A solitary fibrous tumor of the urinary bladder is an extremely rare type of mesenchymal tumor. We present a case of an 85-year-old woman with a large (14.5x10.7x10.1 cm) protruding intravesical mass detected by computed tomography (CT) and magnetic resonance imaging (MRI), which was proven to be a solitary fibrous tumor through histopathological examination. The clinicopathologic and radiological features are here discussed, along with a review of the published literature on this topic. Solitary fibrous tumors of the urinary bladder are more common in men (76%), with a peak incidence in people 40-60 years old. Most such tumors show heterogeneous intensity with a complete capsule. A decrease in the T2WI signal with an increase in collagen tissue content and gradual enhancement on CT/MRI images are their main features. Most such tumors are positive for CD34 under immunohistochemistry (100% in 24 available cases). The majority of tumors (88%) studied have been non-malignant and most patients (95.5%) showed favorable prognosis after a long-term follow-up.
Background: To investigate the clinical efficacy of apatinib in combination with oxaliplatin + 5-fluorouracil + leucovorin in clinical chemotherapy for the advanced gastric cancer. Materials and Methods: Between June 2016 and December 2018, we enrolled a total of 92 patients with advanced gastric cancer who were receiving 4500 cGy of radiation through the 5 weeks after resection of adenocarcinoma, and divided them into two groups as per the treatment strategies, with 46 patients in each group. Patients in the control group underwent the regular chemotherapy (oxaliplatin + 5-fluorouracil + leucovorin), while those in the observation group would additionally receive the medication of apatinib. We compared the efficacy, changes in the levels of high-sensitivity C-reactive protein (hs-CRP) and Tumor necrosis factor (TNFα) in serum, prognosis and adverse reactions between two groups, or before and after treatment. Results: In the observation group, the total effectiveness rate was higher than that in the control group. Also, after treatment, significant decreases were found in levels of high-sensitivity C-reactive protein and TNF-α in serum of patients in the observation group, more evident than those in the control group. Moreover, progression-free survival and total survival durations of patients were significantly longer than those in the control group, while the incidence rate of adverse reaction was reduced sharply (all P < 0.05). Conclusion: our study showed that apatinib combination with oxaliplatin + 5-fluorouracil + leucovorin seems to have promising efficacy, and is worthy of being studied as a new regimen of gastric
Background: Non-small-cell lung carcinoma (NSCLC) as the most common type of lung cancer has the most leading mortality rate among other cancers. Diabetes mellitus is one of the most common comorbidities of this disease. Metformin is a conventional anti-diabetic drug that is evaluated in various studies as an anti-cancer agent. This study was an updated systematic review and meta-analysis evaluating the effect of metformin on NSCLC. Materials and Methods: A systematic search was conducted through PubMed/Medline, EMBASE, and Cochrane library databases and all retrospective studies with the title the effect of metformin on the non-small cell lung cancer were collected. Statistical analyses were carried out using either random-effects or fixed-effects models according to the heterogeneity examined by I statistics and assessing Hazard Ratio of overall survival (OS) using Revman version 5 software. Result: Fourteen studies involving 3164 patients were included in the current meta-analysis. The pooled hazard ratio (HR) of comparison of overall survival (OS) between metformin user diabetic patients and diabetic patients without a history of using metformin was 0.87 (95 % CI 0.74–1.02; P = 0.08). Sub-group analysis showed that when studies were divided by region the HR of OS for Asia was 0.77 (95 % CI 0.65–0.90; P = 0.001), 1.11 (95 % CI 0.72–1.71; P = 0.64) for USA, and 0.86 (95 % CI 0.57–1.30; P = 0.47) for Europe. Conclusion: The use of metformin beside radiotherapy in patients with type 2 diabetes may be associated with a good prognosis. While this impact was just significantly seen in Asian studies.
Background: Conventional radiation dosimetry methods in computed tomography (CT) are not able to measure the dose distribution along the patient’s longitudinal axis. To calculate the dose index on a CT scan, the dose distribution from the center of the radiation field must be calculated. In this study, the most appropriate integral interval for calculating the CT dose index in the axial mode was determined using the Monte Carlo (MC) method based on X-ray photon energy and slice thickness. Materials and Methods: The computed tomography dose index (CTDI) phantom was simulated in the EGSnrc/BEAMnrcMC system and was irradiated with several X-ray energies and several slice thicknesses and dose profiles in phantom were investigated. The area under the dose profile and the scatter to primary radiation dose ratio (SPR) were calculated. Results: The range of scattered beams from the center of the radiation field reaches 450 mm in 140 kV and a 40 mm slice thickness. The SPR value for all levels of X-ray photon energy (between 80 and 140 kV) significantly decreases as slice thickness increases. CT scan imaging technical factors greater than 310 mm from the center of the slice thickness have no effect on the behavior of the scattered radiation. Conclusion: The primary beams are more affected by the energy of the photons, and the scatter beams are more strongly affected by the slice thickness. For 64-slice scanners, the polymethyl methacrylate (PMMA) phantom length should be between 700 mm and 900 mm to yield accurate CTDI estimations.
Background: The importance of dose in prostate radiotherapy is well known, and the dosimetric effects of radiotherapy in node-positive or node-negative patients with prostate cancer have become an important issue. Materials and Methods: Helical tomotherapy (TH) plans of 19 pelvic node-positive [THpn(+) plan] or node-negative [THpn(-) plan] patients with prostate cancer were retrospectively created in our clinic. In these plans, the beam angle was set to cover the planning target volume (PTV) of prostate cancer and minimize the dose to the organs at risk, including the bladder, rectum, femoral head, and bowel. Results: There were no differences in the conformity index, Dmax, Dmean, and homogeneity index of PTV between the THpn (+) and THpn (-) plans (p>0.05). However, V95 in the THpn (+) plan was lower than that in the THpn (-) plan (p=0.017). Moreover, Dmax, V75, V70, V65, V60, V50, V40, V30, and V20 for the rectum were not significantly different between the two plans (p>0.05), whereas Dmean was significantly different (p=0.025). Dmax, V70, V65, and V60 for the bladder were not significantly different between the two plans (p>0.05), whereas V55, V50, V40, and V30 were significantly different (p<0.05). Finally, Dmax and V50 for the femoral head and bowel were significantly different between the two plans (p<0.05). Conclusion: The THpn (+)] and [THpn(-) plans achieved acceptable target dose coverage in prostate
Background: The purpose of this study is to analyze the cumulative dose profile tail beyond the scan lengths of 10-90 cm in CT examinations on central and peripheral axes of water phantoms (10-50 cm diameter). The analysis includes extension, trend, and dependency of the tails on the scan length and phantom diameter. Materials and Methods: A validated Monte Carlo model of a GE LightSpeed 16-slice CT scanner was used to obtain a dose profile from narrow beam collimation (1 mu m). The cumulative dose profile tail was developed by applying the well-known "convolution method", i.e. convolving a dose profile with a RECT function. The tails were analyzed according to the phantom diameter and scan length statistically. Results: For all phantoms, the statistical analysis shows no significant differences between tails of scan lengths of 10-90 cm for peripheral axis and those of scan lengths > 30 cm for the central axis. The tails have an exponential falloff from the scan edge modeled by D(z)=Ae(-Bz). The A and B are related to the falloff speed and amplitude of the tails. By increasing the phantom diameter, the amplitude and falloff speed decrease 82% and 59% on the central axis and 65% and 31% on the peripheral axis respectively. Conclusion: A simple equation was suggested for dose calculation at any point beyond the scan range on the central and peripheral axes of water phantoms. The equation is independent of scan length and is useful for evaluating the dose of organs located at the edge or outside of the scan region.
Background: To evaluate structural variation of the parotid gland in post-radiotherapy oral carcinoma patients. Material and Methods: 52 patients (33 males, 19 females) with histologically confirmed cancer of head and neck region were enrolled. All the patients underwent intensity modulated radiotherapy (IMRT) with linear accelerator. A quantitative analysis was conducted with the help of contrast enhanced computed tomography (CECT) scan regarding the changes in the volume and density of the parotid glands (PGs) along with the assessment of their interrelationship in relation to the mean dose applied to the glands. The evaluations were done immediately after radiotherapy, and after 2 and 3 years. Results: Parotid size reduction was observed in 77.77 % of cases immediately after radiotherapy with a mean dose of 26.66 Gy applied to the parotid glands. Parotid shrinkage reduced to 61.5 % cases three years post radiotherapy. High density changes were revealed by 69.2 % cases immediately after radiotherapy with a mean dose of 34.53 Gy applied to these parotid glands. Low density changes were revealed by 48.1 % cases after 2 years follow up which further reduced to 25 % at three years follow up. Conclusion: There was evidence of structural variation in the PGs during the course of IMRT which was significantly related with the mean dose applied to them. There were high density changes and low density changes immediately after radiotherapy and 2-3 years post-radiotherapy respectively. Further there was volumetric shrinkage post-radiotherapy which shows recovery 2 and 3 years post-radiotherapy.
Background: Inclusion of air-filled cavities in the head and neck treatment fields due to electronic disequilibrium may lead to uncertainties in predicting dose distribution by treatment planning systems (TPS). In this study the Full Scatter Convolution Algorithm (FSC) used in TiGRT treatment planning systems was evaluated using a novel 3D film dosimetry method. Materials and Methods: 9 pieces of EBT2 films were embedded in a rectangular inhomogeneous head and neck phantom. Three approximately small field sizes including sandwiched EBT films which embedded between phantom slabs were exposed with 6 MV X-ray photons. A homemade computer code was developed in MATLAB for the creation of a 3D dose map of irradiated films and calculation of enclosed volumes which were surrounded by isodose lines in films. Then the calculated dose volumes were compared with the same quantities derived from Dose Volume Histogram (DVH) which is available in TPS outputs. Results: Our results showed significant differences between the results of the film dosimetry and DVH values. The maximum difference of calculated and measured values was observed in volumes surrounded by 95% isodose curves and 3x3cm(2) field size (P=0.035) and the minimum difference was observed in volumes surrounded by 95% isodose curves and 5x5cm(2) field size (P=0.047). Conclusions: The results of this study demonstrated overestimated results in volumetric dose calculation of the FSC dose calculation algorithm in the presence of inhomogeneities and the 3x3cm(2) field size. Also, these results confirmed that the utilization of an accurate and comprehensive method such as 3D film dosimetry can be useful for TPS verification.
Background: In this work, a low-dose rate (100mGy/min of whole body gamma irradiation fractionated (0.5, 1, and 2Gy) was used to study the effects of cumulative doses on the expression of target genes implicated in the intestinal inflammatory process in high fat diet (HFD) wistar rats. Material and Methods: Total RNA was extracted and the expression of target genes was measured in the four intestinal segments (duodenum, jejunum, ileum and colon) of HFD Wistar rats. Results: Our in-vivo results in the four intestinal segments (duodenum, jejunum, ileum, and colon) demonstrated that gamma irradiation exposure in HFD rats amplified the low-grade inflammatory state already induced by HFD. This phenomenon occurs through the induction of pro-inflammatory cytokines mainly the tumor necrosis factor-alpha (TNF alpha) and interleukin 6 (IL-6) or via overexpression/increasing of anti-inflammatory response involved interleukin 10 (IL-10) and the growth factor beta (TGF beta) overall the bowel segments. Results suggested that whole body gamma irradiation might have dual roles, first, engraving the inflammatory state already initiated by HFD, and second, an over expressed anti-inflammatory response via anti-inflammatory cytokines mainly IL-10 and TGF beta. Conclusion: The current study clearly demonstrated the important role of the gut in HFD rats during fractionated whole body irradiation (FWBGI) and indicated that TGF beta and IL-10 may be the target in whole body radiotherapy as a mechanism to recompense for the imbalance between pro-inflammatory and anti-inflammatory cytokines.
Background: This study aimed at estimating the mean glandular dose (MGD) and cancer risks during mammography examinations. Materials and Methods: The patients underwent three projections per breast: using craniocaudal (CC), mediolateral oblique (MLO) and mediolateral (ML) projections in a calibrated digital mammography unit at Najran University Hospital, Najran, Saudi Arabia. A total of 510 mammograms were performed, using the three views per breast. The MGD values were estimated indirectly from the entrance surface air Kerma (ESAK) and half-value layer (HVL) based on the conversion factors reported in the literature. The breast cancer risks were estimated based on the data available in the International Commission on Radiological Protection (ICRP) publication 103. Results: Mean breast thickness of 4.4, 5.3 and 5.0 cm and MGD of 1.01±0.3, 1.09±0.2 and 1.09±0.2 mGy were noted for CC, MLO, and ML views, respectively. A significant correlation has been observed between breast thickness and MGD as well as applied exposure factors. Moreover, the results indicated that the cancer risk per projection was estimated to be 178 x10, which can be significant during repeated exposure to these examinations. Conclusion: The comparison with the published data of the countries reported in this study revealed that the mean MGD is comparable or less compared to previous studies. However, young patients required a precise justification. The results are useful for national and professional organisations. Moreover, the results of MGD in Najran could be a helpful guide to the local authorities.
Background: The knowledge of distribution of radionuclides and background radiation levels in the environment is important for assessing the effects of radiation exposure due to both terrestrial and extra-terrestrial sources. Materials and Method: In-situ gamma dose survey and gamma spectrometry was employed to investigate background radiation levels in Ijebu-Ife. Results: In-situ gamma dose rates vary from 0.02 to 0.10 mu Sv/hr with mean value of 0.05 mu Sv/hr which is less than 0.133 mu Sv/hr, recommended by the ICRP. The resulting annual effective dose was below 1 mSv/yr maximum permissible limit for the general public set by the UNSCEAR, 2000. The activity concentrations of the three naturally occurring radionuclides in soils ranged from Below Detection Level (BDL) to 320.11 +/- 28.53, 9.11 +/- 1.65 and 8.55 +/- 0.95 Bq/kg with mean values of 119.05 +/- 11.24 Bq/kg, 4.44 +/- 1.01 Bq/kg and 4.55 +/- 0.62 Bq/kg respectively which are lower than the average values of 400, 35, and 30 Bq/kg recommended by the UNSCEAR, 2000 for 40K, 226Ra, and 232Th respectively. The mean computed values for absorbed dose rate, annual effective dose and radium equivalent are 10.03 nGy/hr, 0.03 mSv/yr, 20.11 Bq/kg respectively, which fall within UNSCEAR, 2000 threshold. Conclusion: A significant positive relationship exists between the in-situ and evaluated effective dose equivalents (r = 0.89, p < 0.05). Radiation dose results indicate insignificant radiological risk, making the study area safe for living and agriculture purposes.
Background: The assessment of radiation dose is of great importance in the optimization process. It is crucial to develop strategies for dose estimation in developing countries in lack of dosimeters. Material and Method: The Entrance Skin Dose (ESD) of 731 patients was calculated using the Davies model. Eight radiological procedures: Chest PA and LAT, lumbar spine AP and LAT, pelvis AP and LAT, skull PA and LAT and three-phase X-ray machines were considered. Based on the mathematical estimation of the radiation output of X-ray machines, a modified Davies model was proposed. The model was compared to others (Edmonds, Tung and Tsai) using their Mean Relative Errors (MRE) with respect to the reference Davies model and the Student's test of comparison of means. The 3rd quartile values were also compared to those found in Cameroon, Nigeria, Iran, France and UK. Results: The MRE of the proposed model in this work (1.9%) was significantly less than the MRE of the Tung and Tsai model (7.1%), which was in turn significantly less than the MRE of the Edmonds model (55.0%). Results also show that, the 3rd quartile values were mostly higher than reference level in UK. High values of doses are attributable to short Focus to Skin Distance (FSD) and high values of charges. Conclusion: The model proposed in this study is a better alternative to the Davies model in the case of absence of dosimeter. An adjustment of technical parameters (FSD and charge) could help reduce high doses.
Intramuscular hemangioma is a rare type of hemangioma. Ossification of an intramuscular hemangioma is even rarer. This study reports the case of a young man admitted to our hospital with complaints of pain and swelling in the right buttock. We were unable to confirm the type of tumor on evaluation of X-ray, ultrasound, magnetic resonance imaging, and needle biopsy examination. The mass was excised and histopathology confirmed the diagnosis of an ossified intramuscular hemangioma with immature ossification. This case report demonstrates that the diagnosis of an immature ossified intramuscular hemangioma should be considered as differential diagnosis in patients presenting with a soft tissue tumor.
Background: Accumulating reports suggest that radiation may change gene expression in cancer cells and promote cell migration and invasion, as well as inducing cancer stem cell (CSC). However, the correlation between these processes and radiation dose has not been shown yet. Therefore, the present study aimed to evaluate the effect of low, medium, and high doses of X-ray on expressing three genes involved in CSC induction in colon cancer cell line (HT-29). Materials and Methods: The cells cultured in flasks were irradiated with X- rays in different doses including 0.1, 2.5, 5, and 10 Gy. Then, the expression of Oct4, CD44, and ALDH1 genes was measured using real-time PCR. PCR efficiency was evaluated for each gene using Linreg PCR software, and relative changes for mRNA were calculated based on the ∆∆Ct method. Results: CD44 gene expression increased equally at all doses. Oct4 and ALDH1 gene expression were not affected by 10 Gy, but low and moderate doses increased them equally. Conclusion: The effects of low and moderate doses on increasing the expression of stem-related genes are equal. In addition, the effect of the high dose on increasing CD44 gene expression was equal to the low and moderate doses.
Background: The purpose of this study was to investigate the dosimetric characteristics of a new type of two-dimensional diode detector array used for quality assurance of stereotactic radiosurgery (SRS). Materials and Methods: The devices used in this study were the SRS MapCHECK detector and the StereoPHAN. The detector has 1013 diode detectors over an area of 77 x 77 mm. The reproducibility, dose linearity, dose rate dependencies, output factors (OPFs) and angular dependencies were investigated as dosimetric characteristics. The OPFs were measured and compared between AP and PA direction ranging from 0.5 x 0.5 to 7 x 7 cm. The angular dependencies were measured using 19 gantry angles. Results: The dose reproducibility and linearities showed sufficient performance of 6 MV and 10 MV. At 40 MU/min, there was a 1.3% difference from the ionization chamber measurements. For the flattening filter-free beam, there was no dose rate dependency from the 400 MU/minute to 2400 MU/minute, and the variation was within 0.5%. For small irradiation fields of 1 cm or less, the measured value of the SMC differed in AP and PA directions by up to 4.5%. The maximum gantry angle dependency of the detector was 5.3%. A maximum difference of -3.1% occurred between the measurements and TPS calculations. Conclusion: Results indicate that the new 2D diode detector is stable and useful for QA and end-to-end testing of SRS due to its excellent dose characteristics, high resolution and ease of handling when combined with the StereoPHAN.
Background: This research focuses on the study of K, U, and Th in a specific area at Kufa Cement Factory Sites in Najaf Governorate, Iraq using the γ-ray spectrometry scintillation detector NaI(Tl). Materials and Methods: Samples of soil were collected from locations around the Kufa cement factory in Najaf city of Iraq that are about 10 km away from the center of Najaf city. They were analyzed to set the concentrations of natural radioactivity samples of K,U and Th. Results: The specific activity values of k, U and Th varied from (378.54±11.39 to 2404.27±26.13)Bq/kg, (15.51±5.88 to 106.08±7.35) Bq/kg and (1.80±3.41 to78.19±3.05) Bq/kg continually. Conclusions: Results demonstrate that the convergences of radiation and doses due to radionuclides in the overviewed area are higher than the safety field of the worldwide average (UNSCAER 2000). Almost all of the radiological parameters are inconsequential to cause any dangerous health problems to people living in the area.
Background: Pretreatment with lithium in thyroid cancer patients before radioiodine therapy (RIT) has been suggested to improve the results of therapy in terms of higher radiation to thyroid tissue and limiting extrathyroid irradiation. Materials and Methods: The beta and gamma radiation to the thyroid gland and lungs in 8 female New Zealand rabbits weighing 2.7 to 3.6 kg were simulated employing GATE Monte Carlo code. The study design was before-after and crossover; rabbits were orally treated with 165 to 288 μCi I with or without pretreatment with 60 mg per day lithium. SPECT/CT imaging was done 20 to 24 hours after RIT providing the distribution and attenuation maps for simulation. The S-values were calculated and compared between the rabbits prepared with and without lithium before RIT by analysis of covariance. Results: For beta radiation, the thyroid to lung S-value ratios (TLR) was 10.5 ± 1.6 with lithium pretreatment and 15.9 ± 12.5 without it. For gamma rays, TLR was 4.8 ± 1.8 vs. 6.7 ± 3.1 in rabbits with and without lithium pretreatment. The values of TLR were higher without lithium pretreatment but statistically insignificant. Conclusion: Lithium demonstrated no improvement in radioiodine uptake in thyroid tissue. Pretreatment of differentiated thyroid cancer patients with lithium before RIT, which is backed by old literature, should be reconsidered.
Background: Local Dose Reference Level (LDRL) values as the standard radiation dose of all radiography examinations are used in medical imaging to reveal the patient dose level or administered activity for a specified imaging procedure. Materials and Methods: The incident air kerma (Ki) was measured for five radiographic examinations (Skull AP/Lat, Chest AP/Lat, Lumbar AP/Lat, Thoracic AP/Lat and Pelvic AP) throughout the province of Kohgiluyeh and Boyer-ahmad (as a deprived area). The founding DRLs results were sort; the third quartile was selected as the average DRL and compared with the other DRLs provinces of Iran as well as the standard data of developed countries. Results: The radiographic LDRL were found to be 0.72, 1.62, 3.06, 2.96, 7.21, 9.99, 7.1, 8.42 and 5.56 mGy for Chest PA, Chest Lat, Skull AP, Skull Lat, Lumbar AP, Lumbar Lat, Thoracic AP, Thoracic Lat and Pelvic AP, respectively. Conclusion: The founding revealed that if the applied radiation protocols are as same as developed countries the DRL values in some projections such as the lumbar vertebrae could be close to international
ObjectiveThe objective of this study was to investigate accuracy of the United Imaging Healthcare's uRT treatment planning system (uRT-TPS), by creating AAPM TG 119 test plans with respectively IMRT and VMAT techniques by homogeneous and heterogeneous phantom. Materials and MethodsThe plans were delivered to the homogeneous and heterogeneous phantom using the United Imaging Healthcare's uRT-Linac 506C. The overall dose calculation accuracy by uRT-TPS with Collapsed Cone Convolution (CC) and Monte Carlo (MC) algorithm was measured and analyzed by creating IMRT and VMAT plans for the 5 test geometries specified in TG 119, by using two kinds of beams FF photon beam and FFF photon beam. The point doses were measured with a Farmer type ion chamber and the fluences were measured with films respectively. Results The result of position accuracy was shown that the worst position accuracy is 0.36 mm and the repeated positioning accuracy of MLC field location was less than 0.25mm. The symmetry deviation of MLC was less than 0.08mm. In this study, the CLs of sMLC, dMLC and VMAT plans with FF photon beams were 2.74%, 2.12%, and 1.36% respectively. As for FFF photon beams, they were 3.76%, 2.14% and 2.90% respectively, whereas the counterpart CL specified in TG119 were 4.5% for the high dose regions and 4.7% for OAR regions. The CLs of Gamma Passing rates for sMLC, dMLC and VMAT plans were 4.59%, 5.35% and 2.15% for FF beam mode, and were 1.82%, 6.12% and 4.82% for FFF beam mode. For the heterogeneous phantom, the maximum deviation is 2.35% for CC and 2.63% for MC algorithm respectively.Conclusion Based on this analysis which were performed in accordance with the TG 119 recommendations, it is evident that the URT treatment planning system and URT-Linac 506C have commissioned IMRT and VMAT techniques with adequate accuracy. and all uRT_TPS treatment plans were recognized as clinically acceptable.
Background: There are data suggesting that low dose radiation induced inflammatory reactions and changes of the immune system could be responsible for late circulatory and other chronic diseases. Chronic low dose radiation of occupationally exposed persons requires careful examination of their immune status. The purpose of this survey was to study some immunological parameters and serum proteins as suitable markers for screening cardiovascular diseases and chronic inflammatory state in NPP personnel. Materials and Methods: Lymphocyte populations were determined using four parameters by flow cytometer. Plasma levels of interleukin IL6, CRP and INFγ were determined by ELISA. Results: The main T lymphocyte populations did not show any differences to controls but there were trends of increasing activated CD3 HLA, CD4+25+ and CD8+38+ T lymphocytes and CRP and IL6 markers. Higher, but not significant averages were recorded for regulatory T lymphocytes probably due to their role in preventing of atherosclerosis. No dependence was established of the studied parameters to cardiovascular or other chronic diseases, a weak correlation was only recorded for IL6 with autoimmune ones (p=0.042). The results show that the age, obesity, and other lifestyle factors, particularly cigarette smoking could be considered as cofounder for circulatory diseases. Conclusion: It could be assume that radiation induced aging of T cells and activation of inflammatory response are partly involved in the development of inflammatory chronic diseases as the more pronounced deviations in the parameters are observed with increasing age and cumulative dose.
