Physiological and Ultrastructural Studies on the Origin of Activator Calcium in Body Wall Muscles of Spoon Worms

To examine the origin of activator Ca and its translocation during contraction in body wall muscles (BWM) of spoon worms, Urechis unicinctus , physiological and ultrastructural studies, including cytochemistry, were performed. The potassium (K-) contracture tension was significantly reduced by the removal of external Ca, and by the application of Mn, La and verapamil. On the other hand, caffeine induced a prolonged contraction. The removal of Ca and Mg from the external solution, and the rapid cooling caused an irregular or oscillatory contraction. These results suggested that, in BWM fibers, the activator Ca is supplied partially from both external solution and intracellular Ca-accumulating structures. Ultrastructural observations revealed that the muscle fibers contain a relatively large amount of sarcoplasmic reticulum (SR). The fractional volume of the SR relative to the fiber volume was 2~5% in all fibers of three muscle layers. To demonstrate the Ca localization, the muscle fibers were fixed by pyroantimonate (PA) methods at resting and contracting states. In the resting fibers, the PA precipitates were exclusively localized in the SR and the inner surface of plasma membrane. On the other hand, in the contracting fibers, they were diffusely distributed in the central regions of myoplasm, and had disappeared from the SR and plasma membrane. X-ray microanalysis revealed that the PA precipitates contain Ca. With the results of physiological experiments, these results indicate that the activator Ca originates not only from the external solution, but also from the intracellular Ca-accumulating structures, the SR and the inner surface of plasma membrane.Full-Length Pape

POST-CONTRAST ACUTE KIDNEY INJURY AFTER CATHETER ANGIOGRAPHY AND EVALUATION OF RISK FACTORS

Purpose : The present study aimed to determine the rate of post-contrast acute kidney injury (PC-AKI) after catheter angiography other than cardiac angiography (CAG), and identify relevant risk factors.Materials and methods : This retrospective study analyzed data from 314 patients who underwent angiography between October 2013 and September 2018. We investigated the incidence of PC-AKI, defined as a ≥50% increase or ≥0.3 mg/dL increase in serum creatinine (SCr) values 1-3 days after angiography according to the European Society of Urogenital Radiology guidelines on contrast media, version 10.0. The effects of patient- and procedure-related factors on the incidence of PC-AKI were evaluated. Data were analyzed using chi-squared and Mann-Whitney U tests, and multivariate logistic regression analysis.Results : PC-AKI developed in 16/314 patients (5.1%). Multivariate logistic regression analysis revealed a correlation of incidence of PC-AKI with advanced age, decreased estimated glomerular filtration rate (eGFR), shock symptoms, and high-dose contrast media within 24 hours. In all patients with PC-AKI, SCr values returned to baseline within 2 weeks.Conclusions : PC-AKI after angiographic examinations developed in 5.1% of patients, and the increase in SCr was reversible. Advanced age, decreased eGFR, shock symptoms, and highdose contrast media within 24 hours are possible risk factors

COMPARISON OF VIRTUAL UNENHANCED AND TRUE UNENHANCED ATTENUATION VALUES BY DUAL-ENERGY CT FOR DETECTING INDISTINCT LIVER METASTASES ON CONTRAST-ENHANCED CT

Purpose : We aimed to evaluate the differences between true unenhanced (TUE) and virtual unenhanced (VUE) computed tomography (CT) performed by contrast-enhanced CT with dualenergy CT in the assessment of liver metastases that were difficult to visually identify with contrast- enhanced CT. Materials and methods : Between April 2018 and September 2019, we identified 266 patients with liver metastases who underwent unenhanced and contrast-enhanced CT with dual-energy CT at our institution, and enrolled 43 liver metastases in 19 patients (7.1%) that were indistinct on contrast-enhanced CT.　Mean CT attenuation values for liver metastases and liver parenchyma were measured, and differences between the CT attenuation values for liver metastases and liver parenchyma were analyzed using VUE CT and TUE CT. Results : The mean CT attenuation values for liver metastases and liver parenchyma in VUE CT versus TUE CT were 51.0 vs. 41.0 HU (p<0.001) and 58.2 HU vs. 61.2 HU (p=0.027), respectively.　The differences in CT attenuation values between liver metastases and liver parenchyma were 10.1 HU on VUE CT vs. 19.3 HU on TUE CT (p<0.001). Conclusion : The contrast between lesions and liver parenchyma on VUE CT was significantly lower than that on TUE CT.　VUE CT cannot currently replace TUE CT

RADIATION THERAPY FOR STAGE ⅢB UTERINE CERVICAL CANCER AT OUR INSTITUTION : TREATMENT OUTCOMES AND PROGNOSTIC FACTORS

PurposeWe examined the treatment outcomes,prognostic factors,and toxicities after radiotherapy for stage IIIB uterine cervical cancer.Methods and MaterialsWe studied patients with stage IIIB uterine cervical cancer who were both diagnosed and treated with combined external beam radiotherapy(EBRT) and intracavitary brachytherapy(ICBT). We retrospectively analyzed the clinical characteristics(age,primary tumor size,lymph node metastasis,and chemotherapy),5-year overall survival(OS) rate,progressionfree survival(PFS) rate,and late toxicities over grade 3.ResultsA total of 25 patients were enrolled in this study.Overall 23 and 2 patients showed complete and partial response,respectively.The objective response was 100%.The 5-year OS and PFS were 73.4% (95% confidence interval [CI] 55.1-91.6%) and 69% (95% CI 49.5-88.0%), respectively.Primary tumor size ≥40 mm was a prognostic factor for poor OS and PFS (HR : 5.088, p=0.024 and HR : 5.088, p=0.033, respectively). Five patients(20%) developed late toxicities over grade 3 with related radiotherapy.ConclusionsLocal tumor control,OS,PFS,and late toxicity rate in this study were similar to those in previous reports. A bulky tumor was identified as a prognostic factor

PALLIATIVE REIRRADIATION WITH AN ACCUMULATED DOSE OF 80 GY FOR PAINFUL BRACHIAL PLEXUS METASTASIS AFTER 60 GY IRRADIATION FOR LYMPH NODE METASTASIS OF BREAST CANCER : A CASE REPORT

The rare condition of brachial plexus metastasis (BPM) from malignant carcinoma causes extreme pain and can limit activities of daily living. A few reports have indicated that palliative irradiation is an effective and safe treatment for BPM ; however, the efficacy and safety of reirradiation for BPM are not well-known. In the present report, we describe the case of a patient with BPM of breast cancer who had a history of receiving 60 Gy of irradiation in 30 fractions to bilateral subclavian areas to treat lymph node metastases, developed extremely painful BPM in the primary irradiated area, and underwent further irradiation with 20 Gy in five fractions. This palliative reirradiation initially resulted in significant pain relief, and the tumors reduced in size immediately after the treatment. Regrowth of the tumors and recurrence of the pain occurred five months after irradiation ; however, further irradiation was not administered as it could be associated with a high risk of plexopathy or myelopathy. This case report describes the tolerability and effectiveness of reirradiation for BPM, the decision process of reirradiation, and the usefulness of modern diagnostic imaging for deciding radiation field and technique to deliver safe and effective reirradiation