OBJECTIVE

Spray-freeze drying (SFD) is a recently applied method to develop pharmaceutical powders. This study aimed to analyze the competence of Trehalose, Mannitol, Lactose, and Sorbitol instability and aerosolization of Immunoglobulin G (IgG) via SFD.

METHODS

Induced soluble aggregates were quantified at 0 and 3 months, and 45 °C using size-exclusion chromatography. Conformation and thermogravimetric assessments were done by Fourier transform infrared spectroscopy and differential scanning calorimetry. Laser light scattering was performed to determine the particle sizes. Aerodynamic features were characterized by twin stage impinger and scanning electron microscopy.

RESULTS

Although sugars/polyols preferably stabilized IgG following the process, storage stabilization was achieved in Trehalose, Trehalose-Lactose, Lactose, and Trehalose-Mannitol-based powders with soluble aggregates <5%. The conformation of antibody was preserved with β sheet content from 66.28% to 76.37%. Particle sizes ranged from 5.23 to 8.12 µm. Mannitol exhibited the best aerodynamic behavior, fine particle fraction (FPF: 70%) but high degree of protein aggregation during storage.

CONCLUSIONS

SFD could favorably stabilize antibody using Trehalose and its combination with Lactose and Mannitol, and also, Lactose alone. Sorbitol disturbed IgG powder recovery. Incorporation of other types of excipient is required for efficient respiratory delivery of IgG molecules.

In a previous study, a small-scale dynamic filtration device (SFD) was analyzed and the basic mechanisms governing the filtration process were characterized. The present work aims at improving the device's performance in terms of actual production. Various operation modes were tested in order to increase permeate flow and concentration factors (CF), while maintaining a fully continuous production mode. Both, a vacuum-enhanced and a pulsating operation mode, proved to be superior to the currently implemented open-operation mode. For example, for lactose, an increase of the CF could be achieved from 1.7 in open mode to 7.6 in pulsating operation mode. The investigated operation strategy enables process control systems to rapidly react to fluctuating feeds that may occur due to changes in upstream manufacturing steps. As a result, not only filtration performance in terms of permeate rate but also process flexibility can be significantly increased. Overall, vacuum-enhanced operation was shown to be most promising for integration into an industrial environment. The option to elevate achievable concentration factors, ease of flow monitoring as well as the ability to react to changes in the feed conditions allow for effective and efficient continuous small-scale filtration.

This study assesses the feasibility of using stereotactic field diode (SFD) as an alternate to gaf chromic films for field output factor (FF) measurement and further evaluating three new detectors for small field dosimetry. Varian 21EX linear accelerator was used to generate 6 and 10 MV beams of nominal square fields ranging from 0.5 × 0.5 cm² to 10 × 10 cm² . One passive (EBT3 films) and five active detectors including IBA RAZOR diode(RD), SFD, RAZOR nanochamber (RNC), pinpoint chamber (PTW31023), and semiflex chamber (PTW31010) were employed. FFs were measured using films and SFD while beam profiles and percentage depth dose (PDD) distribution were acquired with active detectors. Polarity (k_pol ) and recombination (k_s ) effects of ion chambers were determined and corrected for output ratio measurement. Correction factors (CF) of RD, RNC, and PTW31023 in axial and radial orientation were also measured. Stereotactic field diode measured FFs have shown good agreement with films (with difference of <1%). RD and RNC measured beam profiles were within 3% deviation from the SFD values. Variation in k_pol with field size for RNC and PTW31023 was up to 4% and 0.4% (for fields ≥ 1 × 1 cm² ), respectively, while variation in k_s of PTW31023 was <0.2 %. The maximum values of CF have been calculated to be 5.2%, 2.0%, 13.6%, and 25.5% for RD, RNC, PTW31023-axial, and PTW31023-radial respectively. This study concludes that SFD with appropriate CFs as given in TRS 483 may be used for measuring FFs as an alternate to EBT3 films. Whereas RD and RNC may be used for beam profile and PDD measurement in small fields. Considering the limit of usability of 2%, RNC may be used without CF for FF measurement in the smallfields investigated in this study.

Keywords: PTW31023; RAZOR diode; RAZOR nano chamber; correction factors; field output factors; small field dosimetry; stereotactic field diode.

We have proposed the profile-based intensity and frequency corrections for single-snapshot spatial frequency domain (SFD) imaging to mitigate surface profile effects on the measured intensity and spatial frequency in extracting the optical properties. In the scheme, the spatially modulated frequency of the projected sinusoidal pattern is adaptively adjusted according to the sample surface profile, reducing distortions of the modulation amplitude in the single-snapshot demodulation and errors in the optical property extraction. The profile effects on both the measured intensities of light incident onto and reflected from the sample are then compensated using Minnaert's correction to obtain the true diffuse reflectance of the sample. We have validated the method by phantom experiments using a highly sensitive SFD imaging system based on the single-pixel photon-counting detection and assessed error reductions in extracting the absorption and reduced scattering coefficients by an average of 40% and 10%, respectively. Further, an in vivo topography experiment of the opisthenar vessels has demonstrated its clinical feasibility.

Purpose: This review article serves to compare global dermatologic organizations and the available clinical practice guidelines for the use of apremilast in the treatment of psoriasis.Materials and methods: Guidelines from the American Academy of Dermatology (AAD), the National Psoriasis Foundation (NPF), the European S3, the National Institute for Health and Care Excellence (NICE), the French Society of Dermatology (SFD), the Swiss S1, and Italy were reviewed and compared.Results: Of the American and European guidelines available for use of apremilast, several organizations are in agreement regarding the dosage of apremilast, but there are significant disagreements concerning matters such as medication indication, pretreatment laboratory testing, and contraindications to therapy.Conclusion: Apremilast is an effective and well-tolerated treatment option for patients with psoriasis and should be considered in the line of therapy that dermatologists discuss with their patients, especially those with contraindications to other systemic therapies such as biologics. Consideration should be given to the evidence-based recommendations of global dermatology organizations to help guide therapeutic decisions.

Keywords: Apremilast; clinical practice guidelines; phosphodiesterase 4 inhibitor; psoriasis.

OBJECTIVE

Two diodes which do not require correction factors for small field relative output measurements are designed and validated using experimental methodology. This was achieved by adding an air layer above the active volume of the diode detectors, which canceled out the increase in response of the diodes in small fields relative to standard field sizes.

METHODS

Due to the increased density of silicon and other components within a diode, additional electrons are created. In very small fields, a very small air gap acts as an effective filter of electrons with a high angle of incidence. The aim was to design a diode that balanced these perturbations to give a response similar to a water-only geometry. Three thicknesses of air were placed at the proximal end of a PTW 60017 electron diode (PTWe) using an adjustable "air cap". A set of output ratios (ORDet (fclin) ) for square field sizes of side length down to 5 mm was measured using each air thickness and compared to ORDet (fclin) measured using an IBA stereotactic field diode (SFD). kQclin,Qmsr (fclin,fmsr) was transferred from the SFD to the PTWe diode and plotted as a function of air gap thickness for each field size. This enabled the optimal air gap thickness to be obtained by observing which thickness of air was required such that kQclin,Qmsr (fclin,fmsr) was equal to 1.00 at all field sizes. A similar procedure was used to find the optimal air thickness required to make a modified Sun Nuclear EDGE detector (EDGEe) which is "correction-free" in small field relative dosimetry. In addition, the feasibility of experimentally transferring kQclin,Qmsr (fclin,fmsr) values from the SFD to unknown diodes was tested by comparing the experimentally transferred kQclin,Qmsr (fclin,fmsr) values for unmodified PTWe and EDGEe diodes to Monte Carlo simulated values.

RESULTS

1.0 mm of air was required to make the PTWe diode correction-free. This modified diode (PTWeair) produced output factors equivalent to those in water at all field sizes (5-50 mm). The optimal air thickness required for the EDGEe diode was found to be 0.6 mm. The modified diode (EDGEeair) produced output factors equivalent to those in water, except at field sizes of 8 and 10 mm where it measured approximately 2% greater than the relative dose to water. The experimentally calculated kQclin,Qmsr (fclin,fmsr) for both the PTWe and the EDGEe diodes (without air) matched Monte Carlo simulated results, thus proving that it is feasible to transfer kQclin,Qmsr (fclin,fmsr) from one commercially available detector to another using experimental methods and the recommended experimental setup.

CONCLUSIONS

It is possible to create a diode which does not require corrections for small field output factor measurements. This has been performed and verified experimentally. The ability of a detector to be "correction-free" depends strongly on its design and composition. A nonwater-equivalent detector can only be "correction-free" if competing perturbations of the beam cancel out at all field sizes. This should not be confused with true water equivalency of a detector.

The influences of indomethacin--a drug with prostaglandins inhibiting effect--on the cardiovascular and metabolic systems of fetuses were studied. 1) 1mg/day of indomethacin was administered subcutaneously to pregnant Wister rats for 5-6 days. The rats were administered laparotomyon on the 21st day of conception, and the histopathological changes of the lungs of the fetuses were studied. The findings demonstrated no histopathological changes due to indomethacin nor any hypertrophy of the smooth muscles in the small arteries of the lungs. 2) 10-35mg of indomethacin was administered intravenously to rabbits in the final stages of pregnancy, thus, indomethacin was absorbed into the maternal livers, placentas, fetal livers, maternal plasmas, and amniotic fluids as the serum concentrations of indomethacin increased with each added dosage. The percentile changes in relation to the maternal plasma concentration values revealed high percentages in fetal livers, followed by placentas, maternal livers, and fetal plasmas. Amniotic fluid concentrations were as low as 20 percent. 3) As for the clinical results of the use of indomethacin (N = 302), tocolysis showed that abortions numbered 7 out of 101 (5.3%), premature births 63 out of 155 (40.6%), SFD 14 out of 302 (4.6%), perinatal deaths 8 out of 302 (2.6%), and deaths due to distress 3 out of 302 (1%). No neonatal pulmonary hypertension was observed in the 8 premature infants that were delivered dead.

A sensitive, rapid, and simple spectrophotometric method is described for the determination of sulfa drugs. The method is based on the formation of a red-colored product by the diazotization of sulfonamides such as sulfathiazole (SFT), sulfadiazine (SFD), sulfacetamide (SFA), sulfamethoxazole (SFMx), sulfamerazine (SFMr), sulfaguanidine (SFG), and sulfamethazine (SFMt), followed by complexation with dopamine in the presence of molybdate ions in (1 + 1) H2SO4 medium. Absorbance of the resulting red product is measured at 490-510 nm, and the product is stable for 2 days at 27 degrees C. Beer's law is obeyed in the concentration range of 0.04-8.0 microg/mL at the wavelength of maximum absorption. The method was used successfully for the determination of some sulfonamides in tablets and eye drops. Common excipients used as additives in pharmaceuticals do not interfere in the proposed method. The method offers the advantages of simplicity, rapidity, and sensitivity without the need for extraction or heating. The limits of detection and quantitation were calculated for SFT, SFD, SFA, SFMx, SFMr, SFG, and SFMt.

The effect of standardized forced diuresis (SFD) on the serum and urinary electrolyte levels was investigated in 10 cases of severe self-poisoning with hypnotic drugs. Diuresis was initiated by furosemide and maintained at an hourly urinary ouput of 2 litres. Fluid and electrolyte substitution was carried out with a standardized electrolyte solution. Initiation and termination of the SFD was performed abruptly. The mean values of sodium, potassium, chloride and phosphorus in the urine varied widely at the beginning of the SFD, while the calcium and magnesium values varied only slightly. During SFD, urinary stabilization occured at a particular ionogram, in correlation to the electrolyte concentrations in the infusion fluid and with only minimal individual variation. Owing to this satisfactory correlation, none of the patients developed signs of electrolyte disturbances, so that no correction of the infusion constitution was necessary. The abrupt termination of the SFD prevented electrolyte disturbances in the recovery phase.

Sulfur hexafluoride (SFd)-contained gas is a common pollutant emitted during the etching process used in the semiconductor industry. This study demonstrated the application of radio-frequency (RF) plasma in the decomposition of SF6. The decomposition fraction of SF6 [etaSF6 (C(in)-C(out))/C(in) x 100%] and the mole fraction profile of the products were investigated as functions of input power and feed O2/SF6 ratio in an SiO2 reactor. The species detected in both SF6/Ar and SF6/O2/ Ar RF plasmas were SiF4, SO2, Fe2, SO2F2, SOF2, SOF4, S2F10, S2OF10, S2O2F10, and SF4. The results revealed that at 40 W, etaSF6 exceeded 99%, and the reaction products were almost all converted into stable compounds such as SiF4, SO2, and F2 with or without the addition of oxygen. Sulfur oxyfluorides such as SO2F2, SOF2, SOF4, S2OF10, and S2O2F10 were produced only below 40 W. The results of this work can be used to design a plasma/chemical system for online use in a series of a manufacturing process to treat SF6-containing exhaust gases.

Sorsby fundus dystrophy (SFD) is a macular degeneration caused by mutations in TIMP3, the majority of which introduce a novel cysteine. However, the exact molecular mechanisms underlying SFD remain unknown. We aimed to provide novel insights into the functional consequences of a distinct N-terminal mutation. Haplotype reconstruction in three SFD families revealed that the identified c.113C>G, p.(Ser38Cys) mutation is a founder in Belgian and northern French families with a late-onset SFD phenotype. Functional consequences of the p.(Ser38Cys) mutation were investigated by high-resolution Western blot analysis of wild type and mutant TIMP3 using patient fibroblasts and in vitro generated proteins, and by molecular modeling of TIMP3 and its interaction partners. We could not confirm a previous hypothesis on dimerization of mutant TIMP3 proteins. However, we identified aberrant intramolecular disulfide bonding. Our data provide evidence for disruption of the established Cys36-Cys143 disulfide bond and formation of a novel Cys36-Cys38 bond, possibly associated with increased glycosylation of the protein. In conclusion, we propose a novel pathogenetic mechanism underlying the p.(Ser38Cys) TIMP3 founder mutation involving intramolecular disulfide bonding. These results provide new insights into the pathogenesis of SFD and other retinopathies linked to mutations in TIMP3, such as age-related macular degeneration.

OBJECTIVE

To characterize the performance of a new unshielded silicon diode (Razor-IBA) for dose measurements in small flattening filter free beams.

METHODS

The Razor has an active volume of 0.6 mm in diameter and 20 µm in length. The detector response stability in measured dose, dose rate, dose per pulse, and dark current were evaluated. The detector response in square fields (0.6-5.0 cm) was determined using PDD curves, axial beam profiles and output ratios. The performances were compared to that of the previously available SFD-IBA and PFD-IBA diodes.

CONCLUSIONS

The Razor short term stability relative to the SFD was much improved (<±0.1% after 1.2 kGy). The linearity was <±1% (0.05-30 Gy range) and the dose rate dependence was <±0.5% (4-24 Gy/min range). The dose per pulse dependence was <±0.7% (0.08-0.21 cGy/pulse range). The PDDs measured with Razor and PFD differed <1%. A larger dark current was observed with increase in dose (0.0025 pA/Gy) compared to the SFD (0.0002 pA/Gy). This characteristic is attributed to an increased concentration of recombination centers. The beam profile showed good agreement with the SFD. Penumbra differences were <±0.3 mm relative to PFD, with a slight overestimation of the tails (<1%), due to the absence of diode shielding. Output ratios were in good agreement for fields up to 5 × 5 cm(2) (<1%).

CONCLUSIONS

The Razor diode has the same spatial resolution and performance reliability as its predecessor (SFD), but exhibits the additional advantage of improved stability. These features make the Razor diode detector a good candidate for small field dosimetry.

OBJECTIVE

To assess the impact of the detector used to commission small photon beams on the calculated dose distribution in stereotactic radiosurgery (SRS).

METHODS

In this study, six types of detectors were used to characterize small photon beams: three diodes [a silicon stereotactic field diode SFD, a silicon diode SRS, and a silicon diode E], an ionization chamber CC01, and two types of radiochromic film models EBT and EBT2. These detectors were used to characterize circular collimated beams that were generated by a Novalis linear accelerator. This study was conducted in two parts. First, the following dosimetric data, which are of particular interest in SRS, were compared for the different detectors: the total scatter factor (TSF), the tissue phantom ratios (TPRs), and the off-axis ratios (OARs). Second, the commissioned data sets were incorporated into the treatment planning system (TPS) to compare the calculated dose distributions and the dose volume histograms (DVHs) that were obtained using the different detectors.

RESULTS

The TSFs data measured by all of the detectors were in good agreement with each other within the respective statistical uncertainties: two exceptions, where the data were systematically below those obtained for the other detectors, were the CC01 results for all of the circular collimators and the EBT2 film results for circular collimators with diameters below 10.0 mm. The OAR results obtained for all of the detectors were in excellent agreement for all of the circular collimators. This observation was supported by the gamma-index test. The largest difference in the TPR data was found for the 4.0 mm circular collimator, followed by the 10.0 and 20.0 mm circular collimators. The results for the calculated dose distributions showed that all of the detectors passed the gamma-index test at 100% for the 3 mm/3% criteria. The aforementioned observation was true regardless of the size of the calculation grid for all of the circular collimators. Finally, the dose volume histogram results were independent of the size of the calculation grid used.

CONCLUSIONS

The results of this study showed that all of the studied detectors produced similar commissioned data sets for the TPS dose calculations. However, this result only validated the dose distribution calculation in the TPS and could not be used to assess the dose delivery to the target in which the TFS data were used to calculate the monitor units (the TFS data were not used in the TPS dose distribution calculation). Therefore, this study could not be used to determine the most accurate detector commissioning data set; however, all of the detectors exhibited superior performance for the relative dosimetry of small photon beams.

The expression of surface fractal dimension (SFD) for size fractions of the Yellow River sediment was deduced. Based on the expression, the SFD value of different size fractions of the sediment was calculated. The SFD value of the sediment in the Baotou section of the Yellow River is 1.91, and the SFD value of the sediment smaller than 63 microm is 1.36, indicating strong ablation and separating ability of the Yellow River water. Using the modified fractal model, Freundlich model and Langmuir model to fit the data of heavy metal (Cu, Pb, Zn and Cd) adsorption, it is found that the modified fractal model is more available. And the adsorptive thermodynamics is better described by combining the modified fractal model and metastable equilibrium adsorption (MEA) theory. The variation extents of equilibrium adsorption capacity influenced by different grain size are ranked as Cu>> Pb>> Zn approximately equal to Cd. For each selected heavy metal, the higher initial concentration is, the stronger variation of adsorption capacity will be. The adsorptions of Cu and Pb are mainly associated with mineral composition of the sediment, while the adsorptions of Zn and Cd are mainly associated with physical characteristics of the sediment surface.

Social cognition and its association with level of personality organization (PO) were examined in 163 patients with severe somatoform disorders (SFDs) and 151 psychiatric (PSA) control patients. Social cognition was measured with the Social Cognition and Object Relations Scale, which assessed both affective and cognitive facets of social cognition. Levels of PO were assessed using theory-driven profiles of the Dutch Short Form of the Minnesota Multiphasic Personality Inventory (MMPI). The SFD patients exhibited impairments in the cognitive facets of social cognition but not more so than the PSA controls. The results for the affective aspects indicated that the SFD patients exhibited lower levels of emotional investment yet higher affect tone in interactions than the PSA controls. In contrast to the control group, level of PO was not associated with social cognition in SFD. Together, the results indicated that impairments in complexity of mental representations are not specific to SFD patients, yet impairments in emotional investment may be specific to SFD.

In this study, 5-hydroxymethylfurfural (HMF) oxidation was carried out via both the catalytic and the photocatalytic approach. Special attention was devoted to the preparation of the TiO₂-based catalysts, since this oxide has been widely used for catalytic and photocatalytic application in alcohol oxidation reactions. Thus, in the catalytic process, the colloidal heterocoagulation of very stable sols, followed by the spray-freeze-drying (SFD) approach, was successfully applied for the preparation of nanostructured porous TiO₂-SiO₂ mixed-oxides with high surface areas. The versatility of the process made it possible to encapsulate Pt particles and use this material in the liquid-phase oxidation of HMF. The photocatalytic activity of a commercial titania and a homemade oxide prepared with the microemulsion technique was then compared. The influence of gold, base addition, and oxygen content on product distribution in the photocatalytic process was evaluated.

The present study was designed to investigate the targets and synergistic mechanism of Shenfu Decoction (SFD) in the treatment of heart failure. A heart failure animal models was established to evaluate the pharmacological effects of SFD for anti-heart failure, then constructed ingredient-target interaction network by developing ingredient and target databases, the Discovery sdudio software was used for molecular docking. In addition, we validated the predicted protein targets of active ingredients in SFD by using surface plasmon resonance (SPR) technology. Our results demonstrated that SFD could enhance ejection fraction, alleviate myocardial histopathological characteristics, and reduce the level of angiotensin converting enzyme (ACE), aldosterone (ALD), atrial natriuretic polypeptide (ANP) and Renin (REN) in heart failure rat model. In addition, the ingredient database including 349 constituents and target database including 236 proteins were established, and 75 proteins were screened and identified by molecular docking strategy. 22 core target proteins were identified through network pharmacology, and the component-core target network was constructed. Finally, the affinity between the compounds and targets were verified by the SPR analysis method. The present study suggested that SFD may act on ACE 2, REN, ACE, ICAM-1, EGF, HTR2B, PARP1, NPPB and other proteins through AC, BAC, ACN, Re, Rg1, Rb1 to exert synergistic effects against heart failure.

Keywords: Heart failure; Molecular docking; Network pharmacology; Shenfu decoction.

The paper presents guidelines for assessing regional exposure factors (EFs) according to the results of a questionnaire survey of about two thousand persons, including urban workers and/or adult students of the Central Federal District (CFD) and Siberian Federal District (SFD) of Russia. It has been ascertained that in CFD, annual exposure (324 days/year) is less than the standard value defaulted in Guidelines P 2.1.10.1920-04 (350 days/year), which causes a reduction in the chronic average daily dose. Town-dwellers spend the bulk of a day indoors (86 and 87% in CFD and SFD, respectively); 8 and 3% of a day on transport in CFD and SFD, and 7 and 10% indoors in these districts. The findings are in agreement with the data obtained by Russian and foreign investigators and suggest that the daily distribution of a microenvironmental load should be taken into account when health exposures and risks are estimated. The average daily tap water consumption in CFD (2.2 l/day) and SFD (1.7 l/day) is close to 90% percentile of the values recommended by the U.S. EPA (2.4 l/day) and the WHO or less than the value used in the calculation of the Russian maximum permissible concentrations for water (3.0 l/day). The time spent on water procedures by town-dwellers is 36.4 min/day in CFD and 37.6 min/day in SFD (while 29.2 min/day in rural dwellers in SFD) with the standard value of 30 min/day. The findings suggest that the use of the regional values of water-associated EFs increases the chronic average daily dose and therefore a risk upon oral, dermal, and inhalational exposure. The regional features of FEs have been kept in mind on assessing the risk upon multienvironmental exposures to the characteristic components of emission caused by aluminum works in CFD.

The Starr and Ingleton (1992) drive point piston sampler (DPPS) design was modified by fitting it with a Murphy and Herkelrath (1996) type sample-freezing drive shoe (SFDS), which uses liquid carbon dioxide as a cryogen. Liquid carbon dioxide was used to freeze sediments in the lower 0.1 m of the core and the drive-point piston sealed the core at the top preserving the reductive-oxidation (redox) sensitive sediments from the atmosphere and maintaining natural stratigraphy. The use of nitrogen gas to provide positive pressure on the gas system blocked the ingress of water which froze on contact with the cryogen thus blocking the gas lines with ice. With this adaptation to the gas system cores could be collected at greater depths beneath the static water level. This tool was used to collect intact saturated sediment cores from the hyporheic zone of the tidally influenced Fraser River in Vancouver, British Columbia, Canada where steep geochemical and microbial gradients develop within the interface between discharging anaerobic groundwater and recharging aerobic river water. In total, 25 cores driven through a 1.5 m sampling interval were collected from the river bed with a mean core recovery of 75%. The ability to deploy this method from a fishing vessel makes the tool more cost effective than traditional marine-based drilling operations which often use barges, tug boats, and drilling rigs.

In this study, the Grainer's thermal dissipation probe method was applied to monitor sap flux density (SFD) of a mangrove species Kandelia obovata over a period of one year (2010-10-2011-10) in Zhangjiangkou Mangrove National Nature Reserve, Fujian, China. The results showed that both season and diameter class exerted significant effects on the SFD of K. obovata trees. In summer, when the diameter at breast height (DBH) reached 8-10 cm, the highest SFD was found at a depth of 2 cm with a value of 38.21 g·m-2·s-1, which was comparable with those for other mangrove tree species and forested wetland tree species. The mean whole tree transpiration (i.e. daily water use) of all stem size classes demonstrated large changes from winter to summer, increased from 0.14 to 0.19 kg·d-1 in small trees (S, DBH=2-4 cm), from 0.94 to 1.45 kg·d-1 in medium trees (M, DBH=4-8 cm) and from 1.96 to 3.43 kg·d-1 in large ones (L, DBH=8-10 cm). The daily transpiration of K. obovata stand was calculated by summing all size classes, which was then summed up for entire year to estimate annual transpiration of entire K. obovata forest, which was about 100.38 mm, less than 6% of local annual precipitation. Key environmental factors all had significant effects (all P<0.001) on the stand transpiration rate (Es) of K. obovata forest, and photosynthetically active radiation (PAR) and vapor pressure deficit (VPD) were the main driving factors, which explained 60%-92% seasonal variation of Es. The PAR and VPD had larger effects on the Es in summer than that in winter. In addition, we observed an obvious time lag phenomenon in the relationship between Es and PAR or VPD, which should be taken into account when explaining seasonal variation of Es in K. obovata forest.

Methods of combined and multimodality therapy are widely used for the treatment of malignant rectal tumors. However radical operation cannot be performed in 50% of patients, in some cases patients refuse surgery. In such cases patients are given a split course of radiation therapy using local heating of a tumor and a method of daily dose fractionation. Altogether 58 patients with stage T2-4N0-1M0-1 were treated by this method: 38 received thermoradiotherapy, 20 were controls. At the 1st stage the summary focal dose (SFD) was 40 Gy, temperature in a tumor was 42-44 degrees C, interval 3-4 weeks. At the 2nd stage radiotherapy was given with daily dose fractionation (1 + 1.5 Gy at 4-5- h interval), the SFD was 35-40 Gy. The SFD over the entire therapeutic course was 75-80 Gy. Radiation rectitis in thermoradiotherapy was more frequent and severe. Complete tumor regression was observed in 7 (18.4%) patients, marked regression--in 24 (63.2%) patients, insignificant regression--in 5 (13.1%); 2 patients (5.3%) were treated without any effect. 29 (76.3%) patients lived over 2 yrs., 6 (25.8%) patients died of tumor progression.

OBJECTIVE

The prevalence of somatization is dependent on the classification methods and measures used to define it and the context from which the collected data are gathered. The aim of this study was to compare the prevalence of somatization and Somatoform Disorders (SFD) in Primary Health Care.

METHODS

A systematic review of the studies of the prevalence of somatization and SFD in PC (Primary Care) was made, from July 1998 to June 2009. The key words of this investigation, in Pub Med, were; somatoform disorders; somatization; somatisation; medically unexplained symptoms; MUS; functional somatic symptoms, the link with each of these key words having been made to Primary Care. A grid was drawn up for the selection of each article. The criteria for the inclusion of the studies took into account aspects related to the methodology and the instruments used (use of interview) and the clear definition of medically unexplained symptoms, amongst others.

RESULTS

Twelve studies with prevalence values in a PC setting and 1 study of metaanalysis were selected. The values found for the total prevalence of SFD were extremely disperse, taking into consideration the various studies, being between 12% and 57.9%. The same results were found in relation to somatization disorder (between 0.5% and 16.1%) with 10.1%, referred to one study, following the very restrictive criteria of ICD-10. Results were more homogeneous for somatization defined by more abridged criteria, the Somatic Symptom Index 4.6 (SSI4,6) presenting values around 20% in almost the majority of selected studies that estimate the prevalence following this criteria. In the great majority of the studies, SFD increased the relative risk of other mental disorders (depressive and anxiety disorders). Some studies concluded that there was a relative independence of somatization in relation to those disorders, certified by the existence of a specific and cumulative effect of somatization (in relation to depressive and anxiety disorders) on the level of disability and of functional limitations as well as the level of use of resources in PC.

CONCLUSIONS

This last decade has enabled a group of new studies that allow us to understand the extent of somatization in PC, especially in Europe and North America, and to have a more clearly based idea of the needs at service level and investigation level, within the referred area.

The present work examines the change in color reflection in psychogenic pain in patients with somatoform disorders (SFD) during psychotherapeutic treatment, for which empatho-techniques were used. At the start and end of the course the psychophysiological condition was determined according to psychological parameters and assessment of bioelectrical brain activity. All initial indicators for the patients significantly differed from those for the healthy subjects. At the same time, color reflection in the psychogenic pain was characterised by colors in the longwave part of the spectrum, in contradistinction to healthy subjects for whom achromatic and shortwave colors predominated. After the completed course patients with SFD had a significant improvement of all psychophysiological indicators and a lack of color reflectons in the longwave part of the spectrum. The data obtained permits the proposition that there exists a link between the psychogenic pain, its color reflection and anxiety, and also changes in the functional condition of the CNS.