Dose–volume histogram parameters of high-dose-rate brachytherapy for StageI–II cervical cancer(≤4cm) arising from a small-sized uterus treated with a point A dose-reduced plan

学位記番号：医博甲1647

Soft-tissue perineurioma of the retroperitoneum in a 63-year-old man, computed tomography and magnetic resonance imaging findings: a case report

<p>Abstract</p> <p>Introduction</p> <p>Soft-tissue perineuriomas are rare benign peripheral nerve sheath tumors in the subcutis of the extremities and the trunks of young patients. To our knowledge, this the first presentation of the computed tomography and magnetic resonance imaging of a soft-tissue perineurioma in the retroperitoneum with pathologic correlation.</p> <p>Case presentation</p> <p>A 63-year-old Japanese man was referred for assessment of high blood pressure. Abdominal computed tomography and magnetic resonance imaging showed a well-defined, gradually enhancing tumor without focal degeneration or hemorrhage adjacent to the pancreatic body. Tumor excision with distal pancreatectomy and splenectomy was performed, as a malignant tumor of pancreatic origin could not be ruled out. No recurrence has been noted in the 16 months since the operation. Pathologic examination of the tumor revealed a soft-tissue perineurioma of the retroperitoneum.</p> <p>Conclusion</p> <p>Although the definitive diagnosis of soft-tissue perineurioma requires biopsy and immunohistochemical reactivity evaluation, the computed tomography and magnetic resonance imaging findings described in this report suggest inclusion of this rare tumor in the differential diagnosis when such findings occur in the retroperitoneum.</p

Epidemiological Surveys of Methicillin-Resistant Staphylococcus aureus in Tottori Prefecture, Japan

To study the isolation frequency of methicillin-resistant Staphylococcus aureus (MRSA) and susceptibility of MRSA to antibiotics, a questionnaire survey was performed every half year from 1993 until 1997. The questionnaire was sent to medical doctors, and it asked retroactively about the isolation of S. aureus from clinical specimens. The isolation rate of MRSA from patients over 65 years of age was higher, and that from patients under 16 years of age was lower, than the rates in other age groups (P< 0.01). Ratios of isolation of MRSA among S. aureus strains were from 12 to 38% in the clinics, from 39 to 71% in the small-scale hospitals and from 47 to 62% in large-sized hospitals. These isolation rates increased gradually from 1993 to 1997 (P< 0.001). The isolation rate of MRSA from the sputum was higher, and those from pus, pharyngeal secretion and urine were lower, than those from feces and other specimens and from total specimens. The isolation rate of antibiotic-resistant strains of MRSA was highest for penicillins and cepharosporins. MRSA was highly susceptible to arbekacin (isolation rate of resistant strains: 3.0%) and vancomycin (3.0%), and was slightly susceptible to minocycline (21%), doxycycline (24%), amikacin (39%) and dibekacin (37%). These results indicate that more careful surveillance of MRSA and more stringent precautions against nosocomial infection with antibiotic-resistant MRSA are needed in hospitals even in relatively isolated parts of Japan

Rationale and Design of a Prospective, Multicentre, Stop Tyrosine Kinase Inhibitor Trial of Paediatric Patients with Chronic Myeloid Leukaemia with Sustained Complete Molecular Response (STKI-14)

Chronic myeloid leukaemia (CML) is a relatively rare disease in children, accounting for 2–3% of all paediatric leukaemia cases. Generally, children with CML can avoid hematopoietic stem cell transplantation and achieve molecular responses with tyrosine kinase inhibitors (TKI). However, CML stem cells are thought to survive in many patients, even after TKI treatment. Many aspects of the toxic effects of prolonged exposure to TKIs during childhood remain unclear, particularly those regarding growth impairment. This lack of clarity underscores the importance of the present clinical trial, which aims to clarify the feasibility of treatment-free remission (TFR) in children following TKI treatment. We aim to examine the long-term out-comes and complications of TKIs before and after cessation to better understand the unknown complications that could arise in adulthood. This trial targets patients who were diagnosed with CML at an age younger than 20 years, were in the chronic or accelerated phase at initial diagnosis and remained in complete molecular remission for at least 2 years after TKI administration. We will examine the utility of TKI cessation and assess the treatment results of patients who resumed TKI therapy after losing a major molecular response. We will also investigate factors related to the feasibility of a TFR after TKI cessation

LDL-C/HDL-C Ratio Predicts Carotid Intima-Media Thickness Progression Better Than HDL-C or LDL-C Alone

High-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) are strong predictors of atherosclerosis. Statin-induced changes in the ratio of LDL-C to HDL-C (LDL-C/HDL-C) predicted atherosclerosis progression better than LDL-C or HDL-C alone. However, the best predictor of subclinical atherosclerosis remains unknown. Our objective was to investigate this issue by measuring changes in carotid intima-media thickness (IMT). A total of 1,920 subjects received health examinations in 1999, and were followed up in 2007. Changes in IMT (follow-up IMT/baseline IMT × 100) were measured by ultrasonography. Our results showed that changes in IMT after eight years were significantly related to HDL-C (inversely, P < 0.05) and to LDL-C/HDL-C ratio (P < 0.05). When the LDL-C/HDL-C ratios were divided into quartiles, analysis of covariance showed that increases in the ratio were related to IMT progression (P < 0.05). This prospective study demonstrated the LDL-C/HDL-C ratio is a better predictor of IMT progression than HDL-C or LDL-C alone

マウス胸腺の抗体遺伝子転写細胞の分化

Immunoglobulin(Ig) heavy chain gene-transcribing cell diffrentiation was investigated in the thymus of BALB/c mice by the Realtime PCR for membrane-bound form IgM(IgM_m). The ratio of IgM_m to total IgM(IgM_t) was approximately 1 from fetus period to 14 days after the birth, and IgM transcriptions were almost processed to membrane-bound form. Then IgM_m transcriptions decreased and secretory form IgM(IgM_s), the difference between IgM_t and IgM_m, started being detected. It was concluded that thymus Ig gene-transcribing cells underwent the similar differential processes in which B cells developed from immature type having IgM_m to mature type secreting IgM_s, in secondary lymphoid tissues

A novel interplay between the Fanconi anemia core complex and ATR-ATRIP kinase during DNA cross-link repair.

When DNA replication is stalled at sites of DNA damage, a cascade of responses is activated in the cell to halt cell cycle progression and promote DNA repair. A pathway initiated by the kinase Ataxia teleangiectasia and Rad3 related (ATR) and its partner ATR interacting protein (ATRIP) plays an important role in this response. The Fanconi anemia (FA) pathway is also activated following genomic stress, and defects in this pathway cause a cancer-prone hematologic disorder in humans. Little is known about how these two pathways are coordinated. We report here that following cellular exposure to DNA cross-linking damage, the FA core complex enhances binding and localization of ATRIP within damaged chromatin. In cells lacking the core complex, ATR-mediated phosphorylation of two functional response targets, ATRIP and FANCI, is defective. We also provide evidence that the canonical ATR activation pathway involving RAD17 and TOPBP1 is largely dispensable for the FA pathway activation. Indeed DT40 mutant cells lacking both RAD17 and FANCD2 were synergistically more sensitive to cisplatin compared with either single mutant. Collectively, these data reveal new aspects of the interplay between regulation of ATR-ATRIP kinase and activation of the FA pathway