We retrospectively investigated the efficacy and feasibility of concurrent chemoradiotherapy for patients with severe dysphagia caused by oesophageal squamous cell carcinoma. Concurrent chemoradiotherapy was performed in 57 patients with T3 or T4 disease containing M1 lymph node (LYM) disease. Chemotherapy consisted of protracted infusion of 5-fluorouracil (5-FU) 400 mg m À2 24 h À1 on days 1 -5 and 8 -12, combined with 2-h infusion of cisplatin (CDDP) 40 mg m À2 on days 1 and 8. Radiation treatment at a dose of 30 Gy in 15 fractions of the mediastinum was administered concomitantly with chemotherapy. A course schedule with 3-week treatment and a 1 to 2-week break was applied twice, with a total radiation dose of 60 Gy, followed by two or more courses of 5-FU and CDDP. In all, 24 patients (42%) achieved a complete response, and the 3-year survival rate was 19%. Major toxicities were leukocytopenia and oesophagitis, and there were two (4%) treatment-related deaths. In contrast, 22 patients with T3 disease survived longer than 35 patients with T4 disease (P ¼ 0.001); however, the survival rate in 15 patients with M1 LYM disease did not differ significantly from that in 42 patients without M1 LYM disease (P ¼ 0.3545). Our results indicate that definitive chemoradiotherapy is potentially curative for locally advanced oesophageal carcinoma with malignant stricture. The efficacy and survival of patients treated with this regimen are related to the T factor.
Interleukin (IL)-1b is known to play a role in the formation of brain edema after various types of injury. Aquaporin (AQP)4 is also reported to be involved in the progression of brain edema. We tested the hypothesis that AQP4 is induced in response to IL-1b. We found that expression of AQP4 mRNA and protein was significantly up-regulated by IL-1b in cultured rat astrocytes, and that intracerebroventricular administration of IL-1b increased the expression of AQP4 protein in rat brain. The effects of IL-1b on induction of AQP4 were concentration and time dependent. The effects of IL-1b on AQP4 were mediated through IL-1b receptors because they were abolished by co-incubation with IL-1 receptor antagonist. It appeared that IL-1b increased the level of AQP4 mRNA without involvement of de novo protein synthesis because cycloheximide, a protein synthesis inhibitor, did not inhibit the effects of IL-1b. Inhibition of the nuclear factor-jB (NF-jB) pathway blocked the induction of AQP4 by IL-1b in a concentration-dependent manner. These findings show that IL-1b induces expression of AQP4 through a NF-jB pathway without involvement of de novo protein synthesis in rat astrocytes.
Observations of the polar region of the Sun are critically important for understanding the solar dynamo and the acceleration of solar wind. We carried out precise magnetic observations on both the north polar region and the quiet Sun at the east limb with the spectropolarimeter of the Solar Optical Telescope aboard Hinode to characterize the polar region with respect to the quiet Sun. The average area and the total magnetic flux of the kilo-Gauss magnetic concentrations in the polar region appear to be larger than those of the quiet Sun. The magnetic field vectors classified as vertical in the quiet Sun have symmetric histograms around zero in the strengths, showing balanced positive and negative fluxes, while the histogram in the north polar region is clearly asymmetric, showing a predominance of the negative polarity. The total magnetic flux of the polar region is larger than that of the quiet Sun. In contrast, the histogram of the horizontal magnetic fields is exactly the same for both the polar region and the quiet Sun. This is consistent with the idea that a local dynamo process is responsible for the horizontal magnetic fields. A high-resolution potential field extrapolation shows that the majority of magnetic field lines from the kG-patches in the polar region are open with a fanning-out structure very low in the atmosphere, while in the quiet Sun, almost all the field lines are closed.
Malnutrition in the early stage has been reported as an independent predictor of survival in amyotrophic lateral sclerosis (ALS). We analyzed retrospectively the effect of variation of body mass index (BMI) on survival in ALS patients. In total, 77 consecutive ALS patients were enrolled from nine hospitals in Japan. Reduction rate of BMI was calculated from BMI before the disease onset and at the time of the first visit to each hospital. We analyzed the correlation between BMI reduction rate and total disease duration. Results showed that the median BMI reduction rate was 2.5 per year (interquartile range 1.3-3.8). The BMI reduction rate was significantly correlated with survival length (p <0.0001). There was also a significant difference in survival between ALS patients with a BMI reduction rate ≥ and < 2.5 (Kaplan-Meier survival analysis and the log-rank test, p < 0.0001; hazard ratio by the Cox model, 2.9816). In conclusion, faster reduction of BMI at the initial stage before the first visit to hospital predicts shorter survival length also in Japanese ALS patients.
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