加速乳房部分照射における新規照射法:Dynamic WaveArcの線量優位性

京都大学0048新制・課程博士博士(医学)甲第22309号医博第4550号新制||医||1040(附属図書館)京都大学大学院医学研究科医学専攻(主査)教授 戸井 雅和, 教授 富樫 かおり, 教授 武田 俊一学位規則第4条第1項該当Doctor of Medical ScienceKyoto UniversityDFA

Appropriate margin for planning target volume for breast radiotherapy during deep inspiration breath-hold by variance component analysis

BACKGROUND: This study aimed to quantify errors by using a cine electronic portal imaging device (cine EPID) during deep inspiration breath-hold (DIBH) for left-sided breast cancer and to estimate the planning target volume (PTV) by variance component analysis. METHODS: This study included 25 consecutive left-sided breast cancer patients treated with whole-breast irradiation (WBI) using DIBH. Breath-holding was performed while monitoring abdominal anterior-posterior (AP) motion using the Real-time Position Management (RPM) system. Cine EPID was used to evaluate the chest wall displacements in patients. Cine EPID images of the patients (309, 609 frames) were analyzed to detect the edges of the chest wall using a Canny filter. The errors that occurred during DIBH included differences between the chest wall position detected by digitally reconstructed radiographs and that of all cine EPID images. The inter-patient, inter-fraction, and intra-fractional standard deviations (SDs) in the DIBH were calculated, and the PTV margin was estimated by variance component analysis. RESULTS: The median patient age was 55 (35-79) years, and the mean irradiation time was 20.4 ± 1.7 s. The abdominal AP motion was 1.36 ± 0.94 (0.14-5.28) mm. The overall mean of the errors was 0.30 mm (95% confidence interval: - 0.05-0.65). The inter-patient, inter-fraction, and intra-fractional SDs in the DIBH were 0.82 mm, 1.19 mm, and 1.63 mm, respectively, and the PTV margin was calculated as 3.59 mm. CONCLUSIONS: Errors during DIBH for breast radiotherapy were monitored using EPID images and appropriate PTV margins were estimated by variance component analysis

Improving Low-Light Image Recognition Performance Based on Image-adaptive Learnable Module

In recent years, significant progress has been made in image recognition technology based on deep neural networks. However, improving recognition performance under low-light conditions remains a significant challenge. This study addresses the enhancement of recognition model performance in low-light conditions. We propose an image-adaptive learnable module which apply appropriate image processing on input images and a hyperparameter predictor to forecast optimal parameters used in the module. Our proposed approach allows for the enhancement of recognition performance under low-light conditions by easily integrating as a front-end filter without the need to retrain existing recognition models designed for low-light conditions. Through experiments, our proposed method demonstrates its contribution to enhancing image recognition performance under low-light conditions.Comment: 8 pages, 2 figures, 4 table

Activation of ADF/cofilin by phosphorylation-regulated Slingshot phosphatase is required for the meiotic spindle assembly in Xenopus laevis oocytes

We identify Xenopus ADF/cofilin (XAC) and its activator, Slingshot phosphatase (XSSH), as key regulators of actin dynamics essential for spindle microtubule assembly during Xenopus oocyte maturation. Phosphorylation of XSSH at multiple sites within the tail domain occurs just after germinal vesicle breakdown (GVBD) and is accompanied by dephosphorylation of XAC, which was mostly phosphorylated in immature oocytes. This XAC dephosphorylation after GVBD is completely suppressed by latrunculin B, an actin monomer-sequestering drug. On the other hand, jasplakinolide, an F-actin-stabilizing drug, induces dephosphorylation of XAC. Effects of latrunculin B and jasplakinolide are reconstituted in cytostatic factor-arrested extracts (CSF extracts), and XAC dephosphorylation is abolished by depletion of XSSH from CSF extracts, suggesting that XSSH functions as an actin filament sensor to facilitate actin filament dynamics via XAC activation. Injection of anti-XSSH antibody, which blocks full phosphorylation of XSSH after GVBD, inhibits both meiotic spindle formation and XAC dephosphorylation. Coinjection of constitutively active XAC with the antibody suppresses this phenotype. Treatment of oocytes with jasplakinolide also impairs spindle formation. These results strongly suggest that elevation of actin dynamics by XAC activation through XSSH phosphorylation is required for meiotic spindle assembly in Xenopus laevis

Nursing Care Workers' Concerns about Child Restraint System

本調査は患児の救急搬送時のことやCRS (child restraint system)における法規制の理解などに対する看護職の意識と子どもの車での搬送に関する問題への対応を知る目的で実施した｡岡山市内にある病院および保健所･保健センターに勤務している看護職725名(回収率72.2%)を対象に無記名アンケート方式で郵送法にて実施した｡その結果,入退院時の搬送については｢一度も話したことがない者｣は84.6%で,搬送に関してはほとんど関与していなかった｡CRSの除外規定に関する法的理解について5項目質問したが､正解者は40.9%であった｡その他"肥満児および精神的な不穏時のCRSの対応"として は保護者への判断を促す者と医師の判断を仰ぐ者との2通りの意見があった｡ わが国では健常児の非CRS使用時の搬送時に事故がおき運転者責任を問われたが,除外規定に関する判例ではなかった｡今後は交通事故の発生の場合には確実にCRSの問題は運転者の判断を問われることになる｡看護職としては子どもの搬送にCRSは関与していることを認識することへの示唆となるだろう｡This study surveyed nursing care workers (workers) understandings of regulations regarding the emergent transportation of childhood patients and child restraint systems (CRS). It also ascertained how they addressed issues involved in the transportation of children by car. Subjects were 725 workers at hospitals or health centers in Okayama City, who were sent an anonymous style questionnaire that was then retrieved by mail (recovery rate 72.2%). As the results, 84.6% of workers had never discussed childhood patient transportation during admission/discharge, with most not being involved in the transportation of children. Only 40.9% answered correctly to 5 questions regarding the exclusive provisions of CRS used to ascertain understanding of the regulations. There were two responses regarding "CRS application to fat children or those with mental restlessness": some encouraged the parents to make a decision and others took advices from doctors. A driver was held responsible for a car accident in Japan when a healthy child was transported without CRS. No case regarding the exclusive provisions has yet been reported. In cases of car accidents, drivers will from now surely be held responsible for the use of CRS. This survey provided nursing care workers for the opportunity to recognize the importance of CRS in the emergenty transportation of children

Usefulness of diffusion-weighted magnetic resonance imaging for evaluating the effect of hemostatic radiotherapy for unresectable gastric cancer

There are several reports that vouch for the usefulness of diffusion-weighted image (DWI) in making a diagnosis before treatment. However, no study has evaluated the effect of radiotherapy (RT) for unresectable gastric cancer. In the present case report, we evaluated the effectiveness of RT using DWI. An 81-year-old man was hospitalized with a broken bone and then diagnosed with advanced gastric cancer with breeding. He had chorionic renal failure and surgery was impossible. Further, contrast-enhanced computed tomography and magnetic resonance imaging (MRI) were not performed due to renal failure, whereas palliative RT was performed. We followed up the patient using blood test and MRI (DWI) to estimate whether bleeding had stopped or not after radiotherapy. Hemostasis effect was found after 2 weeks of RT. In DWI examination, there was a decrease in the tumor signal intensity 30 days after RT. Similarly, at day 60, the tumor signal intensity further decreased on DWI and the blood test results indicated no progression of anemia. At 4 months after the RT, the patient died because of respiratory failure without any bleeding. DWI is useful not only for the initial diagnosis but also for evaluating the effectiveness of RT.Trial registration: National clinical study registered number: UMIN000026362

Neonatal Fc receptor induces intravenous immunoglobulin growth suppression in Langerhans cell histiocytosis

The neonatal Fc receptor (FcRn) plays a role in trafficking IgG and albumin and is thought to mediate intravenous immunoglobulin (IVIG) therapy for certain diseases. IVIG can be used for the treatment of human Langerhans cell histiocytosis (LCH); however, the mechanism remains unclear. The expression and function of FcRn protein have not been studied in LCH, though the expression of FcRn messenger RNA (mRNA) have been reported. In this report, we confirmed the expression of FcRn in 26 of 30 pathological cases (86.7%) diagnosed immunohistochemically as LCH. The expression was independent of age, gender, location, multi- or single-system, and the status of BRAFV600E immunostaining. We also confirmed the expression of FcRn mRNA and protein in the human LCH-like cell line, ELD-1. FcRn suppressed albumin consumption and growth of IVIG preparation-treated ELD-1 cells, but not of IVIG preparation-untreated or FcRn-knockdown ELD-1 cells. In addition, FITC-conjugated albumin was taken into Rab11-positive recycle vesicles in mock ELD-1 cells but not in FcRn-knockdown ELD-1 cells. IVIG preparation prolonged this status in mock ELD-1 cells. Therefore, ELD-1 recycled albumin via FcRn and albumin was not used for metabolism. Our results increase our understanding of the molecular mechanism of IVIG treatment of LCH

Cell Stress Induced Stressome Release Including Damaged Membrane Vesicles and Extracellular HSP90 by Prostate Cancer Cells

Tumor cells exhibit therapeutic stress resistance-associated secretory phenotype involving extracellular vesicles (EVs) such as oncosomes and heat shock proteins (HSPs). Such a secretory phenotype occurs in response to cell stress and cancer therapeutics. HSPs are stress-responsive molecular chaperones promoting proper protein folding, while also being released from cells with EVs as well as a soluble form known as alarmins. We have here investigated the secretory phenotype of castration-resistant prostate cancer (CRPC) cells using proteome analysis. We have also examined the roles of the key co-chaperone CDC37 in the release of EV proteins including CD9 and epithelial-to-mesenchymal transition (EMT), a key event in tumor progression. EVs derived from CRPC cells promoted EMT in normal prostate epithelial cells. Some HSP family members and their potential receptor CD91/LRP1 were enriched at high levels in CRPC cell-derived EVs among over 700 other protein types found by mass spectrometry. The small EVs (30-200 nm in size) were released even in a non-heated condition from the prostate cancer cells, whereas the EMT-coupled release of EVs (200-500 nm) and damaged membrane vesicles with associated HSP90 alpha was increased after heat shock stress (HSS). GAPDH and lactate dehydrogenase, a marker of membrane leakage/damage, were also found in conditioned media upon HSS. During this stress response, the intracellular chaperone CDC37 was transcriptionally induced by heat shock factor 1 (HSF1), which activated the CDC37 core promoter, containing an interspecies conserved heat shock element. In contrast, knockdown of CDC37 decreased EMT-coupled release of CD9-containing vesicles. Triple siRNA targeting CDC37, HSP90 alpha, and HSP90 beta was required for efficient reduction of this chaperone trio and to reduce tumorigenicity of the CRPC cells in vivo. Taken together, we define "stressome" as cellular stress-induced all secretion products, including EVs (200-500 nm), membrane-damaged vesicles and remnants, and extracellular HSP90 and GAPDH. Our data also indicated that CDC37 is crucial for the release of vesicular proteins and tumor progression in prostate cancer

First observations of 4fce auroral roar

第2回極域科学シンポジウム/第35回極域宙空圏シンポジウム 11月16日（水） 統計数理研究所 3階リフレッシュフロ

Prognostic Factors in Endodontic Surgery Using an Endoscope: A 1 Year Retrospective Cohort Study

This retrospective study clarified the success rate of endoscopic endodontic surgeries and identified predictors accounting for successful surgeries. In this retrospective study, 242 patients (90 males, 152 females) who underwent endoscopic endodontic surgery at a single general hospital and were diagnosed through follow-up one year later were included. Risk factors were categorized into attributes, general health, anatomy, and surgery. Then, the correlation coefficient was calculated for the success or failure of endodontic surgery for each variable, the odds ratio was calculated for the upper variable, and factors related to the surgical prognosis factor were identified. The success rate of endodontic surgery was 95.3%, showing that it was a highly predictable treatment. The top three correlation coefficients were post, age, and perilesional sclerotic signs. Among them, the presence of posts was the highest, compared with the odds ratio, which was 9.592. This retrospective study revealed the success rate and risk factors accounting for endoscopic endodontic surgeries. Among the selected clinical variables, the presence of posts was the most decisive risk factor determining the success of endodontic surgeries