Influence of using history of immune checkpoint inhibitor therapy for neutropenia caused by combination therapy of ramucirumab and docetaxel.

Recently, pretreatment with immune checkpoint inhibitors (ICIs) has been shown to enhance the therapeutic effects of the combination therapy of ramucirumab (RAM) and docetaxel (DTX); however, its influence on the drug's side effects remains unclear. This study investigated the influence of pretreatment with ICIs on the incidence of neutropenia caused by RAM + DTX therapy in patients with non-small cell lung cancer (NSCLC). Patients with NSCLC who received RAM + DTX therapy at Gifu Prefectural General Medical Center between April 2016 and December 2020 were enrolled. Retrospective data regarding age, sex, performance status and detailed treatment history, among others, at treatment initiation were collected from the patients' electronic medical records. Additionally, data on the course number of RAM + DTX therapy, supportive therapy and blood biochemical parameters, including leukocyte and neutrocyte counts, during the treatment period were collected. We identified 41 patients receiving RAM + DTX therapy. Among the more than grade 3 adverse events caused by this therapy, neutropenia was the most common (78.1%). Despite the fact that all previous risk factors influencing this incidence rate had corresponded, the only factor influencing the incidence rate of neutropenia more than grade 3 was ICI treatment history. A difference in the incidence of neutropenia more than grade 3 in the Kaplan-Meier curve was observed between patients with and without ICI pretreatment history (p = 0.037). The pretreatment history of ICI therapy affects the incidence of neutropenia caused by RAM + DTX therapy in patients with NSCLC.

Use of the QuantiFERON-TB Gold test for screening tuberculosis contacts and predicting active disease.

OBJECTIVE: To evaluate the performance of the QuantiFERON(R)-TB Gold (QFT-G) test for screening tuberculosis (TB) contacts and estimating their risk of progressing to active TB disease. METHODS: Data on clinical progression to active disease were collected from public health centres 2 years after close contacts of TB cases had been QFT-G-tested. RESULTS: Among 3102 contacts observed, 419 were QFT-G-positive, and isoniazid (INH) treatment was initiated in 323. Twenty (4.8%) of these 419 developed TB disease. Among 2683 QFT-G-negative persons, 19 were diagnosed with TB (0.7%) during the average follow-up period of 1.6 years. The estimated sensitivity of QFT-G in detecting contacts who would progress to active TB was 51%, or 64% allowing for the effects of INH treatment. Among the QFT-G-negative contacts, all those who developed TB disease were contacts of highly infectious cases. Large-scale tuberculin skin testing was not available. CONCLUSIONS: TB incidence among QFT-G-positive contacts was higher than among QFT-G-negative contacts, but the number of TB cases among QFT-G-negative contacts is non-negligible, especially among contacts of highly infectious cases.

Spin transition in a four-coordinate iron oxide.

Spin transition has attracted the interest of researchers in various fields since the early 1930s, with thousands of examples now recognized, including those in minerals and biomolecules. However, so far the metal centres in which it has been found to occur are almost always octahedral six-coordinate 3d(4) to 3d(7) metals, such as Fe(II). A five-coordinate centre is only rarely seen. Here we report that under pressure SrFe(II)O(2), which features a four-fold square-planar coordination, exhibits a transition from high spin (S = 2) to intermediate spin (S = 1). This is accompanied by a transition from an antiferromagnetic insulating state to a ferromagnetic so-called half-metallic state: only half of the spin-down (d(xz),d(yz)) states are filled. These results highlight the square-planar coordinated iron oxides as a new class of magnetic and electric materials.

Evaluation of the therapeutic effect of radiotherapy on cervical cancer using magnetic resonance imaging.

PURPOSE: This study was performed to evaluate magnetic resonance imaging (MRI) in determining the therapeutic effect of radiotherapy (RT) on cervical cancer. METHODS AND MATERIALS: Serial MRI studies were performed in 42 patients with predominantly advanced cervical cancer before, during, and after radiotherapy. Patients underwent external irradiation combined with high-dose-rate intracavitary (HDR) brachytherapy. T-2 weighted spin-echo pulse sequences with long repetition and echo times were used at a field strength of 1.5 T. Multiple punch biopsies of the cervix were obtained from the high-signal intensity area in all patients at the same time as the MRI. RESULT: In biopsies performed immediately after RT, no residual tumors were found in 36 patients (86%); in 6 patients, residual tumors were observed. The simultaneous MRI study demonstrated no high-signal intensity on T2-weighted images in 28 patients. A high-signal area was observed in 14 patients, and this disappeared 3 months after RT in 8 patients with a negative histological study. The sensitivity, specificity, and accuracy of MRI studies at 3 months after RT were 100%. When the relationship between reduction of tumor volume at 30 Gy and local tumor control was analyzed, every patient with a reduction under 30% gained local control. Also, patients with no residual tumors 3 months after RT gained local control. CONCLUSION: MRI studies performed at 30 Gy of external irradiation and 3 months after RT were predictive factors of local control.

[Roles of outpatient nurses in the care of cancer patients receiving MS Contin tablets].

Pain relief is very important to improve the QOL of cancer patients. Accurate pain assessment and offering suitable drug information on MS Contin tablets (MSC) are important roles of outpatient nurses for the effective use of MSC. We examined the present status of symptom relief among cancer outpatients and from this discuss the practice of outpatient nursing. Forty-eight outpatients receiving MSC were interviewed by mail with regard to pain relief, the side effects of MSC, and the drug information they had been provided. Cancer pain was well controlled in 68% of outpatients by MSC, but MSC was not effective in 13%. Some side effects were observed in 68% of patients, 10% of which were poorly controlled. Sixty-five percent of patients were informed about MSC, but only 47% were informed about measures against these side effects. The following conclusions were reached: 1) MSC should be explained individually and repeatedly, 2) exact informations on a patient's status should be collected using scales and charts, 3) nurse charts should record when MSC is initially administered and when the dosage is changed, and 4) the cases of poorly controlled patients should be studied and specialists consulted if necessary.

[Radiotherapy for carcinoma of the buccal mucosa: analysis of prognostic factors].

The radiotherapeutic results of 55 patients with carcinoma of the buccal mucosa were analyzed to determine the prognostic factors and appropriate treatment modality. They were classified into 5 groups according to treatment modality: group A (preoperative radiotherapy followed by surgery), group B (interstitial implant), group C (electron therapy), group D (mainly external radiotherapy) and group E (external radiotherapy followed by mold therapy with remote afterloading system). The overall 5-year survival rates for groups A, B, C, D, E and the entire group were 50%, 61%, 67%, 29%, 25% and 48%, respectively. The cumulative 5-year local control rates for groups A through E were 81%, 94%, 75%, 33% and 25%, respectively. In univariate analysis, T stage (T1-2 vs. T3-4), N stage (N0 vs. N1-3), clinical stage (II vs. III-IV), histologic grade (well differentiated vs. moderately and poorly differentiated) and treatment modality (A-C vs. D-E) were significantly related to overall survival (p < 0.05). Multivariate analysis revealed that treatment modality (groups A-C) and N0 stage were significantly associated with favorable prognosis (p < 0.05). These results suggest that interstitial implants are comparable with surgery for T1 to early T3 lesions, with or without slight invasion to the bucco-alveolar sulci or retromolar areas, that can be treated with a single-plane implant.

Visual function following congenital cataract surgery.

To evaluate the results of congenital cataract extraction and postoperative visual function, we retrospectively reviewed the records of 95 patients who underwent pars plana (plicata) lensectomy or aspiration surgery. Forty-nine percent of the patients with bilateral aphakia and 25% with bilateral pseudophakia had a Landolt visual acuity of 0.5 or above at the final visit. The figures were 31% and 66% for patients with unilateral aphakia and pseudophakia, respectively. Eight patients (16.3%) with bilateral and 2 patients (5.8%) with unilateral cataract for whom contact lenses were prescribed after surgery attained fine stereopsis. Five of 8 patients (62.5%) with unilateral cataract who had intraocular lens implantation ended up with gross or fine stereopsis. We stress that very early surgery and optical correction in the sensitive period of binocular visual development should be instituted, especially in the presence of dense opacities. A good postoperative visual outcome can be achieved in patients undergoing late surgery if the opacities are light or partial in nature. We also reemphasize the importance of aggressive and diligent visual rehabilitation and occlusion therapy against amblyopia.

[Terminal care of the cancer patient at home--patient and family spending the last moments together].

Some 129 cancer patients were taken care of at home by the visiting nurse team of our hospital since 1994 to 1997; 116 patients have already died, 50 of them at home (group A), and 66 at the hospital (group B). We analyze the differences the between two groups in nutritional assistance, pain control and manpower in looking after a patient. Twice as many patients in group A took nutritional medication (drip infusion or intravenous hyperalimentation, for example) than group B. More patients in group A used oral and suppository morphine than group B. In group A 70% of patients (56% in group B) had more than two persons looking after at home. The important factors for a good recuperation at home are: 1. Available nutritional assist available. 2. Good control. 3. Less burden and anxiety of the person looked after. To spend pain desirable last moments together, it is important for the visiting nurse team to take proper care and to confirm the wishes of the patient and family, considering the rapidly changing conditions of the individual patient.

Thallium-201 single-photon emission tomography in the treatment follow-up of nasopharyngeal carcinoma.

In order to assess the usefulness of thallium-201 single-photon emission tomography (SPET) in the treatment follow-up of nasopharyngeal carcinoma (NPC), a total of 75 201T1 SPET studies were performed in 18 patients with histologically proven NPC. The findings were compared with those of magnetic resonance imaging (MRI) before and after therapy. Four patients received radiotherapy alone while the other 14 received concurrent chemo-radiotherapy. Treatment response was classified as complete (CR) or partial (PR) based on the findings of MRI and 201T1 SPET. Intense 201T1 uptake by the tumour was seen in all 18 patients before treatment. After treatment, MRI showed seven CRs and 11 PRs, whereas 201T1 SPET showed 13 CRs and five PRs. In 12 patients, the results of 201T1 SPET were in agreement with those of MRI. In six patients MRI showed PR but 201T1 showed CR. Follow-up (mean 10.6 months) MRI and 201T1 SPET studies of these six patients revealed that tumour gradually decreased and finally vanished in three patients. This preliminary study indicates that 201T1 SPET has potential in the assessment of early response to treatment of patients with NPC when compared with MRI.

[Evaluation by visiting nurse in end-stage cancers--family questionnaire for patients who died after visiting nurse].

Since April 1994, we have provided visiting nurse care for patients with end-stage of cancers. A questionnaire was sent to 72 families of patients who died of cancer and who received after visiting nurse care. The response rate to the questionnaire was 76.4% (55 patients). One group of 27 patients died at home (Group A), and the other group of 28 patients died in the hospital (Group B). Patients who knew they had cancer accounted for 85.2% in Group A, and 57.1% in Group B. Of all patients, 69.1% desired home nursing, with 77.8% in Group A, and 60.7% in Group B. The satisfaction of families with the visiting nurse was evaluated. In Group A, satisfaction was 66.7% and relative satisfaction was 18.5%. In Group B, satisfaction was 50.0% and relative satisfaction was 25.0%. Satisfaction of patients with the place of death was 81.5% in Group A, and 35.7% in Group B. Many families wished to have the nurse visit 2 times a week, and an hour at each visit. The great mental burden on the families who provide home care for patients with terminal cancer was clear for the questionnaire. Arrangement for a support system for patients and families, through visiting nurse services, is necessary in our hospital.

[Visiting nurse support for patients wishing to die at home].

Thirty-two (1994) and 55 (1995) patients in the terminal stage of many kinds of cancer were cared for satisfactorily at home by a visiting team of nurses from Niigata Cancer Center Hospital. A prostate cancer patient with multiple bone metastasis was suffering from morphine-resistant intractable pain, and highly dependent on medical care. We continued to take care of him by frequent visitation and psychological assist until he eventually died at home according to his wishes. It is important to create a suitable support team for the continual difficult home care of each terminal patient.

[Hemibody irradiation in the treatment of generalized metastases].

Eight sessions of upper and lower hemibody irradiation have been given to 7 patients with generalized metastases from various malignancies. In 5 patients with painful bony metastases, the pain responded to the radiation and in one case, a complete disappearance of pain was obtained. In 2 patients, the hematological suppression that resulted needed supportive care. Hypercalcemia from metastatic cancer was alleviated dramatically in two patients, but not for long duration. Hemibody irradiation seems to provide an effective means for the palliation of painful bony metastases and for hypercalcemia resulting from it.

In vivo characteristics of a transplantable Marek's disease lymphoblastoid cell line, MDCC-MSB1-41C.

A Marek's disease (MD) lymphoblastoid cell line, MDCC-MSB1-41C, was highly transplantable and lethal for chickens. Autopsies showed extensive metastasis in various organs. The transplantabilities of the parent cell line, MDCC-MSB1, and another derivative line, MDCC-MSB1-33C, were transient. MD virus (MDV) could be isolated from the kidneys but not from the peripheral blood leukocytes of chickens inoculated with the MSB1-41C cell line. In addition, anti-MDV antibodies were produced both in chickens inoculated with this cell line and in controls raised with inoculated chickens, but several attempts to isolate MDV from this cell line in vitro failed.