Image-guided robotic stereotactic radiotherapy for synchronous cancer of maxillary gingiva and lung

The use of stereotactic body radiation therapy is rapidly increasing among patients with lung cancer not amenable to surgery. The authors report their experience using the CyberKnife system (Accuray Inc., Sunnyvale, CA, USA) as a treatment option for synchronous cancer of oral squamous cell carcinoma and a malignant lung tumour. An 88-year-old woman with two cancers (oral and lung masses) underwent CyberKnife treatment, with fiducial gold pins implanted using bronchoscopy. Toxicity was limited, and at the 2-year follow-up the lesions had not recurred.

FTIR spectroscopy of three fundamental bands of H2F+

The ν1, ν2, and ν3 bands of H2F(+) were observed with a Fourier transform absorption spectroscopic technique in the 3 and 7 μm regions. The ion was produced with a hollow cathode discharge in a F2, He, and H2 gas mixture. A simultaneous analysis of FT data combined with laser spectroscopic data was carried out using the Watson's A-reduced Hamiltonian to determine molecular constants in vibrationally excited states. The effect of the vibration-rotation interaction between the ν1 and ν3 states was found to be small compared with the case of H2O. The vibration-rotation transitions of the ν2 band were first identified and analyzed to obtain molecular constants in the ν2 state, and the band origin was determined to be 1370.5236 (7) cm(-1) with one standard deviation in parentheses. Determined molecular constants can be used to derive the re structure of H2F(+) as re(H-F) = 0.9608(6) Å, ∠e(H-F-H) = 112.2(2)° with the error corresponding to the uncertainty of the assumed vibration rotation constant γ2(a) and the range of the values derived from three pairs of rotational constants.

THz rotational spectrum of H2F+

In view of recent tremendous advance in astronomical observations in the submillimeter to THz region brought by the Herschel space craft, laboratory high-resolution spectroscopic investigations in that frequency region into unstable molecules, in particular, light hydride ions, are urgently needed. As a part of such endeavor, rotational transitions of H(2)F(+) were observed in the THz-region by using a tunable far-infrared spectrometer. These newly detected lines together with the submillimeter-wave lines obtained previously and the combination differences derived from infrared vibration-rotation lines were subject to a least-squares analysis that yielded a set of molecular constants with much better accuracy. The measured and predicted THz transition frequencies should prove to be a useful probe into detection of interstellar H(2)F(+).

Unit cell parameters of wurtzite InP nanowires determined by x-ray diffraction

High resolution x-ray diffraction is used to study the structural properties of the wurtzite polytype of InP nanowires. Wurtzite InP nanowires are grown by metal-organic vapor phase epitaxy using S-doping. From the evaluation of the Bragg peak position we determine the lattice parameters of the wurtzite InP nanowires. The unit cell dimensions are found to differ from the ones expected from geometric conversion of the cubic bulk InP lattice constant. The atomic distances along the c direction are increased whereas the atomic spacing in the a direction is reduced in comparison to the corresponding distances in the zinc-blende phase. Using core/shell nanowires with a thin core and thick nominally intrinsic shells we are able to determine the lattice parameters of wurtzite InP with a negligible influence of the S-doping due to the much larger volume in the shell. The determined material properties will enable the ab initio calculation of electronic and optical properties of wurtzite InP nanowires.

Usefulness of an original self-completed questionnaire for screening of cancer-related mental disorder in patients with newly diagnosed early breast cancer

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Background: Cancer-related mental disorder reduces (e.g., depression and anxiety disorder) not only treatment compliance but also compromises the quality of life of the patient. However, psychiatric intervention at the cancer notification has been barely performed in Japan because Japanese people traditionally tend to have a prejudice against psychiatric consultation and about sexual activity. In order to provide more effective treatment for breast cancer patients, it is necessary to treat cancer-related mental disorder in Japan.

Methods: Based on Self-rating Depression Scale, Hamilton's Rating Scale for Depression and Beck Depression Inventory, the questionnaires were modified for Japanese patients by psychiatrists and clinical psychologists of our hospital. We asked newly diagnosed breast cancer patients an original self-completed questionnaire regarding the depression and anxiety disorder between January 2010 and March 2011. This questionnaire consists of 14 questions about depression and anxiety disorder without questions of sexual activity, which has two points each question (maximum total points were 28). We recommended the psychiatric interference by a psychiatrist and the clinical psychologist to all patients with more than 14 points in this questionnaire.

Results: We obtained data from 116 patients. No patient refused to answer the questionnaire. 23 patients had higher than 14 points in this questionnaire. Of 23 patients, 9 patients received psychiatric intervention without medication, and four patients received psychotropic medications. Based on the results, we avoided the administration of anticancer agent by intravenous infusion in three patients who had higher than 14 points in the questionnaire. Multivariate analysis revealed that unmarried status is associated with a significantly higher score (OR 16.1; p = 0.013).

Conclusions: Our data suggest that our original self-completed questionnaire is useful for the screening of the cancer-related mental disorder in order to provide appropriate therapy to newly diagnosed breast cancer patients.

Correlation between docetaxel-induced skin toxicity and the use of steroids and H₂ blockers: a multi-institution survey

Steroids and H(2) blockers are commonly used as supportive care for taxane-containing chemotherapy, but they also affect docetaxel's primary metabolizer, cytochrome P(450) 3A4. This retrospective observational study was performed to better understand the effects of these compounds on docetaxel-induced skin toxicities, specifically hand-foot syndrome (HFS) and facial erythema (FE), a relationship that is currently poorly understood. Member institutions of the Japan Breast Cancer Research Group were invited to complete a questionnaire on the occurrence of grade 2 or higher HFS and FE among patients treated between April 2007 and March 2008 with docetaxel as an adjuvant or neoadjuvant chemotherapeutic treatment for breast cancer. We obtained data for 993 patients from 20 institutions. Twenty percent received H(2) blockers, and all patients received dexamethasone. Univariate and multivariate analyses revealed that H(2) blockers are associated with a significantly higher incidence of both HFS and FE. The incidence of FE was significantly higher for the docetaxel + cyclophosphamide (TC) regimen than for non-TC regimens combined. Dexamethasone usage did not affect the incidence of either HFS or FE. In conclusion, use of H(2) blockers as premedication in breast cancer patients receiving docetaxel significantly increases the risk of both HFS and FE.

Feasibility of fibrin glue versus endoclips to close the transgastric peritoneal access site in NOTES in a survival porcine study

INTRODUCTION

Safe peritoneal access and gastric closure are the most important concerns in clinical applications of NOTES. Our past study demonstrated usefulness of the submucosal tunnel technique for safe peritoneal access and closure with endoclips. However, such closure is sometimes difficult and time-consuming. This study investigated the feasibility of fibrin glue for submucosal tunnel closure in a NOTES porcine model.

METHODS

In 10 female pigs each weighing 40 kg, transgastric peritoneoscopy was performed through a 60 mm-long submucosal tunnel created using the endoscopic submucosal dissection technique. After transgastric peritoneoscopy for 30 min, the submucosal tunnel was closed with endoclips in five pigs and fibrin glue in five pigs. After a 7 d follow-up period, the pigs were euthanized for post-mortem examination. Outcome measures included (a) technical feasibility of closure with endoclips versus fibrin glue, (b) clinical monitoring for 7 d, (c) follow-up necropsy at 7 d, and (d) histopathologic examination of the peritoneal access site.

RESULTS

Transgastric peritoneoscopy with submucosal tunnel technique was successful in all pigs. Mean time required to close the mucosal incision site with fibrin glue was 1.6 ± 0.5 versus 19 ± 18.7 min with endoclips. All pigs survived well without complications. Necropsy revealed no peritonitis. There were no differences in transgastric peritoneal access sites between endoclips and fibrin glue. Histopathologic examination of the submucosal tunnel demonstrated wound healing with transmural fibrosis. No adverse effects from fibrin glue were noted.

CONCLUSION

Compared with endoclips, the application of fibrin glue is easy and simple in the closure of transgastric peritoneal access in NOTES.

Reduction of Alzheimer's disease amyloid-β in plasma by hemodialysis and its relation to cognitive functions

BACKGROUND/AIMS

Rapid removal of plasma amyloid-β (Aβ) by blood purification may serve as a peripheral Aβ sink from the brain for Alzheimer's disease therapy. We investigated the reduction of plasma Aβ during hemodialysis and cognitive states.

METHODS

Aβ concentrations and Mini-Mental State Examinations (MMSE) were investigated in 37 hemodialysis patients (68.9 ± 4.1 years).

RESULTS

The dialyzers effectively removed Aβ(1-40) and Aβ(1-42), 63.9 ± 14.4 and 51.6 ± 17.0% at 4 h dialysis, resulting in the reduction of Aβs in whole-body circulation by 51.1 ± 8.9 and 32.7 ± 12.0%, respectively. Although the plasma Aβs before dialysis (750.8 ± 171.3 pg/ml for Aβ(1-40)) were higher than those reported for Alzheimer's disease patients, the cognitive states of hemodialysis patients were relatively normal, especially of longer dialysis vintages.

CONCLUSIONS

Dialyzers effectively reduced Aβs in whole-body circulation. Repeated rapid decrease of plasma Aβs might maintain cognitive state.

Utilization of Valuable Metals from High Level Waste-Decomposition of Water Using Semiconductor Photocatalytic Method Induced by Gamma Ray-

The technique of radiolytic decomposition of water leading to hydrogen production was demonstrated to explore a new field in the utilization of radioactive platinum group metals recovered from high level radioactive waste (HAW) and radioactivity of HAW. The radiation photocatalytic method is based on the technique to decompose water on platinized semiconductor particles under UV-light irradiation which has been widely investigated to develop an alternative energy source. In this study gamma radiation from Co-60 source was applied to produce hydrogen instead of UV-light and a significant amount of hydrogen evolved from catalyst-water suspension. Our preliminary experiments proved a possibility of converting the energy of radiation ionization into chemical energy (hydrogen) by the radiation photocatalytic method.

Development of high-speed polarizing imaging system for operation in high pulsed magnetic field

A high-speed polarizing microscope system combined with a 37 T pulse magnet has been developed. This system was applied to successfully visualize the field-induced collapse of charge-orbital ordering in a layered manganite La(1/2)Sr(3/2)MnO(4). Quantitative analyses of the obtained polarizing microscope images provided clear evidence of this transition in contrast to rather moderate changes in magnetization and magnetoresistance. The ability of this system to carry out quantitative analysis was further tested through the observation of Faraday rotation in a Tb(3)Ga(5)O(12) crystal. The Verdet constant determined from the polarizing images is in reasonable agreement with that in literature. Local intensity analyses of the images indicate that we can investigate magneto-optical signals within an accuracy of 0.85% in an area of 9.6 x 9.6 microm(2).

Mutational analysis of the hepatitis C virus E1 glycoprotein in retroviral pseudoparticles and cell-culture-derived H77/JFH1 chimeric infectious virus particles

Cell entry by enveloped viruses is mediated by viral glycoproteins, and generally involves a short hydrophobic peptide (fusion peptide) that inserts into the cellular membrane. An internal hydrophobic domain within E1 (aa262-290) of hepatitis C virus (HCV) may function as a fusion peptide. Retrovirus-based HCV-pseudotyped viruses (HCVpp; genotype 1a) containing Ala or Pro substitutions at conserved amino acid positions within this putative fusion peptide were generated. Mutation of conserved residues significantly reduced efficiency of HCVpp entry into Huh-7 cells. The majority of amino acid substitutions appeared to disrupt necessary interactions between E1 and E2. For some mutants, reductions in HCVpp-associated E1 were associated with the incorporation of a high molecular weight, hyperglycosylated E2 that displayed decreased CD81-binding. Other entry-deficient mutants displayed normal E1E2 incorporation into pseudoparticles and normal CD81-binding, and therefore might affect viral fusion. One mutant (S283P) consistently displayed two- to threefold higher infectivity than did wild-type. Three mutations that decreased HCVpp infectivity also reduced levels of HCVcc infectious virus production. However, the S283P mutation had a different effect in the two systems as it did not increase production of infectious HCVcc. This comprehensive mutational analysis of the putative HCV fusion peptide provides insight into the role of E1 in its interaction with E2 and in HCV entry.

Submucosal tunneling using endoscopic submucosal dissection for peritoneal access and closure in natural orifice transluminal endoscopic surgery: a porcine survival study

BACKGROUND AND STUDY AIMS

Safe peritoneal access and gastric closure are the most important concerns in the clinical application of natural orifice transluminal endoscopic surgery (NOTES). We aimed to clarify the feasibility of a submucosal tunnel technique using endoscopic submucosal dissection (ESD) for transgastric peritoneal access and subsequent closure for NOTES.

METHODS

Seven female pigs, each weighing about 40 kg were included in the study. The following procedures were performed: (i) after injection of normal saline into the submucosa, the mucosa was cut with a flex knife; (ii) the submucosal layer was dissected using an insulation-tipped electrosurgical knife to make a narrow longitudinal 50-mm submucosal tunnel; (iii) a small incision was made at the end of the tunnel and enlarged with a dilation balloon. After transgastric peritoneoscopy, the mucosal incision site was closed with clips. The following outcome measures were used: (a) evaluation of the technical feasibility of making a submucosal tunnel; (b) clinical monitoring for 7 days; (c) follow-up endoscopy and necropsy; and (d) peritoneal fluid culture.

RESULTS

Natural orifice transluminal endoscopic peritoneoscopy with a submucosal tunnel was successfully carried out in all pigs. The pigs recovered well, without signs of peritonitis. Follow-up endoscopy showed healing of mucosal incision sites without open defects. Necropsy revealed no findings of peritonitis, confirming completeness of gastric closure; there was a thin scar in one pig and adhesion of the omentum in six pigs. Peritoneal fluid culture demonstrated no bacterial growth.

CONCLUSIONS

The submucosal tunnel technique is feasible and effective for transgastric peritoneal access and closure.

Correlation between docetaxel-induced skin toxicity and the use of steroids and H2 blockers: A multi-institution survey

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Background: Docetaxel is a standard drug used for adjuvant or neoadjuvant chemotherapeutic treatment of early breast cancer. With appropriate management of chemotherapy-induced bone marrow toxicity, skin toxicities such as hand-foot syndrome (HFS) and facial erythema (FE) have become dose-limiting. Steroids and H2 blockers are commonly used to provide supportive care to patients being treated with taxane-containing chemotherapeutic regimens, but their effects on skin toxicity are poorly understood. Methods: We asked institutions belonging to the JBCRG to complete a questionnaire regarding the occurrence of grade 2 or higher HFS and FE among patients treated with docetaxel as an adjuvant or neoadjuvant chemotherapeutic treatment for breast cancer between April 2007 and March 2008. Data collected were docetaxel dose, other chemotherapeutic agents administered, dosage regimens for the steroids and H2 blockers (if used), and incidences of grade 2 or higher HFS or FE. Statistical analyses were performed using the chi-squared test. Results: We obtained data for 989 patients from 22 institutions. Most patients received docetaxel at a dose of 75 mg/m2 and 852 patients were treated with docetaxel monotherapy. HFS and FE occurred in 18% and 13% of patients, respectively. The relationships between the incidence of skin toxicity and (i) chemotherapy regimen and (ii) use of H2 blockers are shown below ( Table ). Conclusions: Our data suggest that use of H2 blockers as premedication in breast cancer patients treated with docetaxel significantly increases the risk of both HFS and FE.

[Table: see text]

[Table: see text]