Search

Purpose: Gender inequity in medicine harms society, and often originates in the context of broader societal discrimination. This study explores the experiences of older women in the radiation oncology specialty in Japan and the United States, with an emphasis on understanding how broader gender inequity affects career trajectory. Radiation oncology is an ideal setting to investigate cross-cultural physician gender equity issues, because few women enter the field despite fewer barriers (eg, frequent emergencies, evening/weekend hours, long procedures) that are commonly cited by women as deterrents in specialty selection. Methods and Materials: Between 2012 and 2016, the authors interviewed 14 older women in radiation oncology (department chairs or full professors), with 6 from Japan and 8 from the United States. Multiple analysts identified themes to explore the impact of societal gender inequity on female radiation oncologists’ careers. Results: Five themes were identified: (1) childhood gender constructs affect career aspirations, (2) persistent sexism and gender-based workplace challenges affect women's careers, (3) gender inequity in the home affects women's careers, (4) non–gender-related factors intersect to affect women's career satisfaction, and (5) attaining gender equity appears to be even more challenging in Japan compared with the United States. Conclusions: Female radiation oncologists in 2 of the most technologically advanced countries report that gender discrimination across their lifespans substantially affects career success. Because gender inequality reflects societal injustice and negatively affects scientific progress and patient outcomes, future research should focus on global approaches to address professional and domestic gender constructs that impede women's career progress.

We have designed and evaluated a simple and practical system for CD3+ (T-lymphocyte) and CD19+ (B-lymphocyte) cell counting on-chip using a PDMS microfluidic chip which captures these cells using a pillarbased filtration technique. Conventional pillar-based or membrane-based cell separation methods suffer from the problem of cell clogging, thereby reducing the separating and capturing efficiency of the device. To address these issues, we proposed a unique and simple design of a microfluidic chip with an escape route at the pillar-based cell filtration area in the chip which prevents cell clogging. Currently, the diagnosis, monitoring and treatment of immunodeficiency disorder require quantifying the leukocyte population, especially T-lymphocytes and Blymphocytes, in whole blood. We evaluated the performance of our microfluidic chip by obtaining the ratio of T-lymphocytes and Blymphocytes from whole blood and compared the results to those obtained using a flow cytometer. We confirmed that the cell capture area of the microfluidic chip remains clog-free. We achieved 99.8% efficiency in capturing leukocytes using the microfluidic chip, and the ratio of CD3+ and CD19+ had a coefficient of r = 0.9876 and a coefficient of variation (CV) of 2.77%, from 1 μL of whole blood sample.

Summary Background & aims The associations between dietary magnesium intake and stroke and coronary heart disease (CHD) incidences are inconsistent and not established in Asian. We aimed to determine the association between dietary magnesium intake and the risk of stroke and CHD in a Japanese population. Subjects/Methods We studied 85,293 Japanese subjects by questionnaire at baseline (age 45–74 years, without cardiovascular disease or cancer in 1995 and 1998 for Cohorts I and II, respectively). The participants were followed until the end of 2009 and 2010 in Cohorts I and II, respectively. Dietary magnesium intake was estimated from a self-administered 138-item food-frequency questionnaire. Results After 1,305,738 person-years of follow-up, 4110 strokes and 1283 cases of CHD were documented. The multivariable-adjusted hazard ratios (HRs, 95% confidence intervals, 95%CIs) of CHD for the fourth and fifth quintiles of dietary magnesium intake were 0.70 (0.50–0.99) and 0.66 (0.44–0.97) in men (P for trend = 0.036), respectively, and third quintile of dietary magnesium intake was 0.61 (0.39–0.96) in women (P for trend = 0.241), compared with the lowest quintile in men and women. We observed no decreased risks of incident stroke in men or women with higher dietary magnesium intakes. Conclusions Higher dietary magnesium intake was associated with a reduced risk of CHD in Japanese men.

PURPOSE/OBJECTIVE(S) Uterine cancer patients with supraclavicular or mediastinal lymph node metastasis are usually considered candidates for systemic chemotherapy or are treated with palliative radiotherapy for specific symptom control. However, if there are no additional hematogenous metastasis, we hypnotized that curative radiotherapy could be effective. The purpose of this study was to evaluate the efficacy and toxicity of radiotherapy with curative intent to this type of patients. MATERIALS/METHODS The medical records of uterine cancer patients with supraclavicular or mediastinal lymph nodal metastases, who received radiotherapy for curative intend were reviewed. Both who were initial presented with these lymph node metastases and who were presented as recurrence after treatment were included. Patients with hematogenous metastasis were excluded from the analysis. Overall survival and progression free survival, acute and late adverse effect (NCI-CTC ver. 5) was evaluated. In patients with recurrence, the first site of recurrence was also recorded. RESULTS Eligible patients were 30 (supraclavicular lymph node metastasis: 23, mediastinal lymph node metastasis: 7). Median age was 52 (range 36-82) years. The primary site was cervical cancer in 24 and endometrial cancer in six. De novo tumors were 20 and recurrent tumors were 10. Out of the cervical cancer patients, one patient presented with adenocarcinoma, and the rest had squamous cell carcinoma. Concomitant systemic therapy was performed in 26 patients, which was platinum based in 20 patients, 5FU in five patients, medroxyprogesterone in one patient. The patients with PS0, 1, 2 were 27, 2, 1, respectively. All patients received 60 Gy in 30 fractions to the metastatic site (if de novo tumors, also brachytherapy, whole pelvis and paraaortic lymph node was included). Median follow-up was 16 (range 3-120) months. Acute grade 3-4 esophagitis, neutropenia, anemia, and thrombocytopenia were observed in 6.7%, 56.7%. 40.0% and 13,3%. Late toxicity was observed in one patient which was grade 1 skin induration. One- and two-year overall survival was 66.1% and 45.4%, respectively. One-and two-year progression free survival was 47.4% and 30.7%, respectively. On multivariate analysis, serum squamous cell carcinoma antigen < 6 ng/mL had correlation with good progression free survival. First site of recurrence was lymph node in 11, lung metastasis in six patients, brain metastasis in three patients, and peritoneal dissemination in two patients (one patients presented with two sites of metastasis). CONCLUSION Curative radiotherapy is feasible for Stage IVB or recurrent uterine cancer presenting with supraclavicular or mediastinal lymph node metastasis without hematogenous metastasis. Large scale, prospective trials are warranted. AUTHOR DISCLOSURE A.I. Saito: None.

Intensity modulated radiation therapy (IMRT) is one of the most widely used delivery modalities for radiation therapy for cancer patients. A patient is typically treated in daily fractions over a period of 5-9 weeks. In this paper, we consider the problem of accounting for changes in patient setup location and internal geometry between the treatment fractions, usually referred to as interfraction motion. The conventional method is to add a margin around the clinical tumor volume (CTV) to obtain a planning target volume (PTV). A fluence map optimization (FMO) model is then solved to determine the optimal intensity profiles to deliver to the patient. However, a margin-based method may not adequately model the changes in dose distributions due to the random nature of organ motion. Accounting for interfraction motion in the FMO model essentially transforms the deterministic optimization problem into a stochastic one. We propose a stochastic FMO model that employs convex penalty functions to control the treatment plan quality and uses a large number of scenarios to characterize interfraction motion uncertainties. Some effects of radiotherapy are impacted mainly by the dose distribution in a given treatment fraction while others tend to manifest themselves over time and depend mostly on the total dose received over the course of treatment. We will therefore formulate an optimization model that explicitly incorporates treatment plan evaluation criteria that apply to the total dose received over all treatment fractions and ones that apply to the dose per fraction. Particularly when many structures fall into the former category, this can lead to significant reductions in the dimension of the optimization model and therefore the time required to solve it. We test an example of our model on five clinical prostate cancer cases, showing the efficacy of our approach. In particular, compared to a traditional margin-based treatment plan, our plans exhibit significantly improved target dose coverage and clinically equivalent critical structure sparing at only a modest increase in computational effort.

Purpose To characterize the magnitude of volume change in the postoperative tumor bed before and during radiotherapy, and to identify any factors associated with large volumetric change. Methods and Materials Thirty-six consecutive patients with early-stage or preinvasive breast cancer underwent breast-conserving therapy at our institution between June 2006 and October 2007. Computed tomography (CT) scans of the breast were obtained shortly after surgery, before the start of radiotherapy (RT) for treatment planning, and, if applicable, before the tumor bed boost. Postoperative changes, seroma, and surgical clips were used to define the tumor bed through consensus agreement of 3 observers (B.P., D.I., and J.L.). Multiple variables were examined for correlation with volumetric change. Results Between the first and last scan obtained (median time, 7.2 weeks), the tumor bed volume decreased at least 20% in 86% of patients ( n = 31) and at least 50% in 64% of patients ( n = 23). From the postoperative scan to the planning scan (median time, 3 weeks), the tumor bed volume decreased by an average of 49.9%, or approximately 2.1% per postoperative day. From planning scan to boost scan (median interval, 7 weeks), the median tumor bed volume decreased by 44.6%, at an average rate of 0.95% per postoperative day. No single factor was significantly associated with a change in tumor bed volume greater than 20%. Conclusions The average postlumpectomy cavity undergoes dramatic volumetric change after surgery and continues this change during RT. The rate of change is inversely proportional to the duration from surgery. In this study no factors studied predicted large volumetric change.

Three photoconductive diamond detectors with highly oriented diamond (HOD) films fabricated by the same process were characterized with respect to temporal response, spectral responsivity and its spatial uniformity over the wavelength range from 190 to 250 nm. Temporal measurements showed a drift in the baseline, suggesting the presence of deep level carrier traps. The responsivity of specimen No. 2 was more than twice those of the other two specimens, but it showed an unpredictable current fluctuation. It was found that the spatial uniformities of all the specimens were too low for radiometric purposes. A prominent peak, thought to be due to photoemission, was found in the responsivity spatial distribution of specimen No. 3 under a negative applied voltage.

A prospect for the observation of biochemical reaction by surface plasmon resonance (SPR) is discussed. It has been known that reactions can be monitored either by observation of resonance minimum incidence angle, or by observation of reflectance intensity change at a fixed angle near the resonance minimum. Minimum angle shift measurement is preferred because of better signal to noise ratio (S/N) achievement due to signal averaging effect, inherent in minimum angle determination. However, SPR system with intensity measurement at a fixed angle could be simpler than that with minimum angle shift measurement. The potential for biochemical measurements by SPR at a fixed angle was explored in this report. Theoretical calculation was performed to estimate the signal level of the intensity change at a fixed angle. An SPR measurement system that measures the signal intensity at eight different angles, 0.5° apart, was fabricated to verify the theoretical prediction. Rabbit IgG immunoassay was performed, and demonstrated that measurement of intensity change at a fixed angle has enough sensitivity for biochemical reaction observation. It was demonstrated that below the resonance angle the intensity change waveform of the biochemical reaction is similar to that of resonance minimum data, whereas the polarity of waveform change was reversed above the resonance angle. Merits and demerits of intensity change monitoring and resonance minimum monitoring are discussed.

We report atypical radiographic findings of irregular dural thickening associated with severe brain oedema and compression of the frontal lobe in a 79-year-old man who had a previous diagnosis from tuberculosis that was complicated by diabetes mellitus. The patient was admitted because of deterioration of dizziness, loss of appetite, and dehydration. Magnetic resonance imaging (MRI) revealed hypertrophy of the dura mater along the left frontal lobe. To obtain a correct diagnosis, we biopsied the left frontal dura mater. Pathologically thickening of the dura and lymphocyte infiltration were observed. The patient was given a small dose of corticosteroids to the dural thickening. Although the thickening lessened and the oedema in the left frontal lobe of the brain was ameliorated, the patient’s general condition remained poor, and tuberculosis became evident. He was transferred to another hospital for treatment of the tuberculosis. The radiographical findings associated with hypertrophic pachymeningitis are discussed and the literature is reviewed.

Objective To determine the nature and origin of synovial inflammation in knees with osteoarthritis (OA). Method Synovial samples were obtained from 21 medial compartmental knee OAs from 19 patients. First, using 11 medial knee synovial samples from 9 patients, a quantitative estimation of synovitis was made with both ordinary and immunohistochemical staining. Second, from the other 10 knees, tissue samples were taken from both the medial and the lateral compartments to quantify cells that infiltrated into the synovium. Medial synovium was immunostained using antibodies to anti-type II collagen, CD68, CD2, CD4, CD8, CD15, CD19, CD25, HLA-DR, CD1a and LN5. The lateral synovium was immunostained with anti-type II collagen, CD68, HLA-DR and CD4 antibody as a control. Result Denatured cartilaginous detritus was found captured by synovial lining cells with a strong immunoreactivity to CD68 antibody, and whose phagocytic potential was activated. The number of anti-type II collagen-positive fragments in the medial compartment of the knee was larger than that found in the lateral compartment. Moreover, the population of CD68-positive cells in synovial tissue and HLA-DR-positive cells in the lining layer was larger in the medial compartment than in the lateral compartment. The number of CD4-positive cells (defined as helper/inducer T lymphocytes) was greater in medial synovium than in lateral synovium. Conclusion Overall, this study strongly supports the concept that the synovitis observed in patients with knee OA might be induced by an immunological mechanism involving, to some extent, a macrophage/helper T cell interaction.

Trifluoromethanesulfonic acid (TFMS) was found to solubilize lignite and subbituminous coal in the presence of isopentane at temperature as low as 150°C for three hours under autogeneous pressure of 6.1–6.9 MPa without hydrogen. Yallourn coal gave 63 wt% pyridine soluble fraction after reaction and required more TFMS to achieve the maximum solubility, but the treated Taiheiyo coal could be solubilized in pyridine to the extent of 90% by the same reaction with TFMS. Acid-catalyzed depolymerization with TFMS would be inadequate, because the lignite has many oxygen containing functional groups. The average molecular weight of benzene soluble and THF soluble fraction from the treated Yallourn coal decreased, and their aromaticity increased with the increase of TFMS concentration. In contrast, average molecular weight of soluble fraction from the treated Taiheiyo coal was unchanged, and their aromaticity decreased with the increase of TFMS concentration. It is suggested that TFMS plays an important role in depolymerization of the coal molecules for Yallourn coal solubilization, and accelerates alkylation and hydrogenation in the Taiheiyo coal solubilization. Oxygen functional groups would lower the activity of TFMS as acid catalyst by interaction, leading to the formation of water from the cleavage of aliphatic ether groups and the dehydration of phenoxy OH groups.

The effects of matrices on the expression of adhesion molecules were studied in cultured human umbilical cord vein endothelial cells(HUVEC). The expression of vascular cell adhesion molecule-1 (VCAM-1) but not of intercellular adhesion molecule-1 stimulated with various substances was remarkably low in HUVEC cultured on type IV collagen, the major component of the basement membrane, compared with that on type I collagen. This inhibition was observed not only at the protein level but also at the mRNA level. These data suggested that VCAM-1 expression in endothelial cells is strictly regulated by the underlying basement membrane.

ISAS(Institute of Space and Astronautical Science) launched Japanese first interplanetary explorers, SAKIGAKE and SUISEI toward the Halley's Comet in 1985. In 1990, ISAS also successfully launched a spacecraft, HITEN, which demonstrated Double Lunar Swingby Orbit as a precursor of GEOTAIL spacecraft launched in 1992. GEOTAIL is conducting in—situ exploration of the deep geo—magnetic tail, which extends up to more than 200 Re(Earth Radii) in the night side of the Earth, and such a mission inevitably requires for its trajectory to utilize the double lunar swingby technique. Though SUISEI ceased its mission in 1991 and HITEN also completed its mission in April 1993, ISAS Sagamihara Space Operation Center is currently operating two spacecraft, SAKIGAKE and GEOTAIL by use of a 64m dish antenna of Usuda Deep Space Center as well as a 20m dish antenna of Kagoshima Space Center as a back—up ground station. ISAS is now developing two planetary missions. One of them is LUNAR—A, scheduled for launch in 1997, and it will be followed by PLANET—B, scheduled in 1998. This thesis describes the function of ISAS Deep Space Mission Operation Ground Stations that have been operating past 10 years and the concept of future system which is planning for operation of LUNAR—A and PLANET—B.

Water channel protein (CHIP28) has been initially identified from human erythrocyte and subsequently localized in human kidney, rat kidney and bovine corneal endothelium. We report here cloning of homologous cDNA (CHIP29) from an expression cDNA library constructed from bovine ciliary epithelium poly A+ that codes a 271 amino acid, 28.8 kDa protein. At the amino acid level, bovine CHIP29 is 91% identical to the CHIP28 protein. Analysis of the deduced amino acid sequence indicated a hydrophobic protein with six membrane spanning domains, one N-linked glycosylation site, two conserved NPA boxes common to MIP26 family proteins, and conserved amino acid residue cysteine 189 common to water channels. Northern blotting revealed a major mRNA of 2.8 Kb size expressed in bovine ciliary epithelium. The results presented here confirm the presence of water channel gene in the bovine ciliary epithelium, a primary site for the aqueous humor production.

The structure of 6α-hydroxyeurycomalactone, a new C19 quassinoid, isolated from the roots of Eurycoma longifolia has been established from spectral and by single crystal X-ray analysis; eurycomalactone was also isolated. The cytotoxic activity of some quassinoids from this plant is not mediated through DNA cleaving properties.

Direct detection of these viruses was made by using the PCR for amplifying viral DNA. In virtually all adults low levels of the herpesvirus can be detected. Therefore it is necessary to quantitate the amount of viral DNA, and a method to compare the plasmid containing the cloned target gene was used here. After 35 cycles of amplification, 10 copies of the viral DNA per 100 microliters saliva were detected. The PCR was used to detect increased levels of EBV and HHV-6 in saliva from patients with lymphoproliferative diseases, suggesting that these viruses may play a part in their pathogenesis. Viral detection by such highly sensitive methods as PCR may allow better monitoring of medication, as well as early detection of EBV- and HHV-6 related diseases that may arise in these patients. The great sensitivity of PCR and its ability to analyse very small samples make this technique most suitable for clinical diagnosis.

Background: Although kyphosis and its mobility are reported to be associated with walking ability in elderly people, the causal relationship between them has not been clarified. Purpose:Toclarify the foot pressure pattern in individuals with kyphosis and examine the relationship between spinal kyphosis, mobility, foot pressure pattern, and walking ability. Methods: In 61participants, total inclination and thoracic, lumbar, and sacral anglesweremeasured by the SpinalMouse (IdiagAG,Switzerland). Forty-one of the 61participantswith total inclination >6 degrees and/or lumbar angle < 16 degrees were classified as the kyphosis group (6 men, 35 women; mean age, 78.5 years). The other 20 participants were classified as the control group (3 men, 17 women; 75.5 years). Spinal mobility of the total, thoracic, lumbar, and sacral spine was measured. Walking speed and step length at a comfortable walking speedweremeasured on a flat and straight 10-m course. Simultaneously, the foot pressure pattern was measured by the insole-type foot pressure measurement system (F-Scan II, Nitta, Japan). The anteroposterior length of the center of pressure (COP) path, expressed as the percentage of the foot length (%Long), the transverse width of the COP path, expressed as the percentage of maximum foot width (%Trans), and the partial foot pressure in the heel, central, metatarsal, hallux, and lateral toe area, expressed as the percentage of body weight (%PFP), were calculated. Results: Walking speed (0.8± 0.3 vs. 1.1± 0.3m/s, p= 0.031) and step length (0.4± 0.1 vs. 0.5± 0.1m, p= 0.042) in the kyphosis groupwere significantly lower than those in the control group. Total inclination in the kyphosis group was significantly higher than that in the control group (8.3± 8.2 vs. 1.0± 3.2 degrees, p= 0.007). Lumbar angle (−1.4± 17.2 vs. 24.9± 4.3 degrees, p= 0.008) and sacral inclination (−3.1± 9.3 vs. 9.9± 4.5 degrees, p= 0.008) in the kyphosis group were significantly lower than those in the control group. In the kyphosis group, mobility of the total, lumbar, and sacral spine was significantly lower than that of the control group. The %Long, %Trans, and %PFP of the hallux (4.4± 3.6 vs. 15.1± 6.4%, p= 0.034) and lateral toes (4.2± 3.2 vs. 9.7± 5.4%, p= 0.036) in the kyphosis groupwere significantly lower than those in the control group. A significant correlation was found between spinal inclination and %PFP of the hallux (r=−0.344) and lateral toes (r=−0.310). The %PFP of the hallux (r=0.560) and lateral toes (r= 0.437) also correlated with total spinal mobility. Conclusion(s): In individuals with spinal kyphosis, a decreased walking ability was evident, and severe kyphosis and low mobility of the spine were associated with low toe pressure. Thus, low toe pressure might induce insufficient driving forces, causing decreased walking ability. Implications:We should pay careful attention to the presence of low toe pressure in individuals with spinal kyphosis.

The kapurimycin A3-guanine adduct was formed by alkylation of the antitumour antibiotic with d(CGCG)2. The site of alkylation of the guanine was confirmed by comparative NMR studies with N-7-methyl-guanine in DMSO-d6.