[Clinical target volume : Principles and limits]

BACKGROUND

The clinical target volume (CTV) is regarded fundamental for radiotherapy planning by the International Commission on Radiation Units and Measurements (ICRU).

OBJECTIVES

The aim of this article is to give an overview on the basics and problems of defining the CTV for radiotherapy planning.

MATERIALS AND METHODS

After briefly defining CTV, a short description of the process to homogenize CTV in intraindividual comparisons is given, where special attention is paid to radiological requirements. This information is summarized in a number of tables.

RESULTS

CTV is the most complex volume among the target volumes that have been defined by the ICRU. A survey of the determinants of the definition of CTV is given.

CONCLUSIONS

This overview on the basic rules of how to define CTVs can help to increase the understanding of the radiological requirements for optimum imaging to support radiotherapy planning regardless of the specialty of the physician.

Search for resonant production of second-generation sleptons with same-sign dimuon events in proton-proton collisions at s = 13 TeV

A search is presented for resonant production of second-generation sleptons (μ ~ L ,ν ~ μ ) via the R-parity-violating coupling λ 211 ' to quarks, in events with two same-sign muons and at least two jets in the final state. The smuon (muon sneutrino) is expected to decay into a muon and a neutralino (chargino), which will then decay into a second muon and at least two jets. The analysis is based on the 2016 data set of proton-proton collisions ats = 13 TeV recorded with the CMS detector at the LHC, corresponding to an integrated luminosity of 35.9fb - 1 . No significant deviation is observed with respect to standard model expectations. Upper limits on cross sections, ranging from 0.24 to 730fb , are derived in the context of two simplified models representing the dominant signal contributions leading to a same-sign muon pair. The cross section limits are translated into coupling limits for a modified constrained minimal supersymmetric model with λ 211 ' as the only nonzero R-parity violating coupling. The results significantly extend restrictions of the parameter space compared with previous searches for similar models.

Mutations in TBCK, Encoding TBC1-Domain-Containing Kinase, Lead to a Recognizable Syndrome of Intellectual Disability and Hypotonia

Through an international multi-center collaboration, 13 individuals from nine unrelated families and affected by likely pathogenic biallelic variants in TBC1-domain-containing kinase (TBCK) were identified through whole-exome sequencing. All affected individuals were found to share a core phenotype of intellectual disability and hypotonia, and many had seizures and showed brain atrophy and white-matter changes on neuroimaging. Minor non-specific facial dysmorphism was also noted in some individuals, including multiple older children who developed coarse features similar to those of storage disorders. TBCK has been shown to regulate the mammalian target of rapamycin (mTOR) signaling pathway, which is also stimulated by exogenous leucine supplementation. TBCK was absent in cells from affected individuals, and decreased phosphorylation of phospho-ribosomal protein S6 was also observed, a finding suggestive of downregulation of mTOR signaling. Lastly, we demonstrated that activation of the mTOR pathway in response to L-leucine supplementation was retained, suggesting a possible avenue for directed therapies for this condition.

Interaction of UV light-induced alpha-tocopherol radicals with lipids detected by an electron spin resonance prooxidation effect

The reaction rate constants of the interaction between light-induced alpha-tocopherol radicals with unsaturated lipids in a heterogeneous system compared to a homogeneous system are of the same order of magnitude. The decay rates of compartmentalized alpha-tocopherol radicals were significantly reduced by using negatively charged sodium dodecyl sulfate (SDS) micelles. A partially resolved electron spin resonance (ESR) hyperfine structure was observed under the conditions of both high lipid concentrations in comparison to the alpha-tocopherol concentration and of a regular distribution of alpha-tocopherol molecules inside the heterogeneous lipid structures. Alpha-tocopherol radicals have a considerable prooxidation potential at higher concentrations. Ascorbic acid dissolved in the aqueous medium provokes very fast alpha-tocopherol radical recycling through the boundary layer between the aqueous medium and micelles. By contrast, very slow reactions such as those of alpha-tocopherol radicals with glutathione through this boundary layer are measurable. Despite using the heterogeneous SDS micellar system, the decay kinetics of the alpha-tocopherol radical ESR signal is simply compounded. In addition to the known stabilization effect of cholesterol in membrane systems, cholesterol itself acts as a target molecule attacked by free radicals, e.g. alpha-tocopherol radicals. Using stratum corneum extracts that contain unsaturated lipids and cholesterol the alpha-tocopherol radical can prooxidatively react with these compounds. Using focused UV light generates a high radical yield in a relatively short time compared to the lifetime of the alpha-tocopherol radicals. The decay processes after radical induction can be characterized as consecutive reactions. The compartmentalization of radicals induced in SDS micelles and the close proximity of target molecules are essential if very slow one-electron reductions are to be measured.

Oxidative damage of human skin lipids. Dependence of lipid peroxidation on sterol concentration

Photoprotection against sunburn and associated irradiation-induced damages of the human skin is mainly attributed to the darkening of the biochrome melanin by its oxidation. Human skin lipids were examined for an additional protection by sterols. Lipid vesicles prepared from extracted human skin lipids as well as from mixtures of typical lipids of the stratum corneum were irradiated by UV light in the presence and absence of oxygen. The oxidative degradation of various lipids was measured by quantitative HPTLC, by the dichlorofluorescein fluorescent assay, by the thiobarbituric acid assay and a novel luminol-based chemiluminescence technique. Electron spin resonance was used to look for certain radical intermediates. The results indicate, that sterols, mainly free cholesterol, with their high concentration in the lipid barrier of the stratum corneum (up to 50 mol%) effectively compete with the peroxidation of other human skin lipids (ceramides and free fatty acids).