38 research outputs found
Report of a study using phantom materials, and clinical experience with simultaneous radio-hyperthermotherapy.
Simultaneous radiohyperthermotherapy (SRH) is a combined hyperthermia-radiation therapy in which irradiation is given during heating. Mutual interference between the high energy radiotherapy system (Toshiba LMR-15A) and the 13.56 MHz capacitive heating system (Omron HEH-500C) was tested with phantom materials prior to a clinical trial with SRH. The energy and flatness of irradiation were not affected by the heating system within the range of clinical use. The high energy radiotherapy system did not affect the increase or distribution of temperature during simultaneous treatment. The results of this phantom study indicated that these apparatuses would not produce clinically significant mutual interference during SRH. A clinical trial was performed on a 57-year-old woman with postoperative recurrence of rectal cancer. This is the first reported clinical case treated with true SRH in which external irradiation was administered during mid capacitive heating. Twelve SRH treatments were performed on the recurrent lesion at a frequency of twice a week for six weeks using the apparatuses described above. There was a significant reduction in pain after treatment. The tumor marker carcinoembryonic antigen (CEA) level decreased after treatment. On CT images taken after treatment, the tumor site became a low density area which indicated necrosis. There were no side effects. These results suggest that further clinical study of SRH should be performed to clarify its advantages.</p
プレホスピタル ノ ゲンバ ニオケル ガイショウ ショリョウ
From our experience of emergency cases, the careful prehospital care and treatment are critical factors in good recovery. Diagnosis of the blunt injury, triage, initial therapy and the decision of the adequate institusion are principal for paramedics. We participated in the trauma seminar for japanese paramedics. In the seminar, we learned the method of the primary care for traumatic patient modified from BTLS (Basic trauma life support), which is called PTCJ ( Prehospital Trauma Care Japan). Recently, we used the long-board to secure the neck and the back of the injured-patient. It is helpful for safe transportation because we can prevent the aggravation of spinal injury by keeping the patient’s neck straight. We applied the PTCJ in 3 cases, and the outcomes were satisfactory. We regard the PTCJ should be applied more widely
Label-free multiphoton excitation imaging as a promising diagnostic tool for breast cancer
Histopathological diagnosis is the ultimate method of attaining the final diagnosis; however, the observation range is limited to the two-dimensional plane, and it requires thin slicing of the tissue, which limits diagnostic information. To seek solutions for these problems, we proposed a novel imaging-based histopathological examination. We used the multiphoton excitation microscopy (MPM) technique to establish a method for visualizing unfixed/unstained human breast tissues. Under near-infrared ray excitation, fresh human breast tissues emitted fluorescent signals with three major peaks, which enabled visualizing the breast tissue morphology without any fixation or dye staining. Our study using human breast tissue samples from 32 patients indicated that experienced pathologists can estimate normal or cancerous lesions using only these MPM images with a kappa coefficient of 1.0. Moreover, we developed an image classification algorithm with artificial intelligence that enabled us to automatically define cancer cells in small areas with a high sensitivity of ≥0.942. Taken together, label-free MPM imaging is a promising method for the real-time automatic diagnosis of breast cancer.This is the pre-peer reviewed version of the following article:Matsui T., Iwasa A., Mimura M., et al. Label-free multiphoton excitation imaging as a promising diagnostic tool for breast cancer. Cancer Science 113, 2916 (2022), which has been published in final form at https://doi.org/10.1111/cas.15428. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving
ビョウインマエ シンパイ テイシ ニオケル キュウキュウ キュウメイシ ノ キカン ソウカン ニツイテ : ホンケン ノ ゲンジョウ ト コンゴ ノ カダイ
Activities of Japanese Paramedics have increased and advanced year by year. Especially, intubation for OHCPA(out of hospital cardiopulmonary arrest) is approved since July 2004, but it is necessary to finish the training in Fire-fighter’s school and intubation practice in hospitals. In Fire-fighter’s school, Paramedics attend lectures and simulation, and in hospital, intubation practice for patients. Medical-control is the system for keeping the qualities and verification of details in the scene of pre-hospital medical care. This report discusses the states and problems of paramedic intubation, practice in hospital, airway management, from the questionnaire survey
Total Skin Electron Beam Therapy
The peripherally T-cell lymphoma; Mycosis fungoides etc, has the good radiation sensitivity, and has been adapted for total skin electron beam therapy. In this study the pendular irradiation method was used for the purpose of total skin electron beam therapy in Mycosis fungoides, and physical data on the radiation field and the electron beam energy were useful clinically.皮膚に限局した一連の末梢型T細胞リンパ腫は放射線に対する感受性が高く、電子線治療の適応となる疾患である。こららの疾患は一般的に全身の皮膚に浸潤するため、治療に際してはTarget Volumeの深さに合わせた最小限のエネルギーで全身隈なく照射する必要がある。筆者等は最近臨床で遭遇した菌状息肉症の患者を治療するため、その患者に合った物理的なデータを測定した。照射野の拡大には振子照射法を用い、エネルギー低減方法は装置に装備されている鉛のスキャタラーを低原子番号で、しかも加工のしやすい塩化Vinyl板に交換する方法を工夫した。データとして治療効果、副作用に関係する線量率、エネルギー、及び照射野内平坦度について測定した結果、距離が長くなる関係から線量率が低下する全身照射法の欠点は解消できなかったが、エネルギー及び平坦度については使用可能なデータを得ることができた
Photon background caused by the reduction of the electron beam energy - Materials of scattering foil -
The total skin electron beam therapy has been one of the clinical treatment for peripherally T-cell lymphoma; Mycosis fungoides, adult T-cell lymphoma, and so on. The crucial points in this treatment are not only having an optimum energy level of electron beam for a target volume (a tissue) but also keeping the photon back ground low. It is not easy to regulate those points by the control panel, however, for the equipment that is conventinally used for electron beam, theoretically, is to exchange lead (Pb), which is ordinarily used, to a low atomic number material as a scattering foil. We examined several different kinds and / or various thickness as a scattering foil material that can make the electron beam lower without an increase of the contaminant as X-ray. We hereby reported the results, and strongly suggested the following two materials in use; acrylic plate, carbon board, and so on, which are easily available and worked, would be practically useful for the total skin electron beam therapy
Successful management of refractory pleural effusion due to systemic immunoglobulin light chain amyloidosis by vincristine adriamycin dexamethasone chemotherapy: a case report
<p>Abstract</p> <p>Introduction</p> <p>Refractory pleural effusion in systemic immunoglobulin light chain amyloidosis without cardiac decompensation is rarely reported and has a poor prognosis in general (a median survival of 1.6 months). Moreover, the optimum treatment for this condition is still undecided. This is the first report on the successful use of vincristine, adriamycin and dexamethasone chemotherapy for refractory pleural effusion due to systemic immunoglobulin light chain amyloidosis without cardiac decompensation.</p> <p>Case presentation</p> <p>We report the case of a 68-year old Japanese male with systemic immunoglobulin light chain amyloidosis presenting with bilateral pleural effusion (more severe on the right side) in the absence of cardiac decompensation that was refractory to diuretic therapy. The patient was admitted for fatigue, exertional dyspnea, and bilateral lower extremity edema. He had been receiving intermittent melphalan and prednisone chemotherapy for seven years. One month before admission, his dyspnea had got worse, and his chest radiograph showed bilateral pleural effusion; the pleural effusion was ascertained to be a transudate. The conventionally used therapeutic measures, including diuretics and thoracocentesis, failed to control pleural effusion. Administration of vincristine, adriamycin, and dexamethasone chemotherapy led to successful resolution of the effusion.</p> <p>Conclusion</p> <p>Treatment with vincristine, adriamycin, and dexamethasone chemotherapy was effective for the refractory pleural effusion in systemic immunoglobulin light chain amyloidosis without cardiac decompensation and appears to be associated with improvement in our patient's prognosis.</p
Successful cricothyrotomy for emergency airway management : a case report
A 60 year-old male was brought to our emergency department by ambulance due to sudden onset of dyspnea. On examination, he was in coma since his level of consciousness decreased during transport, blood pressure was 199/111mmHg, heart rate was100 beats per minute, respirations were 10 per minute, blood oxygen saturation level(SpO2)was100% via assisted ventilation with Bag-Valve-Mask, and stridor was heard on auscultation. Those findings indicated airway emergency and endotracheal intubation was required. However, attempts at intubation were unsuccessful due to restriction of mouth opening. Muscle relaxant was then given to perform rapid sequence intubation, which caused vomiting. Failure to ventilation and intubation resulted in cardiopulmonary arrest. Chest compression was started immediately and decision for cricothyrotomy was made. 10 minute after cricothyrotomy, he revived. Subsequently, systemic management including therapeutic normothermia was performed at intensive care unit, then he regained consciousness. He was discharged 1 month after admission
Development of unit for elective subject from fifth to ninth grade to improve cooperative creation (3)
本研究は, 「21世紀型の教科学力」の新たな観点としての「協同的創造力」の育成をめざして, 自分たちで新たな文化を創造する子どもを育てる協同的創造学習のあり方について実証的に研究を進め, 単元モデルと評価方法を開発することを目的としている。そこで, 教科学習を「協同的創造学習」としてとらえ直すとともに, 中学校での従来の選択教科の時間に加えて, 小学校第5・6学年合同の選択教科の時間を新設して「協同的創造力」を特化して育むことにし, 本年度は, 選択教科の単元モデルの充実・改善と評価方法の確立に取り組んだ。その結果, 選択教科において, これまで開発した単元モデルをより充実させたり, 新たな単元モデルを開発したりすることができた。また, 評価の観点を整理し, 子どもの意識調査やカリキュラム評価に継続して取り組むことによって, 子どもの思いを汲み取り単元を見直していくことができた。今後も必修教科と選択教科のつながりや関連性, 各学年の系統性を整理するとともに, 協同的創造力育成の手だてを整理し, 来年度に向けて, これまで培ったものを生かす新たな学習開発を模索していきたいと考えている
Multiple Regulatory Mechanisms to Inhibit Untimely Initiation of DNA Replication Are Important for Stable Genome Maintenance
Genomic instability is a hallmark of human cancer cells. To prevent genomic instability, chromosomal DNA is faithfully duplicated in every cell division cycle, and eukaryotic cells have complex regulatory mechanisms to achieve this goal. Here, we show that untimely activation of replication origins during the G1 phase is genotoxic and induces genomic instability in the budding yeast Saccharomyces cerevisiae. Our data indicate that cells preserve a low level of the initiation factor Sld2 to prevent untimely initiation during the normal cell cycle in addition to controlling the phosphorylation of Sld2 and Sld3 by cyclin-dependent kinase. Although untimely activation of origin is inhibited on multiple levels, we show that deregulation of a single pathway can cause genomic instability, such as gross chromosome rearrangements (GCRs). Furthermore, simultaneous deregulation of multiple pathways causes an even more severe phenotype. These findings highlight the importance of having multiple inhibitory mechanisms to prevent the untimely initiation of chromosome replication to preserve stable genome maintenance over generations in eukaryotes