Radiation therapy for esophageal cancer: results of the patterns of Care Study in Japan 1995–1997

Purpose To report the characteristics and treatment process of esophageal cancer patients treated with radiation therapy (RT) in Japan.Methods and materials The Patterns of Care Study (PCS) in Japan was conducted in 78 facilities nationwide including 40 academic (A) and 38 nonacademic (B) institutions using the original two-stage cluster sampling. Detailed information was accumulated on patients with cancer in the thoracic esophagus in stage I, II, or III who had received RT between 1995 and 1997.Results Of a total of 776 patients, 479 were treated in A institutions and 297 in B institutions. Median age was 67 years; 85.0% were men and 14.3% were women. Patients in stage I disease were more frequently identified in A institutions than in B (18.8% vs. 13.4%; P = 0.001). More than 99% had squamous cell carcinoma by histology, and the main tumors were often located in the midthoracic esophagus (62.2% of all patients). Pretreatment diagnostic modalities such as esophagram, endoscopy, endoscopic ultrasound, and computed tomography were done equally in A and B institutions. Chemotherapy was used for 39.7% of the patients. RT was combined with esophagectomy in the pre- or postoperative setting for 26.8% of the patients. Median fractionation and total external RT dose were 2 Gy and 60 Gy, respectively. Brachytherapy was more frequently used in A institutions than in B (P = 0.001).Conclusions This PCS study revealed the background and process of RT for esophageal cancer in Japan and also revealed the differences of the characteristics of patients and treatment procedures among two types of institutions.     

Differences in the risk of fatty liver for onset of impaired fasting glucose according to baseline plasma glucose levels

Journal of Gastroenterology - It remains unclear whether fatty liver is a risk factor for the onset of abnormal glucose tolerance in any patient. The objective of this study was to clarify the...     

Fish Oil for Attenuating Posttraumatic Stress Symptoms among Rescue Workers after the Great East Japan Earthquake: A Randomized Controlled Trial

No abstract available.     

Multislice CT angiography through an implantable catheter and port system: early experience in detection of vascular complications during hepatic arterial infusion chemotherapy

OBJECTIVE: The purpose of this study was to evaluate the use of multislice CT in the evaluation of vascular patency in patients during hepatic arterial infusion chemotherapy of liver tumors. MATERIALS AND METHODS: Thirty-three patients were prospectively examined by CT angiography through the indwelling catheter and port system. Visibility of hepatic arteries and vascular patency were graded 0 to 3 and were compared with digital subtraction angiography (DSA). RESULTS: Average visualization scores of CT angiography and DSA were 1.7 and 2.5, respectively, in common hepatic artery (CHA) and proper hepatic artery (PHA), 2.5 and 2.3 in right hepatic artery (RHA), 2.6 and 2.6 in left hepatic artery (LHA), 2.3 and 2.2 in segmental RHA, and 2.1 and 2.0 in segmental LHA. Stenoses were found in proximal hepatic arteries in 9 on CT angiography and 13 on DSA. Stenoses were found in branches of the hepatic artery in 21 on CT angiography and 16 on DSA. CONCLUSION: The authors' results indicate that multislice CT angiography of the hepatic arteries is equivalent to DSA and may demonstrate vascular complications of hepatic arterial infusion chemotherapy.     

Quantification of BCR-ABL mRNA in Plasma/Serum of Patients with Chronic Myelogenous Leukemia

Quantification of tumor-associated mRNA extracted from blood cells/tissues containing tumor cells is used for evaluation of treatment efficacy or residual tumor cell burden in tumors including leukemia. However, this method using tumor cell-containing blood/tissue is difficult to evaluate the whole tumor cell burden in the body. In order to establish an efficient method to evaluate the whole tumor cell burden in the body, we tried to quantify tumor-associated mRNA existing in plasma/serum instead of leukemia cell-containing blood cells in patients with chronic myelogenous leukemia (CML) and compared the levels of BCR-ABL mRNA between plasma/serum and peripheral blood cells. mRNA of BCR-ABL, WT1 or GAPDH (control molecule) was detected by real-time RT-PCR using RNA extracted from plasma/serum of almost all the patients with CML. Copy numbers of BCR-ABL mRNA were significantly correlated between plasma/serum and peripheral blood cells. However, levels of BCR-ABL mRNA extracted from serum were low compared with those extracted with peripheral blood cells. The present findings suggest that although real-time RT-PCR of mRNA existing in plasma/serum could be used for evaluating the whole tumor cell burden in the body, it''s required to establish an efficient method to quantify plasma/serum mRNA by nature without degrading during the procedure.     

The combination of type I interferon and ribavirin has an inhibitory effect on mouse hepatitis virus infection

Aim: To determine the differences in efficacy between therapy using IFN‐β and ribavirin, and using IFN‐α and ribavirin. Methods: We studied the effect of combination therapy consisting of IFN‐β and ribavirin on mouse hepatitis virus (MHV) infection in mice. Results: Combination treatment of ribavirin and IFN‐α was more effective than IFN‐α mono‐treatment in the MHV‐mouse system, and combination treatment with ribavirin and IFN‐β was more effective than IFN‐β mono‐treatment in the MHV‐mouse system. Furthermore, administering IFN‐β once or twice one day before combination treatment using ribavirin and IFN‐α was more effective than administering IFN‐α once or twice one day before the combination treatment using ribavirin and IFN‐α. Conclusion: These data indicate that this MHV‐infection system is a good animal model to assess anti‐HCV activity for therapy using IFN and ribavirin, and suggest that administering IFN‐β before the start of combination therapy with ribavirin and IFN‐α promotes the therapeutic effects of combination treatment with ribavirin and IFN‐α ?in chronic hepatitis C patients.     

Usefulness of measurement of lens culinaris agglutinin-reactive fraction of α-fetoprotein as a marker of prognosis and recurrence of small hepatocellular carcinoma

OBJECTIVE: Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein (AFP-L3%) is a recently described marker of hepatocellular carcinoma (HCC), and its usefulness has been demonstrated in many studies. We evaluated the usefulness of serial measurement of AFP-L3% as a marker of prognosis and recurrence after treatment of small HCC. METHODS: AFP-L3% was measured before and after initial treatment in 60 patients with small HCC (maximum diameter < or = 2 cm). AFP-L3% was taken as the ratio of AFP-L3 to total AFP and multiplied by 100%, and levels > or = 10% were considered positive. Outcomes and recurrence were compared between patients AFP-L3%-negative after initial treatment (Group A, n = 43) and patients who were AFP-L3%-positive after initial treatment (Group B, n = 17). RESULTS: Before treatment, AFP-L3% was positive in 14 (23.3%) of the 60 patients. The cumulative survival rate of Group A was significantly longer (p = 0.0091) than that of Group B. The recurrence rate was significantly higher in Group B (p = 0.0104) than in Group A. When recurrence was limited to intrahepatic metastasis, the recurrence rate was significantly higher in Group B (p = 0.0064). However, the recurrence rate of multicentric occurrence did not differ significantly between Groups A and B. CONCLUSIONS: Measurement of AFP-L3% after treatment may be useful for understanding prognosis and recurrence of HCC.     

Characterization of immunoglobulin binding factor in sputum from patients with chronic airway diseases

OBJECTIVE: Immunoglobulin binding factor (IgBF) is known to bind immunoglobulin, to interact with anti-Fc gamma-III antibodies and to be present in the lower respiratory tract of normal healthy subjects. In this study, in order to clarify the role of IgBF in respiratory diseases, we investigated whether IgBF exists in the airway of patients with chronic airway diseases. METHODOLOGY: IgBF was measured in the sputum of 28 normal subjects and 59 patients with chronic airway diseases including 37 cases of chronic bronchitis, 18 bronchiectasis, and four diffuse panbronchiolitis by enzyme-linked immunosorbent assay. RESULTS: Immunoglobulin binding factor concentration in the sputum of patients with chronic airway diseases (purulent sputum, 50.2 +/- 8.2 microg/mL; mucoid sputum, 88.6 +/- 12.8 microg/mL) was higher than that in induced sputum of normal subjects (6.3 +/- 5.5 microg/mL; P < 0.001). Immunoglobulin binding factor level in mucoid sputum was significantly higher than that in purulent sputum (P < 0.05). A significant inverse correlation was shown between the IgBF level and the elastase activity in sputum, and the concentration of IgBF purified from seminal plasma was decreased by treatment with neutrophil elastase, indicating that IgBF might be degraded by elastase. In the gel filtration chromatography of both types of sputum, IgBF was eluted in a region corresponding to a molecular weight of 27 kDa as a single peak. Western blot analysis with a monoclonal antibody to IgBF indicated that IgBF in both types of sputum had a molecular weight of 27 kDa under non-reducing conditions and of 16 kDa under reducing conditions. CONCLUSION: These results demonstrate that a high level of IgBF is present in the respiratory tract of patients with chronic airway diseases and may be related to the pathogenesis of these diseases.