A comparative study of the CT effective dose in whole-body 18F-FDG PET/CT for arm-raised position and arm-lowered position.

INTRODUCTION: This study aimed to investigate and compare the effective dose (ED) delivered by computed tomography (CT) in whole-body positron emission tomography/CT (WB-PET/CT) scans between patients positioned with their arms-raised and those with their arms-lowered during the scan on a large population. METHODS: The retrospective study involved 785 oncology patients who underwent WB-PET/CT scans with 18F-FDG between January and June 2019. Exclusion criteria were applied, resulting in a final analysis of data from 732 adult patients. All of the patients were measured height and weight, and the ED from CT in WB-PET/CT was estimated using the dose length product value and a conversion factor. Statistical analyses were conducted to explore relationships between factors and the ED. Linear regression analysis was performed to investigate connections between weight and ED, and height and ED. Multiple linear regression was used to predict ED based on sex, weight, and arm position. RESULTS: The arm-lowered group had a higher ED than the arm-raised group, and the median dose was 1.1 times higher in the arm-lowered group. The difference in ED between the two groups was found to be greater with higher body weight. Arm-position (ß = 0.460), sex (ß = -0.190), and weight (ß = 0.057) were significant predictors of ED. CONCLUSION: This study demonstrated that arm position, sex, and weight were significant factors influencing the ED from CT scans in WB-PET/CT. IMPLICATIONS FOR PRACTICE: The research underscores the importance of considering these factors when evaluating radiation exposure in clinical practice, particularly for patients undergoing WB-CT imaging. These findings contribute to a better understanding of the radiation dosimetry associated with different patient positions during WB-PET/CT scans.

Assessment of the albumin-bilirubin grade as a prognostic factor in patients with non-small-cell lung cancer receiving anti-PD-1-based therapy.

INTRODUCTION: The albumin-bilirubin (ALBI) grade is a novel indicator of the liver function. Some studies showed that the ALBI grade was a prognostic and predictive biomarker for the efficacy of chemotherapy in cancer patients. The association between the ALBI grade and outcomes in patients with non-small-cell lung cancer (NSCLC) treated with cancer immunotherapy, however, is poorly understood. METHODS: We retrospectively enrolled 452 patients with advanced or recurrent NSCLC who received anti-programmed cell death protein 1 (PD-1)-based therapy between 2016 and 2019 at three medical centers in Japan. The ALBI score was calculated from albumin and bilirubin measured at the time of treatment initiation and was stratified into three categories, ALBI grade 1-3, with reference to previous reports. We examined the clinical impact of the ALBI grade on the outcomes of NSCLC patients receiving anti-PD-1-based therapy using Kaplan-Meier survival curve analysis with log-rank test and Cox proportional hazards regression analysis. RESULTS: The classifications of the 452 patients were as follows: grade 1, n = 158 (35.0%); grade 2, n = 271 (60.0%); and grade 3, n = 23 (5.0%). Kaplan-Meier survival curve analysis showed that the ALBI grade was significantly associated with progression-free survival and overall survival. Moreover, Cox regression analysis revealed that the ALBI grade was an independent prognostic factor for progression-free survival and overall survival. CONCLUSION: The ALBI grade was an independent prognostic factor for survival in patients with advanced or recurrent NSCLC who receive anti-PD-1-based therapy. These findings should be validated in a prospective study with a larger sample size.

Prognostic value of quality-of-life scores in patients with breast cancer undergoing preoperative chemotherapy.

Background: Recently, evaluation of quality of life (QOL) has been recognized as a significant outcome measure in the treatment of several cancers. In this study, the Anti-Cancer Drugs-Breast (ACD-B) QOL score was used to assess disease-specific survival in women with breast cancer undergoing preoperative chemotherapy (POC). Methods: QOL-ACD-B scores were evaluated before and after POC. The cut-off value of QOL-ACD-B contributing to events such as relapse or death was calculated by receiver operating characteristic (ROC) curve analysis. Results: In 300 women with breast cancer treated with POC, QOL was significantly reduced (P < 0·001). A high QOL-ACD-B score before POC was an independent factor in the multivariable analysis of overall survival (hazard ratio 0·26, 95 per cent c.i. 0·04 to 0·96). Conclusion: Evaluation by QOL-ACD-B before POC may be useful to predict the prognosis of patients with breast cancer undergoing POC.

Investigation of the neutron spectrum measurement method for dose evaluation in boron neutron capture therapy.

In boron neutron capture therapy, it is important to evaluate the dose administered to a patient's body outside the tumour area. The exposure dose is evaluated by calculation; however, the calculated value must be validated using a measured value. The dose evaluations based on the measured neutron spectrum are investigated. Multi-foil activation, combined with a LiCaAlF6 scintillation detector and an imaging plate, is proposed as a measurement method. The proposed method can measure the neutron spectrum at various points quickly.

Correction to: Circulating tumor cell clusters-associated gene plakoglobin is a significant prognostic predictor in patients with breast cancer.

[This corrects the article DOI: 10.1186/s40364-017-0099-2.].

Assessment of Canine Pancreas-Specific Lipase and Outcomes in Dogs with Hemodialysis-Dependent Acute Kidney Injury.

BACKGROUND: Renal replacement therapies can be life-saving for dogs with severe acute kidney injury (AKI), however, comorbidities including pancreatitis might affect outcome. HYPOTHESIS/OBJECTIVES: To investigate the prevalence of pancreas-specific lipase (Spec cPL) measurements consistent with pancreatitis (≥400 µg/L) in dogs undergoing intermittent hemodialysis (IHD) for treatment of AKI and to determine whether there were associations between 30-days outcomes and Spec cPL measurements. ANIMALS: Fifty-three client-owned dogs presented to teaching hospitals between November 2008 and September 2016 that underwent IHD. METHODS: Retrospective medical record review from dogs that received IHD for management of AKI and also had a Spec cPL measurement. Association between survival, dialysis-dependency, and Spec cPL measurements was assessed. RESULTS: Forty of 53 (76%) dogs were alive at 30-days and 33/53(62%) had a Spec cPL result ≥400 µg/L. Spec cPL was not significantly different either between surviving (635.5 µg/L, range 29-1,001) and nonsurviving dogs (860 µg/L, range 56-1,001; P = 0.75) or between dialysis-dependent (1,001 µg/L, range 177-1,001) and nondialysis-dependent dogs (520 µg/L, range 29-1,001; P = 0.08). Spec cPL ≥400 µg/L was not significantly associated either with survival (P = 0.74) or dialysis-dependency (P = 0.33). CONCLUSIONS AND CLINICAL IMPORTANCE: Results revealed a high prevalence of Spec cPL ≥400 µg/L in dogs with AKI treated with IHD. No significant associations between Spec cPL and survival or dialysis-dependency in dogs with AKI at 30 days were identified in the current study, however, the latter could be due to lack of power in this study.

Validation of a Clinical Scoring System for Outcome Prediction in Dogs with Acute Kidney Injury Managed by Hemodialysis.

BACKGROUND: A scoring system for outcome prediction in dogs with acute kidney injury (AKI) recently has been developed but has not been validated. HYPOTHESIS: The scoring system previously developed for outcome prediction will accurately predict outcome in a validation cohort of dogs with AKI managed with hemodialysis. ANIMALS: One hundred fifteen client-owned dogs with AKI. METHODS: Medical records of dogs with AKI treated by hemodialysis between 2011 and 2015 were reviewed. Dogs were included only if all variables required to calculate the final predictive score were available, and the 30-day outcome was known. A predictive score for 3 models was calculated for each dog. Logistic regression was used to evaluate the association of the final predictive score with each model's outcome. Receiver operating curve (ROC) analyses were performed to determine sensitivity and specificity for each model based on previously established cut-off values. RESULTS: Higher scores for each model were associated with decreased survival probability (P < .001). Based on previously established cut-off values, 3 models (models A, B, C) were associated with sensitivities/specificities of 73/75%, 71/80%, and 75/86%, respectively, and correctly classified 74-80% of the dogs. CONCLUSIONS AND CLINICAL RELEVANCE: All models were simple to apply and allowed outcome prediction that closely corresponded with actual outcome in an independent cohort. As expected, accuracies were slightly lower compared with those from the previously reported cohort used initially to develop the models.

Successful treatment of severe refractory lupus hepatitis with mycophenolate mofetil.

Systemic lupus erythematosus-related hepatitis, known as lupus hepatitis, is a rare manifestation of systemic lupus erythematosus, and is usually subclinical with mild abnormalities of serum liver enzymes. While cases with clinically significant and refractory lupus hepatitis are uncommon, treatment options for lupus hepatitis are to be established. Here, we report the case of a 45-year-old man with progressive lupus hepatitis accompanied by autoimmune haemolytic anaemia. Lupus hepatitis of this patient was refractory to tacrolimus, azathioprine and cyclophosphamide, but was successfully treated by mycophenolate mofetil. Mycophenolate mofetil might be an effective therapeutic option for refractory lupus hepatitis.

Sexual dimorphism in the facial morphology of adult humans: A three-dimensional analysis.

The objective of this study was to demonstrate sexual dimorphism in the entire three-dimensional facial surface form of adult humans. The sample consisted of female and male groups (n=200; age range, 18-35 years). Three-dimensional images of each participant's face at rest were recorded. A total of 185 variables that described facial surface configuration features were extracted from each image. The variables were compared between the groups using t-tests, and those exhibiting P-values <0.0001 were entered into a stepwise discriminant function analysis for sex determination. Wire mesh fitting was also performed on each image to examine the facial surface morphology. The mean node coordinates of the fitted mesh were compared between the groups using t-tests. Sixty-seven of the 185 variables differed significantly between the groups, and 11 qualified for inclusion in the stepwise analysis. The female group exhibited a greater vertical height of the eye fissure, shorter postero-anterior height of the nasal tip, vertically greater supraorbital ridge, shorter lower face height relative to the total upper anterior face height, more prominent cheeks in the infraorbital region, less prominent cheeks in the buccal region, shorter vertical height of the subnasal region, a smaller nasal hump, and a smaller alar. The discriminant function analysis was 96.5% accurate overall. The wire mesh fitting results showed that the eyes, forehead, and chin were in vertically higher positions in the female group than in the male group. The cheeks and nose were more protuberant in the female group and male group, respectively.

Streptococcus oricebi sp. nov., isolated from the oral cavity of tufted capuchin.

A Gram-stain-positive, catalase-negative, coccus-shaped organism was isolated from the oral cavity of tufted capuchin (Cebus apella). Comparative 16S rRNA gene sequence analysis suggested classification of the organism within the genus Streptococcus. Strain M8T was related most closely to Streptococcus oralis ATCC 35037T (96.17 % similarity) followed by Streptococcus massiliensis CCUG 49690T (95.90 %) based on the 16S rRNA gene. Strain M8T was related most closely to S. massiliensis CCUG 49690T (86.58 %) based on the RNA polymerase ß subunit-encoding gene (rpoB), and to Streptococcus tigurinus AZ_3aT (81.26 %) followed by S. massiliensis CCUG 49690T (80.45 %) based on the 60 kDa heat-shock protein gene (groEL). The phylogenetic trees of 16S rRNA, rpoB and groEL gene sequences showed that strain M8T was most closely related to S. massiliensis. Based on phenotypic characterization as well as 16S rRNA gene and housekeeping gene (rpoB and groEL) sequence data, a novel taxon, Streptococcus oricebi sp. nov. (type strain M8T = JCM 30719T = DSM 100101T), is proposed.

Influence of balancing-side occlusal interference on smoothness of working-side condylar movement and intra-articular space in chewing efforts.

Response of temporomandibular joint (TMJ) articulation adapting to occlusal alteration has been sparsely known. For 10 healthy adults with acceptably good occlusion, an artificial occlusal interference (OI) was introduced to the lower molar on the balancing side of unilateral chewing. Subjects were asked to chew a gum on their preferred side. The chewing jaw movements with/without the OI were recorded using a video-based optoelectronic system. The mandibular movements were generated in each individual's TMJ model reconstructed by magnetic resonance images. The smoothness of local condylar point movements towards the normal direction of the condylar surface and interarticular space on the working side was measured. Overall, the smoothness of condylar point movements in the closing phase was impaired immediately after introduction of the OI. In the intercuspal phase, the OI increased the joint space. After about 60 chewing cycles, the movement smoothness and joint space began to recover. These findings suggest that OI on the balancing side induced irregular stress field translation on the working-side condylar surface followed by acute recovery process.

Temporomandibular joint articulations on working side during chewing in adult females with cross-bite and mandibular asymmetry.

Influence of mandibular asymmetry and cross-bite on temporomandibular joint (TMJ) articulation remained unknown. This study aimed to investigate whether/how the working-side condylar movement irregularity and articular spaces during chewing differ between patients with mandibular asymmetry/cross-bite and control subjects. The cross-bite group and the control group consisted of 10 adult female patients and 10 adult female subjects, respectively. They performed unilateral gum-chewing. The mandibular movements were recorded using a video-based opto-electronic system. The 3D articular surface of the TMJ for each individual was reconstructed using CT/MRI data. For local condylar points, the normalised jerk cost (NJC) towards normal direction to the condylar surface, the angle between tangential velocity vector and condylar long axis and intra-articular space were measured. Three rotatory angles at centre of the condyle were also measured. During closing and intercuspation, (i) movements of posterior portion of the deviated side condyle showed significantly less smoothness as compared with those for the non-deviated side and control subjects, (ii) the rotations of the condyle on the deviated side induced greater intra-articular space at posterior and lateral portions. These findings suggest that chewing on the side of mandibular deviation/cross-bite may cause irregular movement and enlarged intra-articular space at posterior portion of the deviated side condyle.

Objective classification of nose-lip-chin profiles and their relation to dentoskeletal traits.

OBJECTIVES: To objectively classify the nose-lip-chin profiles of adult women and identify any associations between the nose-lip-chin profile patterns and dentoskeletal patterns. SETTING AND SAMPLE POPULATION: Lateral facial photographs and lateral cephalograms were obtained for 229 Japanese women who were being assessed for orthodontic treatment. METHODS: A feature vector that was effective in distinguishing differences in nose-lip-chin profiles was extracted for each photograph. To categorize the records into an optimum number of subclasses according to nose-lip-chin profile configurations, a vector quantization method was applied to the feature vectors of all samples. Dentoskeletal patterns that corresponded to the nose-lip-chin profile subclasses were compared. RESULTS: Eight profile patterns were identified, and the differences among patterns were notably maximized by the nasolabial angle, configuration and vertical length of the subnasal region, vertical thickness of the lip vermilion borders, sagittal position of the upper- and lower-lip vermilion borders and their relation to each other, labiomental angle, depth of the labiomental sulcus, degree of prominence of the chin, and degree of protrusion of the mandible. The dentoskeletal patterns showed significant differences between the classified profile patterns (p < 0.01). CONCLUSIONS: A method to objectively classify the nose-lip-chin profiles of adult women was established, and the nose-lip-chin profile patterns were found to be associated with the dentoskeletal patterns.

A novel strategy inducing autophagic cell death in Burkitt's lymphoma cells with anti-CD19-targeted liposomal rapamycin.

Relapsed or refractory Burkitt's lymphoma often has a poor prognosis in spite of intensive chemotherapy that induces apoptotic and/or necrotic death of lymphoma cells. Rapamycin (Rap) brings about autophagy, and could be another treatment. Further, anti-CD19-targeted liposomal delivery may enable Rap to kill lymphoma cells specifically. Rap was encapsulated by anionic liposome and conjugated with anti-CD19 antibody (CD19-GL-Rap) or anti-CD2 antibody (CD2-GL-Rap) as a control. A fluorescent probe Cy5.5 was also liposomized in the same way (CD19 or CD2-GL-Cy5.5) to examine the efficacy of anti-CD19-targeted liposomal delivery into CD19-positive Burkitt's lymphoma cell line, SKW6.4. CD19-GL-Cy5.5 was more effectively uptaken into SKW6.4 cells than CD2-GL-Cy5.5 in vitro. When the cells were inoculated subcutaneously into nonobese diabetic/severe combined immunodeficiency mice, intravenously administered CD19-GL-Cy5.5 made the subcutaneous tumor fluorescent, while CD2-GL-Cy5.5 did not. Further, CD19-GL-Rap had a greater cytocidal effect on not only SKW6.4 cells but also Burkitt's lymphoma cells derived from patients than CD2-GL-Rap in vitro. The specific toxicity of CD19-GL-Rap was cancelled by neutralizing anti-CD19 antibody. The survival period of mice treated with intravenous CD19-GL-Rap was significantly longer than that of mice treated with CD2-GL-Rap after intraperitoneal inoculation of SKW6.4 cells. Anti-CD19-targeted liposomal Rap could be a promising lymphoma cell-specific treatment inducing autophagic cell death.

Overexpression of Cdk6 and Ccnd1 in chondrocytes inhibited chondrocyte maturation and caused p53-dependent apoptosis without enhancing proliferation.

Cell proliferation and differentiation are closely coupled. However, we previously showed that overexpression of cyclin-dependent kinase (Cdk6) blocks chondrocyte differentiation without affecting cell-cycle progression in vitro. To investigate whether Cdk6 inhibits chondrocyte differentiation in vivo, we generated chondrocyte-specific Cdk6 transgenic mice using Col2a1 promoter. Unexpectedly, differentiation and cell-cycle progression of chondrocytes in the Cdk6 transgenic mice were similar to those in wild-type mice. Then, we generated chondrocyte-specific Ccnd1 transgenic mice and Cdk6/Ccnd1 double transgenic mice to investigate the possibility that Cdk6 inhibits chondrocyte differentiation through E2f activation. Bromodeoxyuridine (BrdU)-positive chondrocytes and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL)-positive chondrocytes were increased in number, and chondrocyte maturation was inhibited only in Cdk6/Ccnd1 transgenic mice (K6(H)/D1(H) mice), which showed dwarfism. Retinoblastoma protein (pRb) was highly phosphorylated but p107 was upregulated, and the expression of E2f target genes was dysregulated as shown by upregulation of Cdc6 but downregulation of cyclin E, dihydrofolate reductase (dhfr), Cdc25a and B-Myb in chondrocytes of K6(H)/D1(H) mice. Similarly, overexpression of Cdk6/Ccnd1 in a chondrogenic cell line ATDC5 highly phosphorylated pRb, upregulated p107, induced apoptosis, upregulated Cdc6 and downregulated cyclin E, dhfr and B-Myb and p107 small interfering RNA reversed the expression of downregulated genes. Further, introduction of kinase-negative Cdk6 and cyclin D1 abolished all effects by Cdk6/cyclin D1 in ATDC5 cells, indicating the requirement of the kinase activity on these effects. p53 deletion partially restored the size of the skeleton and almost completely rescued chondrocyte apoptosis, but failed to enhance chondrocyte proliferation in K6(H)/D1(H) mice. These findings indicated that Cdk6/Ccnd1 overexpression inhibited chondrocyte maturation and enhanced G1/S cell-cycle transition by phosphorylating pRb, but the chondrocytes failed to accomplish the cell cycle, and underwent p53-dependent apoptosis probably due to the dysregulation of E2f target genes. Our findings also indicated that p53 deletion in addition to the inactivation of Rb was not sufficient to accelerate chondrocyte proliferation, suggesting the resistance of chondrocytes to sarcomagenesis.

Fucosylated TGF-ß receptors transduces a signal for epithelial-mesenchymal transition in colorectal cancer cells.

BACKGROUND: Transforming growth factor-ß (TGF-ß) is a major inducer of epithelial-mesenchymal transition (EMT) in different cell types. TGF-ß-mediated EMT is thought to contribute to tumour cell spread and metastasis. Sialyl Lewis antigens synthesised by fucosyltransferase (FUT) 3 and FUT6 are highly expressed in patients with metastatic colorectal cancer (CRC) and are utilised as tumour markers for cancer detection and evaluation of treatment efficacy. However, the role of FUT3 and FUT6 in augmenting the malignant potential of CRC induced by TGF-ß is unclear. METHODS: Colorectal cancer cell lines were transfected with siRNAs for FUT3/6 and were examined by cell proliferation, invasion and migration assays. The expression and phosphorylation status of TGF-ß downstream molecules were analysed by western blot. Fucosylation of TGF-ß receptor (TßR) was examined by lectin blot analysis. RESULTS: Inhibition of FUT3/6 expression by siRNAs suppressed the fucosylation of type I TßR and phosphorylation of the downstream molecules, thereby inhibiting the invasion and migration of CRC cells by EMT. CONCLUSION: Fucosyltransferase 3/6 has an essential role in cancer cell adhesion to endothelial cells by upregulation of sialyl Lewis antigens and also by enhancement of cancer cell migration through TGF-ß-mediated EMT.

Improvements in smoothness of chewing cycles in adults with mandibular prognathism after surgery: a longitudinal study.

Although adults with mandibular prognathism are known to show impaired smoothness of masticatory jaw movements, it remains uncertain whether/how the surgical-orthodontic treatment is effective to improve masticatory jaw movements. The aims of this study were (i) to verify whether the surgical-orthodontic treatment of patients with mandibular prognathism improve smoothness of the chewing jaw movements post-operatively and, if so, (ii) to examine whether the improved parameters show similar quantities as those of the control subjects. The chewing jaw movements for 13 patients with mandibular prognathism were recorded at pre- and post-treatment stages. The patient group was divided into two groups: Class III(closed) showed full occlusal contact at the habitual intercuspal position, whereas Class III(open) showed inability of occlusal contact between the upper and lower anterior teeth. The control group (CG) consisted of 52 subjects having acceptably good occlusion. The normalised jerk cost (NJC), movement duration and peak velocity in jaw closing were compared. For both Class III(open) and Class III(closed) groups, statistical comparisons revealed that the NJC and movement duration were decreased after the treatment, whereas the peak velocity was increased (all P < 0·01). For the Class III(open), these quantities at the post-treatment stage did not show any significant differences compared with those for the CG. It is concluded that the smoothness of chewing jaw movements for patient with mandibular prognathism were improved after treatment, and for the patients with anterior open bite at pre-treatment, the post-operatively achieved smoothness of jaw-closing movements did not differ from those of the CG.

Nationwide surveillance of antimicrobial consumption and resistance to Pseudomonas aeruginosa isolates at 203 Japanese hospitals in 2010.

PURPOSE: In Japan, a national surveillance study of antimicrobial consumption has never been undertaken. This study aimed to describe antimicrobial consumption and resistance to Pseudomonas aeruginosa in 203 Japanese hospitals, to identify targets for quality improvement. METHODS: We conducted an ecological study using retrospective data (2010). Antimicrobial consumption was collected in the World Health Organization (WHO) anatomical therapeutic chemical/defined daily dose (ATC/DDD) format. Rates of imipenem (IPM), meropenem (MEPM), ciprofloxacin (CPFX), or amikacin (AMK) resistance were expressed as the incidence of non-susceptible isolates. Additionally, hospitals were asked to provide data concerning hospital characteristics and infection control policies. Hospitals were classified according to functional categories of the Medical Services Act in Japan. RESULTS: Data were collected from 203 Japanese hospitals (a total of 91,147 beds). The total antimicrobial consumption was 15.49 DDDs/100 bed-days (median), with consumptions for penicillins, carbapenems, quinolones, and glycopeptides being 4.27, 1.60, 0.41, and 0.49, respectively. The median incidences of IPM, MEPM, CPFX, and AMK resistance were 0.15, 0.10, 0.13, and 0.03 isolates per 1,000 patient-days, respectively. Antimicrobial notification and/or approval systems were present in 183 hospitals (90.1 %). In the multivariate analysis, the piperacillin/tazobactam, quinolones, and/or total consumptions and the advanced treatment hospitals showed a significant association with the incidence of P. aeruginosa resistant to IPM, MEPM, CPFX, and AMK [adjusted R (2) (aR (2)) values of 0.23, 0.30, 0.22, and 0.35, respectively). CONCLUSION: This is the first national surveillance study of antimicrobial consumption in Japan. A continuous surveillance program in Japan is necessary in order to evaluate the association among resistance, antimicrobial restriction, and consumption.