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Backgrounds: Anastomotic leakage (AL) represents a major complication after rectal low anterior resection (LAR). Transanal drainage tube (TDT) placement offers a potential strategy for AL prevention; however, its efficacy and safety remain contentious. Methods: A systematic review and meta-analysis were used to evaluate the influence of TDT subsequent to LAR as part of the revision of the surgical site infection prevention guidelines of the Japanese Society of Surgical Infectious Diseases (PROSPERO registration; CRD42023476655). We searched each database, and included randomized controlled trials (RCTs) and observational studies (OBSs) comparing TDT and non-TDT outcomes. The main outcome was AL. Data were independently extracted by three authors and random-effects models were implemented. Results: A total of three RCTs and 18 OBSs were included. RCTs reported no significant difference in AL rate between the TDT and non-TDT groups [relative risk (RR): 0.69, 95% confidence interval (CI) 0.42–1.15]. OBSs reported that TDT reduced AL risk [odds ratio (OR): 0.45, 95% CI 0.31–0.64]. In the subgroup excluding diverting stoma (DS), TDT significantly lowered the AL rate in RCTs (RR: 0.57, 95% CI 0.33–0.99) and OBSs (OR: 0.41, 95% CI 0.27–0.62). Reoperation rates were significantly lower in the TDT without DS groups in both RCTs (RR: 0.26, 95% CI 0.07–0.94) and OBSs (OR: 0.40, 95% CI 0.24–0.66). TDT groups exhibited a higher anastomotic bleeding rate only in RCTs (RR: 4.28, 95% CI 2.14–8.54), while shorter hospital stays were observed in RCTs [standard mean difference (SMD): −0.44, 95% CI −0.65 to −0.23] and OBSs (SMD: −0.54, 95% CI −0.97 to −0.11) compared with the non-TDT group. Conclusions: A universal TDT placement cannot be recommended for all rectal LAR patients. Some patients may benefit from TDT, such as patients without DS creation. Further investigation is necessary to identify the specific beneficiaries. [ABSTRACT FROM AUTHOR]

A correction for the article "A multicenter retrospective study of the risk factors associated with medication‑related osteonecrosis of the jaw after tooth extraction in patients receiving oral bisphosphonate therapy" is presented, published in the April13, 2023, issue of the periodical.

The mapping of available water–ice is a crucial step in the lunar exploration missions. Ground penetrating radars have the potential to map the subsurface structure and the existence of water–ice in terms of the electromagnetic properties, specifically, the permittivity. Slight differences in permittivity can be significantly important when applied in a dry environment, such as on the Moon and Mars. The capability of detecting a small fraction of putative water–ice depends on the permittivity changes in terms of its dependent parameters, such as the frequency, the temperature, the porosity, and the chemical composition. Our work aims at mitigating false detection or overlooking of water–ce by considering their conditions that previous researches did not cover. We measured the permittivity of different lunar regolith relevant analogue samples with a fixed 40 % porosity in the ultra-high-frequency–super-high-frequency band. We used the coaxial probe method to measure anorthosite, basalt, dunite and ilmenite at 20 ∘ C , - 20 ∘ C and - 60 ∘ C , and we find that, at - 60 ∘ C , the permittivity decreases about 6–18 % compared with the values at 20 ∘ C . Within this temperature range, the permittivity is quite similar to the permittivity of water–ice. We find that the conventional calculation would overestimate the permittivity in the low temperature areas, such as the permanently shadowed regions. We also find that each component in the lunar regolith has different temperature-dependent permittivity, which might be important for radar data analysis to detect lunar polar water–ice. Our results also suggest that it should be possible to estimate the water–ice content from radar measurements at different temperatures given an appropriate method. [ABSTRACT FROM AUTHOR]

The metal-insulator transition (MIT), a fascinating phenomenon occurring in some strongly correlated materials, is of central interest in modern condensed-matter physics. Controlling the MIT by external stimuli is a key technological goal for applications in future electronic devices. However, the standard control by means of the field effect, which works extremely well for semiconductor transistors, faces severe difficulties when applied to the MIT. Hence, a radically different approach is needed. Here, we report an MIT induced by resonant tunneling (RT) in double quantum well (QW) structures of strongly correlated oxides. In our structures, two layers of the strongly correlated conductive oxide SrVO3 (SVO) sandwich a barrier layer of the band insulator SrTiO3. The top QW is a marginal Mott-insulating SVO layer, while the bottom QW is a metallic SVO layer. Angle-resolved photoemission spectroscopy experiments reveal that the top QW layer becomes metallized when the thickness of the tunneling barrier layer is reduced. An analysis based on band structure calculations indicates that RT between the quantized states of the double QW induces the MIT. Our work opens avenues for realizing the Mott-transistor based on the wave-function engineering of strongly correlated electrons. The metal-insulator transition is typically controlled by carrier accumulation or chemical doping. Here, the authors realize an alternative method based on resonant tunnelling in a double quantum well structure of strongly correlated oxides, which offers practical advantages over conventional methods. [ABSTRACT FROM AUTHOR]

BepiColombo is a joint mission between the European Space Agency, ESA, and the Japanese Aerospace Exploration Agency, JAXA, to perform a comprehensive exploration of Mercury. Launched on 20 th October 2018 from the European spaceport in Kourou, French Guiana, the spacecraft is now en route to Mercury. Two orbiters have been sent to Mercury and will be put into dedicated, polar orbits around the planet to study the planet and its environment. One orbiter, Mio, is provided by JAXA, and one orbiter, MPO, is provided by ESA. The scientific payload of both spacecraft will provide detailed information necessary to understand the origin and evolution of the planet itself and its surrounding environment. Mercury is the planet closest to the Sun, the only terrestrial planet besides Earth with a self-sustained magnetic field, and the smallest planet in our Solar System. It is a key planet for understanding the evolutionary history of our Solar System and therefore also for the question of how the Earth and our Planetary System were formed. The scientific objectives focus on a global characterization of Mercury through the investigation of its interior, surface, exosphere, and magnetosphere. In addition, instrumentation onboard BepiColombo will be used to test Einstein's theory of general relativity. Major effort was put into optimizing the scientific return of the mission by defining a payload such that individual measurements can be interrelated and complement each other. [ABSTRACT FROM AUTHOR]

Background: The internal strain distribution developing during plastic deformation is important for understanding the mechanical properties of polycrystalline materials. Such distributions may be determined by the microstructural feature tracking method. However, the strain accuracy and the sources of uncertainty of this method are not well quantified yet. Objective: Evaluate the accuracy of local strain determination based on laboratory-based multimodal X-ray tomography measurements. Methods: The plastic deformation behavior of a particle-contained fully recrystallized Al-4mass%Cu alloy was characterized during in-situ tensile testing using absorption contrast tomography to reveal marker particles and diffraction contrast tomography to reveal the grain structure. Results: It was found that the accuracy in strain measurement is inversely proportional to the particle distance, whereas it is independent of the particle size, and the accuracy is not biased by grain boundaries. As an illustrative example, the preliminary analysis of the microstructure-strain relationships reveals significant strain differences both between and within individual grains. Conclusions: The results document the validity and limitations of the microstructural feature tracking method for local strain measurements using a laboratory X-ray source, are of importance for local strain analysis in general and may be considered as an alternative to other methods, e.g. digital image correlation. The measurements allow evaluation of effects of the grain microstructure on the local strain development during plastic deformation. By a preliminary analysis of the strain difference between two selected grains, it is suggested that the grain shape and crystallographic relationships between neighboring grains are of importance for the development of local strains. [ABSTRACT FROM AUTHOR]

Nonlinear damping with respect to vibration amplitude is particularly important in mechanical dynamics. The addition of short fibers to damping materials is considered to result in strong nonlinear damping due to interfacial peeling at the edges of the fibers. However, little has been reported on the occurrence of nonlinear damping in short-fiber reinforced rubber due to compounding difficulties. In this study, we investigated the relationship between the damping characteristics and deformation behavior of microdeformed short-fiber reinforced rubber by X-ray computed tomography (CT). We prepared a damping material with a natural rubber (NR) matrix and micrometer-sized polyethylene terephthalate (PET) fiber filler. The loss factor was identified by dynamic mechanical analysis, and three-dimensional strain maps were obtained using marker tracking in the CT data. The addition of 5 wt% PET fibers to NR resulted in an increase in the loss factor. Experimentally, we found that the nonlinear damping of the composite rubber is affected by the peeling of the filler/matrix interface and the strain inside the material. [ABSTRACT FROM AUTHOR]

An AgGaTe2 layer was prepared using an Ag2Te buffer layer. Ag2Te layers were deposited by the radio-frequency sputtering method. We investigate the variations in the Ag2Te buffer layer surface morphology and composition that take place during annealing. Ag2Te films were annealed in a tube furnace. The composition and surface morphology of the Ag2Te layer were found to vary depending on the thermal annealing temperature and duration. It was confirmed that a dewetting process in the Ag2Te layer occurred with annealing between 200°C and 500°C, and O2 and Mo reacted at 600°C and then became MoO3 compounds. Mo and Te were completely desorbed from the surface at 700°C. This confirmed that the surface morphology of the Ag2Te layer was controlled by the annealing temperature and duration. [ABSTRACT FROM AUTHOR]

Summary: Root amputation, immunosuppressive therapy, mandibular tooth extraction, pre-existing inflammation, and longer duration of treatment with bone-modifying agents were significantly associated with an increased risk of medication-related osteonecrosis of the jaw. Hopeless teeth should be extracted without drug holiday before the development of inflammation in cancer patients receiving high-dose bone-modifying agents.Introduction: No studies have comprehensively analyzed the influence of pre-existing inflammation, surgical procedure-related factors such as primary wound closure, demographic factors, and drug holiday on the incidence of medication-related osteonecrosis of the jaw (MRONJ). The purpose of this study was to retrospectively investigate the relationships between these various factors and the development of MRONJ after tooth extraction in cancer patients receiving high-dose bone-modifying agents (BMAs) such as bisphosphonates or denosumab.Methods: Risk factors for MRONJ after tooth extraction were evaluated with univariate and multivariate analyses. The following parameters were investigated in all patients: demographics, type and duration of BMA use, whether BMA use was discontinued before tooth extraction (drug holiday), the duration of such discontinuation, the presence of pre-existing inflammation, and whether additional surgical procedures (e.g., incision, removal of bone edges, root amputation) were performed.Results: We found that root amputation (OR = 22.62), immunosuppressive therapy (OR = 16.61), extraction of mandibular teeth (OR = 12.14), extraction of teeth with pre-existing inflammation, and longer duration (≥ 8 months) of high-dose BMA (OR = 7.85) were all significantly associated with MRONJ.Conclusions: Tooth extraction should not necessarily be postponed in cancer patients receiving high-dose BMA. The effectiveness of a short-term drug holiday was not confirmed, as drug holidays had no significant impact on MRONJ incidence. Tooth extraction may be acceptable during high-dose BMA therapy until 8 months after initiation. [ABSTRACT FROM AUTHOR]

The minimal ingredients to explain the essential physics of layered copper-oxide (cuprates) materials remains heavily debated. Effective low-energy single-band models of the copper-oxygen orbitals are widely used because there exists no strong experimental evidence supporting multi-band structures. Here, we report angle-resolved photoelectron spectroscopy experiments on La-based cuprates that provide direct observation of a twoband structure. This electronic structure, qualitatively consistent with density functional theory, is parametrised by a two-orbital (dx2-y2 and dz2 ) tight-binding model. We quantify the orbital hybridisation which provides an explanation for the Fermi surface topology and the proximity of the van-Hove singularity to the Fermi level. Our analysis leads to a unification of electronic hopping parameters for single-layer cuprates and we conclude that hybridisation, restraining d-wave pairing, is an important optimisation element for superconductivity. [ABSTRACT FROM AUTHOR]

Summary: Root amputation, extraction of a single tooth, bone loss or severe tooth mobility, and an unclosed wound were significantly associated with increased risk of developing medication-related osteonecrosis of the jaw (MRONJ). We recommend a minimally traumatic extraction technique, removal of any bone edges, and mucosal wound closure as standard procedures in patients receiving bisphosphonates. Introduction: Osteonecrosis of the jaws can occur following tooth extraction in patients receiving bisphosphonate drugs. Various strategies for minimizing the risk of MRONJ have been advanced, but no studies have comprehensively analyzed the efficacy of factors such as primary wound closure, demographics, and drug holidays in reducing its incidence. The purpose of this study was to retrospectively investigate the relationships between these various risk factors after tooth extraction in patients receiving oral bisphosphonate therapy. Methods: Risk factors for MRONJ after tooth extraction were evaluated using univariate and multivariate analysis. All patients were investigated with regard to demographics; type and duration of oral bisphosphonate use; whether they underwent a discontinuation of oral bisphosphonates before tooth extraction (drug holiday), and the duration of such discontinuation; and whether any additional surgical procedures (e.g., incision, removal of bone edges, root amputation) were performed. Results: We found that root amputation (OR = 6.64), extraction of a single tooth (OR = 3.70), bone loss or severe tooth mobility (OR = 3.60), and an unclosed wound (OR = 2.51) were significantly associated with increased risk of developing MRONJ. Conclusions: We recommend a minimally traumatic extraction technique, removal of any bone edges, and mucosal wound closure as standard procedures in patients receiving bisphosphonates. We find no evidence supporting the efficacy of a pre-extraction short-term drug holiday from oral bisphosphonates in reducing the risk of MRONJ. [ABSTRACT FROM AUTHOR]

We aim to use light detection and ranging (LIDAR) to detect dust grains that might be present around asteroid (162173) Ryugu (1999 JU), the target of the Hayabusa2 mission. LIDAR is currently used for observing atmospheric aerosols on Earth by measuring the time profile of the return pulse (received light). In the case of Hayabusa2, LIDAR will be used only to determine whether the energy flux of the return pulse exceeds a certain threshold every 133.33 ns. This simplification significantly reduces the amount of down link data. The profile of the return pulse is estimated from iterative observations by changing the thresholds. Here, the performance of the dust counter mode is examined using a breadboard model, a flight model, and an engineering model. For these tests, we develop a new testing device to simulate various time profiles of the return pulse. We also estimate the lower bound of the number density of dust grains that can be detected. It is shown that the LIDAR on board Hayabusa2 is capable of detecting asteroidal dust if dust grains with size similar to the Hayabusa sample exist around the target body and their number density exceeds $10^{5}~\mbox{m}^{-3}$ . [ABSTRACT FROM AUTHOR]

The Small Carry-on Impactor (SCI) equipped on Hayabusa2 was developed to produce an artificial impact crater on the primitive Near-Earth Asteroid (NEA) 162173 Ryugu (Ryugu) in order to explore the asteroid subsurface material unaffected by space weathering and thermal alteration by solar radiation. An exposed fresh surface by the impactor and/or the ejecta deposit excavated from the crater will be observed by remote sensing instruments, and a subsurface fresh sample of the asteroid will be collected there. The SCI impact experiment will be observed by a Deployable CAMera 3-D (DCAM3-D) at a distance of ∼1 km from the impact point, and the time evolution of the ejecta curtain will be observed by this camera to confirm the impact point on the asteroid surface. As a result of the observation of the ejecta curtain by DCAM3-D and the crater morphology by onboard cameras, the subsurface structure and the physical properties of the constituting materials will be derived from crater scaling laws. Moreover, the SCI experiment on Ryugu gives us a precious opportunity to clarify effects of microgravity on the cratering process and to validate numerical simulations and models of the cratering process. [ABSTRACT FROM AUTHOR]

Background: This study aimed to demonstrate the noninferior efficacy of TachoSil vs. TachoComb in Japanese patients undergoing liver resection and to assess the safety of TachoSil vs. TachoComb in these patients. Methods: This randomized, double-blind, noninferiority study (JapicCTI-090684) involved participants scheduled for liver resection/living donors (age ≥ 20 years). TachoSil or TachoComb (1:1 allocation ratio) was applied to control persistent exudative bleeding after primary hemostasis during liver resection/removal for donation. The primary outcome was hemostasis 5 min after study treatment application. The 95% confidence interval (CI) for the difference in the proportion of participants with hemostasis 5 min after application of TachoSil/TachoComb was determined; noninferiority of TachoSil was indicated if the lower limit of the CI was ≥−14%. Adverse events (AEs) were recorded. Results: All participants in the efficacy analysis (TachoSil: 54/54, 100%; TachoComb: 54/54, 100%) achieved hemostasis 5 min after study treatment application. Therefore, TachoSil was noninferior to TachoComb. All participants experienced ≥1 AE; however, none discontinued because of an AE. Most (≥97.8%) AEs were mild or moderate in severity. Conclusions: These findings confirm the safety profile and noninferior hemostatic efficacy of TachoSil compared with TachoComb. [ABSTRACT FROM AUTHOR]

Harmful animal controls on spotted seals on Rebun Island have been conducted each spring since 2010 due to an increase in the number of seals and damage to local fisheries. To evaluate the influences of controls on seals, we used the numbers of haul-out sites and hauled-out seals, and photo-identification to study differences in the usage patterns of haul-out sites by seals before and after controls. As a result, two major changes were confirmed. Firstly, in spring after controls, the numbers of hauled-out seals at Northern Rebun (NR) greatly decreased, while at Bensashi (Ben) on the southern side of Rebun they greatly increased, compared to spring prior to controls. Secondly, the number of identified seals observed at both NR and Ben (NR-Ben) increased after controls, while most of the seals that changed to NR-Ben after controls were observed only at NR (NR-NR) before controls. Additionally, most of the seals using NR-Ben were observed year-round. The controls had a direct influence on reducing the numbers of seals in the controls area mainly during the period of controls. However, many seals that avoided the controls area used other haul-out sites, and the numbers of year-round-seals on Rebun increased after controls. [ABSTRACT FROM AUTHOR]

Cancer cells gain a growth advantage through the so-called Warburg effect by shifting glucose metabolism from oxidative phosphorylation to aerobic glycolysis. Hypoxia-inducible factor 1 (HIF-1) has been suggested to function in metabolic reprogramming; however, the underlying mechanism has not been fully elucidated. We found that the aberrant expression of wild-type isocitrate dehydrogenase 3α (IDH3α), a subunit of the IDH3 heterotetramer, decreased α-ketoglutarate levels and increased the stability and transactivation activity of HIF-1α in cancer cells. The silencing of IDH3α significantly delayed tumor growth by suppressing the HIF-1-mediated Warburg effect and angiogenesis. IDH3α expression was associated with the poor postoperative overall survival of lung and breast cancer patients. These results justify the exploitation of IDH3 as a novel target for the diagnosis and treatment of cancers. [ABSTRACT FROM AUTHOR]

Chronic granulomatous disease (CGD), a primary immunodeficiency caused by impaired phagocyte killing of intracellular pathogens, is characterized by recurrent, life-threatening, bacterial and fungal infections. As a result of improvements in microbiologic culture and identification techniques, a number of unique filamentous fungi have been reported as significant pathogens in patients with CGD. We report a case of subcutaneous basidiomycete Phellinus mori infection in a patient with CGD. To the best of our knowledge, this is the first reported case of human infection by this fungus. The causative fungus was identified on the basis of its morphological characteristics and nucleotide sequence on the internal transcribed spacer region of the ribosomal RNA gene. This is the fifth case report of filamentous basidiomycetes infecting a patient with CGD; all of these cases have been caused by Phellinus species. We highlight the importance of recognizing filamentous basidiomycetes Phellinus species as possible agents of non- Aspergillus fungal infections in patients with CGD. [ABSTRACT FROM AUTHOR]

The CD40/CD154 co-stimulatory pathway is crucial in alloimmune response. We developed a novel small interfering RNA (siRNA) delivery system with a poly-dA extension at the 5′-end of the siRNA sense strand that was stably incorporated into 1,3-β-glucan (schizophyllan, SPG). This was captured and incorporated into dendritic cells (DCs) through its receptor, Dectin-1, specifically silencing CD40 genes (siCD40) to exert immunoregulatory activity. siCD40/SPG-treated CBA mice permanently accepted B10 fully mismatched cardiac allografts. Consistent with graft survival, the infiltration of CD4+, CD8+ T cells into the graft was lower, and that the numbers of CD40lowCD11c+ DCs cells and CD4+Foxp3+cells were increased in both the graft and in the recipient spleen. In addition, naive CBA recipients given an adoptive transfer of splenocytes from the primary recipients with siCD40/SPG accepted a heart graft from donor-type B10, but not third-party Balb/c mice. In conclusion, the treatment with siCD40/SPG targeting DCs could generate antigen-specific Tregs, resulting in the permanent acceptance of mouse cardiac allografts. These findings have important implications for clarifying the mechanism underlying the induction of tolerance in DCs, and also highlight the potential of immunomodulation and the feasibility of siRNA-based clinical therapy in the transplantation field. [ABSTRACT FROM AUTHOR]

Purpose: This study was performed to investigate important factors of exercise therapies for diabetes patients in Japan. Methods: Subjects were 5,100 patients with type 2 diabetes mellitus. Data from 3,685 patients (88.2 % effective answer rate) who answered the question whether they are performing exercise therapy or not by the questionnaire were analyzed. We used multiple logistic regression analysis to assess the factors associated with exercise therapy in diabetes patients. Results: Exercise and non-exercise therapy groups had 1,926 and 1,759 patients, respectively. The HbA1c level of the exercise therapy group was significantly lower than that in the non-exercise therapy group. The multivariate odds ratios (ORs) of possible factors affecting the exercise therapy group adjusted for age, gender, BMI and living area were as follows: frequency of exercise therapy guidance [OR = 1.89, 95 % confidence interval = 1.40-2.56; reference group (ref.): no exercise therapy guidance], detailed exercise prescription such as type (1.32, 1.08-1.61), frequency (1.60, 1.24-2.06) and duration (1.63, 1.32-2.01; ref.: no exercise prescription), patients who enjoy physical exercise (4.85, 2.97-7.93; ref.: patients who dislike physical exercise) and high level of physical activity (2.31, 1.77-3.03; ref.: low level of physical activity). Conclusion: The results of the current study showed that, concerning exercise therapy education, it is important to maintain the motivation of the patients to participate in exercise therapies, to increase the frequency of guidance, and to provide more detailed exercise prescription such as frequency and duration. [ABSTRACT FROM AUTHOR]

Aims/hypothesis: T helper type (Th) 17 cells have been shown to play important roles in mouse models of several autoimmune diseases that have been classified as Th1 diseases. In the NOD mouse, the relevance of Th1 and Th17 is controversial, because single-cytokine-deficient NOD mice develop diabetes similarly to wild-type NOD mice. Methods: We studied the impact of IL-17/IFN-γ receptor double deficiency in NOD mice on the development of insulitis/diabetes compared with IL-17 single-deficient mice and wild-type mice by monitoring diabetes-related phenotypes. The lymphocyte phenotypes were determined by flow cytometric analysis. Results: IL-17 single-deficient NOD mice showed delayed onset of diabetes and reduced severity of insulitis, but the cumulative incidence of longstanding diabetes in the IL-17-deficient mice was similar to that in wild-type mice. The IL-17/IFN-γ receptor double-deficient NOD mice showed an apparent decline in longstanding diabetes onset, but not in insulitis compared with that in the IL-17 single-deficient mice. We also found that double-deficient NOD mice had a severe lymphopenic phenotype and preferential increase in regulatory T cells among CD4 T cells compared with the IL-17 single-deficient mice and wild-type NOD mice. An adoptive transfer study with CD4CD25 T cells from young non-diabetic IL-17 single-deficient NOD mice, but not those from older mice, showed significantly delayed disease onset in immune-deficient hosts compared with the corresponding wild-type mice. Conclusions/interpretation: These results indicate that IL-17/Th17 participates in the development of insulitis and that both IL-17 and IFN-γ signalling may synergistically contribute to the development of diabetes in NOD mice. [ABSTRACT FROM AUTHOR]

Aims/hypothesis: The pancreas and hypothalamus are critical for maintaining nutrient and energy homeostasis, and combined disorders in these organs account for the onset of the metabolic syndrome. Activating transcription factor 3 (ATF3) is an adaptive response transcription factor. The physiological role of ATF3 in the pancreas has been controversial, and its role in the hypothalamus remains unknown. To elucidate the roles of ATF3 in these organs, we generated pancreas- and hypothalamus-specific Atf3 knockout (PHT- Atf3-KO) mice in this study. Methods: We crossed mice bearing floxed Atf3 alleles with Pdx1-cre mice, in which cre is specifically expressed in the pancreas and hypothalamus, and analysed metabolic variables, pancreatic morphology, food intake, energy expenditure and sympathetic activity in adipose tissue. We also used a hypothalamic cell line to investigate the molecular mechanism by which ATF3 regulates transcription of the gene encoding agouti-related protein ( Agrp). Results: Although PHT- Atf3-KO mice displayed better glucose tolerance, neither plasma glucagon nor insulin level was altered in these mice. However, these mice exhibited higher insulin sensitivity, which was accompanied by a leaner phenotype due to decreased food intake and increased energy expenditure. We also observed decreased hypothalamic Agrp expression in PHT- Atf3-KO mice. Importantly, an increase in ATF3 levels is induced by fasting or low glucose in the hypothalamus. We also showed that ATF3 interacts with forkhead box-containing protein, O subfamily 1 (FoxO1) on the Agrp promoter and activates Agrp transcription. Conclusions/interpretation: Our results suggest that ATF3 plays an important role in the control of glucose and energy metabolism by regulating Agrp. [ABSTRACT FROM AUTHOR]

t(17;19)-acute lymphoblastic leukemia (ALL) shows extremely poor prognosis. E2A-HLF derived from t(17;19) blocks apoptosis induced by the intrinsic mitochondrial pathway and has a central role in leukemogenesis and chemoresistance. Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) is expressed on cytotoxic T cells and natural killer cells and binds with death receptors (DR4/DR5), inducing apoptosis by dual activation of intrinsic and extrinsic pathways, and TRAIL mediates the graft-versus-leukemia (GVL) effect after allogeneic stem cell transplantation (allo-SCT). We found that cell lines and patients' samples of t(17;19)-ALL expressed death receptors for TRAIL, and recombinant soluble TRAIL immediately induced apoptosis into t(17;19)-ALL cell lines. E2A-HLF induced gene expression of DR4/DR5, which was dependent on the DNA-binding and transactivation activities of E2A-HLF through the 5′ upstream region of the start site at least in the DR4 gene. Introduction of E2A-HLF into non-t(17;19)-ALL cell line upregulated DR4 and DR5 expression, and sensitized to proapoptotic activity of recombinant soluble TRAIL. Finally, a newly diagnosed t(17;19)-ALL patient underwent allo-SCT immediately after induction of first complete remission, and the patient has survived without relapse for over 3-1/2 years after allo-SCT. These findings suggest that E2A-HLF sensitizes t(17;19)-ALL to the GVL effect by upregulating death receptors for TRAIL. [ABSTRACT FROM AUTHOR]

Background:Lung adenocarcinoma (LADCA) patients with epidermal growth factor receptor (EGFR) mutations are in general associated with relatively high clinical response rate to EGFR-tyrosine kinase inhibitors (TKIs) but not all responded to TKI. It has therefore become important to identify the additional surrogate markers regarding EGFR-TKI sensitivity.Methods:We first examined the effects of EGFR-TKIs, gefitinib and erlotinib, upon cell proliferation of lung adenocarcinoma cell lines. We then evaluated the gene profiles related to EGFR-TKI sensitivity using a microarray analysis. Results of microarray analysis led us to focus on carcinoembryonic antigen-related cell adhesion molecule (CEACAM) family, CEACAM 3, 5, 6, 7, and 19, as potential further surrogate markers of EGFR-TKI sensitivity. We then examined the correlation between the status of CEACAM 3, 5, 6, 7, and 19 immunoreactivity in LADCA and clinicopathological parameters of individual cases.Results:In the cases with EGFR mutations, the status of all CEACAMs examined was significantly higher than that in EGFR wild-type patients, but there were no significant differences in the status of CEACAMs between TKI responder and nonresponder among 22 patients who received gefitinib therapy. However, among 115 EGFR mutation-negative LADCA patients, both CEACAM6 and CEACAM3 were significantly associated with adverse clinical outcome (CEACAM6) and better clinical outcome (CEACAM3).Conclusion:CEACAMs examined in this study could be related to the presence of EGFR mutation in adenocarcinoma cells but not represent the effective surrogate marker of EGFR-TKI in LADCA patients. However, immunohistochemical evaluation of CEACAM3/6 in LADCA patients could provide important information on their clinical outcome. [ABSTRACT FROM AUTHOR]

Background:In Asia, large-scale studies on anti-HER2 treatment in HER2-positive breast cancer patients with brain metastases are limited. We studied the treatment patterns of these patients in Asia to evaluate the impact of anti-HER2 treatment on the time to occurrence of brain metastases (TTBM) and survival after brain metastasis (BM).Methods:A retrospective study of HER2-positive breast cancer patients diagnosed with BM between January 2006 and December 2008 in six Asian countries was conducted. Demographics, tumour characteristics, treatment details, and events dates were collected from medical records.Results:Data from 280 patients were analysed. Before BM, 63% received anti-HER2 treatment. These patients had significantly longer TTBM than those without anti-HER2 treatment (median 33 vs 19 months; P<0.002). After BM, 93% received radiotherapy, 57% received chemotherapy, and 41% received anti-HER2 treatment (trastuzumab and/or lapatinib). Use of both anti-HER2 agents, primarily sequentially, after BM demonstrated the longest survival after BM and was associated with a significant survival benefit over no anti-HER2 treatment (median 26 vs 6 months; hazard ratio 0.37; 95% CI 0.19-0.72).Conclusion:Anti-HER2 treatment before BM was associated with longer TTBM. Anti-HER2 treatment after BM was associated with a survival benefit, especially when both trastuzumab and lapatinib were utilised. [ABSTRACT FROM AUTHOR]

Purpose: This study was performed to investigate the actual situation and problems of exercise therapy in Japan. Methods: A self-recording questionnaire was prepared and sent to 1,200 randomly selected diabetologists and non-specialist physicians of the Japan Medical Association. Responses were obtained from 403 physicians (34% response rate). Two subgroups of the physicians were extracted according to the rate of exercise guidance provided to patients at their initial visit to the clinic: more than 70% [high-rate of exercise guidance (HG) group, N = 212] and less than 50% [low-rate of exercise guidance (LG) group, N = 131]. Results: The rate of exercise guidance was significantly lower ( p < 0.001) than that of dietary guidance. About 65 and 53% of physicians in both groups responded that their 'lack of time' and the 'absence of an additional consultation fee,' respectively, were the main problems they faced for implementing exercise guidance to patients. Compared with the HG group, a higher number of physicians in the LG group responded that there were no specialized physical exercise educators in their clinics ( p < 0.001). As to the reasons why patients do not perform exercise, 70% of physicians responded that patients 'had no time to exercise' and 'were not eager to perform exercise.' Conclusions: The current survey revealed that, in Japan, the proportion of exercise guidance is low because physicians have no time, they receive no additional consultation fee, and specialized physical exercise educators are lacking. Although an improvement in these factors may lead to higher rates of exercise guidance, we consider that the preparation of specific exercise guidelines for type 2 diabetes patients is essential to effectively implement this therapy in clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the risk of common peroneal nerve injury in FM drilling as compared to transtibial drilling in anatomical double-bundle ACL reconstruction. Methods: Ten cadaveric knees without ligament injury or significant arthritis were used for this study. Knees were secured at 90° and 120° of flexion. In transtibial drilling groups, a guide pin was drilled through either the anteromedial bundle (AMB) or posterolateral bundle (PLB) tibial insertion site to either the AMB or PLB femoral insertion site (tibial insertion site-femoral insertion site: AM-AM, PL-PL, PL-AM and AM-PL). In FM drilling groups (FM-AM and FM-PL),the pin was drilled at the AMB or PLB femoral insertion site through the FM. We measured the shortest distance between the point at which the pin ran through the lateral cortex of the femur and the ipsilateral common peroneal nerve at a knee flexion of 90° and 120°. Results: At a knee flexion of 90°, the shortest mean distance to the common peroneal nerve was 15.3 mm in the FM-PL group, 13.4 mm in the FM-AM group, 27.9 mm in the PL-PL group, 30.8 mm in the AM-AM group, 37.8 mm in the PL-AM group and 29.5 mm in the AM-PL group. At a knee of flexion 120°, the mean distance was 17.3 mm in the FM-PL group, 18.1 mm in the FM-AM group, 32.2 mm in the PL-PL group, 36.6 mm in the AM-AM group, 38.0 mm in the PL-AM group and 35.2 mm in the AM-PL group. Significant differences were observed between 90° and 120° of knee flexion in the FM-AM, PL-PL, AM-AM and AM-PL groups ( P < 0.05).Significant differences were observed at flex 90° between the FM-AM group and AM-AM group, and between the FM-AM group and PL-AM group. Significant differences were observed at flex 120° between the FM-AM group and AM-AM group, between the FM-AM group and PL-AM group and between the FM-PL group and AM-PL group. Conclusion: The distance to the peroneal nerve in FM drilling was significantly longer at 120° than at 90° of knee flexion. Therefore, the risk of peroneal injury using FM drilling should decrease at a higher angle of knee flexion. [ABSTRACT FROM AUTHOR]

Objective: Protein-energy malnutrition is a common disorder in the elderly. Although serum albumin is commonly used as a nutritional marker, data is lacking on serum albumin levels in the elderly. The purpose of this study was to determine whether serum albumin levels decrease with advancing age and to establish reference value and interval of laboratory data for elderly people (75 years and over). Participants: Blood samples from 13821 healthy people, 42064 outpatients, and 15959 inpatients were collected during 2008. Blood from 127 of our nutrition support team (NST) patients was also collected during August 2006 and May 2009, and analyzed. Measurements: Serum albumin, hemoglobin, total cholesterol levels and lymphocyte count were determined. We analyzed the change in each parameter in accordance with age, compared the data for elderly people with younger people, and established new reference values. Clinical outcomes were examined depending on the improved reference values. Results: Albumin was lower in older persons than in younger persons. The estimated reference value and interval were 42 (48-36) g/l in older persons and was much lower in NST patients. Hemoglobin was decreased while cholesterol and lymphocyte count were not changed in older persons: all were markedly decreased in NST patients. Terms of hospital stay were significantly longer and mortality rates were significantly higher in older persons, comparing from above to below using a new reference value of albumin (36 g/l). Conclusions: The serum albumin level decreases with advancing age, but it was maintained to some extent in healthy older people. Serum albumin levels related to the clinical outcome. Hemoglobin and cholesterol levels and lymphocyte count were all lower in NST patients. These measurements may be valuable markers of nutritional status and can help in guiding the need for nutritional support. [ABSTRACT FROM AUTHOR]

Aims/hypothesis: The activation of platelet-derived growth factor receptor-β (PDGFR-β) signalling is increased in the glomeruli and tubules of diabetic animals. In this study, we examined the role of PDGFR-β signalling during the development of diabetic nephropathy. Methods: We recently generated pancreatic beta cell-specific Ca/calmodulin-dependent protein kinase IIα (Thr286Asp) transgenic mice (CaMKIIα mice), which show very high plasma glucose levels up to 55.5 mmol/l and exhibit the features of diabetic nephropathy. These mice were crossed with conditional knockout mice in which Pdgfr-β (also known as Pdgfrb) was deleted postnatally. The effect of the deletion of the Pdgfr-β gene on diabetic nephropathy in CaMKIIα mice was evaluated at 10 and 16 weeks of age. Results: The plasma glucose concentrations and HbA levels were elevated in the CaMKIIα mice from 4 weeks of age. Variables indicative of diabetic nephropathy, such as an increased urinary albumin/creatinine ratio, kidney weight/body weight ratio and mesangial area/glomerular area ratio, were observed at 16 weeks of age. The postnatal deletion of the Pdgfr-β gene significantly decreased the urinary albumin/creatinine ratio and mesangial area/glomerular area ratio without affecting the plasma glucose concentration. Furthermore, the increased oxidative stress in the kidneys of the CaMKIIα mice as shown by the increased urinary 8-hydroxydeoxyguanosine (8-OHdG) excretion and the increased expression of NAD(P)H oxidase 4 (NOX4), glutathione peroxidase 1 (GPX1) and manganese superoxide dismutase (MnSOD) was decreased by Pdgfr-β gene deletion. Conclusions/interpretation: The activation of PDGFR-β signalling contributes to the progress of diabetic nephropathy, with an increase in oxidative stress and mesangial expansion in CaMKIIα mice. [ABSTRACT FROM AUTHOR]

Background/Objectives:The effect of cooking loss on vitamin intake is an important consideration in dietary and epidemiological studies in Japanese. However, because few published food values have considered cooking effect, allowing for cooking loss in the assessment of vitamin intake in Japan has been difficult.Subjects/Methods:Seven-day dietary records and a fasting blood sample were collected from 102 men and 113 women in August of 1994 or 1995. Vitamin intake were estimated using two food databases, one composed of raw food only and the second of cooked food. Estimates were compared with blood levels.Results:Water-soluble vitamin intake using a food database including cooked food was lower than intakes estimated using a database composed of raw food only, except for pantothenic acid and vitamin B12 intake. In particular, vitamin B1 intake was 18.9% lower in men and 16.8% lower in women. However, when subjects were classified into the same and adjacent categories by joint classification by quintiles, appreciable change in ranking of a subject was not observed. Furthermore, the relationship between vitamin intake and biomarker did not improve when intake was calculated using a food database including cooked food.Conclusion:Although the effect of cooking loss on absolute values is not negligible, this might not significantly impact the ranking of subject intake estimations of vitamin intake in epidemiological studies. [ABSTRACT FROM AUTHOR]

A 40-year-old woman discovered through palpation a tumor in the upper lateral quadrant of the left mammary gland. Mammography, ultrasonography (US), and magnetic resonance imaging (MRI) showed a 10 mm diameter tumor. Fluorine-18 fluorodeoxyglucose positron emission tomography ((18)F-FDG-PET) showed abnormal accumulation in the detected tumor, and the maximum standardized uptake value was 2.2. The patient underwent tumor resection. The postoperative histopathological finding was intraductal papilloma. The intraductal papilloma showed strong expression of glucose transporter (GLUT)-4 on membrane and/or cytoplasm, and weak expression of GLUT-1 and GLUT-3 by immunohistochemistry. This case suggests that other glucose transporters (e.g., GLUT-4), other pathological factors, and cytokines may have a close relation with (18)F-FDG accumulation in intraductal papilloma more than GLUT-1 or GLUT-3 expression. [ABSTRACT FROM AUTHOR]

C/EBP homologous protein (CHOP) has been proposed as a key transcription factor for endoplasmic reticulum (ER) stress-mediated β-cell death induced by inflammatory cytokines in vitro . However, the contribution of CHOP induction to the pathogenesis of type 1 diabetes is not yet clear. To evaluate the relevance of CHOP in the pathogenesis of type 1 diabetes in vivo, we generated CHOP-deficient non-obese diabetic ( NOD.Chop) mice. CHOP deficiency did not affect the development of insulitis and diabetes and apoptosis in β-cells. Interestingly, NOD.Chop mice exhibited a delayed appearance of insulin autoantibodies compared to wild-type (wt) mice. Adoptive transfer with the diabetogenic, whole or CD8-depleted splenocytes induced β-cell apoptosis and the rapid onset of diabetes in the irradiated NOD.Chop recipients with similar kinetics as in wt mice. Expression of ER stress-associated genes was not significantly up-regulated in the islets from NOD.Chop compared to those from wt mice or NOD- scid mice. These findings suggest that CHOP expression is independent of the development of insulitis and diabetes but might affect the early production of insulin autoantibodies in the NOD mouse. [ABSTRACT FROM AUTHOR]

Thick (>50 μm) piezoelectric films have been deposited directly on top of steel and aluminum substrates as integrated ultrasonic transducer (IUT) receivers to detect laser generated ultrasound. The film fabrication is based on a sol-gel spray technique. In this study IUTs intrinsically acting as bulk longitudinal wave receivers use various mode conversion approaches and serve as longitudinal, shear, symmetric, anti-symmetric and shear horizontal plate wave receivers. Different laser generation conditions such as point and line sources of different sizes are also applied to investigate the capabilities of IUT receivers. Ultrasonic measurements on metal substrates with planar and curved surfaces at temperature up to 400°C using laser generated and IUT ultrasound receiver are demonstrated. [ABSTRACT FROM AUTHOR]

Bose-Einstein condensates with spin degrees of freedom admit various topological phases and excitations. Non-Abelian vortices offer a remarkable example which is expected to be realized in the cyclic phase of the spin-2 spinor Bose-Einstein condensates. We demonstrate that the non-Abelian property of non-Abelian vortices shows the unique effect in their collision dynamics, i.e., unlike Abelian vortices, they do neither reconnect themselves nor pass through each other but create a rung vortex between them. [ABSTRACT FROM AUTHOR]

High-β plasma is stably confined in the Ring Trap 1 (RT-1) device, a magnetospheric configuration with a levitated dipole field magnet. The plasma pressure is mainly resulted from high temperature electrons generated by electron cyclotron resonance heating (ECH), whose bremsstrulung was observed by an X-ray CCD camera. The coil support structure is the main loss route of the hot electrons, and higher-β discharge is realized by coil levitation. Confinement properties of charged particles in the magnetospheric configuration were investigated by using toroidal non-neutral plasma. Fluctuation-induced inward particle diffusion into the strong magnetic field region was realized due to the onset of diocotron (Kelvin-Helmholtz) instability. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to compare the results of semiquantitative analysis by(18)F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) with plasma osteopontin levels in the same asbestos-related pleural disease population.Materials and Methods: A total of 17 patients with asbestos-related pleural disease were prospectively recruited. They underwent PET/CT, and plasma osteopontin levels were measured. The maximum standardized uptake value (SUVmax) was determined from the most active pleural lesion in each patient.Results: Malignant pleural mesothelioma (MPM) was histologically proven in 6 patients, and 11 patients had proven benign asbestos-related pleural diseases (7 pleural plaques, 4 asbestos pleurisy). Significant differences in SUVmax were found between patients with MPM and those with asbestos pleurisy (P = 0.031) and between patients with MPM and those with pleural plaques (P = 0.012). A significant difference was found in the plasma osteopontin levels between patients with asbestos pleurisy and patients with pleural plaques (Bonferroni correction, P = 0.024). The SUVmax in patients with benign asbestos-related diseases was statistically positively correlated with plasma osteopontin in the same group (Spearman's r = 0.75, P < 0.05).Conclusion: PET/CT might be more helpful than plasma osteopontin for distinguishing benign asbestos-related pleural diseases from MPM, and the SUVmax in benign asbestos-related pleural diseases may reflect changes in pleural inflammation. [ABSTRACT FROM AUTHOR]

The Kaguya gamma-ray spectrometer (KGRS) has great potential to precisely determine the absolute abundances of natural radioactive elements K, Th and U on the lunar surface because of its excellent spectroscopic performance. In order to achieve the best performance of the KGRS, it is important to know the spatial response function (SRF) that describes the directional sensitivity of the KGRS. The SRF is derived by a series of Monte Carlo simulations of gamma-ray transport in the sensor of the KGRS using the full-fledged simulation model of the KGRS, and is studied in detail. In this paper, the method for deriving absolute abundance of natural radioactive elements based on the SRF is described for the analysis of KGRS data, which is also applicable to any gamma-ray remote sensings. In the preliminary analysis of KGRS data, we determined the absolute abundances of K and Th on the lunar surface without using any previous knowledge of chemical information gained from Apollo samples, lunar meteorites and/or previous lunar remote sensings. The results are compared with the previous measurements and the difference and the correspondence are discussed. Future detailed analysis of KGRS data will provide new and more precise maps of K, Th and U on the lunar surface. [ABSTRACT FROM AUTHOR]

Diabetogenic loci for type 2 diabetes have been mapped to mouse chromosome (Chr) 11 and 14 in the Nagoya–Shibata–Yasuda (NSY) mouse, an animal model of type 2 diabetes. We aimed to obtain direct evidence of these genes on each chromosome and to clarify their function and interaction in conferring susceptibility to type 2 diabetes. We established three consomic strains homozygous for diabetogenic NSY-Chr11, NSY-Chr14 or both on the control C3H background (C3H-11NSY, C3H-14NSY and C3H-11NSY14NSY, respectively), and monitored diabetes-related phenotypes longitudinally. The glucokinase gene was sequenced as a positional candidate gene on Chr11. C3H-11NSY mice showed hyperglycaemia associated with impaired insulin secretion and age-dependent insulin resistance without obesity. C3H-14NSY mice exhibited hyperglycaemia mainly due to insulin resistance, with a slight increase in percentage body fat. C3H-11NSY14NSY double consomic mice showed marked hyperglycaemia and obesity, which was not observed in single consomic strains. Sequences of the glucokinase gene were allelically variant between NSY and C3H mice. These data provide direct evidence that Chr11 and Chr14 harbour major susceptibility genes for type 2 diabetes. These two chromosomes interact to cause more severe hyperglycaemia and obesity, which was not observed with the presence of either single chromosome, indicating different modes of gene–gene interaction depending on the phenotype. Marked changes in the phenotypes retained in the consomic strains will facilitate fine mapping and the identification of the responsible genes and their interaction with each other, other genes and environmental factors. [ABSTRACT FROM AUTHOR]

We report the case of a 31-year-old woman who suffered lipiduria after selective transcatheter arterial embolization for renal angiomyolipoma (AML). Computed tomography confirmed cystic liquefactive necrosis with fat-fluid level in AML. Although the process by which AML fat tissue excretion occurs is not clear, we speculated that the infarcted AML was connected to the urinary collection duct system and subsequently its adipose component was excreted into the urine. [ABSTRACT FROM AUTHOR]

Resistin is a cytokine derived from adipose tissue and is implicated in obesity-related insulin resistance and type 2 diabetes mellitus. Polymorphisms of the resistin gene ( RETN) have been shown to affect the plasma resistin concentration. The aims of this study were to identify polymorphisms of RETN that influence plasma resistin concentration and to clarify the relation between plasma resistin level and metabolic disorders in an aged Japanese cohort. The study participants comprised 3133 individuals recruited to a population-based prospective cohort study (KING study). Plasma resistin concentration, BMI, abdominal circumference, blood pressure, fasting plasma glucose and serum insulin concentrations, HbA1c content and serum lipid profile were measured in all participants. The HOMA index of insulin resistance (HOMA-IR) was also calculated. Eleven polymorphisms of RETN were genotyped. A combination of ANOVA and multiple linear regression analysis in screening and large-scale subsets of the study population revealed that plasma resistin concentration was significantly associated with rs34861192 and rs3745368 polymorphisms of RETN. Multiple linear regression analysis with adjustment for age and sex also showed that the plasma resistin level was significantly associated with serum concentrations of HDL-cholesterol, triacylglycerol and insulin, as well as with BMI. Our results implicate the rs34861192 and rs3745368 polymorphisms of RETN as robust and independent determinants of plasma resistin concentration in the study population. In addition, plasma resistin level was associated with dyslipidaemia, serum insulin concentration and obesity. Trial registration: ClinicalTrials.gov NCT00262691 Funding: This study was supported by Grants-in-Aids for Scientific Research from the Japan Society for the Promotion of Science and the Ministry of Education, Culture, Sports, Science, and Technology of Japan. [ABSTRACT FROM AUTHOR]

Background and Objective: Good glycaemic control in patients with diabetes mellitus often requires insulin supplementation therapy. Recent developments of analogue insulin and premixed formulations have increased the therapeutic options for patients who need such therapy. This study aimed to retrospectively clarify appropriate treatment regimens according to age, body mass index (BMI) and duration of diabetes in Japanese patients with type 2 diabetes previously entered in an open-label, randomized trial that compared convenience-oriented biphasic insulin aspart 30 versus multiple injections of insulin aspart with or without NPH insulin. Methods: Japanese insulin-naïve patients were randomized to receive either biphasic insulin aspart 30 twice daily or insulin aspart three times daily with or without multiple injections of NPH insulin for a treatment period lasting 6 months. Results: Reduction of glycosylated haemoglobin (HbA1c) at the end of 6 months was not different in the two treatment groups irrespective of BMI, age and duration of diabetes. However, the achievement rate of HbA1c <7.0% was significantly higher in patients with a BMI <25 kg/m2 in the multipleinjection group and tended to be higher in patients with a diabetes duration <10 years in the twice-daily injection group. Conclusion: Twice-daily injections of biphasic insulin aspart 30 may be more suitable for obese patients whereas multiple injections of insulin aspart with or without NPH insulin may be preferable for those with a longer duration of diabetes. [ABSTRACT FROM AUTHOR]

Purpose: To analyze rectal bleeding prognostic factors associated with prostate brachytherapy (PB) or in combination with external-beam radiation therapy (EBRT) and to examine dosimetric indications associated with rectal bleeding.Materials and Methods: The study included 296 patients followed up for >36 months (median, 48 months). PB was performed alone in 252 patients and in combination with EBRT in 44 patients. PB combined with EBRT is indicated for patients with a Gleason score >6. The prescribed dose was 144 Gy for monotherapy and 110 Gy for PB + EBRT (44-46 Gy).Results: Although 9.1% who received monotherapy had 2.3% grade 2 rectal bleeding, 36.3% who received combined therapy had 15.9% grade 2 rectal bleeding. Combined therapy was associated with higher incidence of rectal bleeding (P = 0.0049) and higher percentage of grade 2 bleeding (P = 0.0005). Multivariate analysis revealed that R-150 was the only significant factor for rectal bleeding, and modified Radiation Therapy Oncology Group (RTOG) grade in monotherapy and biologically equivalent dose (BED) were significant for combined therapy. Moreover, grade 2 rectal bleeding increased significantly at D90 > 130 Gy.Conclusion: Although R-150 was the significant prognostic factor for rectal bleeding and modified RTOG rectal toxicity grade, BED was the significant prognostic factor for modified RTOG rectal toxicity grade. [ABSTRACT FROM AUTHOR]

A 61-year-old woman presented with pancytopenia and underwent a bone marrow biopsy. The patient was diagnosed with nonsecretory myeloma (plasmablastic type) based on both the bone marrow biopsy findings and her laboratory data. Fluorine-18 fluorodeoxyglucose-positron emission tomography ((18)F-FDG-PET) was performed prior to chemotherapy showing diffuse bone marrow uptake, splenic uptake, and focal uptake of the right anterior chest wall. The patient underwent an (18)F-FDG-PET examination to evaluate the curative effects after three cycles of chemotherapy, and no abnormal uptake on (18)F-FDG-PET was found. Bone marrow biopsy to evaluate the curative effect showed no viable tumor cells. We present a rare case of nonsecretory plasmablastic myeloma detected by (18)F-FDG-PET. [ABSTRACT FROM AUTHOR]

Objective: Adenosine triphosphate (ATP) is the parent compound of adenosine and well known as a powerful vasodilator. To investigate the effect of ATP on cerebral blood flow (CBF) and cerebral vessels, (15)O-water positron emission tomography (PET) studies were performed to evaluate changes in CBF and blood volume before and after ATP administration. Methods: Ten healthy young volunteers underwent (15)O-water PET scans under the conditions of baseline, 3 and 1 min after ATP continuous infusion. CBF values in cortical regions of the bilateral middle cerebral arteries and basal ganglia were obtained for each subject. Statistical parametric mapping (SPM) was applied for analysis of regional changes. Physiologic parameters, such as blood gas and blood pressure were also measured. Results: Cortical CBF showed no significant change after continuous infusion of ATP compared with the baseline. Dilatation of major vessels induced by ATP was visualized on SPM analysis. Heart rates increased and mean blood pressure decreased during ATP administration while blood gas data showed no changes between the different conditions. Conclusions: Intravenous ATP administration caused dilatation of major cerebral vessels but no significant change in CBF under normoventilation and decrease in systemic blood pressure, indicating that this no change in CBF under vasodilatory effect of ATP may be caused by cerebral microvascular autoregulation. [ABSTRACT FROM AUTHOR]

Purpose: To describe the prevalence of illicit and non-medical use of drugs, the age of first use, and their correlates in the general population of Japan, based on data collected between 2002 and 2004 as part of the World Mental Health (WMH) surveys.Methods: Participants included were a subsample (n = 887) of the total 2,436 Japanese-speaking respondents aged >or=20 years, randomly sampled from residents in seven cities/municipalities in Japan. Face-to-face household surveys were conducted using the Japanese version of the fully structured WHO WMH Survey Initiative version of the Composite International Diagnostic Interview.Results: Lifetime prevalence of marijuana and cocaine use, non-medical use of prescribed drugs such as tranquilizers, stimulants and analgesics, and use of other substances was 1.5, 0.3, 6.4 and 2.4%, respectively. Lifetime use of marijuana was significantly greater among men. Prescription drug abuse/misuse was significantly more common among the middle-aged (35-49 years) group and those who were married/cohabitating. The 12-month prevalence of marijuana and non-medical use was 0.3 and 1.9%, respectively. Age of first use was likely to be early adulthood. Non-medical use was significantly related to mood disorder, anxiety disorder, intermittent explosive disorder and alcohol abuse/dependence.Conclusions: The present study confirmed lower prevalence of drug use in Japan than in other countries, such as the United States. However, the non-medical use of psychotropic drugs seems more common in Japan. [ABSTRACT FROM AUTHOR]