The structure of DNA was unraveled by Watson and Crick in 1953, and two decades later Arber, Nathans and Smith discovered DNA restriction enzymes, which led to the rapid growth in the field of recombinant DNA technology. From expressing cloned genes in bacteria to expressing foreign DNA in transgenic animals, DNA is now slated to be used as a therapeutic agent to replace defective genes in patients suffering from genetic disorders or to kill tumor cells in cancer patients. Gene therapy provides modern medicine with new perspectives that were unthinkable two decades ago. Progress in molecular biology and especially, molecular medicine is now changing the basics of clinical medicine. A variety of viral and non-viral possibilities are available for basic and clinical research. This review summarizes the delivery routes and methods for gene transfer used in gene therapy.
Changes in patient anatomy may occur either from a tumour volume, position or function of a specific organ at risk, or target volume, weight loss or a reduction in postoperative oedema, and may vary between patients. Adaptive radiotherapy aims to correct morphological variations by realizing one or more plans during the treatment course. Imaging is used to detect these variations, thereby deciding on a potential replanning. At present, adaptive radiotherapy for head neck cancer (HNC) mainly deals with treatment response, such as weight loss or tumor shrinkage. Therefore a properly timed repeat CT scan during treatment is a suitable basis for plan adaptation to account for treatment response.
The osteomas are osseous lesions with slow and asymptomatic growth that most of the times is a finding in radiological exams requested for other reason. It's the most common benign neoplasm of the paranasal sinuses. The osteomas are located mainly in the frontal sinus (37–80%), followed by the ethmoidal sinuses (20%), maxillary sinuses and rarely in the sphenoid sinus.
Although osteoid osteoma is rare in paranasal sinuses, it should be considered if there is a bone density mass and complete excision should be performed with care. Although osteomas are benign tumours, they may enlarge progressively and produce complications. Their resection is not free of risks, so there is some controversy about the management of asymptomatic patients.
Endonasal surgery reduces the morbidity of the treatment but the location and size of the lesions do not allow to employ this technique in all cases.
Surgeons are constantly looking for minimally invasive ways to treat their patients, as recovery is faster when a lesser trauma is inflicted upon a patient, scarring is lessened and there are usually fewer complications in the aftermath of the operation. Through nanotechnology, tiny biosensors could be constructed which could take these factors into account, thus shortening a patients recovery period and saving hospitals money, reducing infection rates within the hospital, reducing the waiting lists for operation and allowing doctors to treat more patients in the same period of time. One of the greatest achievements of nanotechnology in surgery will be what we call the "ideal graft"; that is, biocompatible and durable "repairs" of parts of the body like arteries, joints or even organs. At first, these repairs will be used for healing, but soon afterwards, they will be used for transcendence: to enhance current human abilities.
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