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

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

Local Gene Delivery System by Bubble Liposomes and Ultrasound Exposure into Joint Synovium

Recently, we have developed novel polyethylene glycol modified liposomes (bubble liposomes; BL) entrapping an ultrasound (US) imaging gas, which can work as a gene delivery tool with US exposure. In this study, we investigated the usefulness of US-mediated gene transfer systems with BL into synoviocytes in vitro and joint synovium in vivo. Highly efficient gene transfer could be achieved in the cultured primary synoviocytes transfected with the combination of BL and US exposure, compared to treatment with plasmid DNA (pDNA) alone, pDNA plus BL, or pDNA plus US. When BL was injected into the knee joints of mice, and US exposure was applied transcutaneously to the injection site, highly efficient gene expression could be observed in the knee joint transfected with the combination of BL and US exposure, compared to treatment with pDNA alone, pDNA plus BL, or pDNA plus US. The localized and prolonged gene expression was also shown by an in vivo luciferase imaging system. Thus, this local gene delivery system into joint synovium using the combination of BL and US exposure may be an effective means for gene therapy in joint disorders

A severe skeletal Class III malocclusion treated with Le Fort I combined with sagittal split ramus osteotomy, mandibular body ostectomy and tongue reduction surgery. A case report

This case report describes the orthodontic-orthognathic management of a 17-year-old male patient with extremely severe skeletal Class III malocclusion due to a marked mandibular protrusion with a small and narrowed upper jaw which increased the remarkable concave facial profile. Dental articulation was entirely lacking, resulting in great difficulty in masticating food. A two-jaw surgery combined with mandibular body ostectomy was performed to correct mandibular asymmetry and the severe sagittal skeletal discrepancy (Wits appraisal –36.5 mm and ANB angle –14.3°). Bi-maxillary surgery was performed in two-stages; the first surgery consisted of maxillary advancement with Le Fort I osteotomy followed by a second surgery where a combination of sagittal split ramus osteotomy (SSRO) and mandibular body ostectomy was performed to correct the severe mandibular prognathism. A partial glossectomy was also carried out to address macroglossia. After a total treatment time of 32 months, a Class I occlusion with a favorable facial profile and lip competence were obtained. The occlusion was made approximately ideal, and mastication improved remarkably. Three years after retention, the occlusion was stable and no relapse was observed. The patient’s complaints and orthodontic problems were completely resolved. Therefore, a combination of two-jaw surgeries with Le Fort I maxillary osteotomy, mandibular SSRO, mandibular ostectomy, and glossectomy may be a viable option in the correction of extremely severe anteroposterior skeletal discrepancy

The ubiquitination-deubiquitination cycle on the ribosomal protein eS7A is crucial for efficient translation

Ubiquitination is a major post-translational modification of ribosomal proteins. The role of ubiquitination in the regulation of ribosome functions is still being elucidated. However, the importance of ribosome deubiquitination remains unclear. Here, we show that the cycle of ubiquitination and deubiquitination of the 40S ribosome subunit eS7 is important for efficient translation. eS7 ubiquitination at lysine 83 is required for efficient protein translation. We identified Otu2 and Ubp3 as the deubiquitinating enzymes for eS7. An otu2Δubp3Δ mutation caused a defect in protein synthesis. Ubp3 inhibited polyubiquitination of eS7 in polysomes to keep eS7 in a mono-ubiquitinated form, whereas Otu2 was specifically bound to the free 40S ribosome and promoted the dissociation of mRNAs from 40S ribosomes in the recycling step. Our results provide clues for understanding the molecular mechanism of the translation system via a ubiquitination-deubiquitination cycle

Can Ground-based Telescopes Detect The Oxygen 1.27 Micron Absorption Feature as a Biomarker in Exoplanets ?

The oxygen absorption line imprinted in the scattered light from the Earth-like planets has been considered the most promising metabolic biomarker of the exo-life. We examine the feasibility of the detection of the 1.27 micron oxygen band from habitable exoplanets, in particular, around late- type stars observed with a future instrument on a 30 m class ground-based telescope. We analyzed the night airglow around 1.27 micron with IRCS/echelle spectrometer on Subaru and found that the strong telluric emission from atmospheric oxygen molecules declines by an order of magnitude by midnight. By compiling nearby star catalogs combined with the sky background model, we estimate the detectability of the oxygen absorption band from an Earth twin, if it exists, around nearby stars. We find that the most dominant source of photon noise for the oxygen 1.27 micron band detection comes from the night airglow if the contribution of the stellar PSF halo is suppressed enough to detect the planet. We conclude that the future detectors for which the detection contrast is limited by photon noise can detect the oxygen 1.27 micron absorption band of the Earth twins for ~50 candidates of the late type star. This paper demonstrates the importance of deploying small inner working angle efficient coronagraph and extreme adaptive optics on extremely large telescopes, and clearly shows that doing so will enable study of potentially habitable planets.Comment: 11 pages, 9 figures, accepted for publication in The Astrophysical Journa