Assessment of fetal radiation exposure in pregnant women undergoing computed tomography and rotational angiography examinations for pelvic trauma.

This study aimed to assess fetal radiation exposure in pregnant women undergoing computed tomography (CT) and rotational angiography (RA) examinations for the diagnosis of pelvic trauma. In addition, this study aimed to compare the dose distributions between the two examinations. Surface and average fetal doses were estimated during CT and RA examinations using a pregnant phantom model and real-time dosemeters. The pregnant model phantom was constructed using an anthropomorphic phantom, and a custom-made abdominal phantom was used to simulate pregnancy. The total average fetal dose received by pregnant women from both CT scans (plain, arterial and equilibrium phases) and a single RA examination was ~60 mGy. Because unnecessary repetition of radiographic examinations, such as CT or conventional 2D angiography can increase the radiation risk, the irradiation range should be limited, if necessary, to reduce overall radiation exposure.

Evaluation of radiation dose for inferior vena cava filter placement during pregnancy: A comparison of dosimetry and dose calculation software.

Numerous medical conditions are associated with pregnancy in women, including pulmonary thromboembolism, which can be fatal. An effective treatment of this condition is the positioning of an inferior vena cava filter (IVC-F) under the guidance of X-ray imaging. However, this procedure involves the risk of high radiation exposure to pregnant women and fetuses. Moreover, there are no published reports comparing the values of fetal dose, received during IVC-F placement in pregnant women, determined using dose calculation software and actual measurements. To address this issue, we compared the fetal radiation dose and entrance surface dose (ESD) for pregnant women for gestation periods of 6 and 9 months based on software calculations and actual measurements. The ESD and fetal doses were estimated for a pregnant woman for gestation periods of 6 and 9 months during IVC-F placement. For actual measurements, one pregnant model phantom was constructed using an anthropomorphic phantom, and two custom-made different-sized abdomen phantoms were used to simulate pregnancy. The custom-made abdomen phantoms were constructed using polyurethane. For software calculations, the software utilized a set of anatomically realistic pregnant patient phantoms. The ESD estimated using the software was consistent with the measured ESD, but the fetal dose estimations were more complicated due to fetal positioning. During fetal dose evaluation using software calculations, the user must carefully consider how much of the fetal length is in the irradiation field to prevent underestimation or overestimation. Despite the errors, the software can assist the user in identifying the magnitude of the dose approaching critical limits.

Vowel sound production and its association with cephalometric characteristics in skeletal Class III subjects.

BACKGROUND: This study aimed to evaluate differences in vowel production using acoustic analysis in skeletal Class III and Class I Japanese participants and to identify the correlation between vowel sounds and cephalometric variables in skeletal Class III subjects. MATERIALS AND METHODS: Japanese males with skeletal Class III (ANB < 0°) and Class I skeletal anatomy (0.62° < ANB < 5.94°) were recruited (n = 18/group). Acoustic analysis of vowel sounds and cephalometric analysis of lateral cephalograms were performed. For sound analysis, an isolated Japanese vowel (/a/,/i/,/u/,/e/,/o/) pattern was recorded. Praat software was used to extract acoustic parameters such as fundamental frequency (F0) and the first four formants (F1, F2, F3, and F4). The formant graph area was calculated. Cephalometric values were obtained using ImageJ. Correlations between acoustic and cephalometric variables in skeletal Class III subjects were then investigated. RESULTS: Skeletal Class III subjects exhibited significantly higher/o/F2 and lower/o/F4 values. Mandibular length, SNB, and overjet of Class III subjects were moderately negatively correlated with acoustic variables. LIMITATIONS: This study did not take into account vertical skeletal patterns and tissue movements during sound production. CONCLUSION: Skeletal Class III males produced different /o/ (back and rounded vowel), possibly owing to their anatomical positions or adaptive changes. Vowel production was moderately associated with cephalometric characteristics of Class III subjects. Thus, changes in speech after orthognathic surgery may be expected. A multidisciplinary team approach that included the input of a speech pathologist would be useful.

Beneficial effects of anti-apolipoprotein A-2 on an animal model for coronary arteritis in Kawasaki disease.

BACKGROUND: Kawasaki disease (KD) is usually treated with high-dose intravenous immunoglobulin (IVIg) as severe infectious and other diseases. Due to issues that are associated with immunoglobulin preparation, such as the risk of possible contamination by infectious agents and limited blood banking resources, recombinant immunoglobulins are required. We developed a novel recombinant antibody drug candidate, "VasSF," based on the therapeutic effects it exerted on a mouse spontaneous crescentic glomerulonephritis model (SCG/Kj). Apolipoprotein A-2 (ApoA2) has been identified as one of VasSF's target molecules. METHODS: Here, we tested the potential of anti-apolipoprotein A-2 antibodies (anti-ApoA2) as a new therapeutic drug against KD by examining its effect on a mouse model, in which KD was induced via Candida albicans water-soluble fraction (CAWS). CAWS (2 mg/mouse) was injected intraperitoneally into C57BL/6NCrSlc mice for five consecutive days. The incidence and histological severity of vasculitis in CAWS-induced coronary arteritis in mice administered anti-ApoA2 was examined. The following experimental groups were tested: solvent (only PBS (-) injection); anti-ApoA2 antibodies at dosages of 0.05 mg, 0.1 mg, and 0.5 mg/kg/day; human IgG at 0.1 mg/kg/day. RESULTS: The group treated with anti-ApoA2 0.5 mg/kg/day showed a lower incidence of panvasculitis induced by CAWS, less inflammation of the coronary arteries and aortic roots, and lower levels of serum IL-6, M-CSF, and MIP-1α and 32 cytokines/chemokines compared with those in the solvent group. CONCLUSIONS: The anti-ApoA2 treatment suppressed the development of coronary arteritis in an animal KD model and anti-ApoA2 shows potential as an effective therapeutic candidate for the treatment of KD vasculitis. The use of specific antibodies that display higher vasculitis-suppressing effects, such as anti-ApoA2, may attenuate KD as well as other infectious diseases, with less severe adverse side effects than treatment with IVIg.

Zamamiphidins B and C, Manzamine-Related Alkaloids from an Amphimedon sp. Marine Sponge Collected in Okinawa.

Zamamiphidins B (1) and C (2), two new manzamine-related alkaloids with an unprecedented fused diazahexacyclic ring system, were isolated from an Amphimedon sp. marine sponge collected in Okinawa. The structures of zamamiphidins B (1) and C (2) including the relative configurations were elucidated on the basis of spectroscopic data.

An overview of the intraoral features and craniofacial morphology of growing and adult Japanese cleidocranial dysplasia subjects.

BACKGROUND: Orthodontic treatment for cleidocranial dysplasia (CCD) requires an understanding of the nature of the retained deciduous teeth, supernumerary teeth, delayed eruption of the permanent teeth, and craniofacial morphology from childhood to adulthood. This study aimed to provide an overview of the intraoral and craniofacial characteristics of growing and adult Japanese CCD subjects. METHODS: We assessed cross-sectionally the intraoral features of 28 CCD subjects (males, 15.3 ± 7.0 years; females, 15.2 ± 5.1 years) using orthopantomograms and photographs. Mean facial diagrams (profilograms) of 3 age groups (5-10 years, 11-14 years, over 15 years: adult) were constructed, and linear and angular measurements of 2 age groups (under 15 years, adult) were performed by using cephalograms. The data were compared with Japanese standards. RESULTS: A mean of 11.7 and 8.4 retained deciduous teeth, 10.4 and 15.8 erupted permanent teeth were observed in the adult males and females, and a mean of 6.8 and 5.3 supernumerary teeth were observed in all males and females, respectively. A positive correlation was found between the number of supernumerary teeth and the age at initial visit. Cephalometric analysis showed an average to anteriorly positioned maxilla, a tendency for counter-clockwise rotation of the ramus, and a prognathic mandible in all groups. CONCLUSIONS: The number of supernumerary teeth increased with age. The maxilla was average to anteriorly positioned, and the mandible was counter-clockwise rotated and prognathic for all groups. These characteristic craniofacial morphologies and changes of intraoral conditions at different ages in CCD patients should be considered when proposing rational orthodontic treatment plans.

[Scientific Research Group Report: Nationwide Survey on Radiation Exposure of Pediatric CT Examination in Japan (2018)].

PURPOSE: To understand the latest pediatric computed tomography (CT) exposure required for the revision of national DRLs. METHODS: A questionnaire was sent to 409 facilities where the members of the Japanese Society of Radiological Technology and the Japanese Society of Pediatric Radiology are enrolled. We investigated the imaging conditions, CTDIvol, and DLP of the pediatric head, chest, and abdominal CT examinations. RESULTS: In all, 43 facilities (11%) responded to our survey. multi detector-row CT (MDCT) systems were available in all surveyed facilities. More than 98% of the MDCT systems had more than 64 detector rows. The CTDIvol of all CT protocols was lower than the NDRL due to the progress of updating to MDCTs with radiation exposure reduction functions such as an iterative reconstruction, but the DLP of head and abdominal CT protocols of some age group were higher than NDRL. CONCLUSION: It is necessary to review the imaging protocol with the attending physician and radiologist and consider further optimization of medical exposure.

Characterization and Identification of Bioactive Polyphenols in the Trapabispinosa Roxb. Pericarp Extract.

In this study, we present the isolation and characterization of the structure of six gallotannins (1-6), three ellagitannins (7-9), a neolignan glucoside (10), and three related polyphenolic compounds (gallic acid, 11 and 12) from Trapa bispinosa Roxb. pericarp extract (TBE). Among the isolates, the structure of compound 10 possessing a previously unclear absolute configuration was unambiguously determined through nuclear magnetic resonance and circular dichroism analyses. The α-glucosidase activity and glycation inhibitory effects of the isolates were evaluated. Decarboxylated rugosin A (8) showed an α-glucosidase inhibitory activity, while hydrolyzable tannins revealed stronger antiglycation activity than that of the positive control. Furthermore, the identification and quantification of the TBE polyphenols were investigated by high-performance liquid chromatography coupled to ultraviolet detection and electrospray ionization mass spectrometry analysis, indicating the predominance of gallic acid, ellagic acid, and galloyl glucoses showing marked antiglycation properties. These findings suggest that there is a potential food industry application of polyphenols in TBE as a functional food with antidiabetic and antiglycation activities.

Novel pregnant model phantoms for measurement of foetal radiation dose in x-ray examinations.

This study presents a comparison of novel pregnant model phantoms with a handmade phantom in terms of shape and radiation measurement points to determine which model is more suitable for measuring the foetal radiation dose during x-ray examinations. Novel pregnant model phantoms were constructed using an anthropomorphic phantom in combination with two differently-sized custom-made abdomen phantoms simulating pregnancy, which were constructed from a polyurethane resin. The size and shape of the polyurethane resin were designed based on abdominal sizes and shapes collected from the computed tomography examinations at 18 pregnant patients of one hospital. The handmade pregnant model phantom was constructed using an anthropomorphic phantom and a beach ball containing water. Compared with the handmade phantom, there were additional dose measurement points on the novel pregnant model phantoms. Our model phantoms improved upon the handmade phantom in terms of shape and radiation measurement points. We produced pregnant model phantoms that simulated the shapes and sizes of actual patients for the first time.

Inhibition of lateral shoot formation by RNA interference and chemically induced mutations to genes expressed in the axillary meristem of Nicotiana tabacum L.

BACKGROUND: Lateral branches vigorously proliferate in tobacco after the topping of the inflorescence portions of stems for the maturation of the leaves to be harvested. Therefore, tobacco varieties with inhibited lateral shoot formation are highly desired by tobacco farmers. RESULTS: Genetic inhibition of lateral shoot formation was attempted in tobacco. Two groups of genes were examined by RNA interference. The first group comprised homologs of the genes mediating lateral shoot formation in other plants, whereas the second group included genes highly expressed in axillary bud primordial stages. Although "primary" lateral shoots that grew after the plants were topped off when flower buds emerged were unaffected, the growth of "secondary" lateral shoots, which were detected on the abaxial side of the primary lateral shoot base, was significantly suppressed in the knock-down lines of NtLs, NtBl1, NtREV, VE7, and VE12. Chemically induced mutations to NtLs, NtBl1, and NtREV similarly inhibited the development of secondary and "tertiary" lateral shoots, but not primary lateral shoots. The mutations to NtLs and NtBl1 were incorporated into an elite variety by backcrossing. The agronomic characteristics of the backcross lines were examined in field trials conducted in commercial tobacco production regions. The lines were generally suitable for tobacco leaf production and may be useful as new tobacco varieties. CONCLUSION: The suppressed expression of NtLs, NtBl1, NtREV, VE7, or VE12 inhibited the development of only the secondary and tertiary lateral shoots in tobacco. The mutant lines may benefit tobacco farmers by minimizing the work required to remove secondary and tertiary lateral shoots that emerge when farmers are harvesting leaves, which is a labor-intensive process.

Fetal radiation dose of four tube voltages in abdominal CT examinations during pregnancy: A phantom study.

This study aimed to compare the dose and noise level of four tube voltages in abdominal computerized tomography (CT) examinations in different abdominal circumference sizes of pregnant women. Fetal radiation doses were measured with two anthropomorphic pregnant phantoms and real-time dosimeters of photoluminescence sensors using four tube voltages for abdominal CT. The noise level was measured at the abdomen of two anthropomorphic pregnant phantoms. In the large pregnant phantom, the mean fetal doses performed using 120 and 135 kV were statistically significantly lower than the lower tube voltages (P < 0.05). In the small pregnant phantom, the mean fetal dose performed by 100, 120, and 135 kV was significantly lower than the lowest tube voltage tested (P < 0.05). The ratios of the peripheral mean dose to the centric mean dose showed that the ratios of 80 kV were the highest and those for 135 kV were the lowest in both pregnant phantoms. The ratios of the peripheral mean dose to the centric mean dose decreased as the tube voltage increased. Compared with low tube voltages, high tube voltages such as 120 and 135 kV could reduce radiation doses to the fetus without compromising the image uniformity in abdominal CT examinations during pregnancy. On low tube voltage protocols, the dose near the maternal skin surface may be increased in large pregnant women because of reduced penetration of the x rays.

Novel oseltamivir-resistant mutations distant from the active site of influenza B neuraminidase.

We performed a neuraminidase sequence analysis of thirty-two pediatric patients with influenza B who visited Teikyo University Hospital from January 2016 to March 2017, and found oseltamivir-resistant samples belonging to the Yamagata and Victoria lineages. Comparison with the neuraminidase sequence of oseltamivir-susceptible B/Brisbane/60/2008 revealed 5 common amino acid substitutions in many of these samples. According to the binding free energy calculation, the N340D and E358K substitutions reduced the affinity of oseltamivir to neuraminidase. Unexpectedly, these substitutions were located distant from the oseltamivir-binding site in neuraminidase. According to the molecular dynamics simulations, the N340D substitution rearranged complicated hydrogen bond networks in an extensive surface region of neuraminidase. The E358K substitution extensively altered the electrostatic potential map of the overall neuraminidase structure. Through these novel mechanisms, the N340D and E358K substitutions indirectly influenced the affinity reduction. These results may be useful for designing drugs for the treatment of oseltamivir-resistant virus infections.Communicated by Ramaswamy H. Sarma.

Effect of protective glasses on radiation dose to eye lenses during whole breast irradiation.

OBJECTIVES: The efficacy of radiotherapy for breast cancer has greatly improved owing to better irradiation methods. Radiotherapy aims to deliver therapeutic doses to predetermined target volumes while sparing surrounding healthy tissues. However, there are few reports on radiation exposure to eye lenses, and the recommended exposure limits to ocular lens have been substantially reduced in recent years. This study aimed to investigate the amount of radiation exposure to eye lenses using optically stimulated luminescence dosimeters (OSLDs) and determine whether wearing special protective devices to protect the eyes, as an organ at risk, during whole breast irradiation, is necessary. METHODS: This experiment used OSLDs on water-equivalent phantom to measure the change in scattered radiation dose due to the difference of irradiation field while using 4- and 6-MV photons of TrueBeam linear accelerator. Using a total treatment dose of 50 Gy, a target was positioned to approximate the breast, and a plan was formulated to deliver 2 Gy per treatment by tangential irradiation. The mean (SD) irradiation dose at the lens position outside the irradiation field was reported. RESULTS: The scattered radiation dose outside the irradiation field was more affected by the irradiation field size than by the radiation energy. The out-of-field irradiation dose with a larger field of view was higher than that with a smaller field of view. The use of 0.07- and 0.83-mm-thick lead shield protective glasses reduced the radiation dose by 56.1% (P < .001) and 55.6% (P < .001), respectively. CONCLUSIONS: In this experimental model, the amount of radiation the eye was exposed to during whole breast irradiation was determined by the distance of the eye from the radiation field edge and by wearing protective glasses. In clinical practice, the protection offered by eyeglasses may reduce the risk of long-term side effects and allow the use of higher intensive radiotherapy.

3D evaluation of the morphological and volumetric changes of the tongue and oral cavity before and after orthognathic surgery for mandibular prognathism: a preliminary study.

BACKGROUND: The volumetric ratio of the tongue to the oral cavity has been recognized to be one of the important factors for the maintenance of stable occlusion. Oral cavity capacity is changed after orthognathic surgery in patients with mandibular prognathism; however, the volumetric changes of the oral cavity including the tongue before and after surgery have not been analyzed. The purpose of this study was to evaluate the morphological and volumetric changes of the tongue and oral cavity following orthognathic surgery using a newly developed vinyl polysiloxane impression method. MATERIALS AND METHODS: The study was performed in fifteen subjects who underwent surgical orthognathic treatment. Impressions of the tongue together with the oral cavity were obtained before orthognathic surgery and 1, 3, and 6 months after orthognathic surgery. These impression patterns were scanned using cone-beam computed tomography (CT), and three-dimensional (3D) images of the oral cavity including the tongue, and the upper and lower dental arches were reconstructed. The morphological and volumetric changes in the oral cavity capacity and the tongue volume were examined. RESULTS: The volume of the tongue with the volume of the oral cavity decreased after orthognathic surgery. There was a correlation between the decrease in the oral cavity capacity and tongue volume. The volumetric ratio of the tongue to the oral cavity seems to be maintained before and after orthognathic surgery. CONCLUSION: VPS method, free from radiation exposure, may be useful for investigating the morphological and volumetric changes of the tongue and oral cavity, which may possibly influence the stability of the dental arch and occlusion during surgical orthodontic treatment.

A multicenter study of radiation doses to the eye lenses of medical staff performing non-vascular imaging and interventional radiology procedures in Japan.

PURPOSE: This study aimed to measure the eye lens doses received by physicians and other medical staff participating in non-vascular imaging and interventional radiology procedures in Japan. MATERIAL AND METHODS: From October 2014 to March 2017, 34 physicians and 29 other medical staff engaged in non-vascular imaging and interventional radiology procedures at 18 Japanese medical facilities. These professionals wore radioprotective lead glasses equipped with small, optically stimulated luminescence dosimeters and additional personal dosimeters at the neck during a 1-month monitoring period. The Hp(3) and the Hp(10) and Hp(0.07) were obtained from these devices, respectively. The monthly Hp(3), Hp(10), and Hp(0.07) for each physician and other medical staff member were then rescaled to a 12-month period to enable comparisons with the revised occupational equivalent dose limit for the eye lens. RESULTS: Among physicians, the average annual Hp(3) values measured by the small luminescence dosimeters on radioprotective glasses were 25.5 ± 38.3 mSv/y (range: 0.4-166.8 mSv/y) and 9.3 ± 16.6 mSv/y (range: 0.3-82.4 mSv/y) on the left and right sides, respectively. The corresponding values for other medical staff were 3.7 ± 3.1 mSv/y (range: 0.4-10.4 mSv/y) and 3.2 ± 2.7 mSv/y (range: 0.5-11.5 mSv/y), respectively. CONCLUSIONS: The eye lens doses incurred by physicians and other medical staff who engaged in non-vascular imaging and interventional radiology procedures in Japan were provided. Physicians should wear radioprotective glasses and use additional radioprotective devices to reduce the amount of eye lens doses they receive.

[Nationwide Survey of Medical Radiation Exposure on Cardiovascular Examinations in Japan].

PURPOSE: It is very important to manage the radiation dose of cardiovascular interventional (CVI) procedures. Overseas, the diagnostic reference levels for cardiac interventional procedures were established with the air kerma at the patient entrance reference point (Ka,r) and the air kerma-area product (PKA). Although the Japan DRLs 2015 was established by the Japan Network for Research and Information on Medical Exposure (J-RIME), the Japan DRL for CVIs were established by fluoroscopic dose rates of 20 mGy/min at the patient entrance reference point with 20 cm thickness polymethyl methacrylate (PMMA) phantom. In the present our study, we performed a questionnaire survey of indicated values of angiographic parameters in CVI procedures. METHODS: A nationwide questionnaire was sent by post to 765 facilities. Question focused on angiographic technology, exposure parameters and radiation doses as the displayed dosimetric parameters on the angiographic machine. RESULTS: The recovery rate was 22.8% at 175 out of 765 facilities. In total 1728 cases of the coronary angiography (CAG), 1703 cases of the percutaneous coronary intervention (PCI), 962 cases of the radiofrequency catheter ablation (RFCA) and 377 cases of pediatric CVI. The 75th percentile value of Ka,r, PKA, fluoroscopy time (FT) and number of cine images (CI) for CAG, PCI, RFCA and pediatric CVI were 702, 2042, 644, and 159 mGy, respectively, 59.3, 152, 81.3, and 14.9 Gy・cm2, respectively, 10.2, 35.6, 61.1, and 35.6 min, respectively and 1503, 2672, 722, and 2378 images, respectively. Our investigation showed that the angiographic parameters were different in several CVI procedures. CONCLUSIONS: The displayed dosimetric parameters on the angiographic machine in CVI procedures showed different values. We should classify the dosimetric parameters for each procedure.

VOLUME CT DOSE INDEX AND DOSE-LENGTH PRODUCT VALUES ACCORDING TO FACILITY SIZE IN JAPAN.

The aim of this study was to investigate differences in volume computed tomography dose index (CTDIvol) and dose-length product (DLP) values according to facility size in Japan. A questionnaire survey was sent to 3000 facilities throughout Japan. Data from each facility were collected including bed number, computed tomography (CT) scan parameters employed and the CTDIvol and/or DLP values displayed on the CT scanner during each examination. The CTDIvol and DLP for 11 adult and 6 paediatric CT examinations were surveyed. Comparison of CTDIvol and DLP values of each examination according to facility size revealed key differences in CT dose between small and large facilities. This study highlights the importance of lowering the dose of coronary artery examination with contrast agent in smaller facilities and of lowering the dose of adult and paediatric head CT without contrast agent in larger facilities. The results of this study are valid in Japan.