Paclitaxel-Based Chemotherapy for Advanced Pancreatic Cancer after Gemcitabine-Based Therapy Failure: A Case Series of 5 Patients

Background/Objectives: Gemcitabine (GEM) is a gold-standard chemotherapy agent for advanced pancreatic cancer. Because of the malignant character of the disease, nearly all patients show disease progression despite treatment with GEM-based chemotherapy; therefore, second-line chemotherapy may be beneficial for these patients. We report a retrospective analysis of 5 patients with advanced pancreatic cancer, treated with a paclitaxel-containing regimen as second-, third- or fourth-line chemotherapy after various therapies, such as a GEM-based regimen, S-1 regimen, and chemoradiation. We retrospectively analyzed the efficacy and adverse events, and evaluated the paclitaxel-containing regimens. A review of the literature is also discussed. Results: The median overall survival from the start of salvage therapy was 10.7 months. The disease control rate of the paclitaxel-containing regimen according to RECIST criteria was 60%, including complete response in 0 patients, partial response in 3, and stable disease in 2. Two patients had malignant ascites at the start of this salvage therapy, and in both of them the ascites and clinical complaints improved. Grade 3 and 4 hematological adverse events were observed in 2 patients and 1 patient, respectively. Conclusion: Salvage paclitaxel-based therapy could be beneficial to advanced pancreatic cancer patients who maintain good performance status after several chemotherapy failures

Advanced Clinical Usefulness of Ultrasonography for Diseases in Oral and Maxillofacial Regions

Various kinds of diseases may be found in the oral and maxillofacial regions and various modalities may be applied for their diagnosis, including intra-oral radiography, panoramic radiography, ultrasonography, computed tomography, magnetic resonance imaging, and nuclear medicine methods such as positron emission tomography. Of these modalities, ultrasound imaging is easy to use for the detection of noninvasive and soft tissue-related diseases. Doppler ultrasound images taken in the B-mode can provide vascular information associated with the morphology of soft tissues. Thus, ultrasound imaging plays an important role in confirming the diagnosis of many kinds of diseases in such oral and maxillofacial regions as the tongue, lymph nodes, salivary glands, and masticatory muscles. In the present article, we introduce three new applications of ultrasonography: guided fine-needle aspiration, measurement of tongue cancer thickness, and diagnosis of metastasis to cervical lymph nodes

Hepatic Arterial Infusion Therapy with Cisplatin using Protein Binding Inhibition : Pharmacokinetics and Antineoplastic Effects of Cisplatin Combined with L-Cysteine in Rats

Cisplatin の蛋白結合には共有結合が関与しており、L-cysteine はcisplatin の共有結合を低下させる。そこで、この蛋白結合阻害を利用してcisplatin の肝動注療法の応用性について検討を行った。実験では、Donryu系雄性ラットにおけるL-cysteine 併用時におけるcisplatin の体内動態と抗腫瘍効果の影響について検討した。その結果、L-cysteine 併用においてcisplatin のtotal とfree 濃度に有意な差はみられなかった。また肝癌ラットを使用したin vivo 実験系において、L-cysteine を併用したcisplatin の肝動注はcisplatin のみの投与に比べ、腫瘍増殖率が抑えられる傾向であることを示した。さらに肝組織中における腫瘍部と非腫瘍部におけるcisplatin 濃度において、L-cysteine 併用により腫瘍部と非腫瘍部に有意な差を認めることができた (p<0.01)。以上の結果より、L-cysteine の併用はcisplatin の肝動注療法へ応用できると考えられる。Covalent binding is involved in the protein binding of cisplatin. L-cysteine reduces the covalent binding of cisplatin. We investigated hepatic arterial infusion therapy with cisplatin using protein binding inhibition. In the present experiment, the pharmacokinetics and antineoplastic effects of cisplatin combined with L-cysteine in male Donryu rats were investigated. As a result, no significant difference was noted in the total and free concentrations of cisplatin combined with L-cysteine. In an in vivo experiment using rats with liver cancer, the hepatic arterial infusion of cisplatin combined with L-cysteine showed that it was the tendency that tumor growth rate was inhibited in comparison with administration only for cisplatin. In addition, concentrations of cisplatin increased significantly between tumor and non-tumor regions in liver tissue when combined with L-cysteine (p<0.01). Thus, L-cysteine can be combined with cisplatin for hepatic arterial infusion therapy

Organized and Sustainable Education Program for Drug Abuse Prevention by Yogo-teachers

　学校における喫煙・飲酒・薬物乱用防止教育の充実には，問題行動が顕在化する中学校期だけでなく小学校期 における指導の推進が重要であり，系統的な指導計画を立て，指導者や時間の確保，教材作成などに組織的に取 組み，継続可能なプログラム開発を行う必要がある。そこで，地区内12 校の養護教諭が協働して，発達段階に応 じた系統的・組織的かつ継続可能な地区共通の指導計画を開発し，各校の教育課程・年間計画に位置付けた実践 研究を行った。その結果，指導計画の実施状況は，小学校11 校中，学級活動10 校，ミニ保健指導10 校，長期 休業前指導6 校，広報活動9 校となり，特別支援学校1 校では広報活動のみを行うことができた。小学校におけ る喫煙・飲酒・薬物乱用防止教育の推進には，学校保健活動の中核的役割を担う養護教諭が専門性を活かし協働 して，系統的な指導計画を各校の教育課程に位置付け組織的で継続可能なプログラムとする取組が有効であった

A Method for Locational Risk Estimation of Vehicle&ndash;Children Accidents Considering Children&rsquo;s Travel Purposes

The reduction in locational traffic accident risks through appropriate traffic safety management is important to support, maintain, and improve children&rsquo;s safe and independent mobility. This study proposes and verifies a method to evaluate the risk of elementary school students-vehicle accidents (ESSVAs) at individual intersections on residential roads in Toyohashi city, Japan, considering the difference in travel purposes (i.e., school commuting purpose; SCP or non-school commuting purpose: NSCP), based on a statistical regression model and Empirical Bayes (EB) estimation. The results showed that the ESSVA risk of children&rsquo;s travel in SCP is lower than that in NSCP, and not only ESSVAs in SCP but also most ESSVAs in NSCP occurred on or near the designated school routes. Therefore, it would make sense to implement traffic safety management and measures focusing on school routes. It was also found that the locational ESSVA risk structure is different depending on whether the purpose of the children&rsquo;s travels is SCP or NSCP in the statistical model. Finally, it was suggested that evaluation of locational ESSVA risks based on the EB estimation is useful for efficiently extracting locations where traffic safety measures should be implemented compared to that only based on the number of accidents in the past

Social Dynamics Simulation Using a Multi-Layer Network

The analysis and evaluation of urban structure are important while considering sustainable urban policies. It is necessary to develop a method that can easily analyze the social dynamics that are the result of changes over time in urban transportation and land use. Therefore, by describing the relationships between various agents in urban areas as a network, it is possible to analyze them by focusing on their structures. However, since there are few existing studies on social dynamics using network-based methods, it is necessary to examine the validity and effectiveness of these methods. The purpose of this study is to examine the possibility of urban analysis and evaluation focusing on the network shape by describing the urban activities and modeling the dynamics with a multilayer network. In particular, we focus on household composition and individual facility access, examine what kind of interpretation is possible for network indicators, and mention the applicability of complex networks to urban analysis. The model was applied to a two-dimensional grid virtual city, and the household composition and individual facility accessibility were quantified using the centrality index