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• Guidelines for the fabrication of custom molds using dental putty are provided. • Fundamental dosimetric characteristics of dental putty were measured using films. • High-dose-rate brachytherapy using dental putty-based custom mold is feasible. • Pretreatment dosimetry is desirable when dental putty mold is used. To investigate the feasibility of using dental putty to fabricate custom molds for high-dose-rate (HDR) brachytherapy of oral mucosal melanoma. Practical guidelines of using dental putty for the custom mold fabrication are presented. Dose measurements were performed using radiochromic films to understand the dosimetric characteristics of dental putty. The percentage depth dose (PDD) and profile curves were obtained using a single Co-60 source located on top of a cubic volume of the dental putty. Two custom molds were fabricated for a patient with mucosal melanoma lesions, which were spread throughout the right mandibular gingiva and soft palate regions. Furthermore, pretreatment dosimetry for both lesions was performed to evaluate the delivery quality of the resulting HDR brachytherapy plans and adjust the overall dose level. Prescribed doses for the two oral cavity regions were successfully delivered with a reasonable dose uniformity. Based on the measured single-source PDD curve, the maximum dose was observed at a depth of approximately 1 mm, which indicated steep dose gradients at depths ranging from 0 to 2 mm. Furthermore, a simulation with the measured single-source two-dimensional profile revealed that a source-to-source distance of 10 mm was appropriate to generate a uniform dose distribution at a source-to-surface distance of 5 mm. The use of a custom mold was found to be feasible for HDR brachytherapy while carefully considering the source-to-surface and source-to-source distances. Pretreatment delivery verification would be necessary when a uniform dose distribution is required. [ABSTRACT FROM AUTHOR]

Our purpose was to investigate the interfraction and intrafraction reproducibility and practical applicability of continuous positive airway pressure (CPAP) for left breast volumetric modulated arc therapy (VMAT). Interfraction reproducibility of the position of the heart was evaluated by measuring the heart-to-target distance on 20 planning computed tomography (CT) and 300 daily cone beam CT of 20 patients with left breast cancer treated with a 15-fraction VMAT. The dosimetric metrics of the whole heart and its substructures were compared between CPAP and free-breathing based VMAT plans. Intrafraction reproducibility was evaluated by measuring the motions of the breast target and diaphragm in 4-dimensional CT of 20 female patients with nonbreast cancer. Lastly, we analyzed the CPAP compliance data of 237 consecutive patients with left-sided breast cancer with and without internal mammary node irradiation (IMNI). The heart position was reproducible as evidenced by an absolute average heart-to-target distance error of 2.0 ± 2.0 mm. Compared with free-breathing, CPAP significantly reduced the mean heart dose and the dose to the left ventricle and left anterior descending artery. The average intrafraction position variation of the breast target was 0.5 ± 0.5, 2.5 ± 2.0, and 1.8 ± 1.4 mm in the mediolateral, craniocaudal, and anteroposterior directions, respectively. CPAP was successfully applied in 221 patients (93%), with a mean heart dose of 1.6 ± 0.7 Gy (IMNI: 2.0 Gy and no IMNI: 1.1 Gy). CPAP has adequate heart-sparing capability and sufficient reproducibility in VMAT for left-sided breast cancer treatment, with a high compliance rate. Thus, CPAP is applicable in routine practice for left-sided breast cancer radiation therapy. [ABSTRACT FROM AUTHOR]

Exercise-based cardiac rehabilitation (CR) is a class 1A recommendation for patients with cardiovascular disease (CVD). However, the reality is that the participation rate of CR in Korea is disastrously low. This study aimed to identify physical activity (PA) levels and to evaluate the preferences and barriers to exercise in patients with CVD. A total of 189 (143 males, 46 females) participants aged 19-75 years who had a history of either heart failure with reduced ejection fraction (HFrEF) or myocardial infarction (MI) were surveyed at an outpatient clinic in a single tertiary hospital from April to June 2021. Their demographic information, domain-specific PA levels (Global Physical Activity Questionnaire), sedentary time, exercise preferences, and exercise barriers were retrieved. Data on heart disease diagnosis and medical history of comorbidities were collected from electronic medical records. The participants' average age was 62 ± 12 years, where 84.7% accounted for HFrEF and 51.3% for MI. 63% of the participants were currently exercising, where those participating in any leisure PA was 43.4%, and those meeting the guideline (≥ moderate PA 150 mins/week) based on leisure PA was 26.5%. Exercising alone (43.5%) or with family (31.4%) was preferred to exercising with friends (11.6%), an expert (6.9%), CVD patients (2.1%), and others (3.7%). Exercising outside (37.0%) or at home (29.8%) was preferred to exercising at a fitness center (10.6%) or the hospital (0.5%). The participants chose walking (66.0%), resistance exercise (35.1%), overstretching (19.0%), and dancing (7.9%). The preferred amount of exercise was ≥30 mins/day (66%), and ≥4 times/week (52.4%). The most common exercise barriers were fatigue (34.0%), low level of fitness (28.5%), and poor self-perceived health (26.4%). The current study provided the PA status of CVD patients along with exercise preferences and barriers that will serve as valuable data for establishing CR programs that better encompass the needs of participants and increase the participation rate. [ABSTRACT FROM AUTHOR]

Objective To investigate the anti-inflammatory effects and the action mechanism of the fruits of Hovenia dulcis ( H. dulcis ) in lipopolysaccharide (LPS)-induced mouse macrophage Raw 264.7 cells. Methods The extract of H. dulcis fruits (EHDF) were extracted with 70% ethanol. Mouse macrophages were treated with different concentrations of EHDF in the presence and absence of LPS (1 μg/mL). To demonstrate the inflammatory mediators including nitric oxide, inducible nitric oxide synthase and cyclooxygenase (COX)-2 expression levels were analyzed by using in vitro assay systems. COX-derived pro-inflammatory cytokines including interleukin-1β, tumor necrosis factor-α and prostaglandin E 2 were determined using ELISA kits. Cell viability, heme oxygenase-1 expression, nuclear factor-kappaB and nuclear factor E 2 -related factors 2 translocation were also investigated. Results EHDF potently inhibited the LPS-stimulated nitric oxide, inducible nitric oxide synthase, COX-2, interleukin-1β and tumor necrosis factor-α expression in a dose-dependent manner. EHDF suppressed the phosphorylation of inhibited kappaB-alpha and p65 nuclear translocation. Treatment of macrophage cells with EHDF alone induced the heme oxygenase-1 and nuclear translocation of nuclear factor E2-related factor 2. Conclusions These results suggest that the ethanol extract of H. dulcis fruit exerts its anti-inflammatory effects by inhibiting inhibited kappaB-alpha phorylation and nuclear translocation of nuclear factor-kappaB. [ABSTRACT FROM AUTHOR]