Factors influencing response to treatment of pulmonary tuberculosis.

We analyzed 150 patients with pulmonary tuberculosis from 1990 to 1996 (i) to evaluate the frequency of drug resistance, (ii) to elucidate factors influencing the response to chemotherapy, and (iii) to attempt to improve the therapeutic approach. Multidrug-resistant tuberculosis strains were not found. By univariate analysis, there were 8 factors associated with an increased sputum conversion time: male gender, prior treatment, complications, progressive chest radiographic findings, a high Ziehl-Neelsen stain score, lymphocytopenia, a high erythrocyte sedimentation rate (ESR), and hypoproteinemia. Complications, prior treatment, a high Ziehl-Neelsen stain score, and a high ESR were independent predictive factors in a Cox proportional hazard model. Recursive partitioning and amalgamation (RPA) defined 3 subgroups that responded to treatment. In order to reduce the time to sputum conversion, poor responders according to the RPA should be treated with a 4-drug regimen containing pyrazinamide.</p

Effects of Instanton Induced Interaction on the Pentaquarks

Roles of instanton induced interactions (III) in the masses of pentaquark baryons, Theta^+ (J=1/2 and 3/2) and Xi^{--}, and a dibaryon, H, are discussed using the MIT bag model in the negative parity case. It is shown that the two-body terms in III give a strong attraction mainly due to the increase of the number of pairs in multi-quark systems. In contrast, the three-body u-d-s interaction is repulsive. It is found that III lowers the mass of Theta^+ as much as 100 MeV from the mass predicted by the bag model without III.Comment: 11 pages, 3 figure

Peritoneal dissemination of prostate cancer due to laparoscopic radical prostatectomy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Peritoneal dissemination with no further metastases of prostate cancer is very rare, with only three cases reported in the available literature. We report the first case of iatrogenic peritoneal dissemination due to laparoscopic radical prostatectomy.</p> <p>Case Presentation</p> <p>A 59-year-old Japanese man underwent laparoscopic radical prostatectomy for clinical T2bN0M0 prostate cancer, and the pathological diagnosis was pT3aN0 Gleason 3+4 adenocarcinoma with a negative surgical margin. Salvage radiation therapy was performed since his serum prostate-specific antigen remained at a measurable value. After the radiation, he underwent castration, followed by combined androgen blockade with estramustine phosphate and dexamethasone as each treatment was effective for only a few months to a year. Nine years after the laparoscopic radical prostatectomy, computed tomography revealed a peritoneal tumor, although no other organ metastasis had been identified until then. He died six months after the appearance of peritoneal metastasis. An autopsy demonstrated peritoneal dissemination of the prostate cancer without any other metastasis.</p> <p>Conclusion</p> <p>Physicians should take into account metastasis to unexpected sites. Furthermore, we suggest that meticulous care be taken not to disseminate cancer cells to the peritoneum during laparoscopic radical prostatectomy.</p

Evaluation of the Surface Water Distribution in North-Central Namibia Based on MODIS and AMSR Series

Semi-arid North-central Namibia has high potential for rice cultivation because large seasonal wetlands (oshana) form during the rainy season. Evaluating the distribution of surface water would reveal the area potentially suitable for rice cultivation. In this study, we detected the distribution of surface water with high spatial and temporal resolution by using two types of complementary satellite data: MODIS (MODerate-resolution Imaging Spectroradiometer) and AMSR-E (Advanced Microwave Scanning Radiometer–Earth Observing System), using AMSR2 after AMSR-E became unavailable. We combined the modified normalized-difference water index (MNDWI) from the MODIS data with the normalized-difference polarization index (NDPI) from the AMSR-E and AMSR2 data to determine the area of surface water. We developed a simple gap-filling method (“database unmixing”) with the two indices, thereby providing daily 500-m-resolution MNDWI maps of north-central Namibia regardless of whether the sky was clear. Moreover, through receiver-operator characteristics (ROC) analysis, we determined the threshold MNDWI (−0.316) for wetlands. Using ROC analysis, MNDWI had moderate performance (the area under the ROC curve was 0.747), and the recognition error for seasonal wetlands and dry land was 21.2%. The threshold MNDWI let us calculate probability of water presence (PWP) maps for the rainy season and the whole year. The PWP maps revealed the total area potentially suitable for rice cultivation: 1255 km2 (1.6% of the study area)

The Usefulness of CYFRA21-1 in Diagnosing and Monitoring Malignant Pleural Mesothelioma

Five patients with malignant pleural mesothelioma (MPM) were studied to determine whether CYFRA 21-1 is useful for diagnosis of this disease. In pleural effusions, the median concentration of CYFRA 21-1 from 4 patients with MPM was significantly higher than for 34 patients with benign diseases. The sensitivity of serum CYFRA 21-1 for diagnosis of MPM was 40% and its concentration changed in proportion to disease activity in all cases. Immunohistochemically, anticytokeratin 19 antibody revealed strong staining in both epithelial and sarcomatous MPM tissues. Based on these results, we conclude that measurement of CYFRA 21-1 in pleural effusions and serum may be useful for diagnosing and monitoring MPM.</p