Introduction: The aim of this paper is to study the distribution of the therapy dosage applied by a modified conventional “field in field” technique and compare it to the distribution of the dosage applied by the standard conventional technique.Methods: The study included ten patients with right side breast cancer, after they were exposed to radical mastectomy and chemotherapy. Radiotherapy dosage of TD 50 Gy in 25 fractions was applied to the anterolateral side of the right thoracic wall, with two opposite conventional tangential fields by the linear accelerator Elekta Synergy and the energy of 6 megavolts (MV). A delineation of the target volume (CTV – Clinical Target Volume) was done within conventional fields. At the XiO system for planning we included additional fields within the existing conventional fields, which was the so called “field in field” technique. On the basis of CTV the Dose Volume Histogram (DVH) was calculated for conventional and “field in field” plans. VD90%, VD95%, VD107%, VD115%, CI and HI were calculated for both techniques. Means were pared with the paired Student's t-test. The results were considered significantly different if p<0.05.Results: VD90% and VD 95% were significantly higher for the “field in field” technique. Therefore, CI also favored the “field in field” technique (p=0.02). There was no difference in VD107% and VD115% between the compared groups. Consequently, there was no statistically significant difference in HI (1.13±0.03 vs.1.13±0.03, p=0.06).Conclusion: Conventional postoperative radiotherapy of localized right side breast cancer by “field in field” technique provides excellent coverage of the target volume by radiotherapy isodose.
Introduction: Doppler analysis of the feto-placental and fetal circulation give dynamic information on the condition of the bloodstream during pregnancy, and early detection of fetal hypoxia. The objectives of the study were: testing whether there is influence of smoking on feto-placental circulation; determining whether there is a link to a number of smoked cigarettes during the day; assessing the benefits of Doppler ultrasonographic screening in detection of fetal hypoxia in pregnant women who smoke during pregnancy. Methods: 300 pregnancies were included in the prospective research. With regard to a number of smoked cigarettes the pregnant women were divided into three groups: I. the first group (moderate smokers) consisted of 100 pregnant women who smoked up to 15 cigarettes a day during pregnancy; II. the second group (heavy smokers) 100 pregnant women who smoked more than 15 cigarettes a day during pregnancy and III. the third group (control group) 100 pregnant women who did not smoke during pregnancy. All pregnant women underwent Doppler measurements of blood circulation (determination of resistance index – RI) in the umbilical artery, fetal aorta and middle cerebral artery. Results: The intensity of smoking has influence to circulation because RI in the umbilical artery and fetal aorta is increased and RI is decreased in the middle cerebral artery in pregnant women heavy smokers in comparison to pregnant women moderate smokers. Conclusion : Doppler sonography of the blood vessels could have an important role in detection of hypoxia and monitoring of the condition of the fetus of pregnant women who smoked during pregnancy.
Introduction: Gynaecological and obstetric surgeries are high risk operations for the development of postoperative inflammatory complications due to the proximity of the genitourinary tract. The aim of this study was to compare the frequency of inflammatory complications in emergency or elective cases of caesarean sections as well as the frequency of complications related to the method of surgical treatment used.Methods: We analyzed inflammatory complications in 450 caesarean sections, which developed in a one year period from June 1st, 2000. to June 1st 2001. Patients were grouped according to the method of the surgery, and on emergency or elective case. Misgav Ladach or Dorfler surgical methods were used.Results: The most common inflammatory complication was wound infection and the most common risk factors for inflammatory complications were premature rupture of membranes and anemia.Conclusions: Long term use of one antibiotic was the most commonly implemented form of antibiotic prophylaxis.
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