Clinical trials on carbon ion radiotherapy (C-ion RT) for the prostate cancer were conducted at the NIRS for over 20 years. The results so far have been quite satisfactory in both toxicity and tumour ...control. In addition, advancement of hypofractionation has been successfully progressed and 12-fraction C-ion RT could be established. To obtain the outcomes of multi-institutional clinical trials, a study group, J-CROS, was organized and conducts several multicenter clinical trials including the prospective study for the high-risk prostate cancer. It is expected that the outcomes of these clinical studies would result in widening the coverage of National Health Insurance for the C-ion RT. Technical progression has been also achieved at the NIRS. The scanning irradiation became available in 2011 and all the prostate cancers are treated with scanning at present. A new clinical trial of 4-fraction C-ion RT for the locally recurrent prostate cancer has been started using dose painting of scanning beam. The rotating gantry of heavy ion beam was also installed. These technical progressions enable to perform the intensity modulated ion therapy with carbon beam alone or with various ion species.
An interplanetary (IP) shock has a large impact on magnetospheric ions. Satellite observations have shown that soon after arrival of the IP shock, overall intensity of the ions rapidly increases and ...multiple energy dispersion appears in an energy‐time spectrogram of the ions. In order to understand the response of the magnetospheric ions to IP shock, we have performed test particle simulation under the electric and magnetic fields provided by the global magnetohydrodynamic simulation. We reconstructed the differential flux of H+, He+, and O+ ions at (7, 0, 0) Re in GSM coordinates by means of the semi‐Lagrangian (phase space mapping) method. Simulation results show that the ions respond to the IP shock in two different ways. First, overall intensity of the flux gradually increases at all pitch angles. As the compressional wave propagates tailward, the magnetic field increases, which accelerates the ions due to the gyrobetatron. Second, multiple energy‐time dispersion appears in the reconstructed spectrograms of the ion flux. The energy‐time dispersion is caused by the ion moving toward mirror point together with tailward propagating compressional wave at off‐equator. The ions are primarily accelerated by the drift betatron under the strong electric field looking dawnward. The dispersion is absent in the spectrogram of equatorially mirroring ions. The dispersion appears at higher energy for heavier ions. These features are consistent with the satellite observations. Because the acceleration depends on bounce phase, the bounce‐averaged approximation is probably invalid for the ions during the interval of geomagnetic sudden commencement.
Plain Language Summary
Solar storm can cause a significant compression of the magnetosphere on the dayside. The compression starts at the subsolar point and propagates toward the nightside in the magnetosphere. Some ions bouncing between the Northern Hemisphere and the Southern Hemisphere are found to be accelerated selectively when the ions move together with the propagation of the compressional wave. As a consequence, striped structures appear in the energy versus time spectrum of the ion.
Key Points
Magnetospheric ions respond to IP shock in different ways; rapid increase in flux at all pitch angles and multiple energy‐time dispersion
Energy‐time dispersion is caused by ions moving toward the mirror point together with tailward propagating fast mode wave
Energy‐time dispersion appears at higher energies in spectrograms of heavier ions. The dispersion is absent in equatorially mirroring ions.
The purpose of this study was to evaluate the feasibility of a new shortened 3-week treatment schedule of carbon ion radiotherapy (CIRT) for prostate cancer.
Beginning in May 2010, patients with ...T1b-T3bN0M0, histologically proven prostate adenocarcinoma were enrolled in the phase II trial of CIRT. Patients received 51.6 GyE in 12 fractions over 3 weeks (protocol 1002). The primary end point was defined as the incidence of late adverse events that were evaluated based on the Common Terminology Criteria for Adverse Events version 4.0. Biochemical failure was determined using the Phoenix definition (nadir +2.0 ng ml(-1)).
Forty-six patients were enrolled, and all patients were included in the analysis. The number of low-, intermediate-, and high-risk patients was 12 (26%), 9 (20%), and 25 (54%), respectively. The median follow-up period of surviving patients was 32.3 months. Two patients had intercurrent death without recurrence, and the remaining 44 patients were alive at the time of this analysis. In the analysis of late toxicities, grade 1 (G1) rectal haemorrhage was observed in 3 (7%) patients. The incidence of G1 haematuria was observed in 6 (13%) patients, and G1 urinary frequency was observed in 17 (37%) patients. No ⩾G2 late toxicities were observed. In the analysis of acute toxicities, 2 (4%) patients showed G2 urinary frequency, and no other G2 acute toxicities were observed.
The new shortened CIRT schedule over 3 weeks was considered as feasible. The analysis of long-term outcome is warranted.
Summary
Background. Although the precise pathomechanism of psoriasis is still unknown, various cytokines and growth factors derived from T cells, dendritic cells or keratinocytes, are critically ...involved in this disease. There have been several studies determining the serum levels of cytokines in patients with psoriasis, but with conflicting results. The levels of various cytokines and growth factors were measured in the sera of patients with psoriasis and compared with those of healthy controls. The correlation with disease severity was also determined.
Methods. Sera were collected from 122 patients with psoriasis and 78 healthy controls for ELISA analysis to evaluate the levels of cytokines and growth factors. The severity of psoriasis was determined by the Psoriasis Area and Severity Index (PASI).
Results. Serum levels of tumour necrosis factor (TNF)‐α, interferon (IFN)‐γ, interleukin (IL)‐2, IL‐6, IL‐7, IL‐8, IL‐12, IL‐17, IL‐18 and vascular endothelial growth factor (VEGF) were significantly increased in patients with psoriasis compared with those of healthy controls. The serum levels of IL‐2, soluble intercellular adhesion molecule‐1, epidermal growth factor, hepatocyte growth factor and amphiregulin were not significantly different from those of healthy controls. Increased serum levels of TNF‐α, IFN‐γ, IL‐12, IL‐17, IL‐18 and VEGF correlated with PASI. Furthermore, these cytokine levels were decreased after psoriasis treatment. In contrast, serum levels of IL‐10 were decreased in psoriasis and negatively correlated with PASI.
Discussion. Serum levels of TNF‐α, IFN‐γ, IL2, IL‐6, IL‐7, IL‐8, IL‐12, IL‐17, IL‐18 and VEGF were positively correlated and that of IL‐10 was negatively correlated with PASI in Japanese patients with psoriasis. These parameters might be useful for determining the disease activity of psoriasis.
Films of 1:1 blend and films non-blended were prepared from poly(
l-lactic acid) (PLLA) and poly(
d-lactic acid) (PDLA) with a solution casting method, and the mechanical properties and morphology of ...the films were investigated using tensile tests, dynamic mechanical relaxation measurements, polarizing optical microscopy, differential scanning calorimetry (DSC) and X-ray diffractometry. The tensile strength, Young’s modulus, and the elongation-at-break of 1:1 blend films were found to be higher than those of non-blended films when their weight-average molecular weight (
M
w) was in the range 1×10
5–1×10
6. The enthalpy of melting for stereocomplex crystallites in 1:1 blend films was higher than that of homo-crystallites when
M
w of polymers was below 2×10
5, while this relationship was reversed when
M
W increased to 1×10
6. Spherulites formation was suppressed in 1:1 blend films, whereas large-sized spherulites with radii of 100–1000
μm were formed for non-blended PLLA and PDLA films, irrespective of
M
w. The mechanical properties of 1:1 blend films superior to those of non-blended films were ascribed to the micro-phase structure difference generated as a result of formation of many stereocomplex crystallites which acted as intermolecular cross-links during solvent evaporation of blend solution. On the contrary, non-blended films had larger-sized spherulites of less contacting area with the surrounding spherulites.
Dissolved radiocesium concentrations in river water in a high‐dose‐rate forest watershed in Fukushima Prefecture were investigated under base flow and storm flow conditions. Under base flow ...conditions, dissolved 137Cs concentrations in water (Bq/L) were relatively high in summer, and these levels were higher than particulate 137Cs concentrations (Bq/L). Under storm flow, particulate 137Cs concentration became dominant as the suspended solid concentration increased. Throughout the monitoring period, dissolved 137Cs concentrations in water (Bq/L) were higher under storm flow than base flow conditions and were positively correlated with runoff intensity. Factors influencing changes in dissolved 137Cs concentrations were investigated by measuring the 137Cs concentration of suspended solid (Bq/kg) and dissolved 137Cs of unsaturated soil water, throughfall, and rainfall, together with other main solute concentrations. The 137Cs concentration per unit weight of suspended solids in river water was not strongly correlated with runoff intensity. Additionally, dissolved 137Cs concentrations of soil water, groundwater, and rainfall were not detected, while higher dissolved 137Cs concentrations were detected in throughfall than river water. K+ concentrations were higher under storm flow than base flow, and dissolved organic carbon increased toward the peak flow rate. These findings suggested that one main factor influencing generation of dissolved 137Cs in the river water was leaching from organic material in flooded areas. However, further investigation is needed to clarify the dominant source of dissolved 137Cs in river water.
Key Points
Dissolved 137Cs concentration in forest river water peaked in summer under base flow
Dissolved 137Cs concentrations became higher under storm flow relative to base flow
The 137Cs desorbed from litter might be an influential source of dissolved 137Cs in river water
Summary Vitamin K and D deficiency and decreased bone mineral density (BMD) were highly prevalent in patients with inflammatory bowel disease (IBD), especially Crohn's disease (CD). Dietary intakes ...of these vitamins, however, were above the Japanese adequate intakes in IBD patients, suggesting that malabsorption is the basis for hypovitaminosis K and D and decreased BMD. Introduction We have studied the possible involvement of vitamin K and D deficiency in the pathogenesis of decreased BMD in IBD. Methods Seventy patients with IBD were evaluated for their BMD; plasma levels of vitamin K; phylloquinone (PK), menaquinone-7 (MK-7), and 25OH-D; serum PTH, protein induced by vitamin K absence (PIVKA-II), and undercarboxylated osteocalcin (ucOC) levels; and their food intake. Results Compared with ulcerative colitis (UC) patients, CD patients had significantly lower plasma vitamin K and 25OH-D concentrations; significantly higher serum levels of PTH, PIVKA-II, and ucOC; and significantly lower BMD scores at almost all measurement sites. More IBD patients were vitamin K deficient in bone than in liver. Multiple regression analyses revealed that low plasma concentrations of vitamin K and 25OH-D were independent risk factors for low BMD and that they were associated with the patients' fat intake, but not with their intake of these vitamins. Conclusion IBD patients have high prevalence of decreased BMD and vitamin K and D deficiency probably caused by malabsorption of these vitamins.
The National Institute of Radiological Sciences in Chiba, Japan has offered carbon ion radiotherapy (CIRT) since 1994 using carbon ion beams generated by the heavy ion medical accelerator in Chiba ...(HIMAC). The total number of cases treated with the HIMAC exceeded 5000 in July 2009. Here, we present a retrospective analysis of CIRT for sacral chordoma. The study included 95 patients with medically unresectable sacral chordomas treated between 1996 and 2007. The median age of the patients was 66 years. Of all the patients, 84 had not been treated previously and 11 had a locally recurrent tumour following previous resection. The carbon ion dose ranged from 52.8 to 73.6 GyE (median 70.4 GyE) in a total of 16 fixed fractions over 4 weeks. The median clinical target volume was 370 cm(3). The overall survival rate at 5 years for all 95 patients was 86%, and follow-up survival time was 42 months (range, 13-112 months). The 5-year local control rate was 88% and median time to local failure was 35 months (range, 13-60 months). Of the 95 patients, 91% remained ambulatory with or without a supportive device. Two patients experienced severe skin or soft tissue complications requiring skin grafts. 15 patients experienced severe sciatic nerve complications requiring continuing medication. CIRT appears effective and safe in the management of patients with sacral chordoma and offers a promising alternative to surgery.
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