Abstract The safety and efficacy of treatment with liposomal amphotericin B (L-AMB) in elderly patients has not been clarified, especially in Japanese patients. Therefore, we retrospectively analyzed ...33 elderly patients with hematological diseases of at least 65 years old who received L-AMB between 2009 and 2012. Their clinical outcomes were compared to those of 21 patients who were younger than 65 years. L-AMB was administered for empirical therapy ( n = 2) or target therapy for possible ( n = 14) or probable/proven ( n = 17) invasive fungal infection. There was no discontinuation of L-AMB due to adverse events. More than 2-fold increases from the baseline Cre, AST, and ALT values were observed in 21.2%, 39.4%, and 45.5% of the older group and 38.1%, 61.9%, and 52.4% of the younger group, respectively. The concurrent use of nephrotoxic antibiotics was the only risk factor for the development of a 2-fold increase in the serum Cre level. The duration of L-AMB was significantly longer in patients who developed grade III–IV hypokalemia. A partial or complete response was observed in 54.8% and 62.5% of the elderly and younger groups, respectively. In conclusion, L-AMB therapy appeared to be acceptably safe as empirical therapy or treatment for invasive fungal infection.
: Rabbitfish are a restricted lunar‐synchronized spawner that spawns around a species‐specific lunar phase. It is not known how the fish perceive changes in cues from the moon. One possible ...explanation is that rabbitfish utilize changes in moonlight intensity to establish synchrony. The purpose of the present study was to examine whether or not the pineal gland of the golden rabbitfish can directly perceive changes in moonlight intensity. Isolated pineal glands were statically cultured under natural or artificial light conditions and melatonin secreted into the culture medium was measured using a time‐resolved fluoroimmunoassay. Under an artificial light/dark cycle, melatonin secretion significantly increased during the dark phase. Under continuous light conditions, melatonin secretion was suppressed, while culture under continuous dark conditions seemed to duplicate melatonin secretion corresponding to the light/dark cycle in which the fish were acclimated. When cultured pineal glands were kept under natural light conditions on the dates of the full and the new moon, small amounts of melatonin were secreted at night. Moreover, exposure of cultured pineal glands to artificial and natural light conditions resulted in a significant decrease of melatonin secretion within 2 hr. These results suggest that the isolated pineal gland of golden rabbitfish responds to environmental light cycles and that ‘brightness’ of the night moon has an influence on melatonin secretion from the isolated pineal gland.
Diverse circadian systems related to phylogeny and ecological adaptive strategies are proposed in teleosts. Recently, retinal photoreception was reported to be important for the circadian pacemaking ...activities of the Nile tilapia
Oreochromis niloticus. We aimed to confirm the photic and circadian responsiveness of its close relative—the Mozambique tilapia
O. mossambicus. Melatonin production in cannulated or ophthalmectomized fish and its secretion from cultured pineal glands were examined under several light regimes. Melatonin production in the cannulated tilapias was measured at 3-h intervals; it fluctuated daily, with a nocturnal increase and a diurnal decrease. Exposing the cannulated fish to several light intensities (1500–0.1 lx) and to natural light (0.1 and 0.3 lx) suppressed melatonin levels within 30 min. Static pineal gland culture under light–dark and reverse light–dark cycles revealed that melatonin synthesis increased during the dark periods. Rhythmic melatonin synthesis disappeared on pineal gland culture under constant dark and light conditions. After ophthalmectomy, plasma melatonin levels did not vary with light–dark cycles. These results suggest that (1) Mozambique tilapias possess strong photic responsiveness, (2) their pineal glands are sensitive to light but lack circadian pacemaker activity, and (3) they require lateral eyes for rhythmic melatonin secretion from the pineal gland.
We conducted a retrospective collaborative investigation of bortezomib (Bor) plus dexamethasone (Dex) therapy (BD Tx) for 88 relapsed or refractory (Rel/Ref) MM patients at six institutes. One cycle ...BD Tx comprised of Bor (1.3 mg/m
2
/day) on days 1, 4, 8 and 11, and Dex on days 1, 2, 4, 5, 8, 9, 11 and 12, every 21 days, and the mean number of BD Tx cycles was 3. The overall response rate was 66.9%, the median overall survival (OS) was 510 days, and the median progression-free survival (PFS) was 113 days. Attainment of partial response (PR) with the first course of BD Tx associated with the longer OS and PFS and late good responder, while no patient who did not achieve PR with the first cycle attained better than very good PR (VGPR) with the subsequent BD Tx. Patient age of less than 64 years old also associated with the longer OS and PFS. In addition, both an earlier disease stage and Dex dosage had a significant impact on OS, while the attainment of VGPR within 2 cycles had a significantly longer PFS. Earlier BD Tx courses may be predictive for the subsequent therapeutic pathway of Rel/Ref MM.
We have been developing a no-insulation (NI) REBCO coil which is expected to be applied to medical accelerators and magnetic resonance imaging as a technology that can achieve both high thermal ...stability and high current density. Due to the flat shape and much greater, than the thickness, width of a REBCO-coated conductor, the screening currents are remarkably induced by changing the magnetic flux that penetrates the tape vertically. For insulated (INS) coils, this screening current causes an irregular magnetic field (screening current-induced magnetic field (SCIF)). Also, in the NI coil, an excitation delay occurs because of the current flowing in the radial direction with coil excitation. Therefore, as the cause of irregular magnetic field, it is necessary to simultaneously consider the influence of both the excitation delay and SCIF. In this study, we numerically investigate the magnetic field in the NI coil. The SCIF and an excitation delay reduce magnetic accuracy in the NI coil. Thus, we propose an energization waveform that can improve the magnetic field accuracy even if there is an excitation delay. Besides, we verified its effectiveness.
We aim to develop REBCO coil systems for high-magnetic-field whole-body magnetic resonance imaging and medical cyclotron for cancer therapy. These applications require high temporal stability and ...spatial uniformity of the generated magnetic field. Although the magnetic field generated during excitation changes very slowly, a screening-current-induced magnetic field (SCIF) is generated, which affects the required accuracy of the magnetic field. To reduce the SCIF, we focus on two methods: 1) a current control method, and 2) the use of striated coated conductors. When adopting a striated coated conductor, it is necessary to plate copper onto it in order to maintain its thermal stability and mechanical strength. However, in the copper-plated layer, changes in the magnetic field induce a coupling current, which flows between the filaments of the REBCO coated conductor. In this study, we apply the overshoot method with a plateau as a current control to eliminate the effect of coupling currents in the copper plating layer. We numerically analyzed the effectiveness of this overshoot method by visualizing the changes in the current distributions in a model pancake coil wound with a REBCO-coated conductor separated into two filaments. For that purpose, we used a three-dimensional nonlinear transient electromagnetic field computation in which the spiral arrangement of the pancake coil windings is appropriately considered.
The roles of high-dose chemotherapy/chemo-radiotherapy with either autologous or allogeneic hematopoietic stem cell supports in the treatment lymphoma continue to change. Introduction of molecular ...targeting agents and other new drugs to the standard chemotherapy have improved the treatment outcome significantly, and hematopoietic stem cell transplantation (HSCT) is not currently used as part of first-line therapy. As opposed to this, autologous HSCT are widely used for the treatment of relapsed or refractory lymphoma. Allogeneic HSCT is also increasingly being considered. However, the outcome of HSCT in relapsed/refractory lymphoma remains unsatisfactory, and a variety of molecular targeting approaches are currently being incorporated in order to improve the outcome of HSCT for lymphoma.
近年，光化学オキシダント汚染の広域化がみられる中で，簡便かつ実用的に測定局の最適配置を検討する方法が必要とされている．本研究では，大津市とその周辺においてオゾンと窒素酸化物について既存の測定局のデータをパッシブサンプラーで補間した上でクリギング法を適用して，オゾンおよびポテンシャルオゾンを対象に濃度の空間分布予測手法を検討し，その予測精度について評価した．パッシブサンプラーによる測定は十分な精度と真度であり，自動測定機のデータと同等に扱えることが確認出来た．クリギング法による空間分布予測精度は概ね良好でO3 および PO の空間分布予測に有効な手法であることがわかった．クリギングの過程で得られるレンジは空間代表スケールを表し，風速との間に正の相関が認められた．ただし，長距離輸送等により対象領域全体が同一の気塊の影響を受ける場合，あるいはローカルの発生源の影響が大きい場合には，化学輸送モデルによる解析や排出インベントリを補助変数とする回帰クリギング法を用いた解析が必要であると考えられた．
Objectives The final evaluation of the Japanese government's Healthy Parents and Children 21 project in 2014 noted an increase in low birth weight infants as an aspect that worsened. In order to ...reduce the number of low birth weight infants, miscarriages, and stillbirths in Kurume City, we conducted a survey aimed at researching new measures, including the search for new risk factors of birth complications.Methods The participants of this study were 2,986 pregnant women who submitted a pregnancy notification form in 2014. We excluded women who moved away from Kurume city or for whom birth weight records could not be obtained. Information from the pregnancy notification form was linked to birth weight records to examine the relationships between low birth weight infants, miscarriages, stillbirths, and pregnancy attributes. Variables that were shown to be related in an initial univariate analysis were analyzed further in a multiple logistic regression analysis with low birth weight, miscarriage, or stillbirth as the response variables.Results A multiple logistic regression analysis showed that being 35 years or older (odds ratio OR: 1.41), height less than 158 cm (OR: 1.45), non-pregnant body mass index (BMI) less than 18.5 (OR: 1.48), and detection of physical abnormalities by a physician during the pregnancy (OR: 2.20) were independent maternal factors that were significantly associated with low birth weight. Being aged 35 years or older (OR: 2.05) and smoking (OR: 3.42) were independent factors that were significantly associated with miscarriage and stillbirth. In addition, the cessation of alcohol use (OR: 0.51) significantly reduced this risk.Conclusion Because some biological factors such as “age” and “non-pregnant BMI” are invariable, we encourage pregnant women to get checkups to detect abnormalities early or to attend birthing classes that offer mental support, especially for pregnant women over 35 years. We want to tell young generations that pregnant women over 35 are at an increased risk of having low birth weight infants, miscarriages, and stillbirths, and those pregnant women with a lower BMI have an increased risk of low birth weight infants. “Maintenance of appropriate body weight,” “smoking,” “alcohol,” socioeconomic issues such as “lack of systems for seeking advice and support staff,” and “financial concerns” can be improved with health education from public health nurses and multidisciplinary support interventions. At the Children Care Support Center in Kurume city, professionals work together to provide continuous support to families during pregnancy, childbirth, and parenting. As a result, we may be able to contribute to reducing the number of low birth weight infants, miscarriages, and stillbirths.
