Images of interest. Hepatobiliary and pancreatic: Tumor thrombi in esophageal varices.
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Antineoplastic Combined Chemotherapy Protocols↗
Biomedical subjects
T Nakano
Publications and source records attributed to T Nakano.
Peginterferon {alpha}-2b and ribavirin therapy in chronic hepatitis C genotype 4: impact of treatment duration and viral kinetics on sustained virological response.
BACKGROUND: The response rates and duration of peginterferon alpha (PEG-IFN-alpha) and ribavirin combination therapy in chronic hepatitis C genotype 4, the prevalent genotype in the Middle East and Africa, are poorly documented. AIMS: To compare the efficacy and safety of 24, 36, or 48 weeks of PEG-IFN-alpha-2b and ribavirin therapy in chronic hepatitis C genotype 4. METHODS: In this prospective, randomised, double blind study, 287 patients with chronic hepatitis C genotype 4 were randomly assigned to PEG-IFN-alpha-2b (1.5 mug/kg) once weekly plus daily ribavirin (1000-1200 mg) for 24 weeks (group A, n = 95), 36 weeks (group B, n = 96), or 48 weeks (group C, n = 96) and followed for 48 weeks after completion of treatment. Early viral kinetics and histopathological evaluation of pre- and post treatment liver biopsies were performed. The primary end point was viral clearance 48 weeks after completion of treatment. RESULTS: Sustained virological response was achieved in 29%, 66%, and 69% of patients treated with PEG-IFN-alpha-2b and ribavirin for 24, 36, and 48 weeks, respectively, by intention to treat analysis. No statistically significant difference in sustained virological response rates was detected between 36 and 48 weeks of therapy (p = 0.3). Subjects with sustained virological response showed greater antiviral efficacy (epsilon) and rapid viral load decline from baseline to treatment week 4 compared with non-responders and improvement in liver histology. The incidence of adverse events was higher in the group treated for 48 weeks. CONCLUSION: PEG-IFN-alpha-2b and ribavirin for 36 or 48 weeks was more effective in the treatment of chronic hepatitis C genotype 4 than treatment for 24 weeks. Thirty six week therapy was well tolerated and produced sustained virological and histological response rates similar to the 48 week regimen.
Adult↗
Sexual behaviour and high risk human papillomavirus infections in Japanese women.
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Adolescent↗
Identification of Fabry's disease by the screening of alpha-galactosidase A activity in male and female hemodialysis patients.
BACKGROUND: Although previous studies reported that the prevalence of Fabry's disease was 0.16 - 1.2% in hemodialysis (HD) patients based on measurement of a-galactosidase A (alpha-Gal A) activity, few reports detected female patients by the screening for alpha-Gal A. Here we determined the prevalence of Fabry's disease not only in male but also in female HD patients by measuring alpha-Gal A. METHODS: Plasma alpha-Gal A was measured in 696 consecutive males (n = 401) and females (n = 295) on HD. Patients with low plasma alpha-Gal A were examined for leukocyte alpha-Gal A, and patients with low leukocyte alpha-Gal A underwent alpha-Gal A gene sequence analysis for possible mutations, and family survey. RESULTS: Among 15 patients with low plasma alpha-Gal A activity, 4 male patients with low leukocyte alpha-Gal A and 1 female patient revealing low plasma alpha-Gal A were detected in 696 HD patients (0.7% of total patients). 3 of these 5 patients were already diagnosed to have the classical type of Fabry's disease. The other 2 patients were newly diagnosed as Fabry's disease, and did not have typical manifestations of Fabry's disease other than renal failure and left ventricular hypertrophy. DNA analysis of these 2 newly diagnosed patients revealed that each had an alpha-Gal missense mutation, previously identified (E66Q, M2961). CONCLUSION: Fabry's disease should be considered in the etiology of unexplained end-stage renal disease. Not only affected males but also affected females undergoing HD patients can be readily diagnosed by alpha-Gal A activities and gene analysis. These patients and their family members may benefit from enzyme replacement therapy for Fabry's disease.
Adult↗
[Perioperative management for lung cancer with interstitial pneumonia].
The purpose of this study was to review perioperative managements from the clinical features and the postoperative course of lung cancer patients with interstitial pneumonia (IP). Twenty-two patients with IP were divided into 2 groups: the acute exacerbation (AE) group (6 patients) and the non-acute exacerbation (NAE) group (16 patients). There was no significant difference in the patient background between the 2 groups. In hematological examination, KL-6 levels were significantly higher in the AE group than in the NAE group. There was no significant difference in the respiratory function tests in the both groups, and the heart rate after 2 flights test was significantly higher in the AE group than in the NAE group. There was no significant difference in operation-related factors, tumor-related factors and the postoperative course in the both groups. No postoperative death occurred in our 22 patients probably due to adequate treatments of IP which was managed by our detailed manual. Long-term follow-up for lung cancer patients with IP undergoing surgical intervention is needed to prevent AE.
Aged↗
[Surgical resection of T3 and T4 lung cancer].
Lung cancer invading neighboring anatomical structures such as the chest wall, pericardium, diaphragm, and left atrium are categorized as T3 or T4, which is regarded as locally advanced lung cancer. The purpose of this study was to evaluate results of surgical treatment of T3-4N0-2M0 non-small cell lung cancer according to involved organs. From 1981 to April 2005, 148 patients with lung cancer invading neighboring organs were surgically treated in our hospital. The 5-year survival was 41.4% in all cases. According to 5-year survival of clinical characteristics, the chest wall (parietal pleura) group (45.5%) had a significantly better prognosis compared with the left atrium (0%, p = 0.03) and diaphragm (0%, p = 0.04) groups. T3N0 (50.3%), IIB (55.4%), IIIA (44.6%), and complete resection groups (49.0%) showed a significantly better prognosis compared with T3N2 (27.9%, p = 0.01), III B (0%, p < 0.0001), and incomplete resection groups (13.9%, p < 0.0001), respectively. These results indicate that the prognosis of patients with N2 disease or incomplete resection remains poor in regardless with the type of involved organs.
Adult↗
Improved measurement of the K+-->pi+nunu; branching ratio.
An additional event near the upper kinematic limit for K+-->pi(+)nunu; has been observed by experiment E949 at Brookhaven National Laboratory. Combining previously reported and new data, the branching ratio is B(K+-->pi(+)nunu;)=(1.47(+1.30)(-0.89))x10(-10) based on three events observed in the pion momentum region 211<P<229 MeV/c. At the measured central value of the branching ratio, the additional event had a signal-to-background ratio of 0.9.
Journal Article↗
Randomised phase II study of docetaxel/cisplatin vs docetaxel/irinotecan in advanced non-small-cell lung cancer: a West Japan Thoracic Oncology Group Study (WJTOG9803).
Docetaxel plus cisplatin and docetaxel plus irinotecan are active and well-tolerated chemotherapy regimens for advanced non-small-cell lung cancer (NSCLC). A randomised phase II study compared their efficacy and toxicity in 108 patients with stage IIIb/IV NSCLC, who were randomised to receive docetaxel 60 mg m(-2) and cisplatin 80 mg m(-2) on day 1 (DC; n=51), or docetaxel 60 mg m(-2) on day 8 and irinotecan 60 mg m(-2) on day 1 and 8 (DI; n=57) every 3 weeks. Response rates were 37% for DC and 32% for DI patients. Median survival times and 1- and 2-year survival rates were 50 weeks (95% confidence interval: 34-78 weeks), 47 and 25% for DC, and 46 weeks (95% confidence interval: 37-54 weeks), 40 and 18% for DI, respectively. The progression-free survival time was 20 weeks (95% confidence interval: 14-25 weeks) with DC and 18 (95% confidence interval: 12-22 weeks) with DI. Significantly more DI than DC patients had grade 4 leucopenia and neutropenia (P<0.01); more DC patients had grade >/=2 thrombocytopenia (P<0.01). Nausea and vomiting was more pronounced with DC (P<0.01); diarrhoea was more common with DI (P=0.01). Three treatment-related deaths occurred in DC patients. In conclusion, although the DI and DC regimens had different toxicity profiles, there was no significant difference in survival.
Adult↗
Functional analysis of the tumour suppressor gene PTEN in murine B cells and keratinocytes.
To investigate the roles of the PTEN (phosphatase and tensin homologue deleted from chromosome 10)/PI3K (phosphoinositide 3-kinase) signalling pathway in vivo, we have generated a series of mutant mice with null or tissue-specific gene-targeted deletions of Pten. Here we present our investigations of Pten function in B cells and keratinocytes in mice. Mice with a B cell-specific mutation of Pten showed increased serum autoantibodies and elevated numbers of B1a cells. Among conventional B (B2) cells in mutant spleens, numbers of marginal zone B cells were significantly increased, while those of follicular B cells were reciprocally decreased. Immunoglobulin class switch recombination was defective and associated with impaired induction of activation-induced cytidine deaminase. Mice with a keratinocyte-specific mutation of Pten exhibited epidermal hyperplasia, hyperkeratosis and accelerated skin morphogenesis. Within 3 weeks of birth, 90% of these animals died of malnutrition, possibly caused by hyperkeratosis of the oesophageal epithelia. Surviving mutant mice developed spontaneous skin tumours within 8.5 months of birth, and chemical treatment accelerated the onset of tumours. Our data show that PTEN is an important regulator in B cells and keratinocytes.
Animals↗
Development of software for internal dose calculation from bioassay measurements.
Recently developed biokinetic models of ICRP permit increasingly realistic descriptions of the behaviour of radionuclides in the human body. This, however, has made the interpretation of bioassay data extremely difficult. Thus computer programs for implementing these models are in need, but very few are available. The present work describes personal-computer-based software, MONDAL2 (monitoring to dose calculation ver. 2), that enables users to estimate intake activity and the resulting effective doses from bioassay measurements for both workers and members of the public. This software runs on Microsoft Windows 95, 98, Millennium edition, 2000 or XP. If the system is to be fully copied to a hard disk, hard disk space of 23 MB is required. This software is distributed by the National Institute of Radiological Sciences free of charge.
Age Factors↗
Images of interest. Hepatobiliary and pancreatic: cholangiocarcinoma with chylous ascites.
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Bile Duct Neoplasms↗
Characteristics of postictal headache in patients with partial epilepsy.
Migraine-like features sometimes characterize the headache that follows epileptic seizure (postictal headache, PIH). We compared patients with different types of epilepsy to investigate the association between migraine-like PIH and seizure type. Subjects comprised 364 patients with partial epilepsy. Epilepsy types were temporal lobe epilepsy (TLE, n = 177), frontal lobe epilepsy (FLE, n = 116), and occipital lobe epilepsy (OLE, n = 71). Patients participated in a structured interview pertaining to PIH as well as interictal headache and family history of migraine. Headaches were classified according to the International Headache Society criteria, which was modified for this study. Forty percent had PIH and 26% of these patients had migraine-like PIH. Migraine-like PIH occurred significantly more often in cases of TLE and OLE than in cases of FLE. In addition, the incidence of interictal migraine headache was significantly higher in patients with migraine-like PIH. These results suggest that migraine-like PIH is related to particular regions of epileptogenic focus and that susceptibility to migraine headache predisposes to migraine-like PIH.
Adolescent↗
A case of rhabdomyosarcoma of the vagina in an elderly woman.
Most rhabdomyosarcomas of the vagina (RMSV) occur in infants and children up to six years old. RMSV in elderly patients is extremely rare. We report a case of a 70-year-old woman with RMSV. She had received surgery for uterine endometrial cancer one year before and a vaginal polypoid tumor was noted during routine follow-up vaginal examination. She was referred to our department for radiation therapy following partial tumorectomy of the lesion. She was given three sessions of intra-vaginal radiation therapy, once a week with 6 Gy at 7.5 mm below the vaginal surface and external irradiation of 50 Gy to the pelvis. However, paraaortal lymph node metastasis developed during initial radiation therapy. Furthermore, multiple bone metastases appeared at the completion of the radiation therapy. Six months after initial treatment the patient died from progression of the disease. Autopsy demonstrated small residual tumor at the primary site as well as multiple systemic metastases.
Aged↗
Beam-polarization asymmetries for the p(gamma-->, K+)Lambda and p(gamma-->, K+)Sigma(0) reactions for E(gamma)=1.5-2.4 GeV.
Beam polarization asymmetries for the p(gamma-->,K+)Lambda and p(gamma-->,K+)Sigma(0) reactions are measured for the first time for E(gamma)=1.5-2.4 GeV and 0.6<cos((theta(c.m.)(K+))<1.0 by using linearly polarized photons at the Laser-Electron-Photon facility at SPring-8 (LEPS). The observed asymmetries are positive and gradually increase with rising photon energy. The data are not consistent with theoretical predictions based on tree-level effective-Lagrangian approaches. Including the new results in the development of the models is, therefore, crucial for understanding the reaction mechanism and to test the presence of baryon resonances which are predicted in quark models but are thus far undiscovered.
Journal Article↗
High dose-rate brachytherapy source localization: positional resolution using a diamond detector.
A potential real-time source position verification process for high dose-rate (HDR) brachytherapy treatment is described. This process is intended to provide immediate confirmation that a treatment is proceeding according to plan, so that corrective action can be taken if necessary. We show that three dosimeters are in principle sufficient and demonstrate the feasibility of the process using a diamond detector and an Ir-192 source. An error analysis including all identified sources of error shows that this detector is capable of locating the distance to the source to within 2 mm for distances up to 12 cm. This positional accuracy is less than the diameter of typical HDR catheters indicating that a diamond detector can be used to accurately determine the distance to the source. The uncertainty in the distance is found to increase with distance.
Algorithms↗
Evidence for a narrow S = +1 baryon resonance in photoproduction from the neutron.
The gamman-->K(+)K(-)n reaction on 12C has been studied by measuring both K+ and K- at forward angles. A sharp baryon resonance peak was observed at 1.54+/-0.01 GeV/c(2) with a width smaller than 25 MeV/c(2) and a Gaussian significance of 4.6sigma. The strangeness quantum number (S) of the baryon resonance is +1. It can be interpreted as a molecular meson-baryon resonance or alternatively as an exotic five-quark state (uuddsmacr;) that decays into a K+ and a neutron. The resonance is consistent with the lowest member of an antidecuplet of baryons predicted by the chiral soliton model.
Journal Article↗
Spectral intermode coupling in a model of isotropic turbulence.
We investigate the nonlinear coupling between the so-called explicit modes, identified with wave numbers k such that 0< or =k< or =k(c), and implicit modes, defined such that k(c)< or =k< or =k(max). Here k(c) is an arbitrarily chosen cutoff wave number and k(max) is the ultraviolet cutoff as determined by viscous damping. The stresses arising from the nonlinearity in the Navier-Stokes equations are categorized as "implicit-implicit" (or "Reynolds") and "explicit-implicit" (or "cross"). These arise from dynamic coupling between different regions of wave number space. Their respective effects on momentum, kinetic energy, and energy flux are assessed. The analysis is based on a model system comprising the Navier-Stokes equations and the Edwards-Fokker-Planck energy equation [S. F. Edwards, J. Fluid Mech. 18, 239 (1964)] which is known to retain all the symmetries of homogeneous, isotropic turbulence. The Reynolds stress is found to be responsible for long-range energy transfers. It can be represented by an effective viscosity and is mainly determined by dynamical friction. The cross term is more complicated, involving both diffusive and frictional effects. For long-range coupling it can be expressed as a modification of the effective viscosity, while for short-range coupling it may be modeled on the assumption that implicit scales are slaved to explicit scales. Thus, both the random and coherent aspects of intermode coupling in turbulent flows are relevant in the cross term. The imposition of a continuity requirement on energy transfer leads to a new parametrization that represents the effect of absent modes in a truncated spectral simulation, and takes into account the phase-coupling (coherent) effects, as well as the usual viscositylike (random) effects.
Journal Article↗
Dissecting aneurysms of the middle cerebral artery: neuroradiological and clinical features.
There are few reported cases of nontraumatic dissecting aneurysms of the middle cerebral artery (MCA), and their neuroradiological and clinical features have not been analysed. We looked at these aspects in a collaborative study. We reviewed 13 patients diagnosed as having a dissecting aneurysm of the MCA based on clinical signs and neuroradiological findings in 46 stroke centres between 1995 and 1999. There were four patients who presented with cerebral ischaemia, and nine who presented with bleeding. Of the former group, three were aged less than 15 years. Cerebral angiography showed extensive stenosis and a double lumen of the M1 portion in all four patients. High signal on T1-weighted images around the arterial flow void, due to intramural haematoma, was often seen in the second week. MR angiography showed findings corresponding those of intra-arterial angiography in all four cases. We saw an infarct on CT or MRI in territory of the perforating branches of the M1 segment in all four patients. In the patients presenting with bleeding, pure subarachnoid haemorrhage or a sylvian fissure haematoma was seen on initial CT, and the predominant angiographic finding was dilatation with stenosis, but the site of the lesions was not uniform. A double lumen or intimal flap was seen in about half the cases. Rebleeding occurred within 14 days of the onset in five of the nine patients, with a poor prognosis.
Adolescent↗