肝細胞癌に対する機能画像を用いた体幹部定位放射線治療計画

広島大学(Hiroshima University)博士(医学)Doctor of Philosophy in Medical Sciencedoctora

Staphylococci Isolated from Raw Milk of Yak and Cattle in Mongolia

Occurrence, characterization, detection of enterotoxin and antimicrobial susceptibility profile in staphylococci isolated from yak and cattle in Mongolia were investigated. Staphylococci were isolated from 72 (74%) of the 97 raw milk samples investigated. Of the samples containing staphylococci, 69% (50/72) were from yak, whereas 31% (22/72) were from cattle. Of the samples containing staphylococci, S. aureus was detected in 14% (7/50) of yak milk samples and in 68% (15/22) of cattle samples. Staphylococcal enterotoxin C (SEC) was detected in 19% (5/26) of the S. aureus strains investigated. Three of the enterotoxigenic strains were from yak and two from cattle. None of the S. aureus strains tested produced SEA, SEB, or SED. The MICs of 12 antimicrobial agents for 45 isolates of Staphylococcus spp. from yak and cattle were determined. Broth microdilution was used for the susceptibility testing and because of high oxacillin MICs all isolates were also subjected to oxacillin agar screening and PCR for the mecA gene. Nitrocefin test was used to determine β-lactamase production. The proportion of resistance to β-lactamse based on β-lactamase production was high (37-84%). However, no mecA gene was detected. Resistance to erythromycin, clindamycin, chloramphenicol, tetracycline, trimethoprim and fusidic acid was recorded among isolates from both yak and cattle. Cephalothin resistance was found only among coagulase-negative staphylococci from yak

Occurrence of enterotoxic Staphylococcus aureus in raw milk from yaks and cattle in Mongolia.

Staphylococcal food poisoning is considered one of the leading foodborne illnesses in humans worldwide and is associated with contaminated foods of animal origin, such as milk and dairy products. In this study, we investigated the occurrence of staphylococci and the enterotoxigenic properties of Staphylococcus aureus isolated from raw milk from yaks (Bos mutus) and cattle in Mongolia. Staphylococci were isolated from 72 (74%) of the 97 raw milk samples. Of the samples containing staphylococci, 69% (50 of 72) were from yaks and 30.5% (22 of 72) were from cattle. S. aureus was detected in 10% of yak (7 of 72) and 21% of cattle (15 of 72) milk samples. Staphylococcal enterotoxin C was detected in 23% (5 of 22) of the S. aureus strains investigated, based on the reverse passive latex agglutination technique. Three of the five enterotoxigenic strains were from yaks and two were from cattle. None of the S. aureus strains tested produced staphylococcal enterotoxins A, B, or D. To our knowledge, this is the first report of the occurrence of staphylococci and enterotoxigenic S. aureus in milk from yaks and cattle in Mongolia

Radiation protection infrastructure-challenges in developing countries

A special session was held in the International Radiation Protection Association (IRPA15) Congress to address the particular challenges facing developing countries regarding radiation protection infrastructure. The objective was to identify and share the key challenges facing developing countries regarding the ability to introduce and establish effective radiation protection programmes. The experiences of key international organisations (International Atomic Energy Agency, Pan American Health Organisation and World Health Organisation) that have support programmes were discussed, along with a perspective from several countries with developing programmes. The key common challenges include: governmental commitment at senior levels, with provision of the necessary resources: establishment of an independent regulatory body and related infrastructure: appropriate numbers of qualified staff in all necessary fields, including their education and training: supporting physical infrastructure, such as dosimetry and measurement equipment including calibration laboratories. In addressing these challenges the importance of support from the key international organisations was emphasised. More emphasis should be given to the application of the graded approach. The establishment of support networks at a national or regional level that allow for the sharing of experiences and resources, and that support the wellbeing of isolated professionals, is also crucial. In this aspect the support from wider professional bodies such as IRPA and established national radiation protection societies can also play a key role

Implementation of 3D conformal radiotherapy technology at the National Cancer Centre Mongolia : a successful Asia-Pacific collaborative initiative

Introduction: Mongolia has a population of 3.3 million and is classified by the WHO as a lower middle-income country. Cancer is now a major public health issue and one of the leading causes of mortality. Within the framework of an existing national cancer control plan, the National Cancer Centre of Mongolia (NCCM) aimed to implement 3D conformal radiation planning and linac-based treatment delivery. Methods: In 2018, an opportunity arose for collaboration between the Mongolia Society for Radiation Oncology (MOSTRO), the National Cancer Centre Mongolia (NCCM), the Asia-Pacific Radiation Oncology Special Interest Group (APROSIG) of the Royal Australian and New Zealand College of Radiologists (RANZCR) and the Asia-Pacific Special Interest Group (APSIG) of the Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM) and radiation therapists (RTTs) from a range of Australian centres. We describe here the results to date of this collaboration. Results: Despite a number of significant technical and practical barriers, successful linac commissioning was achieved in 2019. Key factors for success included a leadership receptive to change management, stable bureaucracy and health systems, as well as a synchronised effort, regional cooperation and mentorship. Conclusion: Future directions for ongoing collaborative efforts include a continued focus on education, practical training in radiotherapy planning and delivery and postgraduate education initiatives. Radiotherapy safety and quality assurance remain an ongoing priority, particularly as technological advances are sequentially implemented

Implementation of 3D conformal radiotherapy technology at the National Cancer Centre Mongolia: A successful Asia‐Pacific collaborative initiative

Introduction: Mongolia has a population of 3.3 million and is classified by the WHO as a lower middle-income country. Cancer is now a major public health issue and one of the leading causes of mortality. Within the framework of an existing national cancer control plan, the National Cancer Centre of Mongolia (NCCM) aimed to implement 3D conformal radiation planning and linac-based treatment delivery. Methods: In 2018, an opportunity arose for collaboration between the Mongolia Society for Radiation Oncology (MOSTRO), the National Cancer Centre Mongolia (NCCM), the Asia-Pacific Radiation Oncology Special Interest Group (APROSIG) of the Royal Australian and New Zealand College of Radiologists (RANZCR) and the Asia-Pacific Special Interest Group (APSIG) of the Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM) and radiation therapists (RTTs) from a range of Australian centres. We describe here the results to date of this collaboration. Results: Despite a number of significant technical and practical barriers, successful linac commissioning was achieved in 2019. Key factors for success included a leadership receptive to change management, stable bureaucracy and health systems, as well as a synchronised effort, regional cooperation and mentorship. Conclusion: Future directions for ongoing collaborative efforts include a continued focus on education, practical training in radiotherapy planning and delivery and postgraduate education initiatives. Radiotherapy safety and quality assurance remain an ongoing priority, particularly as technological advances are sequentially implemented

Preliminary survey of 3D image-guided brachytherapy for cervical cancer at representative hospitals in Asian countries.

3D image-guided brachytherapy (3D-IGBT) has become a standard therapy for cervical cancer. However, the use of 3D-IGBT is limited in East and Southeast Asia. This study aimed to clarify the current usage patterns of 3D-IGBT for cervical cancer in East and Southeast Asia. A questionnaire-based survey was performed in 11 countries within the framework of the Forum for Nuclear Cooperation in Asia. The questionnaire collected the treatment information of patients with cervical cancer who underwent 3D-IGBT. The cumulative external beam radiotherapy and 3D-IGBT doses were summarized and normalized to a biological equivalent dose of 2 Gy per fraction (EQD2) using a linear-quadratic model. Of the 11 institutions representing the participating countries, six (55%) responded to the questionnaire. Overall, data of 36 patients were collected from the six institutions. Twenty-one patients underwent whole-pelvic irradiation and 15 underwent whole-pelvic irradiation with central shielding. Patients received a median of four treatment sessions of 3D-IGBT (range, 2-6). All 3D-IGBT sessions were computed tomography (CT)-based and not magnetic resonance image-based. The median doses to the high-risk clinical target volume D90, bladder D2cc, rectum D2cc and sigmoid colon D2cc were 80.9 Gy EQD2 (range, 58.9-105.9), 77.7 Gy EQD2 (range, 56.9-99.1), 68.0 Gy EQD2 (range, 48.6-90.7) and 62.0 Gy EQD2 (range, 39.6-83.7), respectively. This study elucidated the current patterns of 3D-IGBT for the treatment of cervical cancer in East and Southeast Asia. The results indicate the feasibility of observational studies of CT-based 3D-IGBT for cervical cancer in these countries