Effectiveness of Newly Developed Water-Equivalent Mouthpiece during External Beam Radiotherapy for Oral Cancer

The objective of this study was to research the effectiveness of newly developed water-equivalent mouthpiece during external beam radiotherapy for oral cancer. In external beam radiotherapy for cancer of the tongue, floor of the mouth, and lower gingiva, it is possible to prescribe a low dose to the upper gingiva and hard palate at an open mouth position using a mouthpiece. However, the inhomogeneity correction resulting from the air cavity and the mobility of the tongue produced by an open mouth position should be considered. Therefore, a new mouthpiece was designed to be fixed by the dental arch, and the air cavity of the mouth can be filled with water-equivalent material. In 30 patients with previously treated oral cancer, the simulated homogeneity index of the calculated water-equivalent mouthpiece by a treatment-planning system was significantly better than that of a conventional mouthpiece (p = 0.004). This new mouthpiece facilitates excellent dose distribution while attaining immobilization of the tongue in patients with oral cancer

Robot-Assisted Total Hysterectomy of Extremely Unusual Pelvic Anatomy: A Case Report and Literature Review

We report a case of robot-assisted total hysterectomy in a patient with extremely rare pelvic anatomy. Robot-assisted total laparoscopic hysterectomy was performed for lobular endocervical glandular hyperplasia on the left side of the uterus. The sigmoid colon was present between the two uterine corpora of a uterine didelphys and was attached to the bladder via the mesentery and fat. During surgery, the surgeon left the console and confirmed the magnetic resonance images. The surgery was then completed safely after the surgeon understood the anatomy. The postoperative condition was good, and the patient was discharged on postoperative day 5. Robot-assisted surgery has various advantages, including a good field of view, accuracy of instrument movement, and ease of viewing information in the medical record by pausing the operation. Robot assisted surgery improves not only safety and operational precision but also intraoperative convenience. Further studies are needed regarding the specific anatomy seen in this case

Comparative analysis of photosynthetic properties in ice algae and phytoplankton inhabiting Franklin Bay, the Canadian Arctic, with those in mesophilic diatoms during CASES 03-04

Psychrophilic phytoplankton and ice algae were collected in Franklin Bay, the Canadian Arctic, in late May 2004, and the photosynthetic properties were measured at 4°C using a pulse amplitude modulation fluorometer (Phyto-PAM). Rapid light curve measurements allowed for the assessment of the photosynthetic efficiency (α), maximal electron transport rate (rETRmax), and minimum saturating irradiance (Ek) in the samples. The values of α in phytoplankton (0.63-0.68) were much larger than those in ice algae (0.10-0.51), and the values of rETRmax in phytoplankton (4.6-6.7) were relatively larger than those in ice algae (1.8-4.3). However, Ek showed similar values in both samples and were around 10μmol photonsm^・s^. These values were systematically compared with those obtained from mesophilic marine diatoms (a centric diatom, Chaetoceros gracilis, and a pennate diatom, Phaeodactylum tricornutum) grown under various irradiances in the laboratory. The highly shade-adapted features of ice algae and phytoplankton were disclosed through this comparative analysis. It was also found that the non-photochemical quenching was much higher in psychrophilic samples than in mesophilic diatoms grown under moderate irradiance. Furthermore, in ice algae and phytoplankton, the decrease in rETR at high irradiances was prominent, showing that they were highly susceptible to photoinhibition. Our comparative analysis using psychrophilic phytoplankton, ice algae and two strains of mesophilic diatoms also revealed that the dependency on the xanthophyll cycle for the protection mechanisms of photosystems were remarkably different between the groups, indicating that the acclimation strategies to growth irradiances were variable between species. Such variable acclimation strategies could be one of the forces that results in a diverse algal flora that enables this region around Franklin Bay to be a productive area, even though the psychrophilic phytoplankton and ice algae are highly shade-adapted

Endometrial Cancer Arising in Adenomyosis That Could Not Be Diagnosed by Endometrial Biopsy: A Case Report

Uterine adenomyosis is an estrogen-dependent tumor and one of the most common benign diseases in sexually mature women. The frequency of endometrial cancer associated with adenomyosis has been reported to be 18%–66%. On the other hand, endometrial cancer arising in adenomyosis (EC-AIA) is extremely rare. EC-AIA is now considered a different entity from and has a worse prognosis than endometrial cancer with adenomyosis (EC-A). In the present study, we report a case of endometrial cancer with adenomyosis in which endometrial biopsy failed to provide a definitive diagnosis. A 63-year-old female patient presented with endometrial thickening. Endometrial cytology was positive, and magnetic resonance imaging (MRI) showed small lesions suggestive of endometrial cancer with shallow invasion and adenomyosis. However, an endometrial biopsy showed only metaplasia, and careful follow-up was initiated. Subsequent endometrial cytology showed enlarged and round nuclei, uniform chromatin distribution, no thickening of nuclear margins, and abundant cytoplasm appearing in a sheet-like arrangement, suggesting atypical cells of endometrial glands with metaplasia. Three suspicious positive results and one positive result were observed, but repeated biopsies did not lead to the diagnosis of malignancy. The patient underwent diagnostic hysterectomy 19 months after the initial visit. The postoperative histopathological diagnosis was stage IA endometrial cancer (endometrioid carcinoma G1). This case of endometrial cancer associated with adenomyosis was difficult to diagnose. Our findings demonstrate that EC-AIA should be considered even if no lesions were detected by endometrial biopsy

Effect of dental metal artifact conversion volume on dose distribution in head‐and‐neck volumetric‐modulated arc therapy

Purpose: During treatment planning for head‐and‐neck volumetric‐modulated arc therapy (VMAT), manual contouring of the metal artifact area of artificial teeth is done, and the area is replaced with water computed tomography (CT) values for dose calculation. This contouring of the metal artifact areas, which is performed manually, is subject to human variability. The purpose of this study is to evaluate and analyze the effect of inter‐observer variation on dose distribution. Methods: The subjects were 25 cases of cancer of the oropharynx for which VMAT was performed. Six radiation oncologists (ROs) performed metal artifact contouring for all of the cases. Gross tumor volume, clinical target volume, planning target volume (PTV), and oral cavity were evaluated. The contouring of the six ROs was divided into two groups, small and large groups. A reference RO was determined for each group and the dose distribution was compared with those of the other radiation oncologists by gamma analysis (GA). As an additional experiment, we changed the contouring of each dental metal artifact area, creating enlarged contours (L), reduced contours (S), and undrawn contours (N) based on the contouring by the six ROs and compared these structure sets. Results: The evaluation of inter‐observer variation showed no significant difference between the large and small groups, and the GA pass rate was 100%. Similar results were obtained comparing structure sets L and S, but in the comparison of structure sets L and N, there were cases with pass rates below 70%. Conclusions: The results show that the artificial variability of manual artificial tooth metal artifact contouring has little effect on the dose distribution of VMAT. However, it should be noted that the dose distribution may change depending on the contouring method in cases where the overlap between PTV and metal artifact areas is large

Risk-adjusted therapy for pediatric non-T cell ALL improves outcomes for standard risk patients: results of JACLS ALL-02

This study was a second multicenter trial on childhood ALL by the Japan Childhood Leukemia Study Group (JACLS) to improve outcomes in non-T ALL. Between April 2002 and March 2008, 1138 children with non-T ALL were enrolled in the JACLS ALL-02 trial. Patients were stratified into three groups using age, white blood cell count, unfavorable genetic abnormalities, and treatment response: standard risk (SR), high risk (HR), and extremely high risk (ER). Prophylactic cranial radiation therapy (PCRT) was abolished except for CNS leukemia. Four-year event-free survival (4yr-EFS) and 4-year overall survival (4yr-OS) rates for all patients were 85.4% ± 1.1% and 91.2% ± 0.9%, respectively. Risk-adjusted therapy resulted in 4yr-EFS rates of 90.4% ± 1.4% for SR, 84.9% ± 1.6% for HR, and 66.5% ± 4.0% for ER. Based on NCI risk classification, 4yr-EFS rates were 88.2% in NCI-SR and 76.4% in NCI-HR patients, respectively. Compared to previous trial ALL-97, 4yr-EFS of NCI-SR patients was significantly improved (88.2% vs 81.2%, log rank p = 0.0004). The 4-year cumulative incidence of isolated (0.9%) and total (1.5%) CNS relapse were significantly lower than those reported previously. In conclusion, improved EFS in NCI-SR patients and abolish of PCRT was achieved in ALL-02

管理栄養士養成課程学生における切砕技術の変容と課題

【要旨】管理栄養士養成課程学生を対象として調理技能調査および質問紙調査を実施し，4年間の切砕技術の変容を調査した。調理技能調査の結果，1，2 年次には制限時間内に切り終わらない学生もいたが，4年次では全員が制限時間内に切り終えていた。切断物の評価は，どの年次でも「やや不揃い」，「不揃い」の学生が多かった。4 年間通して一人暮らしであった学生のうち半数以上が週 3～4 回以上食事作りをしていた。自炊を始めたことにより自身の切砕技術が向上したと考えている学生が多かった。日常の食事で「野菜そのものを買う」学生が多く，野菜を切るときに速さや均一さを「意識していない」学生が多かった。キャベツのせん切りをするときの包丁の持ち方は，全握式を選択した学生が多かった。均一さを備えた技術の習得には，切り方に応じた包丁の持ち方の指導，日常の食事作りにおいても速さや均一さの意識を持たせること，家庭で繰り返し練習させる課題の工夫が必要と考える。Abstract: Students from a registered dietitian training program were administered questionnaires and cooking skills examinations to determine changes in their knife skills over the course of their four-year program. Examination of cooking skills revealed that, while all fourth-year students were able to complete a chopping task within the designated time limit, some first and second-year students were unable to do so. Evaluations of the chopped items found many students’ work to be “unevenness” or “a little unevenness,” regardless of year group. Of those students who lived alone during the four-year program, more than half cooked meals at least three or four times a week. Many students believed that their knife skills had improved as a result of them starting to cook for themselves. Many reported buying unprocessed vegetables for everyday meals, while a high number stated that they did not pay attention to speed or evenness when chopping vegetables. When choosing a knife grip for julienning cabbage, many students selected whole grip style. To allow students to master the skills needed to chop evenly, we must provide guidance on the knife grips appropriate to each cutting technique; encourage their awareness of the speed and evenness of their chopping, even in the preparation of their own daily meals; and devise tasks that will allow them to practice through repetition at home

A novel transgenic chimaeric mouse system for the rapid functional evaluation of genes encoding secreted proteins

A major challenge of the post-genomic era is the functional characterization of anonymous open reading frames (ORFs) identified by the Human Genome Project. In this context, there is a strong requirement for the development of technologies that enhance our ability to analyze gene functions at the level of the whole organism. Here, we describe a rapid and efficient procedure to generate transgenic chimaeric mice that continuously secrete a foreign protein into the systemic circulation. The transgene units were inserted into the genomic site adjacent to the endogenous immunoglobulin (Ig) κ locus by homologous recombination, using a modified mouse embryonic stem (ES) cell line that exhibits a high frequency of homologous recombination at the Igκ region. The resultant ES clones were injected into embryos derived from a B-cell-deficient host strain, thus producing chimaerism-independent, B-cell-specific transgene expression. This feature of the system eliminates the time-consuming breeding typically implemented in standard transgenic strategies and allows for evaluating the effect of ectopic transgene expression directly in the resulting chimaeric mice. To demonstrate the utility of this system we showed high-level protein expression in the sera and severe phenotypes in human EPO (hEPO) and murine thrombopoietin (mTPO) transgenic chimaeras

Anticancer drug clustering in lung cancer based on gene expression profiles and sensitivity database

BACKGROUND: The effect of current therapies in improving the survival of lung cancer patients remains far from satisfactory. It is consequently desirable to find more appropriate therapeutic opportunities based on informed insights. A molecular pharmacological analysis was undertaken to design an improved chemotherapeutic strategy for advanced lung cancer. METHODS: We related the cytotoxic activity of each of commonly used anti-cancer agents (docetaxel, paclitaxel, gemcitabine, vinorelbine, 5-FU, SN38, cisplatin (CDDP), and carboplatin (CBDCA)) to corresponding expression pattern in each of the cell lines using a modified NCI program. RESULTS: We performed gene expression analysis in lung cancer cell lines using cDNA filter and high-density oligonucleotide arrays. We also examined the sensitivity of these cell lines to these drugs via MTT assay. To obtain our reproducible gene-drug sensitivity correlation data, we separately analyzed two sets of lung cancer cell lines, namely 10 and 19. In our gene-drug correlation analyses, gemcitabine consistently belonged to an isolated cluster in a reproducible fashion. On the other hand, docetaxel, paclitaxel, 5-FU, SN-38, CBDCA and CDDP were gathered together into one large cluster. CONCLUSION: These results suggest that chemotherapy regimens including gemcitabine should be evaluated in second-line chemotherapy in cases where the first-line chemotherapy did not include this drug. Gene expression-drug sensitivity correlations, as provided by the NCI program, may yield improved therapeutic options for treatment of specific tumor types

一人暮らしの管理栄養士養成課程学生における 食事作り意識・実践の変化と課題の検討

【要旨】A 大学栄養学科 2016 年度入学生を対象に記名自記式質問紙調査を実施し，一人暮らしの者 20 名（女性 17 名，男性 3 名）の回答より 1～2 年次から 4 年次までの食事作りへの意識・実践の変化を分析した。食事作り意識の変化として，何も見ずに作ることができると考える料理が 35 項目中 5 項目有意に増加し（p＜0.05），食事の「栄養バランス」「料理・味付けの組み合わせ」等に気を付けている者が増加した。また各年次で共通して，食品選択で重視していることに「価格」，食事作りで気を付けていることに「作り方が簡単」「短時間で 食事を準備」，料理の参考に「インターネット」「高校までの家庭料理」と回答する者が多く，大学での習得知 識や教科書等を参考とする者は少なかった。食事作り実践の変化として，泡立て器，スケール，おろし器，ゴムベラの調理器具所有者は有意に増加した（p＜0.05）一方，月 1 回以上作る料理の種類は減少が見られた。食事作りを「ほぼ毎日」する者は 5 割，主食・主菜・副菜の揃った食事を「毎食食べる」者は 3 食いずれも 15% 以下と年次による大きな変動はなかった。4 年次までに料理のレパートリーの広がりや食事バランスへの意識 向上が見られた反面，実際の食事作り実践や食事内容へ反映する者は少ないことが課題として示されたことから，学生の生活状況等を考慮し，日常において継続的な食事作りと食事内容の充実に繋がる教育上の工夫が必要と考えられる。Abstract: A self-administered questionnaire survey was conducted on students enrolled in the Department of Nutrition at University A in 2016. On the basis of the answers provided by 20 students living alone (17 women, 3 men), in first and second year and then to the fourth year, we analyzed changes in awareness of and practice around meal preparation. As a change in awareness of meal preparation, the number of students who believe they can cook meals without using a recipe increased significantly for 5 out of 35 dishes (p<0.05), and the number of students paying attention to the "nutrition balance" and "combination of dishes and seasoning" of meals increased. Furthermore, regardless of academic year, many students answered that "price" is important in food selection and mentioned the phrases "easy to make" and "prepare meals in a short time" as considerations when cooking meals, and used the "Internet" and "home cooking up to high school" for reference, while few referred to the knowledge acquired at university and from textbooks. As a change in the practice of meal preparation, the number of those owning whisks, scales, graters, and rubber spatula cookware increased significantly (p <0.05), while the variety of dishes cooked at least once a month decreased. Fifty percent of the students made meals "almost every day," and fewer than 15% of the students "eat every meal" with a staple food, main dish, and side dish in regular meals three times a day, and there was no significant change from year to year. By the fourth year, students’ cooking repertoire had expanded, and awareness of the dietary balance had increased, but this was rarely reflected in students’ actual dietary preparation practice and dietary content. Considering students’ living conditions, educational measures need to be devised that lead to continuous meal preparation and enrichment of meal content in daily life