Pathological Complete Response Patients after Neoadjuvant Chemotherapy in Breast Cancer

Cases of breast cancer metastasis after achieving a pathological complete response (pCR) with neoadjuvant chemotherapy (NAC) are sometimes encountered in clinical practice. We investigated the prognostic factors for pCR in patients with breast cancer after NAC. This retrospective cohort study included patients with localized breast cancer who underwent NAC followed by surgery between 2004 and 2020 and achieved a pCR. The associations between clinical factors and distant metastasis-free survival rate were statistically analyzed. We analyzed data for 127 patients. Twelve patients (9.4%) had distant metastases, and seven (5.5%) died. For estrogen receptor (ER)-positive patients, the distant metastasis-free survival rate was 94.6% for both 5 and 8 years. In contrast, ER-negative patients had a distant metastasis-free survival rate of 87.6% and 85.4% for 5 and 8 years (p=0.094), respectively. In cT0-2 patients, the distant metastasis-free survival rate was 92.4% for 5 years and 90.5% for 8 years, whereas in cT3-4 patients, the distant metastasis-free survival rate was 83.5% for 5 years and 83.5% for 8 years (p=0.301). This study suggested that patients with ER-negative, pre-NAC cT3 or T4 breast cancer who had achieved a pCR after NAC tended to have a worse prognosis

Nowcast and forecast of galactic cosmic ray (GCR) and solar energetic particle (SEP) fluxes in magnetosphere and ionosphere – Extension of WASAVIES to Earth orbit

Real-time estimation of cosmic-ray fluxes on satellite orbits is one of the greatest challenges in space weather research. Therefore, we develop a system for nowcasting and forecasting the galactic cosmic ray (GCR) and solar energetic particle (SEP) fluxes at any location in the magnetosphere and ionosphere during ground-level enhancement (GLE) events. It is an extended version of the WArning System for AVIation Exposure to SEP (WASAVIES), which can determine event profiles by using real-time data of the count rates of several neutron monitors (NMs) at the ground level and high-energy proton fluxes observed by Geostationary Operational Environmental Satellites (GOES) satellites. The extended version, called WASAVIES-EO, can calculate the GCR and SEP fluxes outside a satellite based on its two-line element (TLE) data. Moreover, organ absorbed-dose and dose-equivalent rates of astronauts in the International Space Station (ISS) can be estimated using the system, considering its shielding effect. The accuracy of WASAVIES-EO was validated based on the dose rates measured in ISS, as well as based on high-energy proton fluxes observed by POES satellites during large GLEs that have occurred in the 21st century. Agreement between the nowcast and forecast dose rates in ISS, especially in terms of their temporal structures, indicates the usefulness of the developed system for future mission operations

ガクセイ アンケート チョウサ ニヨル コウギ ヒョウカ ト ソノ モンダイテン

近年,医学教育改革が目まぐるしく行われている.その中で,学生による講義評価が行われはじめているが,まだその報告は少ない.獨協医科大学では学年委員会が主体となって,講義・実習に対するアンケート調査を第1学年から第4学年まで行った.その結果,講義に対して「十分に満足している」という学生は,どの学年においても多くはなかった.さらに,「わかりやすい講義」をしている教員の共通点は,板書・プリント・シラパスを活用しているという点であった.実習に関しては,「基礎医学」に関わる実習に対しての評価が高かった.今後の医学教育において,学生の意見の反映がよりよい講義につながるものと考えられる.Extensive innovations in medical education have been carried out in recent years in our country. Although student evaluations of lectures have been conducted, there have been few reports on this issue. Thus, our committee consisting of representatives of every grade played a leading role in making and evaluating a questionnaire investigation of the lectures and the experiments. The investigation covered students from freshmen to seniors. We found that there were few students in each grade who were satisfied with the lectures. Students gave high marks to lecturers who wrote in detail on the blackboard, distributed well-organized documents, and made practical use of the syllabus. Experiments concerning the preclinical course were also well accepted. We consider that this sort of investigation will be influential in improving the quality of lectures

Anesthetic management of cesarean section in COVID-19-positive pregnant women in Japan: Three case reports and review of the literature

Cesarean delivery may be performed if a pregnant woman develops coronavirus disease 2019 (COVID-19) in the prenatal period; however, perioperative management is controversial. Herein, we report the anesthetic management of cesarean sections in three pregnant women with COVID-19. In addition, we reviewed the literature on perioperative anesthesia management in pregnant women with COVID-19. Three pregnant women between the 37th and 38th weeks of gestation developed COVID-19 and were transferred to our hospital for cesarean section. Intraoperative spinal anesthesia was administered, and postoperative analgesia included intravenous morphine. Postoperatively, all patients were administered anticoagulant therapy. We used a negative pressure-controlled operating room for the cesarean sections, and the staff used Level 3 personal protective equipment with N95 masks, face shields, double gloves, full-body gowns, and shoe covers. None of the operating room staff, including the anesthesiologist, were infected with COVID-19 due to patient care. Spinal anesthesia, rather than general anesthesia, is recommended for cesarean sections in pregnant women with COVID-19. In addition to the risk of thrombosis, it is necessary to manage anesthesia in pregnant women infected with COVID-19 while considering accessibility to the ward for postoperative management and familiarity of ward staff

Pathological Complete Response Patients after Neoadjuvant Chemotherapy in Breast Cancer

Cases of breast cancer metastasis after achieving a pathological complete response (pCR) with neoadjuvant chemotherapy (NAC) are sometimes encountered in clinical practice. We investigated the prognostic factors for pCR in patients with breast cancer after NAC. This retrospective cohort study included patients with localized breast cancer who underwent NAC followed by surgery between 2004 and 2020 and achieved a pCR. The associations between clinical factors and distant metastasis-free survival rate were statistically analyzed. We analyzed data for 127 patients. Twelve patients (9.4%) had distant metastases, and seven (5.5%) died. For estrogen receptor (ER)-positive patients, the distant metastasis-free survival rate was 94.6% for both 5 and 8 years. In contrast, ER-negative patients had a distant metastasis-free survival rate of 87.6% and 85.4% for 5 and 8 years (p=0.094), respectively. In cT0-2 patients, the distant metastasis-free survival rate was 92.4% for 5 years and 90.5% for 8 years, whereas in cT3-4 patients, the distant metastasis-free survival rate was 83.5% for 5 years and 83.5% for 8 years (p=0.301). This study suggested that patients with ER-negative, pre-NAC cT3 or T4 breast cancer who had achieved a pCR after NAC tended to have a worse prognosis

Nowcast and forecast of galactic cosmic ray (GCR) and solar energetic particle (SEP) fluxes in magnetosphere and ionosphere – Extension of WASAVIES to Earth orbit

Real-time estimation of cosmic-ray fluxes on satellite orbits is one of the greatest challenges in space weather research. Therefore, we develop a system for nowcasting and forecasting the galactic cosmic ray (GCR) and solar energetic particle (SEP) fluxes at any location in the magnetosphere and ionosphere during ground-level enhancement (GLE) events. It is an extended version of the WArning System for AVIation Exposure to SEP (WASAVIES), which can determine event profiles by using real-time data of the count rates of several neutron monitors (NMs) at the ground level and high-energy proton fluxes observed by Geostationary Operational Environmental Satellites (GOES) satellites. The extended version, called WASAVIES-EO, can calculate the GCR and SEP fluxes outside a satellite based on its two-line element (TLE) data. Moreover, organ absorbed-dose and dose-equivalent rates of astronauts in the International Space Station (ISS) can be estimated using the system, considering its shielding effect. The accuracy of WASAVIES-EO was validated based on the dose rates measured in ISS, as well as based on high-energy proton fluxes observed by POES satellites during large GLEs that have occurred in the 21st century. Agreement between the nowcast and forecast dose rates in ISS, especially in terms of their temporal structures, indicates the usefulness of the developed system for future mission operations

Correction Notice to: Nowcast and forecast of galactic cosmic ray (GCR) and solar energetic particle (SEP) fluxes in magnetosphere and ionosphere – Extension of WASAVIES to Earth orbit

Real-time estimation of cosmic-ray fluxes on satellite orbits is one of the greatest challenges in space weather research. Therefore, we develop a system for nowcasting and forecasting the galactic cosmic ray (GCR) and solar energetic particle (SEP) fluxes at any location in the magnetosphere and ionosphere during ground-level enhancement (GLE) events. It is an extended version of the WArning System for AVIation Exposure to SEP (WASAVIES), which can determine event profiles by using real-time data of the count rates of several neutron monitors (NMs) at the ground level and high-energy proton fluxes observed by Geostationary Operational Environmental Satellites (GOES) satellites. The extended version, called WASAVIES-EO, can calculate the GCR and SEP fluxes outside a satellite based on its two-line element (TLE) data. Moreover, organ absorbed-dose and dose-equivalent rates of astronauts in the International Space Station (ISS) can be estimated using the system, considering its shielding effect. The accuracy of WASAVIES-EO was validated based on the dose rates measured in ISS, as well as based on high-energy proton fluxes observed by POES satellites during large GLEs that have occurred in the 21st century. Agreement between the nowcast and forecast dose rates in ISS, especially in terms of their temporal structures, indicates the usefulness of the developed system for future mission operations

5-Aminosalicylic acid alters the gut microbiota and altered microbiota transmitted vertically to offspring have protective effects against colitis

Abstract Although many therapeutic options are available for inflammatory bowel disease (IBD), 5-aminosalicylic acid (5-ASA) is still the key medication, particularly for ulcerative colitis (UC). However, the mechanism of action of 5-ASA remains unclear. The intestinal microbiota plays an important role in the pathophysiology of IBD, and we hypothesized that 5-ASA alters the intestinal microbiota, which promotes the anti-inflammatory effect of 5-ASA. Because intestinal inflammation affects the gut microbiota and 5-ASA can change the severity of inflammation, assessing the impact of inflammation and 5-ASA on the gut microbiota is not feasible in a clinical study of patients with UC. Therefore, we undertook a translational study to demonstrate a causal link between 5-ASA administration and alterations of the intestinal microbiota. Furthermore, by rigorously controlling environmental confounders and excluding the effect of 5-ASA itself with a vertical transmission model, we observed that the gut microbiota altered by 5-ASA affected host mucosal immunity and decreased susceptibility to dextran sulfate sodium-induce colitis. Although the potential intergenerational transmission of epigenetic changes needs to be considered in this study, these findings suggested that alterations in the intestinal microbiota induced by 5-ASA directed the host immune system towards an anti-inflammatory state, which underlies the mechanism of 5-ASA efficacy