The Utility of the Combined Use of 123I-FP-CIT and 123I-MIBG Myocardial Scintigraphy in Differentiating Parkinson’s Disease from Other Parkinsonian Syndromes

【Background】123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy and 123I-FP-CIT dopamine transporter single photon emission computed tomography (DAT-SPECT) provide specific information that distinguish Parkinson’s disease (PD) from parkinsonian syndromes other than PD (non-PD), including atypical parkinsonian disorder (APD) and non-PD other than APD (nPD-nAPD). The purpose of this study was to determine whether combining DAT-SPECT and MIBG myocardial scintigraphy using multiparametric scoring system (MSS) could improve diagnostic test accuracy in discriminating PD from APD or discriminating PD from nPD-nAPD. 【Methods】A total of 52 patients, including 36 PD, eight APD and eight nPD-nAPD, underwent both MIBG myocardial scintigraphy and DAT-SPECT, were evaluated. The heart-to-mediastinum (H/M) ratios (early and delayed), washout-rate (WR), the average (Ave) and asymmetry index (AI) of specific binding ratio (SBR) were calculated. Cutoff values were determined, using ROC analysis, for discriminating PD from APD and for discriminating PD from nPD-nAPD, on five parameters. All cases were scored as either 1 (PD) or 0 (nPD-nAPD or APD) for each parameter according to its threshold in each discrimination. These individual scores were summed for each case, yielding a combined score to obtain a cutoff value for the MSS in each discrimination. 【Results】For discriminating PD from nPD-nAPD, the highest accuracy was 80% at a cutoff value of 19% for the WR and a cut off value of 2 improved diagnostic accuracy to 84% for MSS. For discriminating PD from APD, the highest accuracy was 86% at a cutoff value of 2.8 for the H/M ratio (late) and a cut off value of 2 showed diagnostic accuracy of 86% for MSS. 【Conclusion】A MSS has comparable or better accuracy compared to each parameter of MIBG myocardial scintigraphy and DAT-SPECT in distinguishing PD from nPD-nAPD or distinguishing PD from APD

Identification of a Vitamin-D Receptor Antagonist, MeTC7, which Inhibits the Growth of Xenograft and Transgenic Tumors In Vivo

Vitamin-D receptor (VDR) mRNA is overexpressed in neuroblastoma and carcinomas of lung, pancreas, and ovaries and predicts poor prognoses. VDR antagonists may be able to inhibit tumors that overexpress VDR. However, the current antagonists are arduous to synthesize and are only partial antagonists, limiting their use. Here, we show that the VDR antagonist MeTC7 (5), which can be synthesized from 7-dehydrocholesterol (6) in two steps, inhibits VDR selectively, suppresses the viability of cancer cell-lines, and reduces the growth of the spontaneous transgenic TH-MYCN neuroblastoma and xenografts in vivo. The VDR selectivity of 5 against RXRα and PPAR-γ was confirmed, and docking studies using VDR-LBD indicated that 5 induces major changes in the binding motifs, which potentially result in VDR antagonistic effects. These data highlight the therapeutic benefits of targeting VDR for the treatment of malignancies and demonstrate the creation of selective VDR antagonists that are easy to synthesize

平成29年度「卒業研究」実践報告

今年度の卒業研究はテーマ設定に関する時間を確保するために、2年次の「T-GAP」の内容に卒業研究の内容を含めて実施した。評価に関しては国際バカロレアの「課題論文」(EE)を参考にしつつ、生徒の実態に沿う形で評価規準を作り直して使用した。テーマ設定に時間をかけたころとなどにより、多くの先行研究を参考にし、主体的に課題を設定して卒業研究に取り組む姿が確認された

Cu-Catalyzed three-component coupling reactions using nitriles, 1,3-dienes and silylboranes

This paper reports novel Cu-catalyzed three-component coupling reactions using nitriles, 1, 3-dienes and silylboranes. The desired reactions proceed at room temperature and yield β, γ-unsaturated ketones with a (dimethylphenylsilyl)methyl moiety at the α-position. Diverse nitriles participate in the reaction and the corresponding products were obtained in good to high yields with high regioselectivity

Current practice patterns of osteoporosis treatment in cancer patients and effects of therapeutic interventions in a tertiary center.

Cancer and osteoporosis have high incidence rates in older populations. However, the treatment of osteoporosis among cancer patients has not been adequately described. Our purpose was to clarify the current practice patterns of osteoporosis treatment among cancer patients in an academic cancer center, and to analyze the efficacy of treatment interventions. Patient records from April 2009 to March 2018 were retrospectively reviewed, and the study included a total of 316 cancer patients with osteoporosis. After patients' data extraction, the patients were divided into two groups, with (n = 144) or without treatment (n = 172), and compared the outcomes of these groups to evaluate the medication effect. The primary outcome was new radiographic fragility fractures during the study period. The related factors associated with fracture injuries and the rate of adverse events, such as osteonecrosis in the jaw and atypical femoral fractures, were analyzed. The rate of treatment intervention was 45.6% among the patient groups. Among patients in the study group, breast cancer patients (n = 107) were mostly treated (n = 79, 73.8%) with oral bisphosphonate. A significant difference in new fracture rate was observed between the two groups (treatment group, 30.6%; non-treatment group, 54.7%), and the risk of fracture was 42% lower in the treatment group (hazard ratio, 0.58; 95% confidence interval, 0.39-0.86; p<0.05). Previous chemotherapy, steroid use, and older age were significantly associated with increased rate of new fragility fractures. The adverse event rate was 3.5% (presented in five cases). Older cancer patients who receive chemotherapy or steroids are strongly recommended undergo bone quality assessment and appropriate osteoporosis treatment to improve their prognosis

Morphological Characteristics of Olecranon Fractures in Adults: a Computed Tomography-based Study

The aim of this study was to identify the fragment’s shape by evaluating olecranon fractures. We examined the CT images of 48 olecranon fractures (28 women and 20 men).Mean age was 59.9 years. On the olecranon’s posterior surface, we measured the distance between the apex of the olecranon fragment and the radial edge of the flat spot on the short axis and the width of the flat spot on the same short axis. The tip radial ratio (i.e., the tip radial edge to the flat spot width) was derived from these parameters. The mean tip radial edge was 1.96mm, and the flat spot width was 12.64mm; therefore, the tip radial ratio was 0.15mm. Radial inclination on the articular surface was 30.55˚. Our findings confirmed our hypothesis that the fracture lines run from the proximal ulnar side to the distal radial side on the olecranon’s posterior and articular surfaces

The Threat of Longitudinal Cracking after Distal Radius Fracture Treatment with Volar Locking Plate

The purpose of this study was to examine the occurrence rate of longitudinal cracks and associated characteristics following volar locking plate fixation of the distal radius. Using case records from Shizuoka Saiseikai General Hospital dated between March 2008 and March 2015, a total of 419 eligible adult patients were identified. Standard anteroposterior postoperative radiographs were evaluated to classify longitudinal crack occurrence. Documented variables were compared between patients with longitudinal cracking and those without. Univariate analyses were conducted among each plate group. There were 38 confirmed cases of cracking (Acu-Loc: n=25, Acu-Loc 2: n=11, VA-TCP: n=2). All cracks healed within 4 to 6 weeks after the operation. Plate type, along with patient age and sex were significantly associated with the occurrence of a longitudinal crack (p&lt;0.05). Although no severe complications related to longitudinal cracking were observed, associated risks for specific patient groups should be considered