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Purpose: In synthetic q-space learning (synQSL), which uses deep learning to infer the diffusional kurtosis (K), a bias that depends on the noise level added to the synthetic training data occurs. The purpose of this study was to evaluate K inference using synQSL and bias correction., Methods: Using the synthetic test data and the real image data, K was inferred by synQSL, and bias correction was performed. Then, those results were compared with K inferred by fitting by the least-squares fitting (LSF) method. At this time, the noise level of the training data was set to 3 types, the noise level of the synthesis test data was set to 5 types, and the number of excitation (NEX) of the real image data was set to 4 types. Robustness of inference was evaluated by the outlier rate, which is the ratio of K outliers to the whole brain. We also evaluated the root mean square error (RMSE) of the inferred K., Results: The outlier rate inferred by synQSL without correction was significantly lower in the test data of each noise level than that by the LSF method and was further reduced by correction. In addition, the RMSE of NEX 1 with NEX 4 as the correct answer based on the real image data had the smallest correction result of K by synQSL., Conclusion: Inferring K using synQSL and bias correction is a robust and small error method compared to that using the LSF method.

A 73-year-old female was hospitalized with thrombotic microangiopathy (TMA) diagnosis because of consciousness disturbance, anemia, thrombocytopenia, renal dysfunction, and electrocardiogram abnormality. The patient died on day 12 of the symptom onset. The immunohistochemical analysis of microclot found in the autopsy of coronary artery confirmed TMA. It was suggested that the relationship to collagen disease by antinuclear antibody positive and the necessity of initiating circulation management and plasma exchange immediately before approximately 1×10 4 of platelets for the prognosis. The findings suggested considering TMA at the time of an unidentified shock, particularly acute adrenal insufficiency.

Evaluation of dosimetric impact of the interplay effect between multi-leaf collimator (MLC) movement and tumor respiratory motion during volumetric modulated arc therapy (VMAT) delivery using polymer gel dosimeter was taken as an example in this article. An excellent gas barrier PAN (polyacrylonitrile) bottle filled with polyacrylamide-based gel dosimeter contained magnesium chloride as a sensitizer (iPAGAT dosimeter) was set to the QUASAR™ respiratory motion phantom (Modus), and was moved with motion amplitudes (peak-to-peak amplitude) of 1 and 2 cm with a 4 second period during VMAT delivery by the Novalis Tx linear accelerator (Varian/BrainLAB). Two spherical GTVs with 2 cm diameter and two PTVs were defined considering the respiratory motion and setup uncertainties. Three-dimensional (3D) dose distribution in iPAGAT dosimeter was read out by the 3T MRI system, and was evaluated by the dose profiles, gamma analysis and the dose-volume histogram (DVH) using in-house developed software. As a result, interplay effect was negligible since dose coverage of GTV was sufficient during VMAT delivery with simulated respiratory motion.

Purpose: The aim of our study is to evaluate whether an 18 F-FDG PET/CT image quality is influenced by the obesity type visceral fat or subcutaneous fat., Methods: We chose continuously 68 patients with obesity (35 subcutaneous fats and 33 visceral fats) who underwent an 18 F-FDG PET/CT scan at our clinic from January 3, 2015 to June 30, 2015. And then, we calculated the noise equivalent count (NEC density ), the signal to noise ratio of the liver (SNR liver ), and the ratio of random coincidence counts to total prompt (random/prompt countrate) on each PET/CT image., Results: We observed that NEC density was decreased as the body mass index (BMI) and the abdominal circumference increased regardless of the obesity type. When the BMI was on the same degree between two types, however, NEC density of a visceral fat was 21.6% that is inferior to that of subcutaneous fat on the average. A similar relation was satisfied also in abdominal circumference. Conversely, random/prompt countrate of a visceral fat was more than that of subcutaneous fat when the abdominal circumference and BMI were on the same degree, respectively. Overall, random/prompt countrate tended to increase as BMI and the abdominal circumference increased. With respect to SNR liver , the value of a visceral fat was inferior to that of subcutaneous fat unconditionally., Conclusion: When the BMI and abdominal circumference are on the same degree, respectively, the 18 F-FDG PET/CT image quality of visceral fat is inferior to that of subcutaneous fat. The measure is to extend the collection time by about 20% in the pelvic area from the abdomen of visceral fat type obesity.

Purpose: Subcutaneous fat is a non-radioactive material surrounding the radioactive material. We developed a phantom, and examined the effect of subcutaneous fat on PET image quality., Methods: We created a cylindrical nonradioactive mimic of subcutaneous fat, placed it around a cylindrical phantom in up to three layers with each layer having a thickness of 20 mm to reproduce the obesity caused by subcutaneous fat. In the cylindrical phantom, hot spheres and cold spheres were arranged. The radioactivity concentration ratio between the hot spheres and B.G. was 4:1. The radioactivity concentration of B.G. was changed as follows: 1.33, 2.65, 4.00, and 5.30 kBq/mL. 3D-PET images were collected during 10 minutes., Results: When the thickness of the mimicked subcutaneous fat increased from 0 mm to 60 mm, noise equivalent count decreased by 58.9‒60.9% at each radioactivity concentration. On the other hand, the percentage of background variability increased 2.2‒5.2 times. Mimic subcutaneous fat did not decrease the percentage contrast of the hot spheres, and did not affect the cold spheres., Conclusion: Subcutaneous fat decreases the noise equivalent count and increases the percentage of background variability, which degrades PET image quality.

We analyzed 16 cases (23 therapeutic sites) of post-operative recurrence of esophageal cancers that were treated with high-precise radiation therapies.The recurrence sites were cervical lymph nodes (5 cases), superior mediastinal lymph nodes (5 cases), posterior mediastinal lymph nodes (3 cases), regional lymph nodes with anastomosis (2 cases), abdominal paraaortic lymph node (3 cases), and regions with hematogenous metastasis (5 cases: liver, lung, spleen, and dissemination to the diaphragm bottom).By recurrence number, 10 cases presented with a single lesion, and 6 cases had multiple lesions.The effect of the treatment was complete response (CR) in all cases, and 6 cases maintained CR.The median of the overall survival after radiotherapy was 562 (132-1,231) days.Analysis of the prognostic factors for the overall survival from a recurrence revealed that the metastatic number (single) (p=0.003), and the metastatic pattern(hematogenous metastasis) (p= 0.004), significantly improved prognosis.We conclude that radiotherapy is an option to extend prognosis in some recurrence cases.

A 77-year-old man was admitted because of fever. A small number of large CD20-positive neoplastic cells were seen in the bone marrow specimen. Clinical symptoms improved with oral prednisolone. After 11 months, abdominal CT scan revealed a liver mass. The biopsy specimen from the liver mass showed diffuse infiltration of large CD20-positive neoplastic cells. The patient was diagnosed as having diffuse large B-cell lymphoma. It was of particular interest that only neoplastic B cells within small blood vessels in the liver mass were positive for CD5. The patient died of lymphoma three months after diagnosis.

The aim of this study was to compare the setup difference measured with ExacTrac X-ray 6D (ETX6D) and cone-beam computed tomography (CBCT) for non-invasive fractionated radiotherapy. Setup data were collected on a Novalis Tx treatment unit for both a head phantom and patients with intracranial tumors and a pelvic phantom and patients with prostate cancer. Initially, setup was done for a phantom using ETX6D. Secondly, a treatment couch was shifted or rotated by each already known value. Thirdly, ETX6D and CBCT scans were obtained. Finally, setup difference was determined: the registrations of ETX6D images with the corresponding digitally reconstructed radiographs using ETX6D fusion, and registrations of CBCT images with the planning CT using online 6D fusion. The setup difference between ETX6D and CBCT was compared. The impact of shifts and rotations on the difference was evaluated. Patients' setup data was similarly analyzed. In phantom experiments, the root mean square (RMS) of difference of the shift and rotation was less than 0.45 mm for translations, and 0.17 degrees for rotations. In intracranial patients' data, the RMS of that was 0.55 mm and 0.44 degree, respectively. In prostate cancer patients' data, the RMS of that was 0.77 mm and 0.79 degree, respectively. In this study, we observed modest setup differences between ETX6D and CBCT. These differences were generally less than 1.00 mm for translations, and 1.00 degrees for rotations, respectively.

The focus of this work is to evaluate the dosimetric impact of treatment planning for three-dimensional conformal radiotherapy (3DCRT) and intensity-modulated radiotherapy (IMRT) of prostate cancer using Varian/BrainLAB 120-leaf high-definition multileaf collimator (HD120 MLC) with 2.5 mm leaf width and Varian 120-leaf millennium multileaf collimator (M120 MLC) with 5 mm leaf width. We measured the leaf transmission and dosimetric leaf gap (DLG) of two multileaf collimator (MLC) systems using Farmer ionization chamber. The dosimetric impact of treatment planning for 3DCRT and IMRT of prostate cancer for ten clinical cases using two MLC systems was evaluated quantitatively. 3DCRT was divided to 3DCRT(middle) as fitting at middle of leaf tip and 3DCRT(outside) as fitting at outside of leaf tip. The leaf transmission factor and DLG of HD120 MLC for 6 and 10 MV X-ray decreased by 0.2% and 1 mm, respectively, compared to M120 MLC. The mean conformity index of PTV of treatment planning for prostate 3DCRT(middle), 3DCRT(outside) , and IMRT decreased by 0.9%, 6.6%, and 0.9% and the mean homogeneity index increased 2.3%, 13.0%, and 4.2%, respectively. The mean V20, V40, and V65 decreased by 2.4%, 6.6%, and 4.5% for bladder and 3.3%, 6.1%, and 5.9% for rectum, respectively. The results of this work demonstrated that the dose conformity of PTV improved and the dose of bladder and rectum decreased for 3DCRT and IMRT of prostate cancer using HD120 MLC compared to M120 MLC, because of reduction of leaf width, leaf transmission, and rounded leaf end transmission.

Accumulation of information about genetics and epigenetics has accelerated research investigating the inherent individual variation in cancer susceptibility. Gene polymorphisms, in particular single nucleotide polymorphisms, are being evaluated for their role in various cancers including prostate cancer. Especially, polymorphisms of hormone-related genes such as steroid-hormone receptors in prostate cancer have been recently focused and used in molecular epidemiology. In this article, we present data from the molecular epidemiology about Japanese prostate cancer using polymorphisms of hormone-related genes and offer suggestions for further research.

Even in the modern era of advanced external radiotherapy, brachytherapy is an important and useful modality of radiotherapy. In North America and Europe, it has been noted that the proportion of prostate cancer patients treated by HDR or LDR interstitial brachytherapy is rapidly increasing, as it offers several practical and theoretical advantages over external radiotherapy. HDR treatment with 192Ir remote afterloader provides an optimized dose distribution controlled by an accurate dwell time and position of 192Ir source. LDR brachytherapy is a simple, minimally invasive, and outpatient based procedure that avoids hospitalization and allows the patient an early recovery and rapid return to normal activities. It has produced good 10-year outcome with relatively low morbidity. Although in Japan this treatment was behind North America and Europe, the 125I-seed source was approved by the Japanese FDA and a rule for patient discharge was developed recently. The first case was treated in September 2003 and this treatment is expected to become an important option for early prostate cancer. Several areas of brachytherapy including treatment planning, choice of radionuclide, treatment procedure, and treatment outcome are discussed in this paper.

Although one-dimensional densitometry has been widely performed for linac dosimetry, it is a time-consuming, labor-intensive procedure. We studied a new densitometry system (DD-System) that consists of a personal computer and common flatbed-type scanner, with regard to its usefulness for daily QC checks in comparison with conventional densitometry. The spatial resolution of the DD-System is very high, and its accuracy of measurements of field size and flatness are equivalent to those of a conventional system at an optical density <2.0. Although the performance of the image scanner limits the maximum optical density of our system, this system can acquire high-resolution two-dimensional dose distributions quickly and easily. In conclusion, the DD-System is very useful for reducing the amount of time and effort required in daily QC activities. We consider this system applicable to the analysis of complicated dose distributions in this era of IMRT.

The optimal inhalation flow of dry powder formula fluticasone dipropionate (DFP) is not known. This study investigated the clinical effects of inhaling a flow of DFP. A randomized cross-over trial was applied to 13 patients with chronic persistent asthma. After a 2-week run-in period using the current dose of beclomethasone from a metered dose inhaler (BDP-run), BDP was replaced with an equipotent amount of DFP. The patients entered either an 8-week run with high-flow (> 100 L/min) inhalation followed by a 4-week run with medium-flow (70 L/min) (HM group) or a medium-flow run followed by a high-flow run (MH group). The peak inhaling flow from DFP was measured daily. The mean of the inhalation flow in the high-flow run (111.4 +/- 3.6 (SE) L/min) was significantly higher than that (77.3 +/- 0.6 L/min) in the medium-flow run. In both groups, morning and evening peak expiratory flows (PEFs) increased in the first week of change from BDP to DFP, peaking in the first 8-week run, then maintained this level until the end of the following 4-week run. When PEFs in the last week of the 3 runs were compared, those during the DFP-run of either flow were significantly larger than those during the BDP-run, but the PEFs during the high-flow and medium-flow runs were not significantly different. The asthma symptoms also improved with a change from BDP to DFP, but the symptoms did not change with a change in the inhalation flow rate. An inhaled flow of up to 111 L/min is acceptable in terms of clinical efficacy for the use of DFP.

To investigate the effects of exposure to styrene vapor on pregnancy, mice proved to be pregnant were exposed to 0, 2, 20 and 100 ppm styrene continuously for 24 hours during the period from day 0 to day 15 of gestation. A special small exposure chamber which can accurately maintain a constant low concentration of styrene vapor was made and used in the experiment. 1) In the 100 ppm group, hyperkinesis was presented in the chamber during the exposure period and inhibition of body weight gain was found (p < 0.01). No deaths occurred in any of the groups. 2) At necropsy of dams, no significant difference was found between the styrene exposed groups and the control group in any of the fertility indices, number of implantations, number of live fetuses, percentage of resorptions, or in the percentage of dead fetuses. The 100 ppm group showed lower fetal and placental weights (p < 0.01). 3) Gross necropsy of dams in the 100 ppm group showed significantly decreased adipose tissue. The liver, kidney and spleen weights were also low (p < 0.01). 4) When exposed to 100 ppm, which corresponds to 5 times the permissible concentration, i.e., 20 ppm, for 24 hours, non-pregnant dams showed no abnormality, while pregnant dams showed inhibition of body weight gain and significantly lower fetal and placental weights and maternal organ weights. Therefore, careful consideration should be given to exposure of women of childbearing age to styrene.

We report the case of a 63-year-old woman who developed cough and fever with migratory lung infiltrates three months after completion of right breast irradiation following conservative surgery. Lung infiltrates were initially localized in the irradiated area, but later spread to unirradiated areas in both lungs. No cause of migratory pneumonitis other than irradiation was found, and we clinically diagnosed this case as radiation-induced migratory pneumonitis similar to BOOP, without lung biopsy. Steroid therapy resulted incomplete resolution of lung infiltrates. The reported case clearly differed from typical radiation pneumonitis. We suggest that lung irradiation might trigger the development of migratory pneumonitis with a clinical pattern similar to that of BOOP.

Dry power steroid was firstly introduced in Japan in 1998. We measured peak inspiratory flow (PIF) through a Diskhaler in the following groups: well-trained medical representative (EX group, n = 5), respiratory physicians (RP group, n = 19) and non-medical staffs (NM group, n = 31) who were not familiar with Diskhaler, and asthmatic patients who had been briefly trained by a video movie (TP group, n = 93). When PIF was less than 50 l/m dry powders were frequently remained in the brister. The mean PIF in the EX group was 96.1 +/- 12.6 l/m (mean +/- SD). Since the relationship between the PIF and airway pressure (Paw) during Diskhaler use was expressed as PIF = 16.3 square root of Paw-1.19 (r = 0.97), we calculated PIF from Paw measured by a handy barometer made by ourselves. The mean PIF in RP group was 77.0 +/- 30.1 l/m, and 36.8% of the subjects developed inappropriate PIF (i.e., above 100 l/m or below 50 l/m). In NM group the mean PIF was 53.5 +/- 20.4 l/m which was significantly higher than RP group. In this group 54.8% of the subjects yielded inappropriate PIF. The mean PIF in TP group was 64.9 +/- 24.5 l/m which was significantly lower than that in RP group. Those who developed inappropriate PIF occupied 43.2% of the RP subjects. We concluded that a quantitative presentation of PIF in mandatory to achieve an effective use of Diskhaler.

Cancer treatment outcome should be evaluated not only with conventional parameters of survival, local control, and response rate, but with quality-of-life (QOL) based parameters. As radiation therapy is a treatment to eradicate cancer without resection of tissues or organs, a better functional or cosmetic result could be obtained compared with surgical treatment. If basically functional or cosmetic results are better, QOL of the patient could be expected to be even more superior. Patient QOL should be assessed from the physical, psychological, and social standpoints. So, adequate instruments or scoring systems are essential to obtain data. In this paper, we introduce an outline of QOL-related research activities in cancer treatment, especially in radiation therapy. We also attempt to assess the functional outcome and late complications, which would affect patient QOL. Finally, the concept of quality adjusted survival time or utility analysis is also mentioned.

The CD36 molecule is a multifunctional membrane type receptor glycoprotein that reacts with thrombospondin, collagen, oxidized LDL and long-chain fatty acids (LCFA). LCFA are one of the major cardiac energy substrates, hence LCFA metabolism may have an important role in cardiac diseases. In this study, we analyzed CD36 expression in 200 patients with heart diseases [44 patients with hypertrophic cardiomyopathy (HCM), 16 with dilated cardiomyopathy (DCM), 26 with old myocardial infarction (OMI), 55 with angina pectoris (AP) and 59 with other miscellaneous heart diseases] using a flow cytometer. 123I-beta-methyl-p-iodophenylpentadecanoic acid (BMIPP) myocardial accumulation was also examined in some patients. Eight patients (2 with HCM, 1 with DCM, 2 with OMI, and 3 with AP) were diagnosed as having type I CD36 deficiency (neither platelets nor monocytes expressed CD36). Sixteen patients (3 with HCM, 1 with DCM, 1 with OMI, 8 with AP, and 3 with other heart diseases) showed type II CD36 deficiency (monocytes expressed CD36 but platelets did not). In all 8 patients with type I CD36 deficiency, there was no BMIPP accumulation in the heart. However, in 13 patients with type II CD36 deficiency, focally reduced BMIPP accumulation was observed, but there were no patients without BMIPP accumulation. CD36 deficiency was observed in a higher proportion (12%) of patients with heart disease in this study than in a reported control study. Type I CD36 deficiency is associated with absence of BMIPP accumulation in the heart, hence it may have an important role in LCFA metabolic disorders and some types of cardiac hypertrophy as well as other heart diseases.

A 57 years old male consulted our hospital in complaining chest oppression and short of breath. Familial and dilated phase hypertrophic cardiomyopathy (HCM) was detected by ECG, echocardiography, left ventriculography and left ventricular endomyocardial biopsy. 201T1 SPECT showed regional increased accumulation in the ventricular septum, however, no myocardial accumulation of 123I-beta-methyl-p-iodophenylpentadecanoic acid (123I-BMIPP) was observed. We analyzed CD36 in this patient, and found he had type 1 CD36 deficiency. Myocardial uptake of long-chain fatty acids occurs via a specific transporter, which is homologous with human CD36. We hypothesize that CD36 deficiency, especially type 1 CD36 deficiency, might be one factor of no myocardial 123I-BMIPP uptake.

The characteristics of hyperventilation syndrome (HVS) were studied in 508 patients who visited our hospital over 11 years. Information regarding symptoms and laboratory data was collected from the clinical records, and outcome was surveyed with a questionnaire mailed to all patients. Patients with acute HVS ranged in age from 5-85 years, and acute HVS was particularly prevalent among women in their late teens. Triggers of HVS included anxiety, nausea & vomiting, and fever due to the common cold. The primary symptoms were dyspnea and numbness, but these differed from the symptoms that appeared during a provoked attack, Half of the patients had no underlying disorder, but the others were suffering from neurosis, cardiovascular disorders, or other diseases. These characteristics of acute HVS did not differ from those seen in patients in whom the diagnosis of HVS was confirmed with arterial blood gas analysis. Half of the patients recovered without treatment, and the others underwent paper-bag rebreathing or intravenous infusion of sedatives. The prevalence of chronic HVS was 2% and almost all those patients were middle-aged women. In contrast, the questionnaire revealed that half of the patients had repeated HVS attacks. In 10% of the patients, these attacks persisted for more than 3 years. Many of these patients reported that they sighed frequently and felt air hunger while in remission. These findings were compatible with the criteria for chronic HVS. Therefore, it may be possible to diagnose HVS from symptoms alone, without hyperventilation provocation tests. In conclusion, these data underscore the importance of clinical symptoms in the diagnosis of HVS.

Asthmatic patients are sometimes ignorant of their treatment and of the pathophysiology of their disease. In such patients, anxiety about the disease may worsen their condition. We studied the effects of an educational program for bronchial asthma. In 45 patients, the Severity of Asthma Scores before and after the program were measured. Sixty percent of the patients were assessed as "improved". On self-administered questionnaires concerned with asthma, most of the patients indicated that the program significantly improved their condition, reduced apprehension about the disease, and increased their trust in the hospital. In 24 patients, three psychological tests were done. Results of the comprehensive asthma inventory indicated that the program was useful for dependent and self-disciplined patients, but was not useful for resigned and depressed patients. The Y-G test showed that most of the patients who were helped by the program were introverted. Results of the Edwards Personal Preference Schedule revealed a difference in desire between the group that benefitted from the program and the group that did not. These results suggest that each group had a certain inclination toward psychogenic symptoms. Therefore, psychological tests are useful for predicting the effects of education. In conclusion, educational programs for patients with bronchial asthma may affect morbidity from asthma. Possible mechanisms include relief of anxiety about the disease and improvement in the patient's compliance with prescribed therapy.

Contraction of tracheal smooth muscle during mechanically induced coughing was studied in dogs. Recordings of smooth muscle tension were obtained from the cervical trachea, which is not influenced by intrathoracic pressure. We observed that during breathing at rest, tracheal smooth muscle contracts and relaxes in synchrony with phrenic nerve activity. When cough occurs, the tracheal smooth muscle contracts continuously and tonically with no rhythmic correlation to phrenic nerve activity. Sometimes the contraction starts before the phrenic nerve activity increases. A neuromuscular blocking agent caused a significant decrease in phrenic nerve activity in response to mechanical stimulation. The correlation between phrenic nerve activity and tracheal smooth muscle tension during normal breathing was also observed after afferent inputs from pulmonary mechanoreceptors were interrupted. During coughing, however, this correlation was lost. From these results we conclude that the neural control of tracheal smooth muscle is at least partially independent of phrenic nerve activity during coughing. Because coughing was attenuated by neuromuscular blocking agents, we speculate that there is a positive feedback mechanism from receptors in the chest wall or airway, which increases the magnitude of coughing.

This study reported the radiation induced apoptosis in 6 cases with malignancies that were observed rapid tumor regression with radiotherapy up to 10 Gy. Microscopic examinations of 6 cases revealed the tumor cell number reduction and the appearance of apoptotic cells in the irradiated cases. It is suggested that the radiation-induced apoptosis plays an important role in rapid tumor regression by radiotherapy and occurs not only in lymphoma which has been recently reported in vitro but also in carcinoma.

A survey of intestinal parasites was conducted on 198 foreign workers aged 19-27 from Inodonesia and Philippines. They work for a private company in Ishikawa Prefecture as technical trainee. On the base of stool examination, 94 (71%) out of 133 Indonesians and 48 (74%) of 65 Filipinos had intestinal helminths and/or protozoan infections. The prevalence of Ascaris lumbricoides, Trichuris trichura and Hookworm was 4.5, 64.1, 10.6%, respectively. In addition, the positive rate of the cyst of Entamoeba coli, Endolimax nana, Blastocystis hominis and Giardia lumblia was 11.1, 5.6, 4.5 and 2.0%, respectively. No E. histolytica was found; however, counter current immunoelectrophoresis revealed that one out of 112 sera possessed the antibody against the antigen of HK-9 strain of E. histolytica. Sixty-three cases of trichuriasis were treated with mebendazole at a dose of 200 mg/day x 3 consecutive days. Re-examination revealed that 53 (85.5%) of them were cured.

The alteration ratio of lung field CT numbers in different respiratory phases was studied in 52 patients with chronic pulmonary obstructive disease (COPD) and 20 subjects with normal lung. The 52 patients with COPD consisted of 30 with clinically diagnosed chronic pulmonary emphysema (CPE), 15 with suspected CPE (sCPE) and seven with bronchial asthma (BA). The 20 subjects with normal lung were divided into two groups according to age. CT images were obtained in each case under different respiratory conditions, i.e., full inspiration and end expiration. The following parameters were employed for numerical evaluation: %(I-E)Apex = (MLDApexI-MLDApexE/MLDApexE x 100 %(I-E)Mid = (MLDMidI-MLDMidE)/MLDMidE x 100 %(I-E)Base = (MLDBaseI-MLDBaseE)/MLDBaseE x 100 %(I-E)Whole = (MLDWholeI-MLDWholeE)/MLDWholeE x 100 where MLD is mean lung density and the letters I and E stand for full inspiration and end expiration, respectively. The small letters Apex, Mid, Base and Whole stand for apex cut, mid-thorax cut, base cut and whole lung, respectively. The values of %(I-E)Whole were significantly different between disease groups except for those between the sCPE and BA groups. The values of %(I-E)Whole showed a good positive correlation with FEV1.0% (r = 0.79) and V25/H (r = 0.80) and a good negative correlation RV/TLC (r = -0.75). Diagnostic differentiation of COPDs by %(I-E)Whole values identified 80% of CPE cases and 91% of normal lung cases. In the sCPE group, the values of %DLco in patients with %(I-E)Whole above 9% were smaller than those in patients with %(I-E)Whole under 9%.(ABSTRACT TRUNCATED AT 250 WORDS)

High-resolution computed tomography (HR-CT) was performed on 20 patients with pyrophilitosis. Small nodular opacities in these patients could be divided by HR-CT into two types, namely, tiny irregular branching structures (TIB) and small round opacities (SRO). TIB had a centrilobular distribution and were characteristic of pyrophillitosis. SRO had both centrilobular and perilobular distributions and were considered to be changes modified by the aspiration of silica. Large opacities (LO) of pyrophillitosis were classified into three types, that is, spherical type, flat type parallel to the bronchus and flat type parallel to the thoracic wall. The spherical type was seen in patients exposed to both pyrophillite and silica, while the flat types were seen in patients exposed to only pyrophillite and were characteristic opacities of pyrophillitosis. Pulmonary emphysema was found in only one patient with pyrophillitosis, whereas mediastinal lymph node swelling and calcification were seen in most patients with pyrophillitosis. HR-CT is useful in making a more accurate evaluation of these lesions.

In the course of a search for novel antibiotics, an antiplatelet substance was isolated from the fermentation broth of Streptomyces sp. No. 82-85. Thereafter, the active substance was identified as pyrrole-2-carboxylic acid (P2C) by structural studies. The effects of P2C on adenosine diphosphate (ADP)-, arachidonic acid-, collagen- or tumor cell-induced platelet aggregation were examined in vitro and ex vivo. In in vitro studies, P2C (25-100 micrograms/ml) suppressed the aggregation of platelets of normal Wistar rats. The intraperitoneal administration of P2C (200 mg/kg) to rats and rabbits suppressed platelet aggregation induced by ADP, arachidonic acid and collagen when examined for 0.5-3 hours after administration. The agent also suppressed platelet aggregation induced by both mouse syngenic tumors, Meth-A fibrosarcoma and IMC carcinoma in vitro.

Antitumor activity of Juzen-Taiho-Toh (JTX) and combination effect of JTX with antitumor agents were studied using murine tumors. In order to determine the antitumor activity of JTX, mice inoculated ip with IMC carcinoma (1 X 10(6) cells/CDF1 mouse), sarcoma-180(1 X 10(6) cells/ICR mouse) or Meth-A fibrosarcoma (1 X 10(6) cells/BALB/c mouse) were treated with JTX (12.5-50 mg/kg/day) ip on day 1 through day 10, and the survival days of mice were examined. Treatment with 25 mg/kg/day produced 38.7% increase of life span against IMC carcinoma. However, no antitumor effect was observed on solid form of these tumors by the daily treatment with JTX. Combination effect of JTX and antitumor agents was also examined. ICR mice inoculated sc with 1 X 10(6) cells of sarcoma-180 on day 0 were treated with JTX (2,000 mg/kg/day) po on day-7 through day 30. In addition, some of these groups received mitomycin C (5 mg/kg), cytoxan (67 mg/kg) or adriamycin (2.5 mg/kg) iv on days 3, 8 and 11, and the size of tumor grown in sc site was measured by a caliper. In combination with JTX, mitomycin C resulted in a significantly greater tumor growth inhibition than could be obtained with mitomycin C alone. Secondly, BALB/c or C57BL/6 mice inoculated sc with 1 X 10(4) cells of Meth-A fibrosarcoma or 1 X 10(5) cells of B16 melanoma on day 0 were treated with JTX (2,000 mg/kg/day) po on day 1 through day 30. Some of these group received ip with mitomycin C (3 mg/kg), adriamycin (2 mg/kg), 5-FU (33 mg/kg) or cytoxan (67 mg/kg) on days 3, 6, 9, 12, 15 and 18. From this result, the group treated with JTX and mitomycin C also showed a higher tumor-growth inhibition. Thus, a combination of a high dose of mitomycin C with JTX was more effective than mitomycin C alone.

A prospective randomized study for the analysis of optimal schedule for the patients with bone metastases was performed. From February 1986 through January 1987, a total of 131 patients entered on this trial. The data from 129 patients out of 131 were available for the analysis of prognostic factors by Cox's regression model. As a whole, it was clear that first significant prognostic factor was urinary hydroxyproline/creatinine ratio (p = 0.0001), second primary site (p = 0.0001), third pain score (p = 0.0005) and fourth other organ metastasis except bone (p = 0.0006). In the group of lung cancer, first significant prognostic factor was urinary hydroxyproline/creatinine ratio (p = 0.0007), second multiplicity of bone metastasis (p = 0.0113), and third pain score (p = 0.0270).

During the period between 1972 and 1978, 226 patients were operated on for carcinoma of the uterine cervix at Hiroshima University, and 91 patients were treated by postoperative external irradiation. Patients with lymph node metastasis showed markedly lower five-year survival rates stage I: 44.4%; stage II: 45.0%) than those without lymph node metastasis (99.3% and 84.0%, respectively). In view of benefits of postoperative radiotherapy in the treatment of cervical cancer, only to the node positive and tumor rest patients is recommended.