トクシマ ダイガク ビョウイン ニュウイン カンジャ ノ シカテキ ニーズ : コウクウ カンリ センター ニオケル ウケイレ ジョウキョウ カラ

Tokushima University Hospital Oral Health Management Center was created in April 2006 in order that medical inpatients could be easily referred to the dental section. From April 2007 to August 2009, among the 658 inpatients referred by the Oral Health Management Center, 210 requested professional oral healthcare. Requests for professional oral healthcare are currently increasing. Among 244 patients who asked for a bedside visit, 184 requested professional oral healthcare. Most inpatients were referred from the Division of Blood Internal Medicine; and the second Division referring numerous inpatients was that of Neurological Disorders. The increased tendency for professional oral healthcare requests might be related to the closer working relations among NST staff in the hospital, and/or better knowledge regarding the importance of oral health by medical doctors and nurses. The needs for dental services for inpatients varies. It is important for dental professionals to cooperate with medical care staff, and to be capable of dealing with various general conditions

A Clinical Evaluation of American Brachytherapy Society Consensus Guideline for Bulky Vaginal Mass in Gynecological Cancer

Objectives American Brachytherapy Society (ABS)-recommended interstitial brachytherapy (IBT) should be considered for bulky vaginal tumor thicker than 5 mm. The aim of this study was to evaluate the ABS consensus guideline for patients with severe vaginal invasion based on our long-term follow-up results.Methods/MaterialsThe study included 7 patients with vaginal cancer and 14 patients with cervical cancer invading to the lower vagina. Based on prebrachytherapy magnetic resonance imaging findings, patients received intracavitary brachytherapy (ICT) for vaginal tumors 5 mm or less or IBT for vaginal tumors less than 5 mm. Nine patients received ICT and the remaining 12 patients received IBT. For dosimetric comparison, an experimental recalculation as the virtual IBT for patients actually treated by ICT, and vice versa, was performed.Results The 5-year local control rate for all tumors was 89.4%. No differences in local control between ICT- and IBT-treated groups were observed (P = 0.21). One patient experienced a grade 3 rectal complication. There were no significant differences in the CTV D90 and rectum D2cc between the 2 groups (P = 0.13 and 0.39, respectively). In the dosimetric study of ICT-treated patients, neither the actual ICT plans nor the experimental IBT plans exceeded the limited dose for organs at risk, which were recommended in the guideline published from the ABS. In the IBT-treated patients, D2cc for bladder and rectum of the experimental ICT plans was significantly higher than for the actual IBT plans (P < 0.001 and <0.001, respectively), and 11 experimental ICT plans (92%) exceeded the limited dose for bladder and/or rectum D2cc.Conclusions Tumor control and toxicity after selected brachytherapy according to vaginal tumor thickness were satisfactory; IBT instead of ICT is recommended for patients with vaginal tumor thickness greater than 5 mm to maintain bladder and/or rectum D2cc

Relationship between Protection against Cold and the Physiological Index during a Cold Environment

A snow cave is a bivouac shelter used in mountain climbing that is widely used as a shelter against the cold during winter. In the outdoors, wind velocity and air temperature have an influence on temperature change. It could stabilize body temperature if it can control the convection of ambient air. This paper could develop a theory focusing on the relation between physiological indexes and the protection against the cold while staying in a snow cave. For example, protection against the cold could be thermal insulation underwear, thermal insulation gloves, thermal insulation socks, a steam warmed temperature sheet and a rescue sheet. Measurement items were heart rate, blood pressure, rectal temperature, score of a subjective thermal sensation and the activity of the parasympathetic nervous system. It was clarified that the protection against the cold could be effective for the decrease of the physiological index. These field studies suggest that they would enable the adaptation in the adjustment range of the autonomic nervous system given these protections against the cold

Early deprivation induces competitive subordinance in C57BL/6 male mice

Rodent models have been widely used to investigate the impact of early life stress on adult health and behavior. However, the social dimension has rarely been incorporated into the analysis due to methodological limitations. This study characterized the effects of neonatal social isolation (early deprivation, ED) on adult C57BL/6 mouse behavior in a social context using our recently developed behavioral test protocols for group-housed mice. During the first two postnatal weeks, half of the pups per dam were separated from their dam and littermates for 3. h per day (ED group). Post weaning, ED and control pups were electronically tagged and co-housed. At 12. weeks, the mixed cohorts were transferred to IntelliCages, equipped with computer-controlled operant chambers. Access to the chambers was used as an index to analyze novel object response, behavioral flexibility, and competitive dominance with minimal experimenter intervention. In general, ED had greater effects on males; ED males exhibited reduced body weight, increased novelty response, and were subordinate to control littermates when competing for reward access. Male ED mice also demonstrated mildly impaired reversal learning. Analyzing gene expression changes in brain regions controlling emotion, stress, spatial memory, and executive function revealed reduced BDNF and c-Fos in hippocampal CA1, enhanced c-Fos in the basolateral amygdala, reduced Map2 while enhanced HSD11β2 in prefrontal cortex of ED males. In male mice, it was suggested that neonatal social isolation results in sustained changes in social behavior with altered function of limbic and frontal cortices

Knowledge-based planning using pseudo-structures for volumetric modulated arc therapy (VMAT) of postoperative uterine cervical cancer: a multi-institutional study

Background: The aim of this study was to investigate the performance of the RapidPlan (RP) using models registered pseudo-structures, and to determine how many structures are required for automatic optimization of volumetric modulated arc therapy (VMAT) for postoperative uterine cervical cancer. Materials and methods: Pseudo-structure around the PTV were retrospectively contoured for patients who had completed treatment at five institutions. For 22 common patients, plans were generated with a single optimization for models with two (RP_2), four (RP_4), and five (RP_5) registered structures, and the dosimetric parameters of these models were compared with a clinical plan with several optimizations. Results: Most dosimetric parameters showed no major differences between each RP model. In particular, the rectum Dmax, V50Gy, and V40Gy with RP_2, RP_4, and RP_5 were not significantly different, and were lower than those of the clinical plan. The average proportions of plans achieving acceptable criteria for dosimetric parameters were close to 100% for all models. Using RP_2, the average time for the VMAT planning was reduced by 88 minutes compared with the clinical plan. Conclusion: The RapidPlan model with two registered pseudo-structures could generate clinically acceptable plans while saving time