A Physically-Based Type II Supernova Feedback Model in SPH Simulations

We implement and test a core-collapse Type II SN feedback that is physically motivated and produces good agreement with observations in galaxy formation simulations. The model includes both kinetic and thermal feedback, allowing wind particles to receive a velocity kick that mimics galactic winds and distributes mass and metallicity to the interstellar and intergalactic medium. We also include a phenomenological stellar feedback to study a possible enhancement of the efficiency of the SN-II feedback by creating lower-density ambient gas medium of the stellar populations by distribution of thermal energy. Our SN-II model is unique in the sense that it computes the wind velocity and the lifetime of a supernova remnant by considering its evolution with the Sedov-Taylor solution rather than taking them as constant values. We find that by combining SN-II and stellar feedback the model alleviates overcooling and missing satellites problems. The model also produces outflows without a need for turning off hydrodynamical interactions, cooling and star formation by hand. Our preliminary results with cosmological zoom-in simulations imply the new model successfully reproduces the stellar-to-halo mass ratio. We conclude that the Sedov-Taylor solution can be used to reasonably approximate the physical properties and evolutional time scales of supernova remnants in the galaxy formation numerical simulations

Radiation therapy and photodynamic therapy for biliary tract and ampullary carcinomas

The purpose of radiation therapy for unresectable biliary tract cancer is to prolong survival or prolong stent patency, and to provide palliation of pain. For unresectable bile duct cancer, there are a number of studies showing that radiation therapy is superior to the best supportive care. Although radiation therapy is used in many institutions, no large randomized controlled trials (RCTs) have been performed to date and the evidence level supporting the superiority of this treatment is low. Because long-term relief of jaundice is difficult without using biliary stenting, a combination of radiation therapy and stent placement is commonly used. As radiation therapy, external-beam radiation therapy is usually performed, but combined use of intraluminal brachytherapy with external beam radiation therapy is more useful for making the treatment more effective. There are many reports demonstrating improved response rates as well as extended survival and time to recurrence achieved by this combination therapy. Despite the low level of the evidence, this combination therapy is performed at many institutions. It is expected that multiinstitutional RCTs will be carried out. Unresectable gallbladder cancer with a large focus is usually extensive, and normal organs with high radio sensitivity exist contiguously with it. Therefore, only limited anticancer effects are to be expected from external beam radiation therapy for this type of cancer. The number of reports on ampullary cancer is small and the role of radiation therapy in this cancer has not been established. Combination treatment for ampullary cancer consists of either a single use of intraoperative radiation therapy, postoperative external beam radiation therapy or intraluminal brachytherapy, or a combination of two or three of these therapies. Intraoperative radiation therapy is superior in that it enables precise irradiation to the target site, thereby protecting adjacent highly radiosensitive normal tissues from irradiation. There are reports showing extended survival, although not significant, in groups undergoing intraoperative or postoperative radiation therapy compared with groups without radiation therapy. To date, there are no reports of large RCTs focusing on the significance of radiation therapy as a postoperative adjuvant treatment, so its usefulness as a postoperative adjuvant treatment is not proven. An alternative treatment is photodynamic therapy. There is an RCT demonstrating that, in unresectable bile duct cancer, extended survival and improved quality of life (QOL) have been achieved through a combination of photodynamic therapy and biliary stenting, compared with biliary stenting alone. Results from large RCTs are desired

Guidelines for chemotherapy of biliary tract and ampullary carcinomas

Few randomized controlled trials (RCTs) with large numbers of patients have been conducted to date in patients with biliary tract cancer, and standard chemotherapy has not been established yet. In this article we review previous studies and clinical trials regarding chemotherapy for unresectable biliary tract cancer, and we present guidelines for the appropriate use of chemotherapy in patients with biliary tract cancer. According to an RCT comparing chemotherapy and best supportive care for these patients, survival was significantly longer and quality of life was significantly better in the chemotherapy group than in the control group. Thus, chemotherapy for patients with biliary tract cancer seems to be a significant treatment of choice. However, chemotherapy for patients with biliary tract cancer should be indicated for those with unresectable, locally advanced disease or distant metastasis, or for those with recurrence after resection. That is why making the diagnosis of unresectable disease should be done with greatest care. As a rule, pathological diagnosis, including cytology or histopathological diagnosis, is preferable. Chemotherapy is recommended in patients with a good general condition, because in patients with general deterioration, such as those with a performance status of 2 or 3 or those with insufficient biliary decompression, the benefit of chemotherapy is limited. As chemotherapy for unresectable biliary tract cancer, the use of gemcitabine or tegafur/gimeracil/oteracil potassium is recommended. As postoperative adjuvant chemotherapy, no effective adjuvant therapy has been established at the present time. It is recommended that further clinical trials, especially large multi-institutional RCTs (phase III studies) using novel agents such as gemcitabine should be performed as soon as possible in order to establish a standard treatment

Flowcharts for the management of biliary tract and ampullary carcinomas

No strategies for the diagnosis and treatment of biliary tract carcinoma have been clearly described. We developed flowcharts for the diagnosis and treatment of biliary tract carcinoma on the basis of the best clinical evidence. Risk factors for bile duct carcinoma are a dilated type of pancreaticobiliary maljunction (PBM) and primary sclerosing cholangitis. A nondilated type of PBM is a risk factor for gallbladder carcinoma. Symptoms that may indicate biliary tract carcinoma are jaundice and pain in the upper right area of the abdomen. The first step of diagnosis is to carry out blood biochemistry tests and ultrasonography (US) of the abdomen. The second step of diagnosis is to find the local extension of the carcinoma by means of computed tomography (CT), magnetic resonance imaging (MRI), magnetic resonance cholangiopancreatography (MRCP), percutaneous transhepatic cholangiography (PTC), and endoscopic retrograde cholangiopancreatography (ERCP). Because resection is the only way to completely cure biliary tract carcinoma, the indications for resection are determined first. In patients with resectable disease, the indications for biliary drainage or portal vein embolization (PVE) are checked. In those with nonresectable disease, biliary stenting, chemotherapy, radiotherapy, and/or best supportive care is selected

A Modified Random Sampling Method Using Unidirectionally Solidified Specimen: Solute Partition Coefficients in Fe-Cr-Ni-Mo-Cu Alloys

A random sampling method using Fe-19.9 mass% Cr-24.8 mass% Ni-4.5 mass% Mo-1.5 mass% Cu alloy quenched during unidirectional solidification was applied to examine the measurement accuracy of the solute partition coefficients between the solid and liquid phases. Better agreement between the solute profiles obtained by the random sampling and Scheil’s equation was observed at appropriate regions where the solid fraction ranged from 0.9 to 1 at quenching. The partition coefficients of Cr, Ni, Mo, and Cu were determined to be 0.95, 1.01, 0.71, and 0.84, respectively. The values obtained using the present method agreed well with the values measured using the in-situ measurement method, which is recognized to be a reliable technique. The developed technique, which uses conventional equipment and techniques such as a unidirectional solidification furnace and scanning electron microscopy/energy-dispersive X-ray spectroscopy, requires less time to determine the solute partition coefficients than conventionally used techniques. Thus, the modified random sampling method presented in this study can be used for systematic measurements of solute partition coefficients