The total radioactive Cs concentration in final-instar
Stenopsyche marmorata
larvae from the Mano River, Fukushima Prefecture, in 2013 was found to be >1000 Bq kg
−1
in dry weight. The concentration ...of radioactive Cs in the river water itself was on the order of 0.01 Bq kg
−1
, while its concentration in drifting fine particulate organic matter (FPOM) was on the order of 10,000 Bq kg
−1
in dry weight. When excretion experiments were performed in the summer and winter, significant decreases in the Cs concentrations in the whole body of
S. marmorata
were observed in both seasons. The biological half-life of Cs-137 was 5.3 and 8.8 h for the nonwintering generation and the wintering generation, respectively. Another elimination test using a stable Cs solution was performed, and the Cs concentration was observed to decrease rapidly to 7.5% of its original level in the digestive tract of
S. marmorata
after 72 h, but stable Cs remained in muscle and extra-alimentary tissue of
S. marmorata
. As the total radioactive Cs in the water was quite low, its concentration in
S. marmorata
from the Mano River reflects the fact that it feeds on FPOM. The radioactive Cs concentration in the FPOM significantly declined in 2015, but a corresponding decline was not observed for
S. marmorata
. We therefore infer that ultrafine particulate matter such as suspended vermiculite clay is strongly contaminated with radioactive Cs, and that this radioactive Cs passes continuously through the digestive tract of
S. marmorata
.
To compare the prevalence of nephrotoxicity between patients with a solitary-functioning kidney versus those with bilateral-functioning kidneys during the administration of cisplatin-based ...chemotherapy for advanced urothelial carcinoma.
We retrospectively analyzed 244 advanced urothelial carcinoma patients treated with cisplatin-based chemotherapy between 2004 and 2010 at 17 institutes in Japan. The 24 h creatinine clearance, Cockcroft-Gault formula, and estimated glomerular filtration rate equation (eGFR), were compared before all chemotherapies. The urinary tract function status was determined based on the data of nephroureterectomy, hydronephrosis, and relief of upper urinary tract obstruction. A total of 244 patients were divided into four groups according to their urinary tract functioning status and eGFR results, including bilateral-functioning kidneys with pretreatment eGFR ≥60 mL/min/1.73 m
group (n = 83, 34.0%); a solitary-functioning kidney with pretreatment eGFR ≥60 mL/min/1.73 m
group (n = 36, 14.8%); bilateral-functioning kidneys with pretreatment eGFR < 60 mL/min/1.73 m
group (n = 45, 18.4%); and a solitary-functioning kidney with pretreatment eGFR < 60 mL/min/1.73 m
group (n = 80, 32.8%).
The prevalence of nephrotoxicity with impaired eGFR of > 10% and 30% from baseline in the post-third-course of chemotherapy was significantly higher in patients with bilateral-functioning kidneys than in those with a solitary-functioning kidney, among patients with pretreatment eGFR < 60 mL/min/1.73 m
(p = 0.023 and p = 0.026). During all courses of chemotherapy, the prevalence of nephrotoxicity with impaired eGFR of > 20% from baseline were significantly higher in patients with bilateral-functioning kidneys than those with a solitary-functioning kidney among patients with pretreatment eGFR < 60 mL/min/1.73 m
(p = 0.034), whereas no significant difference was observed among patients with pretreatment eGFR ≥60 mL/min/1.73 m
.
The results suggest that cisplatin-based chemotherapy may have more nephrotoxicity in patients with bilateral-functioning kidneys than in those with a solitary-functioning kidney.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Objectives
To describe a novel dorsal vein complex preserving technique for intrafascial nerve‐sparing laparoscopic radical prostatectomy and to evaluate its postoperative outcomes.
Methods
A total ...of 109 patients who underwent laparoscopic radical prostatectomy by a single surgeon were evaluated, including 44 patients with dorsal vein complex preserving technique for intrafascial nerve‐sparing laparoscopic radical prostatectomy, 20 patients with conventional intrafascial nerve‐sparing laparoscopic radical prostatectomy and 45 patients with non‐nerve‐sparing laparoscopic radical prostatectomy. Functional outcomes were evaluated using a self‐administered questionnaire (Expanded Prostate Cancer Index Composite). Continence was defined as zero to one security pad per day. Oncological outcomes were evaluated based on positive surgical margin.
Results
In the dorsal vein complex preserving technique for intrafascial nerve‐sparing laparoscopic radical prostatectomy group, the continence rate was 57%, 77% and 95% at 1, 3 and 12 months, respectively. The continence rate in the conventional intrafascial nerve‐sparing laparoscopic radical prostatectomy group was 37%, 63% and 90%, and in the non‐nerve‐sparing laparoscopic radical prostatectomy group it was 23%, 57% and 82% at 1, 3, and 12 months, respectively. The dorsal vein complex preserving technique for intrafascial nerve‐sparing laparoscopic radical prostatectomy group showed a significantly earlier recovery from incontinence compared with that in the conventional intrafascial nerve‐sparing laparoscopic radical prostatectomy and non‐nerve‐sparing laparoscopic radical prostatectomy groups (log–rank test, P = 0.044 and P < 0.001). Similarly, the dorsal vein complex preserving technique for intrafascial nerve‐sparing laparoscopic radical prostatectomy group tended to show a more early recovery in relation to urinary function of the Expanded Prostate Cancer Index Composite. Regarding sexual function, there were no significant differences between the dorsal vein complex preserving technique for intrafascial nerve‐sparing laparoscopic radical prostatectomy and conventional intrafascial nerve‐sparing laparoscopic radical prostatectomy groups. In pT2 patients, the positive surgical margin rate of the dorsal vein complex preserving technique for intrafascial nerve‐sparing laparoscopic radical prostatectomy group (11%) was similar to that of the other two groups (conventional intrafascial nerve‐sparing laparoscopic radical prostatectomy 7%; non‐nerve‐sparing laparoscopic radical prostatectomy 11%).
Conclusions
The dorsal vein complex preserving technique for intrafascial nerve‐sparing laparoscopic radical prostatectomy technique provides early recovery from incontinence without adversely affecting the oncological outcome.
The aim of the study is to clarify the clinical effects of first-line chemotherapy regimens for advanced urothelial cancer on clinical responses and survival of patients grouped by renal function.
In ...this multicenter retrospective cohort study, 345 urothelial cancer patients received systemic chemotherapy for metastatic or unresectable disease in 17 centers (2004-10).
Two hundred and forty-one patients were treated with methotrexate, vinblastine, doxorubicin and cisplatin/methotrexate, epirubicin and cisplatin (n = 136) or gemcitabine and cisplatin (n = 105) followed by carboplatin-based treatments, non-platinum treatments or other regimens. After 2008, gemcitabine and cisplatin was the most frequently used regimen in patients with an estimated glomerular filtration rate < 60 ml/min/1.73 m(2) and in those with estimated glomerular filtration rate ≥ 60 ml/min/1.73 m(2). The gemcitabine and cisplatin patients' complete response rate was 10.5% and their response rate was 52.4%, which was highest among all regimens. Gemcitabine and cisplatin demonstrated a better 3-year overall survival when the estimated glomerular filtration rate was ≥ 60 ml/min/1.73 m(2) (31.4%), but it tended to be worse when the estimated glomerular filtration rate was < 60 ml/min/1.73 m(2) (14.1%). In the latter cases, the dose reduction rate of gemcitabine and cisplatin was high (43.9%). Among the patients with estimated glomerular filtration rate < 60 ml/min/1.73 m(2), the 1-year overall survival of the patients treated with a reduced dose of gemcitabine and cisplatin was significantly lower than that of those treated with standard-dose gemcitabine and cisplatin (26.2 vs. 60.3%, respectively, P = 0.0108).
Gemcitabine and cisplatin provided favorable responses and survival in patients with estimated glomerular filtration rate ≥ 60 ml/min/1.73 m(2) but unsatisfactory oncological outcomes in patients with estimated glomerular filtration rate < 60 ml/min/1.73 m(2), especially when treated with a reduced dose. Alternative regimens might be optimal rather than reduced-dose gemcitabine and cisplatin in patients with estimated glomerular filtration rate < 60 ml/min/1.73 m(2).
Objectives
To develop a modified technique of “total pelvic floor reconstruction” during non‐nerve‐sparing laparoscopic radical prostatectomy, and to determine its effect on postoperative urinary ...outcomes.
Methods
A total of 128 patients who underwent non‐nerve‐sparing laparoscopic radical prostatectomy were evaluated, including 81 with total pelvic floor reconstruction and 47 with non‐total pelvic floor reconstruction. Nerve‐sparing cases were excluded. Urinary outcomes were assessed with self‐administrated questionnaires (Expanded Prostate Cancer Index Composite) at 1, 3, 6 and 12 months after laparoscopic radical prostatectomy. The total pelvic floor reconstruction technique included two concepts involving posterior and anterior reconstructions. In posterior reconstruction, Denonvilliers' fascia was approximated to the bladder neck and the median dorsal raphe by slipknot. The anterior surface of the bladder‐neck was approximated to the anterior detrusor apron and the puboprostatic ligament collar for anterior reconstruction.
Results
There were no significant differences between the two groups in the patients' characteristics, and in perioperative and oncological outcomes. In the total pelvic floor reconstruction group, the continence rates at 3, 6 and 12 months after laparoscopic radical prostatectomy were 45.7%, 71.4%, and 84.6%, respectively. In the non‐total pelvic floor reconstruction group, the continence rates were 26.1%, 46.8% and 60.9%, respectively. The total pelvic floor reconstruction technique resulted in significantly higher continence rates at 3, 6 and 12 months after laparoscopic radical prostatectomy, respectively (all P < 0.05). The mean interval to achieve continence was significantly shorter in the total pelvic floor reconstruction group (mean 7.7 months) than in the non‐total pelvic floor reconstruction group (mean 9.8 months; P = 0.0003).
Conclusion
The total pelvic floor reconstruction technique allows preservation of the blood supply to the urethra and physical reinforcement of the pelvic floor. Therefore, this technique is likely to improve urinary continence outcomes after laparoscopic radical prostatectomy.
Background
The Kidney Disease: Improving Global Outcomes group (KDIGO) defined acute kidney injury (AKI) as an elevation of serum creatinine (sCR) exceeding 0.3 mg/dl within 48 h. The widely used ...adverse events criteria for chemotherapy, Common Toxicity Criteria for Adverse Events Version 4.0 (CTCAE v4.0), also defined AKI as sCR exceeding 0.3 mg/dl, but with no provision of a time course. Here, we attempted to clarify the impact of AKI (CTCAE v4.0) during cisplatin-based chemotherapy on clinical outcome of patients with advanced urothelial cancer (UC).
Methods
This multicenter retrospective study included 230 UC patients who received cisplatin-based chemotherapy.
Results
During the first chemotherapy course, AKI (CTCAE v4.0) episodes were observed in 61 patients (26.5 %), whereas only four patients (1.5 %) experienced AKI (KDIGO) episodes. Both the pretreatment estimated glomerular filtration rate (eGFR) and creatinine clearance by Cockcroft–Gault formula were not efficient predictors for the development of AKI (CTCAE v4.0). AKI (CTCAE v4.0) impacted renal function: at the start of second-course chemotherapy, the average eGFR of the patients with AKI (CTCAE v4.0) was 54.1 ml/min/1.73 m
2
, significantly lower than that of patients without AKI (CTCAE v4.0) (63.4 ml/min/1.73 m
2
). As a result, only 57.4 % of patients with AKI (CTCAE v4.0) received the planned treatment at the second course. The survival of the patients who developed AKI (CTCAE v4.0) was significantly worse than that of the patients who did not. The 3-year OSs were 10.3 and 21.4 %, respectively (
P
= 0.02).
Conclusion
The present study demonstrated that AKI (CTCAE v4.0) during chemotherapy had a negative impact on both the intensity of subsequent chemotherapy and oncological outcomes.
Background
The standard regimen of systemic chemotherapy for patients with advanced urothelial cancer (UC) changed from methotrexate, vinblastine, adriamycin, and cisplatin (MVAC) to gemcitabine and ...cisplatin (GC) in 2008 when the use of gemcitabine for UC began to be reimbursed by public health insurance in Japan. We examined its influence on the chemotherapy trend in elderly patients aged ≥80 years.
Methods
Among 345 patients included in our previous multicenter retrospective cohort study (chemotherapy for urothelial carcinoma: renal function and efficacy study; CURE study), the outcome of 30 patients aged ≥80 years was reviewed before and after 2008 and compared with 315 young patients.
Results
There were only 7 (4.6 %) elderly individuals among all registered patients before 2008, whereas the number increased to 23 (12 %) after 2008. Before 2008, only one elderly patient received MVAC, while GC (whose rate was similar to the rate in young patients) was administered to 13 patients (56.5 %) after 2008. The chemotherapeutic effect and overall survival (OS) rate was not significantly different between young and elderly patients. In the elderly treated with the GC regimen, the renal impairment rate after the first cycle was significantly higher, and the presence of distant metastases and renal impairment were independent prognostic factors in a multivariate analysis.
Conclusion
Since GC was approved as the standard regimen for first-line chemotherapy in UC, selected elderly patients have been able to safely receive systemic chemotherapy like young patients. The clinical response rate and OS rate were similar to the young, but we need to monitor changes in renal function more closely in the elderly treated with GC.
In the cardiopulmonary support system with an ECMO (extracorporeal membrane oxygenation), ahigher pump head is demanded for a blood pump. In order to realize a blood pump with higher pump head, ...higher anti-hemolysis and thrombosis performances, astudy on the development of unprecedented multistage blood pump was conducted. In consideration of the applicationof the blood pump for pediatric patients, a miniature two-stage centrifugal blood pump with the impeller's diameter of40mm was designed and the performance was examined in experiments and computations. Some useful knowledge for a design of the blood pump with higher anti-hemolysis and thrombosis performances was obtained.
Objective
We developed fiducial imaging‐guidance markers for the prostate with less imaging artifacts than currently commercially available markers. The aim of this study was to evaluate the imaging ...artifacts and potential usefulness and safety of these novel fiducial imaging markers in preclinical experiments.
Methods
We selected specific metal materials and a shape that can minimize artifacts in line with a license we obtained for a metal with a gold‐platinum (Au‐Pt) alloy composition that maximized artifact‐free MRI images. Both phantom and canine prostate tests were conducted in order to evaluate the imaging artifacts for three imaging modalities, MRI, CT and ultrasound, and the risk of migration of the markers from the site of insertion to elsewhere, as well as crushing.
Results
The newly developed Au‐Pt material had less imaging artifacts in the MRI, CT and ultrasound imaging modalities in comparison with current commercially available fiducial markers made from gold materials only. The Au‐Pt markers had sufficient strength and durability and were considered to be potentially clinically useful and safe markers.
Conclusion
The developed Au‐Pt markers could be potential tools for accurate lesion‐targeted, organ‐preserving therapies such as lesion‐targeted focal therapy and active surveillance in addition to conventional radiation therapies.
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