مجله دانشکده پزشکی اصفهان
پیاپی 543 (هفته سوم آبان 1398)

Intensity-Modulated Radiation Therapy (IMRT) is one of the best methods in the treatment of optic nerve sheath meningioma (ONSM) with tumor growth control and visual stabilization. In this study, various IMRT techniques were evaluated from the point of view of dose fall-off beyond the target boundaries to achieve the optimal technique.

The optimization of 3 IMRT techniques was performed using 3, 5, and 7 fields with 6 MV photons in 15 patients with ONSM using Prowess Panther treatment planning system. To evaluate treatment plans, in addition to data extracted from dose-volume histogram (DVH) and evaluation of target coverage indices, differential and cumulative dose gradient indices (DGIs) were calculated and compared between the three techniques.

The maximum and the mean dose received by the tumor increased with increasing number of IMRT fields. The uniformity (UI) and homogeneity (HI) indices were significantly different between the 3-field and 7-field techniques; and the conformity index (CI) was close to ideal value (0.99) in 7-field technique. Difference of differential dose gradient index (dDGI) was negligible between the three techniques, and only at the 45% isodose level, there was a significant difference between the 5- and 7-field techniques. Cumulative dose gradient index (cDGI) showed smaller values in 7-field technique than the other two techniques.

The three IMRT techniques have no considerable statistical difference in dose fall-off rate beyond tumor boundaries; and their choice in the treatment of ONSM depends on the physician's discretion based on the whole patient's conditions.

Since the effect of immobilization of the upper limb, despite its importance, is usually neglected in the analysis of gait, the purpose of the present study was to assess the effect of removal upper limb arm swing on 3-dimentional (3D) body center of mass displacement during gait.

20 healthy women were asked to walk at normal speed in two conditions of normal upper extremity arm swing. The location of body mass center was determined by force plate, and then the data were analyzed using statistical descriptive, Kolmogorov-Smirnov, and paired t tests (P < 0.0.5).

Except for displacement in the vertical plate (P = 0.04), the center of mass in the anterior-posterior (P = 0.30) and lateral planes (P = 0.08) showed no significant displacement.

Reducing arm swing during walking can increase the vertical displacement of the center of mass, and the magnitude of the force exerted from the ground. Sport and rehabilitation clinicians should consider this statement.

The aim of this study was to evaluate the effects of neostigmine on inflammatory parameters and histopathological changes of granulation tissue.

The Air Pouch model was developed in six groups of male Wistar rats. Briefly, the rats were anesthetized, and then 20 ml and 10 ml of sterile air were injected subcutaneously (SC) on the back of the animals on days 0 and 3, respectively. On day 6, inflammation was induced by injection of 2 ml of carrageenan 1% into pouches. Normal saline as control and neostigmine (35, 70, 140, 200, and 310 µg/kg) was administered intraperitoneally (IP) concurrently with carrageenan. After 6 hours, the rats were sacrificed; pouch fluid was collected to determine exudate volume and the number of accumulated cells. The pouches were dissected out and weighed, and histopathological characteristics were evaluated.

Neostigmine (70 µg/kg) reduced leukocyte accumulation (P < 0.050), exudate volume (P < 0.001), and granulation tissue weight (P < 0.001) compared to the carrageenan control group. Inflammatory parameters were increased by neostigmine 200 μg/kg (P < 0.050). The results of histopathological studies of granulation tissue showed that higher doses of neostigmine provided more anti-inflammatory effects.

From this study, it may be concluded that in the air pouch inflammatory model, neostigmine at different doses has different effects on peripheral inflammation. These effects are likely mediated by regulatory effects of the agent on the immune system.