Correlations between intraplan and postplan parameters in I-125 permanent prostate brachytherapy using loose seeds or linked seeds.

The purpose of this study was to determine the most appropriate seed arrangement by comparing two different methods (linked seeds and loose seeds). A total of sixty-one patients (28 linked seed brachytherapy cases and 33 loose seed brachytherapy cases) with clinically localized prostate cancer were treated with I-125 permanent prostate brachytherapy. Modified peripheral loading was the method used for seed placement. The parameters evaluated were as follows: prostate D90, V100, and V150; urethral D90, D10, and D5; and rectal V100 (RV100) and D2 (RD2). Coefficient parameters (r and r2) were assessed by regression analysis. Prostate V150, urethral D90, urethral D10, urethral D5, and RD2 showed significant correlations between both methods in all patients. Urethral D90, urethral D10, urethral D5, and RD2 showed significant correlations in patients who received linked seed brachytherapy. Prostate V150, urethral D90, urethral D10, urethral D5, RV100, and RD2 showed significant correlations in patients who received loose seed brachytherapy. Urethral D90, urethral D10, urethral D5, and RD2 showed significant correlations in the linked seed and loose seed brachytherapy analyses. In contrast, prostate D90 and prostate V100 showed no correlation. Parameters of normal organ damage showed good correlations between intraplan and postplan parameters. These parameters may be useful to determine normal organ damage during guided brachytherapy with two different methods (linked seeds and loose seeds).

Intelectin1 ameliorates macrophage activation via inhibiting the nuclear factor kappa B pathway.

Inteletin1 (Itln1) is an adipokine that is abundantly expressed in intestine, ovary, and lung. The expression levels of ITLN1 are decreased in the presence of diabetes or obesity, but the mechanisms of its production and function are still controversial. The aim of this study is to elucidate the mechanisms of ITLN1 synthesis and ITLN1-associated macrophage activation. To analyze the effects of high fat and high-carbohydrate diet (HFHCD) on the expression of ITLN1 in the intestine, the mice were fed a HFHCD for 8 weeks. HFHCD feeding enhanced the endoplasmic reticulum (ER)-stress in the intestine and inhibited the expression of Itln1 in the intestinal endocrine cells and lowered circulating ITLN1 levels. In contrast, treatment with a chemical chaperone and reduction of ER-stress restored the expression of Itln1 in the intestine of HFHCD-fed mice. Furthermore, in vitro studies indicated that ITLN1 physically interacts with adiponectin receptor 1 and suppresses lipopolysaccharide-induced mRNA expressions of pro-inflammatory cytokines and phagocytosis activities via inhibition of the nuclear factor kappa B-signaling pathway in macrophages. These results suggest that diet-induced ER-stress decreases circulating ITLN1 via inhibition of its synthesis in the intestine, and a reduction of circulating ITLN1 might enhanced the expression of proinflammatory cytokines and macrophage activation, following exacerbate the chronic inflammation of metabolic syndrome.

Hydrogen Charging of Aluminum using Friction in Water.

A new method of hydrogen charging of aluminum was developed by means of a friction in water (FW) procedure. This procedure can easily introduce high amounts of hydrogen into aluminum based on the chemical reaction between water and non-oxide coated aluminum.

Angiopoietin-Like Protein 2 Promotes the Progression of Diabetic Kidney Disease.

Context: Angiopoietin-like protein 2 (ANGPTL2) is a circulating, proinflammatory protein. Objective: To examine the role of ANGPTL2 in the pathogenesis of diabetic kidney disease (DKD), we studied the epigenetic regulation of angptl2 expression in patients with diabetes. Design, Setting, Participants, and Intervention: We determined the relationship between serum ANGPTL2 levels and the progression of DKD in cross-sectional (220 patients) and cohort (145 patients, 7-year follow-up) studies. Furthermore, we investigated the direct effect of ANGPTL2 on podocyte function. Main Outcomes: The main outcome was progression of DKD. Results: We found that the expression of angptl2 was decreased by the methylation of its promoter region. Multivariate logistic regression analyses revealed that the baseline level of serum ANGPTL2 was an independent risk factor for the progression of DKD during follow-up periods. In cultured podocytes, ANGPTL2 directly increased albumin permeability through the translocation of zonula occludens-1 from the membrane to the cytosol via activation of focal adhesion kinase. Conclusions: ANGPTL2 might be directly involved in podocyte dysfunction and independently associated with the progression of DKD stages.

The ligand-bound thyroid hormone receptor in macrophages ameliorates kidney injury via inhibition of nuclear factor-κB activities.

In chronic kidney disease (CKD) patients, inflammation plays a pivotal role in the progression of renal fibrosis. Hypothyroidism is associated with an increased occurrence of atherosclerosis and inflammation, suggesting protective roles of thyroid hormones and their receptors against inflammatory processes. The contribution of thyroid hormone receptors to macrophage differentiation has not been well documented. Here, we focused on the endogenous thyroid hormone receptor α (TRα) in macrophages and examined the role of ligand-bound TRα in macrophage polarization-mediated anti-inflammatory effects. TRα-deficient irradiated chimeric mice showed exacerbated tubulointerstitial injury in a unilateral ureteral obstruction model. Compared with wild-type macrophages, macrophages isolated from the obstructed kidneys of mice lacking TRα displayed increased expression of proinflammatory cytokines that was accompanied by enhanced nuclear translocation of p65. Comparison of TRα-deficient bone marrow-derived macrophages with wild-type macrophages confirmed the propensity of the former cells to produce excessive IL-1ß levels. Co-culture of these macrophages with renal epithelial cells induced more severe damage to the epithelial cells via the IL-1 receptor. Our findings indicate that ligand-bound TRα on macrophages plays a protective role in kidney inflammation through the inhibition of NF-κB pathways, possibly by affecting the pro- and anti-inflammatory balance that controls the development of CKD.

Impact compressive and bending behaviour of rocks accompanied by electromagnetic phenomena.

It is well known that electromagnetic phenomena are often observed preceding earthquakes. However, the mechanism by which these electromagnetic waves are generated during the fracture and deformation of rocks has not been fully identified. Therefore, in order to examine the relationship between the electromagnetic phenomena and the mechanical properties of rocks, uniaxial compression and three-point bending tests for two kinds of rocks with different quartz content, granite and gabbro, have been carried out at quasi-static and dynamic rates. Especially, in the bending tests, pre-cracked specimens of granite were also tested. Using a split Hopkinson pressure bar and a ferrite-core antenna in close proximity to the specimens, both the stress-strain (load-displacement) curve and simultaneous electromagnetic wave magnitude were measured. It was found that the dynamic compressive and bending strengths and the stress increase slope of both rocks were higher than those observed in static tests; therefore, there is a strain-rate dependence in their strength and stress increase rate. It was found from the tests using the pre-cracked bending specimens that the intensity of electromagnetic waves measured during crack extension increased almost proportionally to the increase of the maximum stress intensity factor of specimens. This tendency was observed in both the dynamic and quasi-static three-point bending tests for granite.

Comparison between shorter straight and thinner microtapered insulin injection needles.

BACKGROUND: Many diabetes patients who require insulin perform multiple subcutaneous injections every day that often cause pain, discomfort, and anxiety. We compared efficacy (glycemic control) and patient preference for two types of needle: a shorter straight needle (32 gauge×4 mm, straight wall; Nippon Becton Dickinson Co., Ltd., Tokyo, Japan; hereafter referred to as BD32S4) and a thinner microtapered needle (33-gauge tip and 28-gauge base×5 mm, double-tapered wall; Terumo Corp., Tokyo, Japan; hereafter referred to as TR33T5) in a single-center study. PATIENTS AND METHODS: Eighty-four patients with diabetes were enrolled in a randomized, open-label crossover trial. The patients injected their usual insulin dosage with one type of needle for 4 weeks and then switched to the other type for the next 4 weeks. The serum glycated albumin level was measured before and after each 4-week period. Each patient assessed pain during injection on a 150-mm visual analog scale (VAS). Needle preference, perceptions of handling, and acceptance were assessed by the patients, who completed a questionnaire after using each type of needle for 4 weeks. RESULTS: In total, 79 patients completed the study. There was no difference of glycemic control between the two needles. The mean VAS score was -14.5 mm (95% confidence interval, -20.9, -8.0 mm), indicating that the patients perceived less pain with the BD32S4 needle. In the overall evaluation, a significantly higher percentage of patients selected the BD32S4 as the better needle compared with the TR33T5 (60.3% vs. 19.2%; P<0.0001). CONCLUSIONS: The BD32S4 needle was more highly evaluated and was preferred by the patients with respect to pain during injection, usability, and visual impression, without having a negative impact on glycemic control. The overall preference of patients for the shorter needle in this study suggests that needle length may be one of the major contributing factors for patients' comfort in insulin injection, although the other relevant factors of needles still need to be considered.

Relationship between radiation pneumonitis and organizing pneumonia after radiotherapy for breast cancer.

BACKGROUND: Radiation pneumonitis (RP) and organizing pneumonia (OP) are the two main types of lung damage that can occur after lung irradiation. The goal of this study was to evaluate the relationship between RP and OP after irradiation for breast cancer. METHODS: Four hundred and twenty-eight patients who underwent radiotherapy for breast cancer were identified. The whole breast was irradiated with two tangential photon beams. Chest computed tomography (CT) scan were performed when patients showed any symptoms that were suspicious for pneumonitis. RESULTS: Five patients (1.2%) were diagnosed with OP. All five patients showed ground glass opacities and consolidation of the border of the lesion of RP in the radiation fields. Infiltration of OP spread from the site of RP to the hilum of the ipsilateral lung. Between RP and OP, a free region space (FRS) could be detected. CONCLUSIONS: OP is closely related to RP. All OP lesions developed near the site of RP.

[Chemoradiotherapy for anal squamous cell carcinoma].

In the guidelines on American National Comprehensive Cancer Network, local excision with adequate margin is recommended as a primary treatment for patients with T1, N0, and well-differentiated anal margin cancers. Otherwise, concurrent chemotherapy using mitomycin C(10mg/m², day 1 and 29)and 5-FU(1,000mg/m2/day, continuous intravenous infusion, day 1-4 and 29-32)with radiation(total dose of 45-59 Gy)is the recommended primary treatment for all other stages of nonmetastatic anal margin and anal canal cancer. Abdominoperineal resection is performed for patients with local recurrent diseases or residual tumor after chemoradiotherapy. Chemotherapy, using cisplatin(100mg/m², day 2)and 5-FU(1,000mg/m²/day, day 1-5)every four weeks, is recommended for patients with distant metastases, and radiotherapy can also be given for the local control of symptomatic anal lesions. Abdominoperineal resection has been performed in Japan; however, use of chemoradiotherapy is expected to increase for patients with anal squamous cell carcinoma. Clarification of the correct positioning of chemoradiotherapy using cisplatin, and the development of treatment using oral anticancer agents, are expected in the future by a clinical trial now in progress.

Effect of the α-glucosidase inhibitor miglitol on the glucose profile in Japanese type 2 diabetic patients receiving multiple daily insulin injections.

Strict postprandial glycemic control may have a preventive effect on atherogenesis in patients with type 2 diabetes. The α-glucosidase inhibitor (α-GI) miglitol is useful for controlling the early postprandial increase of glucose, but the combined effect of miglitol and multiple daily insulin injections (MDI) on glucose excursion has not been evaluated. First, we retrospectively compared the daily glucose profile, evaluated by self-monitoring of blood glucose (SMBG) at nine times on the day before discharge from hospital, between type 2 diabetic patients receiving MDI (n=81) or MDI plus miglitol at 150 mg daily (n=24). Second, we prospectively examined the effect of adding miglitol to MDI on the daily glucose profile (SMBG) in 19 other type 2 diabetic patients. Although the daily insulin dosage and the glucose level before meals did not differ between the two groups, the 1-h postprandial glucose level after each meal, 2-h glucose level after lunch and dinner, mean and standard deviation of glucose, and amplitude of glucose excursion were significantly lower or smaller in the MDI plus miglitol group than in the MDI group. All of these glucose parameters were significantly improved by adding miglitol to MDI in the prospective cohort of 19 patients. In conclusion, adding miglitol to MDI reduces postprandial glucose levels and attenuates daily glucose fluctuation in type 2 diabetic patients. This trial was registered with UMIN (no. UMIN000005383).

Clinical usefulness of a newly developed body surface navigation and monitoring system in radiotherapy.

In radiotherapy, setup precision has great influence on the therapeutic effect. In addition, body movements during the irradiation and physical alternations during the treatment period might cause deviation from the planned irradiation dosage distribution. Both of these factors could undesirably influence the dose absorbed by the target. In order to solve these problems, we developed the "body surface navigation and monitoring system" (hereafter referred to as "Navi-system"). The purpose of this study is to review the precision of the Navi-system as well as its usefulness in clinical radiotherapy. The Navi-system consists of a LED projector, a CCD camera, and a personal computer (PC). The LED projector projects 19 stripes on the patient's body and the CCD camera captures these stripes. The processed image of these stripes in color can be displayed on the PC monitor along with the patient's body surface image, and the digitalized results can be also displayed on the same monitor. The Navi-system calculates the height of the body contour and the transverse height centroid for the 19 levels and compares them with the reference data to display the results on the monitor on a real-time basis. These results are always replaced with new data after they are used for display; so, if the results need to be recorded, such recording commands should be given to the computer. 1) Evaluating the accuracy of the body surface height measurement: from the relationship between actual height changes and calculated height changes with torso surface by the Navi-system, for the height changes from 0.0 mm to ± 10.0mm, the changes show the underestimation of 1.0-1.5 mm and for ± 11.0mm to ± 20.0 mm, the underestimation of 1.5-3.0 mm. 2) Evaluating the accuracy of the transverse height centroid measurement: displacement of the inclined flat panel to the right by 5.0 mm, 10.0 mm, 15.0 mm and 20.0 mm showed the transverse height centroid calculated by the Navi-system for 0.024 ± 0.007 line/pair (mean ± SD), 0.045 ± 0.006 line/pair, 0.066 ± 0.006 line/pair and 0.089 ± 0.007 line/pair, respectively. Also, displacement of the inclined flat panel to the left by 5.0 mm, 10.0 mm, 15.0mm and 20.0 mm showed the transverse height centroid calculated by the Navi-system for 0.015 ± 0.007 line/pair (mean ± SD), 0.034 ± 0.007 line/pair, 0.053 ± 0.008 line/pair and 0.071 ± 0.007 line/pair, respectively. 3) Clinical usefulness of the Navi-system: on using the Navi-system, the frequency of radiotherapy replanning increased from 5.2% to 21.8%, especially in pelvic or abdominal irradiation. We developed a new navigation system for the purpose of compensating for the weakness of MVCT, CBCT and other systems, as well as for having a screening function. This Navi-system can monitor the patient continuously and measure change in height of the patient's body surface from the basic plane, in real time. It can also show the results both qualitatively and quantitatively on the PC monitor.

Intrahepatic lipid content is linked to insulin resistance in obese subjects.

BACKGROUND: Abdominal visceral fat (VAT) and intrahepatic lipid (IHL) are associated with insulin resistance in obese subjects, but VAT is usually measured on CT scans at the umbilical level or on MRI images of the partial abdomen. Thus, the association of the total abdominal visceral fat volume (VFV) with insulin resistance is unclear. In this study, we evaluated the correlations of obesity-related factors, including VFV and IHL, with clinical markers of insulin resistance (HOMA-R and the MATSUDA Index), and then assessed the effect of weight loss on these factors and markers. METHODS: The study population consisted of 30 obese Japanese subjects with a BMI > 25 kg/m(2) (13 men and 17 women) who underwent a 75-g oral glucose tolerance test to calculate HOMA-R and the MATSUDA Index, dual energy X-ray absorptiometry (DEXA) for measurement of body fat (%-Fat), proton magnetic resonance spectroscopy ((1)H MRS) to assess IHL, and whole abdominal CT scanning (from the top of the liver to the floor of the pelvic cavity = about 700 slices) to determine the total abdominal subcutaneous fat volume (SFV) and VFV. Seven subjects from the original population were placed on a diet and exercise program, and these indices were examined again after 5% reduction of body weight. RESULTS: Abdominal SFV, VFV, and IHL were mutually independent, but BMI and %-Fat were not independent of the other factors. According to multiple regression analysis, IHL (but not SFV or VFV) was significantly correlated with both HOMA-R and the MATSUDA Index in obese patients. Weight reduction by 5% led to improvement of the MATSUDA Index and decreased the number of subjects with metabolic syndrome, and the reduction of IHL was greater than that of SFV or VFV. These results suggest that IHL may be a superior marker of insulin resistance.

Health benefits for women staying with their husbands during a long-term trip to a hot springs spa.

The authors collected saliva samples from 15 married couples and 13 women staying with a female companion (N = 43) during an 8-day stay at a spa resort in Nagano, Japan. To examine changes in endocrinological stress markers, the authors evaluated participants' levels of salivary cortisol and chromogranin A (CgA) by enzyme-linked immunosorbent assay. By the eighth day, women staying with their husbands had significantly increased levels of cortisol and CgA. During the protocol, the authors observed no significant variation in levels of cortisol or CgA for either the women who were staying with same-sex companions or the male spouses. These findings suggest that the effects of long-term stays in a spa resort are more beneficial for married women staying with their husbands than for either married men or women staying with female companions.

Cerebral glucose metabolism change in patients with complex regional pain syndrome: a PET study.

PURPOSE: The aim of this study was to examine abnormalities of the central nervous system in patients with chronic pain who were diagnosed with complex regional pain syndrome (CRPS). MATERIALS AND METHODS: Brain activity was assessed using (18)F-fluorodeoxyglucose positron emission tomography. The data collected from 18 patients were compared with data obtained from 13 normal age-matched controls. RESULTS: Our results showed that glucose metabolism was bilaterally increased in the secondary somatosensory cortex, mid-anterior cingulated cortex (ACC) or posterior cingulated cortex (PCC) (or both), parietal cortex, posterior parietal cortex (PPC), and cerebellum as well as in the right posterior insula and right thalamus in our patients. In contrast, glucose metabolism was reduced contralaterally in the dorsal prefrontal cortex and primary motor cortex. Glucose metabolism was bilaterally elevated in the mid-ACC/PCC and the PPC, which correlated with pain duration. CONCLUSION: These data suggested that glucose metabolism in the brains of patients with CRPS changes dramatically at each location. In particular, glucose metabolism was increased in the areas concerned with somatosensory perception, possibly due to continuous painful stimulation.

Low efficacy of 18F-FDG PET for detection of uveal malignant melanoma compared with 123I-IMP SPECT.

UNLABELLED: Earlier investigations showed that N-isopropyl-p-123I-iodoamphetamine SPECT (123I-IMP SPECT) is useful for the diagnosis of uveal malignant melanoma, whereas the feasibility and usefulness of 18F-FDG PET in uveal malignant melanoma have not yet been established. We compared the usefulness of 123I-IMP SPECT and 18F-FDG PET for the detection of uveal malignant melanoma on the same subjects. METHODS: Nineteen patients (10 men, 9 women) with suspected uveal malignant melanoma were examined by 123I-IMP SPECT. Thirteen of them were also examined by 18F-FDG PET. 123I-IMP SPECT was performed at 15 min or at 3 and 24 h after intravenous administration of 123I-IMP. RESULTS: In 12 of 19 study patients, 123I-IMP SPECT obtained at 24 h after intravenous administration of 123I-IMP delineated an area of increased uptake in the site corresponding to the ocular tumor. All of the ocular tumors in the 12 123I-IMP SPECT-positive patients were confirmed histopathologically and clinically to be uveal malignant melanoma. The other 7 123I-IMP-SPECT-negative patients have been monitored under the diagnosis of choroidal nevus, choroidal hemangioma, hyperplasia of the pigment epithelium of the retina, or idiopathic inflammatory lesions without any complications. In a total of 13 patients examined by 18F-FDG PET, 9 of whom were 123I-IMP SPECT positive and 4 were negative, only 1 patient showed abnormal uptake of 18F-FDG PET in the site corresponding to the ocular tumor. Therefore, 8 of 9 patients with uveal malignant melanoma showed false-negative results in 18F-FDG PET. The 18F-FDG PET-positive patient with uveal malignant melanoma had the largest tumor mass with a short diameter of 12 mm, a long diameter of 17 mm, and a height of 7 mm. In the other 8 18F-FDG PET-negative patients, the tumors had a dimension of 11 x 13 x 7 mm or less. CONCLUSION: 123I-IMP SPECT is a sensitive and accurate method for the detection of uveal malignant melanoma, whereas the efficacy of 18F-FDG PET for this purpose is low because of a high incidence of false-negative results. 123I-IMP SPECT is far more superior in comparison with 18F-FDG PET in detecting uveal malignant melanoma.

Health effects of a long-term stay in a spa resort.

The authors examined periodic changes in endocrinological stress markers in saliva samples collected from 31 women who spent 8 days in a spa resort. Levels of salivary cortisol and chromogranin A (CgA) were evaluated by enzyme-linked immunosorbent assay. To evaluate health-related lifestyle factors, patterns of behavior, perceived stressors, and stress reactions of the subjects, the authors administered written questionnaires. Individuals who scored poorly on an index evaluating lifestyle health factors, or reported stressful life events, showed a significant increase in CgA levels during the stay. This suggests that, for these people, the long stay in the spa ameliorated stress. These findings are somewhat different from those of studies in which researchers have evaluated the effects of shorter-term leisure trips.

Adsorption and desorption properties of trans-resveratrol on cellulose cotton.

The adsorption and desorption properties of trans-Resveratrol (Res) on the cellulose cotton were investigated under various conditions, such as the pH, alcohol percentage, temperature and equilibrium times. Moreover, the acidic-dissociation constants were determined to be pKa1 = 8.01, pKa2 = 9.86 and pKa3 = 10.5 by a curve-fitting method. Also, it was found that the adsorption depended on the temperature and salting effect. On the other hand, the desorptions from cellulose were examined using several kinds of water-miscible organic solvents (methanol, ethanol, acetone and THF).

Medical assessment of the health effects of short leisure trips.

Using responses to questionnaires and results of saliva samples from 40 women, the authors assessed the effects on health of participation in a short leisure trip (2 nights, 3 d) to Kyushu Island in Japan. They addressed transportation, sightseeing, and group activities during the tour, which might differ from participants' usual activities. Levels of the salivary endocrinological stress markers cortisol and chromogranin A (CgA) were determined by enzyme-linked immunosorbent assay (ELISA). In each of the groups with characteristics considered healthy and related to lifestyle, patterns of behavior, perceived stressors, and stress reactions, a decrease in the cortisol levels and an increase in the CgA levels were apparent during the tour. The baseline for stress hormone changes was the levels on awakening on Day 1 (i.e., immediately before the tour). These findings suggest that even short periods of travel can bring about a reduction in di-stress and acquisition of eu-stress, experienced as feeling uplifted or fulfilled.

Quantitative analysis for assessing regional function of liver by using 99mTc-GSA SPECT.

In the present study, we developed quantitative index for evaluating regional liver function using 99mTc diethylenetriamine-pentaacetic acid galactosyl human serum albumin (GSA). A three head SPECT equipped with a low energy high resolution parallel hole collimator was used. Used pre-filter was Butterworth and axial images were reconstructed by a ramp filter without attenuation correction. Correlation between SPECT counts and net concentration of activity of radioisotopes was evaluated in basic consideration using LKS and Nine-Ball phantoms. SPECT Counts = 0.6 x RI concentration. There was a simple correlation among GSA receptor amounts (Cr), injected GSA amounts (S), free GSA amounts (Cf), and intra hepatic receptor ratio ((Cr ratio)). Cr = S - Cf. (Cr ratio) = Cr/S, 0 < (Cr ratio) < 1. Injected GSA amounts can be calculated from injected net RI counts. Free GSA amounts can be evaluated from counts of the heart. GSA receptor amounts can be assumed by performing SPECT three times in series. Regional GSA receptor amounts can be evaluated from the ratio between the region's counts and whole counts. In clinical SPECT images, we could evaluate the regional GSA receptor amounts before and after chemolipiodolization. In conclusion, our method is a simple quantitative index of analyzing regional GSA receptor amounts.