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Purpose: In this study, we aimed to develop an application that computes dose values resembling diagnostic reference level (DRL) conditions when disparity prevents direct dose comparisons between the national diagnostic reference levels in Japan 2020 (Japan DRLs_2020) and facility-specific computed tomography (CT) protocols., Methods: We developed an application using the R programming language and RStudio software that computes dose values and median values based on Japan DRLs_2020 imaging conditions following extraction of necessary information for dose calculations from the Radiation Dose Structured Report (RDSR) and Digital Imaging and Communications in Medicine (DICOM) tags. To ensure a user-friendly experience, we used the Shiny package to develop a graphical user interface that enables the application to operate seamlessly in web browsers., Results: The developed application successfully facilitated the calculation of dose and median values that aligned with the Japan DRLs_2020 for protocols whose imaging range and acquisition timing differed from those of the Japan DRLs_2020., Conclusion: By calculating dose values that align with DRL conditions, our application contributes to the implementation and optimization of dose management in CT for facilities that use diverse imaging protocols.

Tazobactam/piperacillin (TAZ/PIPC) is widely used in the treatment of infectious disease. In this study, three hundred and sixty-three patients who were treated with the recommended dose of TAZ/PIPC were investigated for the proportion of time above the minimum inhibitory concentration (%TAM) and the frequency of renal and liver dysfunction. Of the whole patient population, 5.23%, exhibited increased creatinine levels, 9.37% and 8.82% exhibited increased aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels, respectively. The patients who exhibited high serum creatinine (SCr) levels before administration, exhibited significant increases of AST (p=0.0121). The patients who exhibited low albumin levels before administration, exhibited significant decreases in renal function (p=0.0041). In the case of a breakpoint (BP) of 64 μg/mL, the arrival probabilities of %TAM of 30% and 50% were 99.4% and 76.9%, respectively. We suggested that the dose of TAZ/PIPC should be adjusted according to the interview form finding and a %TAM>50% (maximal bactericidal action).

A 74-year-old-woman who had never smoked was diagnosed in 2004 with cT3N2M1, stage IV primary pulmonary adenocarcinoma. After seven courses of chemotherapy with carboplatin and paclitaxel, she was given gefitinib as second-line therapy and made satisfactory progress. However, gefitinib was discontinued after 3 years of treatment due to re-growth of the tumors. She was then given chemotherapy with docetaxel as a third-line therapy. Over the course of time, meningeal carcinomatosis occurred in conjunction with her previous disease. Upon re-treatment with gefitinib, her meningeal carcinomatosis showed some improvement despite the growing primary tumor, so her QOL was improved. She is now visiting a hospital as an outpatient. When analysis of the EGFR gene mutant was conducted, deletion mutation of E746-A750 in exon 19 was revealed in the 2004 pulmonary tissue, as well as the cytological examination of cerebrospinal fluid and pulmonary tissue after recurrence. No change has been observed. Once gefitinib proved effective, re-treatment with gefitinib was considered useful after its discontinuation.

A radioimmunoassay kit (SHIONORIA P-PLA2) to measure human serum pancreatic phospholipase A2 (P-PLA2) concentrations was evaluated for their basic properties and clinical usefulness. The performance of the kit was found to be quite satisfactory. To test its clinical usefulness, specimens mainly from patients with pancreatic diseases were obtained and examined for serum P-PLA2 levels. All serum specimens from patients with acute pancreatitis (n = 7) were found to have elevated levels of serum P-PLA2. In patients with chronic pancreatitis (n = 93) and pancreatic cancer (n = 37), serum P-PLA2 levels showed a wide range of distribution, from abnormally elevated values to abnormally low values. We compared these data with those of other pancreatic markers such as: amylase, elastase 1, trypsin, and PSTI. Among these, P-PLA2 was highly specific to pancreatic disease and best represented the state of pancreatic disorders. Abnormally elevated levels of serum P-PLA2 concentrations seem to reflect the inflammation of pancreas, while abnormally low levels indicate the hypofunction of pancreatic exocrine glands. These results suggest that the measurement of serum P-PLA2 concentrations is a useful diagnostic test for pancreatic disorders.