Clinical characterization and successful treatment of 6 patients with Churg-Strauss syndrome-associated neuropathy

Objective: To confirm the reported findings and clarify unknown clinical features of Churg-Strauss syndrome (CSS) -associated neuropathy and design appropriate treatment. Patients and Methods: We assessed the clinical features of 6 patients with CSS-associated neuropathy. Results: Mononeuritis multiplex was present in 4 cases and polyneuropathy in the remaining cases. Both groups progressed to sensori-motor polyneuropathy in an acute or subacute course. All cases showed bronchial asthma and eosinophilia. Two cases with serum antineutrophil cytoplasmic antibodies to myeloperoxidase (MPO-ANCA) had an acute clinical course and severe symptoms. Nerve conduction studies (NCS) of these 2 cases revealed conduction blocks at the initial stage, although NCS finally indicated sensori-motor axonopathy at the involved extremities. For treatment, high-dose corticosteroid therapy for 4 cases, and cyclophosphamide combined with corticosteroids for one case, were effective. For the remaining case, intravenous immunoglobulin (IVIg) at the chronic phase resulted in a slow improvement of neuropathy in the symptomatic aspect. There was no relapse of neuropathy with low dose corticosteroid treatment for 14-24 months after the initial treatment, except one case. There was also no relapse in the other case that was treated with moderate-dose steroids. Conclusion: Our study showed that CSS-associated neuropathy is a treatable disorder and that the first choice therapy is high-dose corticosteroid. In cases where corticosteroids are ineffective or for severe cases, immunosuppressive therapy (cyclophosphamide) with steroids should be considered, and IVIg might be a treatment option

Thin cathode glass gas electron multiplier detector for carbon beam dose imaging

An optically read-out glass gas electron multiplier (G-GEM) detector is expected to simplify complicated quality assurance measurements for hadron therapies by imaging the dose distribution of the incident beam. However, the effect of secondary particles from the detector itself has not been well studied. In this paper, we evaluate a design that reduces the secondary particles from the cathode of a G-GEM detector. Specifically, we assembled detectors with thin cathodes and assessed their effect on the secondary particle production in simulations and experiments. The experiments were carried out under 290 MeV/u 12C ion bombardment at the Heavy Ion Medical Accelerator in Chiba. The clinical intensity of the thin cathode detector was compared with that of a conventional thick cathode G-GEM detector. The improved chamber design reduced the dose contributions of secondary particles from the cathode without degrading the dose imaging performance

Regulation of Human Melanoma Growth and Metastasis by AGE–AGE Receptor Interactions

Advanced glycation end products (AGE), nonenzymatically glycated protein derivatives, have been implicated in the development and progression of diabetic angiopathies, including skin dermopathy. Nevertheless, the involvement of AGE in the development and progression of melanoma has not been fully elucidated. In this study we investigated the expression levels of their receptor for AGE (RAGE) in human melanoma and subsequently studied the effects of AGE on melanoma growth and migration. First, RAGE was detected in the cytoplasm of human melanoma cells (G361 and A375). Among the different types of AGE, glyceraldehyde- and glycolaldehyde-derived AGE significantly stimulated the growth and migration of human melanoma cells. Furthermore, tumor formation of melanoma cell xenografts in athymic mice was prevented by treatment with anti-RAGE neutralizing antibodies. In tumor-bearing mice, survival rates were prolonged, and spontaneous pulmonary metastases were inhibited by treatment using anti-RAGE neutralizing antibodies. In addition, all AGE were present in beds of human melanoma tumor, whereas they were barely detected in normal skin. These results suggest that AGE might be involved in the growth and invasion of melanoma through interactions with RAGE and represent promising candidates for assessing the future therapeutic potential of this therapy in treating patients with melanoma

Development and characterization of optical readout well-type glass gas electron multiplier for dose imaging in clinical carbon beams

The use of carbon ion beams in cancer therapy (also known as hadron therapy) is steadily growing worldwide; therefore, the demand for more efficient dosimetry systems is also increasing because daily quality assurance (QA) measurements of hadron radiotherapy is one of the most complex and time consuming tasks. The aim of this study is to develop a two-dimensional dosimetry system that offers high spatial resolution, a large field of view, quick data response, and a linear dose–response relationship.We demonstrate the dose imaging performance of a novel digital dose imager using carbon ion beams for hadron therapy. The dose imager is based on a newly-developed gaseous detector, a well-type glass gas electron multiplier. The imager is successfully operated in a hadron therapy facility with clinical intensity beams for radiotherapy. It features a high spatial resolution of less than 1 mm and an almost linear dose–response relationship with no saturation and very low linear-energy-transfer dependence. Experimental results show that the dose imager has the potential to improve dosimetry accuracy for daily QA