Search

The Earthquake Research Committee (ERC), the Headquarters for Earthquake Research Promotion, Japan, issued a new report on long-term evaluation of the occurrence of large earthquakes along the Nankai trough, southwestern Japan, in 2013, which was made along the line of the revision of national earthquake counter measures according to the 2011 Great Eastern Japan Earthquake Disaster. The central issue was the 30-yr probability, but the method to estimate probability was not changed from the previous one issued in 2001 based on the time-predictable model, which led to a 60%–70% chance of M ≥ 8 event during the coming 30 yr. However, there are several drawbacks in this evaluation such as neglect of errors in uplift data, inconsistency between uplift rate and geodetic and geomorphological data, mechanical interpretation of time-predictable model, and contradiction between the assumptions in Brownian passage time model and time-predictable model. Because ERC calculates probability with average recurrence intervals for other subduction and active fault zones, the same scheme should be adopted to the Nankai trough.

Stereotactic body radiotherapy (SBRT) uses hypofractionated and more precise irradiation methods, and has the advantages of shorter duration, better outcomes, and fewer side effects than conventional radiotherapy. However, the optimal dosage remains unclear. The purpose of the study was to analyze our preliminary treatment results and safety. We retrospectively analyzed 32 patients (primary cancer, 22 ; metastatic cancer, 10) who underwent SBRT for pulmonary tumors at our hospital from April 2015 to June 2020. SBRT was performed with escalated dose prescriptions (up to 55Gy in 4 fractions/64Gy in 8 fractions for peripheral/central lesions, respectively). We evaluated the local control rate (LC rate), overall survival (OS), progression-free survival (PFS), disease-specific survival (DSS), and adverse events. The target lesions comprised 22 primary lung cancers and 13 metastatic lung cancers. The 2-year LC, OS, PFS, and DSS rates were 82.5%, 68.3%, 50.5%, and 88.0% for primary lung cancer patients and 83.1%, 29.9%, 23.1%, and 48.6% for metastatic lung cancer patients, respectively. Five cases of radiation pneumonitis of grade 2 or higher, one of grade 1 dermatitis and 1 of esophagitis were observed as adverse events. We showed that the treatment outcomes of SBRT for primary and metastatic lung cancers were mostly acceptable.

Introduction: The use of technetium 99m diethylenetriaminepentaacetic acid-galactosyl human serum albumin (99mTc-GSA) scintigraphy parameters, HH15 and LHL15, in assessing the future liver remnant function is not expedient because of their nonlinear behaviour against liver volume. Uptake rate constant for the binding of 99mTc-GSA to asialoglycoprotein receptors is probably more favourable, but the reported calculation methods are complex. We devised a simple method to calculate the uptake rate constant, KrGSA. Methods: Radioactivity counts for the entire liver and heart regions were extracted at 10, 20, and 30 min. Using whole liver and heart volumes measured from single-photon emission computed tomography images, free radioactivity corresponding to the liver blood pool was subtracted. The time activity curve was fitted to the equation L(t) = L(∞) × [1 − Exp (−kt)] using Microsoft Office Excel (add-in free programme Solver)®, where L(∞) is the count at plateau level and k denotes KrGSA. Results: KrGSA values accurately identified liver cirrhosis and were similar to the KICG. The areas under the curve for KrGSA and KICG in the receiver operating characteristic analysis were 0.808 and 0.795, respectively, and a good correlation was seen between KrGSA and KICG. Discussion/Conclusion: KrGSA can be utilized as an alternative to KICG in assessing the future liver remnant function.

For thymic epithelial tumors, simple contact with adjacent structures does not necessarily mean invasion. The purpose of our study was to develop a simple noninvasive technique for evaluating organ invasion using routine pretreatment computed tomography (CT).This retrospective study analyzed the pathological reports on 95 mediastinal resections performed between January 2003 and June 2020. Using CT images, the length of the interface between the primary tumor and neighboring structures (arch distance; Adist) and maximum tumor diameter (Dmax) was measured, after which Adist/Dmax (A/D) ratios were calculated. Receiver operating characteristic (ROC) curves were used to analyze the Adist and A/D ratios.An Adist cut-off of 37.5 mm best distinguished between invaded and non-invaded mediastinal great veins based on ROC curves. When Adist 37.5 mm was used for diagnosis of invasion of the brachiocephalic vein (BCV) or superior vena cava (SVC), the sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and area under the ROC curve for diagnosis of invasion were 61.9%, 92.5%, 81.25%, 82.2%, 81.97%, and 0.76429, respectively. Moreover, there were significant differences between BCV/SVC Adist 37.5 mm and ≤ 37.5 mm for 10-year relapse-free survival and 10-year overall survival (p 0.01).When diagnosing invasion of the mediastinal great veins based on Adist 37.5 mm, we achieved a higher performance level than the conventional criteria such as irregular interface with an absence of the fat layer. Measurement of Adist is a simple noninvasive technique for evaluating invasion using CT. Key Points • Simple contact between the primary tumor and adjacent structures on CT does not indicate direct invasion. • Using CT images, the length of the interface between the primary tumor and neighboring structures (arch distance; Adist) is a simple noninvasive technique for evaluating invasion. • Adist 37.5 mm can be a supportive tool to identify invaded mediastinal great veins and surgical indications for T3 and T4 invasion by thymic epithelial tumors.

The efficacy of stereotactic radiotherapy (SRT) has been well established for postoperative residual and recurrent nonfunctioning pituitary adenomas (NFPAs). However, the risk of visual impairment due to SRT for lesions adjacent to the optic pathways remains a topic of debate. Herein, we evaluated the long-term clinical outcomes of hypofractionated stereotactic radiotherapy (HFSRT) for perioptic NFPAs. From December 2002 to November 2015, 32 patients (18 males and 14 females; median age 63 years; range, 36–83 years) with residual or recurrent NFPAs abutting or displacing the optic nerve and/or chiasm (ONC) were treated with HFSRT. The median marginal dose was 31.3 Gy (range, 17.2–39.6) in 8 fractions (range, 6–15). Magnetic resonance imaging (MRI) and visual and hormonal examinations were performed before and after HFSRT. The median follow-up period was 99.5 months (range, 9–191). According to MRI findings at the last follow-up, the tumor size had decreased in 28 (88%) of 32 patients, was unchanged in 3 (9%), and had increased in 1 (3%). The successful tumor size control rate was 97%. Visual functions remained unchanged in 19 (60%) out of 32 patients, improved in 11 (34%), and deteriorated in 2 (6%). Two patients had deteriorated visual functions; no complications occurred because of the HFSRT. One patient developed hypopituitarism that required hormone replacement therapy. The result of this long-term follow-up study suggests that HFSRT is safe and effective for the treatment of NFPAs occurring adjacent to the ONC.

Purpose : The present study aimed to determine the rate of post-contrast acute kidney injury (PC-AKI) after catheter angiography other than cardiac angiography (CAG), and identify relevant risk factors.Materials and methods : This retrospective study analyzed data from 314 patients who underwent angiography between October 2013 and September 2018. We investigated the incidence of PC-AKI, defined as a ≥50% increase or ≥0.3 mg/dL increase in serum creatinine (SCr) values 1-3 days after angiography according to the European Society of Urogenital Radiology guidelines on contrast media, version 10.0. The effects of patient- and procedure-related factors on the incidence of PC-AKI were evaluated. Data were analyzed using chi-squared and Mann-Whitney U tests, and multivariate logistic regression analysis.Results : PC-AKI developed in 16/314 patients (5.1%). Multivariate logistic regression analysis revealed a correlation of incidence of PC-AKI with advanced age, decreased estimated glomerular filtration rate (eGFR), shock symptoms, and high-dose contrast media within 24 hours. In all patients with PC-AKI, SCr values returned to baseline within 2 weeks.Conclusions : PC-AKI after angiographic examinations developed in 5.1% of patients, and the increase in SCr was reversible. Advanced age, decreased eGFR, shock symptoms, and highdose contrast media within 24 hours are possible risk factors.

The beneficial effects of brain-derived neurotrophic factor (BDNF)—a member of the neurotrophin family—on cognitive function or dementia are well established in both rodents and human beings. In contrast, little is known about the association of proBDNF—a precursor protein with opposing neuronal effects of BDNF—with cognitive function in non-demented older adults. We analyzed brain magnetic resonance imaging findings of 256 community-dwelling older adults (mean age of 68.4 years). Serum BDNF and proBDNF levels were measured by quantitative enzyme-linked immunosorbent assay. Logistic regression analysis revealed that older age, less physical activity, hippocampal atrophy, and lower BDNF levels were independently associated with memory impairment determined by the Rivermead Behavioral Memory Test. Path analysis based on structural equation modeling indicated that age, sport activity, hippocampal atrophy and BDNF but not proBDNF were individually associated with Rivermead Behavioral Memory Test scores. These findings suggest that impaired BDNF function, in addition to physical inactivity and hippocampal atrophy, is associated with age-related memory impairment. Therefore, BDNF may be a potential target for dementia prevention.