. Here, we address the main issues in the design of a VHEE FLASH machine. We present preliminary results for a compact C-band system aiming to reach a high accelerating gradient and high current necessary to deliver a Ultra High Dose Rate with a beam pulse duration of 3μs.

METHODS

The proposed system is composed by low energy high current injector linac followed by a high acceleration gradient structure able to reach 60-160 MeV energy range. To obtain the maximum energy, an energy pulse compressor options is considered. CST code was used to define the specifications RF parameters of the linac. To optimize the accelerated current and therefore the delivered dose, beam dynamics simulations was performed using TSTEP and ASTRA codes.

RESULTS

The VHEE parameters Linac suitable to satisfy FLASH criteria were simulated. Preliminary results allow to obtain a maximum energy of 160 MeV, with a peak current of 200 mA, which corresponds to a charge of 600 nC.

CONCLUSIONS

A promising preliminary design of VHEE linac for FLASH RT has been performed. Supplementary studies are on going to complete the characterization of the machine and to manufacture and test the RF prototypes.

An integrated approach with homeopathic medicine and electro-acupuncture in anaesthesiology during breast cancer surgery: Case reports

This study investigates the effect of a combination of homeopathic medicine and electro-acupuncture in two patients with breast cancer and severe liver disease who could not receive standard anaesthesia therapy due to liver problems. Specifically, measurable and quantifiable parameters were used to evaluate whether an integrated approach-consisting of electro-acupuncture and a homeopathic medicine diluted above Avogadro's limit (that is, above a potency of 12CH) during the pre-surgical, surgical and post-surgical phases--can improve general well-being of a patient undergoing breast cancer surgery. In breast cancer surgery, we employed an integrated approach consisting of induction with hypnotics and muscle relaxants, followed by maintenance with anaesthetic gas, combined with a homeopathic treatment (Arnica montana 15CH and Apis mellifica 15CH) before and after surgery and an electro-acupuncture treatment performed in the pre- and post-surgical phases without any analgesic/pain relieving medications. Both of the patients treated with the integrated approach improved their overall condition without need for other common pain relieving medicines. Additionally, thanks to their rapid awakening, the patients were not relocated to a protected area and the hospitalization was shorter. A multidisciplinary approach incorporating homeopathic medicine and electro-acupuncture can be a solution for patients who need or ask about a different and/or safer alternative to the standard treatment. This approach can offer a safe, much less expensive, non-invasive and viable alternative for such cases. Moreover it can be useful for an opioids free anesthesia.

Lipid-lowering effect of bergamot polyphenolic fraction: role of pancreatic cholesterol ester hydrolase

Bergamot polyphenolic fraction (BPF) has been shown to positively modulate several mechanisms involved in metabolic syndrome, suggesting its use in therapy. In particular, it is able to induce a significant amelioration of serum lipid profile in hyperlipemic patients at different levels. The purpose of our study was to investigate the effect of BPF on cholesterol absorption physiologically mediated by pancreatic cholesterol ester hydrolase (pCEH). An in vitro activity assay was performed to study the effect of BPF on pCEH, whereas the rate of cholesterol absorption was evaluated through in vivo studies. In particular, male, Sprague-Dawley rats (200–225 g) were fed either normal chow or chow supplemented with 0.5% cholic acid, 5.5% peanut oil, and varying amounts of cholesterol (0 to 1.5%). BPF (10 mg/Kg) was daily administrated by means of a gastric gavage to animals fed with lipid supplemented diet for 4 weeks and, at the end of the study, plasma lipids and liver cholesteryl esters were measured in all experimental groups. Our results show that BPF was able to inhibit pCEH activity and this effect was confirmed, in vivo, via detection of lymphatic cholesteryl ester in rats fed with a cholesterol-rich diet. This evidence clarifies a further mechanism responsible for the hypolipemic properties of BPF previously observed in humans, confirming its beneficial effect in the therapy of hypercholesterolemia and in the treatment of metabolic syndrome.

Daily motor performance after switching levodopa to melevodopa: an open-label on advanced Parkinson's disease with "delayed-on" and/or"wearing-off"

AIM

Aim of the present study was to evaluate the clinical efficacy, tolerability and quality-of-life measures to melevodopa in advanced Parkinson's disease (PD) with motor fluctuations (MFs).

METHODS

A total of 37 patients with advanced PD and MFs participated in the study. Patients were switched from standard l-dopa/carbidopa to melevodopa and were treated for 10 weeks.

RESULTS

Assessment of "On-Day" time demonstrated improvement to about 0.7 hour in the melevodopa treatment. The benefit was greater in patients with "delayed-on" (P=0.002) and especially in those with both "delayed-on" and "wearing-off" (P<0.001). Most patients showed a significant improvement in PDQ-39 total score (P=0.002) and PSI distress domain (P<0.001). Instead, not significant difference was observed in patients with only wearing-off.

CONCLUSION

These data show that melevodopa is an effective agent for improving daily motor performance and quality-of-life in PD with "delayed-on", also in association with "wearing-off".

Bell's palsy: a manifestation of prediabetes?

BACKGROUND

Idiopathic peripheral facial nerve palsy or Bell's palsy (BP) is the most common cause of facial nerve palsy.

OBJECTIVE

To evaluate the role of glucose metabolism abnormalities in BP.

METHODS

We identified 148 patients with unilateral BP and 128 control subjects. In all we evaluated glucose level at fasting and after a 2-h oral glucose tolerance test (2h-OGTT). In addition we determined insulin resistance (IR), by HOMA-index. Patients and controls were divided in to two groups, according to their Body Mass Index (BMI).

RESULTS

Following a 2h-OGTT, the prevalence of glucose metabolism abnormalities was significantly higher in patients with BP than in controls (P < 0.001). Impaired glucose tolerance (IGT) was found in 57 (38%) patients and in 23 (18%) controls, while a new-diagnosed DM (NDDM) was found in 29 (19%) patients and in 8 (6%) controls. The IR was significantly increased only in BP patients with BMI ≥ 24.9 (P = 0.005). BMI, waist circumference, blood pressure, tryglicerides, serum lipid, drugs use were not significantly different between patients and controls.

CONCLUSIONS

In this study we found that prediabetes is frequently associated with facial palsy. We propose to perform a 2h-OGTT in patients with peripheral facial palsy and normal fasting glycaemia. HOMA-index should be evaluated in obese facial palsy patients.

Decoherence in yeast cell populations and its implications for genome-wide expression noise

Gene expression "noise" is commonly defined as the stochastic variation of gene expression levels in different cells of the same population under identical growth conditions. Here, we tested whether this "noise" is amplified with time, as a consequence of decoherence in global gene expression profiles (genome-wide microarrays) of synchronized cells. The stochastic component of transcription causes fluctuations that tend to be amplified as time progresses, leading to a decay of correlations of expression profiles, in perfect analogy with elementary relaxation processes. Measuring decoherence, defined here as a decay in the auto-correlation function of yeast genome-wide expression profiles, we found a slowdown in the decay of correlations, opposite to what would be expected if, as in mixing systems, correlations decay exponentially as the equilibrium state is reached. Our results indicate that the populational variation in gene expression (noise) is a consequence of temporal decoherence, in which the slow decay of correlations is a signature of strong interdependence of the transcription dynamics of different genes.

Minimization of transcriptional temporal noise and scale invariance in the yeast genome

The analysis of transcriptional temporal noise could be an interesting means to study gene expression dynamics and stochasticity in eukaryotes. To study the statistical distributions of temporal noise in the eukaryotic model system Saccharomyces cerevisiae, we analyzed microarray data corresponding to one cell cycle for 6200 genes. We found that the temporal noise follows a lognormal distribution with scale invariance at the genome, chromosomal and sub-chromosomal levels. Correlation of temporal noise with the codon adaptation index suggests that at least 70% of all protein-coding genes are a noise minimization core of the genome. Accordingly, a mathematical model of individual gene expression dynamics was proposed, using an operator theoretical approach, which reveals strict conditions for noise variability and a possible global noise minimization/optimization strategy at the genome level. Our model and data show that minimal noise does not correspond to genes obeying a strictly deterministic dynamics. The natural strategy of minimization consists in equating the mean of the absolute value of the relative variation of the expression level (alpha) with noise (eta). We hypothesize that the temporal noise pattern is an emergent property of the genome and shows how the dynamics of gene expression could be related to chromosomal organization.

Biomass production of the mycorrhizal fungus Suillus grevillei: effect of pH and ammonium

The ability of the ectomycorrhizal fungus Suillus grevillei (Klotzsch) Singer to grow in agitated submerged culture was investigated by employing the Marx-Melin-Norkrans (MMN) medium. The operating conditions suitable for improving the biomass production were determined. Batch experimental tests were carried out in either shake flasks or a stirred tank reactor. The results showed that at least two factors strongly affected the fungal growth, namely the pH and the ammonia-nitrogen concentration in the medium. By controlling the acidity in the pH range 4-5 with a Na-citrate buffer solution and introducing the ammonia-nitrogen in a step-feed way (without exceeding a concentration of approximately 0.07 kg N/m3), the exponential growth phase continued for longer than that of the control culture (no stationary phase seemed to be reached after 17 days) and an approximately 2-fold increase of the biomass/substrate growth yield was obtained compared with the control culture.

Macro approach and fuzzy modeling of entrapped biocatalyst

The interactions between a strain of Saccharomyces cerevisiae and an alginate matrix are investigated to ascertain the main factors affecting the bioreaction evolution. During the tests several parameters (glucose, ethanol, calcium ion and biomass concentration, pH, and alginate bed diameter) were evaluated, coupled with microscopic investigation inside the beads to determine the spatial biomass distribution. A detailed analysis of macro parameters and a correlation among them are proposed using a fuzzy algorithm. A global two-step fuzzy model results in which biomass distribution inside the beads is represented as a hidden parameter.

Fate of genetically modified Rhizobium leguminosarum biovar viciae during long-term storage of commercial inoculants

A study was carried out to assess the behaviour, in terms of strain survival and genetic stability, of genetically modified micro-organisms (GEMs) during their storage in commercial-type agricultural inoculants. Three genetically modified Rhizobium leguminosarum biovar viciae strains were constructed, using a gene cassette containing an inducible lacZ gene from Escherichia coli and mercury resistance determinants from transposon Tn 1831. In the first case the genes have been integrated into the chromosome, the second strain contains the inducible cassette on a plasmid, in the third case the cassette is carried by the same plasmid, but the lacZ is constitutively expressed at high levels, due to the removal of the regulatory structure (lac operator) between the gene and its promoter. Three inoculum formulations, based on liquid, vermiculite and peat carriers, were prepared using the genetically modified strains, and were monitored during a period of up to 16 months. Results indicate a high stability of the chromosomally integrated markers. The plasmid-borne modification also was very stable, though the presence of the plasmid affected the strain growth kinetics. In contrast, the strain containing the highly expressed lacZ showed dramatic marker instability. Strain behaviour in stored inoculant packages reflected that observed in batch cultures; moreover, prolonged storage appeared to magnify differences found in in vitro cultures.

Acinetobacter radioresistens metabolizing aromatic compounds. 1. Optimization of the operative conditions for phenol degradation

A strain of Acinetobacter radioresistens was able to utilize phenol as the only carbon and energy source, after an acclimatization period of 3 days in which increasing phenol concentrations from 50 to 200 mg/l were supplied. At 30 degrees C, the complete phenol utilization in batch degradation tests occurred in 2.5-3 h at pH 7 and 8, but it increased strongly at pH 6 (over 40 h). No microbial growth was detected at 40 degrees C, while at 20 degrees C (pH 7-8) the time necessary for complete phenol degradation was about twofold longer than that at 30 degrees C (pH 7-8) revealing a good capability of the strain as a seed-micro-organism for enhancing phenol degradation. The bacterial growth in acclimatized cultures, evaluated with the viable cell count, always displayed a trend consistent with the use of phenol as a substrate with an eventual lag phase and then an exponential phase, while in the non-acclimatized cultures an initial stage of cellular death was observed.

[Clinical and functional sequelae of bronchiolitis]

The authors carried out a follow-up on twenty-five children, affected with bronchiolitis in the early years of life, at seven years of age, in order to evaluate their clinical status and pulmonary function. Their parents were questioned about diseases of the small airways following to acute bronchiolitis. PRIST and RAST were effected in fourteen children; an evaluation of the pulmonary function with spirometry, flow-volume curve and body-plethysmography was done in every child. Then the flow-volume curve was repeated after bronchial provocation test with exercise (free running). Abnormalities of the pulmonary function at resting significant for small airways' obstruction were observed. A great number of children with bronchial hyperreactivity (60%) was observed after bronchial provocation test with exercise, particularly in those with genetic predisposition; 6/14 (43%) showed sensitization to many inhalant allergens, without correlation with genetic predisposition, clinical sequences and bronchial hyperreactivity.

[Radioactive phosphorus (32P) in the diagnosis of ocular tumors. Results and therapeutic doses]

Because of phosphorus involvement in metabolic processes, 32P is a suitable radioisotope for the investigation of the function of normal and malignant cells. The basic principles of the 32P test are analysed. This paper presents the results on a series of patients who underwent the 32P uptake test at the Ospedale Oftalmico of Turin. An evaluation of the dose to the patient is also presented.

[Bronchiolitis: new pathogenetic aspects and personal cases]

The etiological, epidemiological and pathogenetical features of bronchiolitis and some clinical and biochemical data concerning seventy nine cases were discussed. It has been underlined the possible pathogenetical role of immunoallergic mechanism (immunoreactions type II, III, IV and VI), and of alterations of humoral immunocompetence (rise of IgM and deficit of IgA). Moreover it has been pointed out that hereditary, socioeconomical and environmental factors could play an important role in determining the seriousness of the clinical picture. The relationship between bronchiolitis and the respiratory diseases of the following years have been examinated.