Early Intake of Radiocesium by Residents Living Near the Tepco Fukushima Dai-ichi Nuclear Power Plant After the Accident. Part 2: Relationship Between Internal Dose and Evacuation Behavior in Individuals

The Tokyo Electric Power Company's Fukushima Dai-ichi Nuclear Power Plant (FDNPP) accident exposed members of the public to radiation. This study analyses the relation between personal behavior data obtained from 112 out of 174 subjects who underwent whole-body measurements by the National Institute of Radiological Sciences (NIRS) during the period from 27 June to 28 July 2011 and their committed effective doses (CEDs) from Cs and Cs. The whereabouts of the 112 persons living in municipalities near the FDNPP (mainly, Namie town) on several days in March 2011 are graphed on maps. It was confirmed that most subjects started evacuation promptly and had left the 20-km-radius of the FDNPP by the end of 12 March. The individual CEDs were poorly correlated with the person's distances from the FDNPP at any day in March. Meanwhile, the percentage of persons remaining within the 20-km radius of the FDNPP was 100% at 16:00 on 12 March and 42.9% at 0:00 on 15 March for those with CEDs > 0.1 mSv, whereas the corresponding values were much lower for those with CEDs ≤ 0.1 mSv. This suggests that the time of evacuation would be one of the crucial factors for the early intake; however, more personal behavior data are needed to be analyzed to clarify the relevance to the individual internal dose

Relationship between changes in quality of life and genitourinary toxicity grade after brachytherapy with I-125 alone for localised prostate cancer

Background: The relationship between the grading of toxicities based on toxicity criteria and longitudinal changes in quality of life (QOL) scores after permanent prostate brachytherapy (PPB) for localized prostate cancer remains unclear. This study aimed to evaluate these relationships. Materials and methods: We assessed 107 patients treated with PPB using Iodine-125 alone from May 2007 to April 2010. Disease-specific QOL scores before PPB and at 1, 3, 6, 12, and 24 months after PPB were retrospectively evaluated with the Expanded Prostate Cancer Index Composite (EPIC), focusing on urinary domains. Toxicities were graded using the Radiation therapy oncology group and the European organization for research and treatment of cancer toxicity criteria. Results: The median follow-up duration was 116 (range 18–148) months. Thirty-four patients (31.8%) developed grade ≥ 2 acute genitourinary (GU) toxicities; six (5.6%) developed grade ≥ 2 late GU toxicities. The general urinary domain score dropped significantly at 1 month (77.1 ± 14.1) post-PPB compared to the baseline score (92.2 ± 8.2), and then gradually returned to the baseline level by 12 months (93.7 ± 8.3) post-PPB. Reductions in the general urinary domain scores, including its subscale scores at 1, 3, and 6-months post-PPB were significantly greater among patients with grade ≥ 2 GU toxicity than among those with grade 0–1 GU toxicity. Changes in urinary domain scores demonstrated a close relationship with acute GU toxicity grades after PPB. Conclusions: Longitudinal assessments of the EPIC QOL scores provided additional information regarding time-course changes in GU toxicities after PPB.

Skin Perfusion Pressure Is a Prognostic Factor in Hemodialysis Patients

Peripheral arterial disease (PAD) is common in hemodialysis patients and predicts a poor prognosis. We conducted a prospective cohort study to identify risk factors for PAD including skin perfusion pressure (SPP) in hemodialysis patients. The cohort included 373 hemodialysis patients among 548 patients who received hemodialysis at Oyokyo Kidney Research Institute, Hirosaki, Japan from August 2008 to December 2010. The endpoints were lower limb survival (peripheral angioplasty or amputation events) and overall survival of 2 years. Our results showed that <70 mmHg SPP was a poor prognosis for the lower limb survival and overall survival. We also identified age, history of cardiovascular disease, presence of diabetes mellitus, smoking history, and SPP < 70 mmHg as independent risk factors for lower limb survival and overall survival. Then, we constructed risk criteria using the significantly independent risk factors. We can clearly stratify lower limb survival and overall survival of the hemodialysis patients into 3 groups. Although the observation period is short, we conclude that SPP value has the potential to be a risk factor that predicts both lower limb survival and the prognosis of hemodialysis patients

MTHFR, Homocysteine, and Schizophrenia

Previous studies suggest that elevated blood homocysteine levels and the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism are risk factors for schizophrenia. However, the effects of gender and MTHFR C677T genotypes on blood homocysteine levels in schizophrenia have not been consistent. We first investigated whether plasma total homocysteine levels were higher in patients with schizophrenia than in controls with stratification by gender and by the MTHFR C677T genotypes in a large cohort (N = 1379). Second, we conducted a meta-analysis of association studies between blood homocysteine levels and schizophrenia separately by gender (N = 4714). Third, we performed a case-control association study between the MTHFR C677T polymorphism and schizophrenia (N = 4998) and conducted a meta-analysis of genetic association studies based on Japanese subjects (N = 10 378). Finally, we assessed the effect of plasma total homocysteine levels on schizophrenia by a mendelian randomization approach. The ANCOVA after adjustment for age demonstrated a significant effect of diagnosis on the plasma total homocysteine levels in all strata, and the subsequent meta-analysis for gender demonstrated elevated blood homocysteine levels in both male and female patients with schizophrenia although antipsychotic medication might influence the outcome. The meta-analysis of the Japanese genetic association studies demonstrated a significant association between the MTHFR C677T polymorphism and schizophrenia. The mendelian randomization analysis in the Japanese populations yielded an OR of 1.15 for schizophrenia per 1-SD increase in plasma total homocysteine. Our study suggests that increased plasma total homocysteine levels may be associated with an increased risk of schizophrenia

Endoscopic Ultrasound-Guided Gallbladder Drainage for Aberrant Right Posterior Duct Obstruction Developing after Placement of a Covered Self-Expandable Metallic Stent in a Patient with Distal Biliary Obstruction

Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) has been utilized as an alternative endoscopic technique for patients with acute cholecystitis. In addition to EUS-guided hepaticogastrostomy and EUS-guided cystogastrostomy, EUS-GBD has been reported as being useful for biliary drainage in cases with distal malignant biliary obstruction instead of conventional endoscopic retrograde cholangiopancreatography. We present a case of successful EUS-GBD for malignant obstruction of an aberrant hepatic duct draining directly into the cystic duct

ガクガンメン リョウイキ ニオケル コツチユ ニ タイスル テイシュツリョク チョウオンパ パルス ショウシャ ノ シヨウ ケイケン

Fracture healing has traditionally been thought to be a naturally optimized process with predetermined time-course for bone metabolism, and no one had had an idea that fracture healing may be manipulated to occur at a faster rate. In 1980s, the use of low-intensity pulsed ultrasound (LIPUS) was demonstrated with a significant promotion of bone healing and LIPUS has been used extensively for bone fractures in the limbs. On the other hand, the effectiveness of LIPUS for maxillofacial bone fractures has not been studied yet. In clinical orthodontics, there are many cases closely related to bone healing: the traumatic bone fracture in maxillofacial region, the osteotomy of jaw deformity, and the bone grafting in to alveolar cleft. The purpose of this study was to examine the benefit of LIPUS to the acceleration of maxillofacial bone healing. Thirty-five patients received LIPUS after surgery served as subjects. Of total subjects, 11 patients had surgery for maxillofacial bone fracture fixation, 7 patients with jaw deformity had orthognathic surgery, and 17 patients affected by cleft lip and palate underwent alveolar cleft bone grafting. Five-seven days after surgery, the patient received 15 minutes of LIPUS (BR sonic-pro, ITO Co., Tokyo, Japan) per day for 14 days. A LIPUS signal was transmitted at a frequency of 1.0 MHz with a spatial-average intensity of 160 mW and pulsed 1: 4. In addition, we used the visual analogue scale (VAS) for pain assessment, and simple radiographs and computed tomography (CT) for evaluation of the bone healing. In most cases, pain disappeared within one week after surgery. In the patients with bone fracture fixation or jaw osteotomy, bone healing was validated by plain radiographs and/or CT taken at 3 months after surgery, leading to stable occlusion. In the cases with alveolar bone grafting, early bone formation was observed from CT taken at 3 months after surgery. In addition, the catabolic effects of LIPUS exposure were not found at all. In conclusion, LIPUS application might involve in acceleration of maxillofacial bone healing after surgery. Therefore, LIPUS may be a promising therapeutic tool for bone healing in maxillofacial region

Detection of Progeny Immune Responses after Intravenous Administration of DNA Vaccine to Pregnant Mice

A number of factors influence the development of tolerance, including the nature, concentration and mode of antigen presentation to the immune system, as well as the age of the host. The studies were conducted to determine whether immunizing pregnant mice with liposome-encapsulated DNA vaccines had an effect on the immune status of their offspring. Two different plasmids (encoding antigens from HIV-1 and influenza virus) were administered intravenously to pregnant mice. At 9.5 days post conception with cationic liposomes, injected plasmid was present in the tissues of the fetus, consistent with trans-placental transfer. When the offspring of vaccinated dams were immunized with DNA vaccine, they mounted stronger antigen-specific immune responses than controls and were protected against challenge by homologous influenza virus after vaccination. Moreover, such immune responses were strong in the offspring of mothers injected with DNA plasmid 9.5 days after coitus. These results suggest that DNA vaccinated mothers confer the antigen-specific immunity to their progeny. Here we describe the methods in detail as they relate to our previously published work