Design of teleoperation system with a force-reflecting real-time simulator

We developed a force-reflecting teleoperation system that uses a real-time graphic simulator. This system eliminates the effects of communication time delays in remote robot manipulation. The simulator provides the operator with predictive display and feedback of computed contact forces through a six-degree of freedom (6-DOF) master arm on a real-time basis. With this system, peg-in-hole tasks involving round-trip communication time delays of up to a few seconds were performed at three support levels: a real image alone, a predictive display with a real image, and a real-time graphic simulator with computed-contact-force reflection and a predictive display. The experimental results indicate the best teleoperation efficiency was achieved by using the force-reflecting simulator with two images. The shortest work time, lowest sensor maximum, and a 100 percent success rate were obtained. These results demonstrate the effectiveness of simulated-force-reflecting teleoperation efficiency

Tumorigenicity, Motility and Liver Metastasis of Human Gastric Carcinoma Lines with High Metastatic Potential in the Liver of Nude Mice

To analyze the human gastric carcinoma metastasis to the liver, a human gastric carcinoma line, AZ521 was injected into the spleens of nude mice. Cells from the few liver metastatic foci of injected AZ521 were expanded in vitro and subsequently injected into the spleens of nude mice. By repeating these proce-dures five times, we were able to obtain a cell line, designated AZ-H5c, with high metastatic potential in nude mice. It was observed that animals had liver metastasis in 10 of 12 (83%) cases injected with AZ-H5c, whereas only 14% with parental AZ521. The growth activity in vivo of AZ-H5c cells is much more rapid than that of AZ521 cells, but its growth activity in vitro is slower. The mortile activity in vitro of AZ-H5c is stronger than that of AZ521. These results suggest that our model can provide a new approach to basic and clinical studies of cancer metastasis

Significant effect of polymorphisms in CYP2D6 and ABCC2 on clinical outcomes of adjuvant tamoxifen therapy for breast cancer patients

Purpose The clinical efficacy of tamoxifen is suspected to be influenced by the activity of drug-metabolizing enzymes and transporters involved in the formation, metabolism, and elimination of its active forms. We investigated relationships of polymorphisms in transporter genes and CYP2D6 to clinical outcome of patients receiving tamoxifen. Patients and Methods We studied 282 patients with hormone receptor–positive, invasive breast cancer receiving tamoxifen monotherapy, including 67 patients who have been previously reported. We investigated the effects of allelic variants of CYP2D6 and haplotype-tagging single nucleotide polymorphisms (tag-SNPs) of ABCB1, ABCC2, and ABCG2 on recurrence-free survival using the Kaplan-Meier method and Cox regression analysis. Plasma concentrations of tamoxifen metabolites were measured in 98 patients receiving tamoxifen 20 mg/d. Results CYP2D6 variants were significantly associated with shorter recurrence-free survival (P = .000036; hazard ratio [HR] = 9.52; 95% CI, 2.79 to 32.45 in patients with two variant alleles v patients without variant alleles). Among 51 tag-SNPs in transporter genes, a significant association was found at rs3740065 in ABCC2 (P = .00017; HR = 10.64; 95% CI, 1.44 to 78.88 in patients with AA v GG genotypes). The number of risk alleles of CYP2D6 and ABCC2 showed cumulative effects on recurrence-free survival (P = .000000055). Patients carrying four risk alleles had 45.25-fold higher risk compared with patients with ≤ one risk allele. CYP2D6 variants were associated with lower plasma levels of endoxifen and 4-hydroxytamoxifen (P = .0000043 and .00052), whereas no significant difference was found among ABCC2 genotype groups. Conclusion Our results suggest that polymorphisms in CYP2D6 and ABCC2 are important predictors for the prognosis of patients with breast cancer treated with tamoxifen

マンセイ シッカン デ セイシン ショウジョウ オ テイスル カンジャ エノ チイキ セイシンカ イリョウ モデル ジギョウ オヨビ ソノ ヒョウカ : セイシン カンゴ センモン カンゴフ ト リエゾン チーム ノ ヤクワリ

The purpose of this study was to show the effectiveness of psychiatric liaison consultation team for the people with chronic illness in the general hospital. Psychiatric liaison consultation team was constructed by certified nurse specialist (CNS), psychiatrist, clinical psychologist, nurse and social worker. Case manager was CNS and team intervened to the patients according to the standard of intervention by team. Intervention had been implemented by CNS mainly. Thirty one patients who consented to this study were intervened by CNS and team between July of 2007 and Feb.2008. They had chronic illness which was SLE, cancer and other physical illness without mental illness. BPRS, GAF, and LSP were written by CNS at the time of baseline before intervention and at the end time of intervention. Furthermore patients wrote CES-D and SF-36 by themselves at the baseline and the end point of intervention. Those questionnaires were returned by mail. CSQ was written by patients at the end of intervention. Thirty one patients had high depression score at the baseline and after intervention depressive state was improved. And they had lower SF-36 compared with that of the people who had chronic illness in another study. Furthermore they needed to be supported psychosocially by CNS to prevent worse their symptom. And they had psychosocial needs and those needs should be intervened by interdisciplinary team. In conclusion, the role of CNS and interdisciplinary team were discussed in order to meet the patients\u27 needs and to prevent worse their symptom in the general hospitals

窩洞形成時における術者のストレスに関する研究

Dentists require precise skills during operations in limited space, e.g. inside a molar. In consequence, they are prone to have stress thereafter. To find out what the cause of the stress is, analyses were performed on 28 students in the 5^ year of Ohu University, Dental School. In these experiments, as non-parametric statistic analysis was appropriate for the purpose, the subjects could be divided into 2 groups, high- and low-stress ones. Nervous sweating, blood flow rate and the pulse rate during each of 5 trials of simulating operations with Dent Sim were measured in the subjects as indicators of stress. Results were : 1. A relationship between sweat volumes and trials : Most subjects of the high-stress group showed more than 0.150 mg/cm^2/min in the first trial of the operation, and less than that value according as the trial was repeated. On the other hand, in the low-stress group, sweat volumes ranged between 0.061 and 0.072 mg/cm^2/min through the trials. The former volumes were significantly higher th an the latter through the trials. 2. A relationship between the periods of the operation and trial times : The average operation periods in the first trial for the high- and low-stress groups were 259 and 361 sec, respectively, while those in the fifth trial were 170 and 215 sec. This difference between the two groups may depend on neatness of the latter group. 3. A relationship between the assessment scores with Dent Sim and experience (training) : The average scores in the first trial for the high- and low-stress groups were 62.5 and 65.5, respectively, while those in the fifth trial were 67.5 and 69.0, respectively. There was significant difference between the two groups for the first trial, but not in the fifth. 4. The locations causing stress for the operators during cavity preparation in a molar were estimated as the center of the lateral ventricle, the labial side and the center of the central portion of the cavity for the high-stress group. However, whole central portion in the molar caused stress for the low-stress one. In conclusion, these findings suggest that training sessions of dental care is critical for reducing stress of operators, and important to improve their skills

Volume-based parameters on FDG PET may predict the proliferative potential of soft-tissue sarcomas

Introduction: Soft-tissue sarcomas (STS) are rare types of tumors that have variable levels of tumor differentiation. F-18 fluorodeoxyglucose positron emission tomography (FDG PET) has been established as an useful tool for STS patients, and the metabolic tumor volume (MTV) and total lesion glycolysis (TLG) are reported to be useful in various cancers. We compared the diagnostic value of four PET parameters (maximum standardized uptake value [SUVmax], SUVmean, MTV, and TLG) from two acquisition timings for predicting the expression of the pathological marker of cell proliferation Ki-67, based on pathological investigation. Materials and methods: In this retrospective study, we investigated 20 patients (59±19 years old, 18-87 years old) with pathologically confirmed STS who underwent FDG PET before surgical intervention. The patients fasted ≥6 h before the intravenous injection of FDG. The whole body was scanned twice; at an early phase (61.5±2.6 min) and at a delayed phase (118.0±2.1 min) post-injection. The SUVmax, SUVmean, MTV, and TLG of the primary lesion were measured with a tumor boundary determined by SUV ≥2.0. Ki-67 was measured using MIB-1 immunohistochemistry. We used Pearson's correlation coefficient to analyze the relationships between the PET parameters and Ki-67 expressions. The Kaplan-Meier analysis with the log-rank test was performed to compare overall survival between high-group and low-group at each of the four PET parameters and Ki-67 expression. Results: All four PET parameters at each phase showed significant correlations with Ki-67. Among them, the Pearson's correlation coefficient (r) was largest for TLG (r=0.76 and 0.77 at the early and delayed phases, respectively), followed by MTV (0.70 and 0.72), SUVmax (r=0.65 and 0.66), and SUVmean (r=0.62 and r=0.64). From early to delayed phases, the SUVmax and SUVmean both increased in all 20 patients, whereas the MTV and TLG increased in 13/20 (65%) and 16/20 (80%) patients, respectively. None of the %increases of the PET parameters were significantly correlated with Ki-67. The overall survival was shorter for high-SUVmax, high-SUVmean, high-TLG, and high-Ki-67 groups than the other groups, although the difference did not reach statistical significance. Conclusion: The SUVmax, SUVmean, MTV, and TLG acquired at both 1 and 2 h after injection showed significant correlations with Ki-67. Among them, correlation coefficient with Ki-67 expression was highest for TLG, although the best parameter should be determined in a larger population. The delayed-phase FDG PET was equally useful as that of early-phase to predict tumor aggressiveness in STS

Reproducibility and uptake time dependency of volume-based parameters on FDG-PET for lung cancer

Background: Volume-based parameters, such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG), on F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) are useful for predicting treatment response in nonsmall cell lung cancer (NSCLC). We aimed to examine intra- and inter-operator reproducibility to measure the MTV and TLG, and to estimate their dependency on the uptake time. Methods: Fifty NSCLC patients underwent preoperative FDG-PET. After an injection of FDG, the whole body was scanned twice: at the early phase (61.4 ± 2.8 min) and delayed phase (117.7 ± 1.6 min). Two operators independently defined the tumor boundary using three different delineation methods: (1) the absolute SUV threshold method (MTVp and TLGp; p = 2.0, 2.5, 3.0, 3.5), (2) the fixed% SUVmax threshold method (MTVq% and TLGq%; q = 35, 40, 45), and (3) the adaptive region-growing method (MTVARG and TLGARG). Parameters were compared between operators and between phases. Results: Both the intra- and inter-operator reproducibility were high for all parameters using any method (intra-class correlation > 0.99 each). MTV3.0 and MTV3.5 resulted in a significant increase from the early to delayed phase (P < 0.05 for both), whereas MTV2.0 and MTV2.5 neither increased nor decreased (P = n.s.). All of the MTVq% values significantly decreased over time (P < 0.01), whereas MTVARG and TLG with any delineation method increased significantly (P < 0.05). Conclusions: High reproducibility of MTV and TLG was obtained by all of the methods used. MTV2.0 and MTV2.5 were the least sensitive to uptake time, and may be good alternatives when we compare images acquired with different uptake times, although applying constant uptake time is important for volume measurement