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The vasodilator effect of nitroglycerin in spastic MCA may not be mediated by an increase in cGMP levels, suggesting an involvement of hyperpolarization of the smooth muscle cells. Given the increase in rCBF, nitroglycerin may be therapeutic for the treatment of vasospasm.

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Although weight transfer is an important component of gait rehabilitation, the biomechanical strategy underlying the vertical ground reaction force loading/unloading in individuals with unilateral transfemoral amputation between intact and prosthetic limbs remains unclear. We investigated weight transfer between limbs at different walking speeds in 15 individuals with unilateral transfemoral amputation and 15 individuals without amputation as controls, who walked on an instrumented treadmill. The normalized unloading and loading rates were calculated as the slope of decay and rise phase of the vertical ground reaction force, respectively. We performed linear regression analyses for trailing limb’s unloading rate and leading limb’s loading rate between the prosthetic, intact, and control limbs. While loading rate increased with walking speed in all three limbs, the greatest increase was observed in the intact limb. In contrast to the other limbs, the prosthetic limb unloading rate was relatively insensitive to speed changes. Consequently, the regression line between trailing prosthetic and leading intact limbs deviated from other relationships. These results suggest that weight transfer is varied whether the leading or trailing limb is the prosthetic or intact side, and the loading rate of the leading limb is partially affected by the unloading rate of the contralateral trailing limb.

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BACKGROUND AND PURPOSE:

Surgical resection is considered a standard therapy for malignant melanoma (MM). However, it has not yet been established as an optimal treatment strategy for gynecological MMs, particularly owing to their very low incidence rates. We retrospectively analyzed clinical outcomes of carbon-ion radiotherapy (C-ion RT) for gynecological MMs. The eligibility criterion was the presence of histologically confirmed gynecological MM. Patients with pelvic or inguinal lymph node metastases were included, while those with distant metastases were excluded. The pelvic and inguinal lymph node regions were irradiated with up to 36 gray relative biological effectiveness (Gy (RBE)) followed by a gross tumor volume boost of up to 57.6 Gy (RBE) or 64 Gy (RBE) in 16 fractions over 4 weeks. Thirty-seven patients (median age: 71 years) were examined. In total, 22 patients had vaginal tumors, 12 had vulval tumors, and 3 had cervical uterine tumors. The median follow-up periods were 23 months (range: 5–103 months) for all patients and 53 months (range: 16–103 months) for survivors. Thirty of 37 patients (81%) achieved complete tumor disappearance. The 2-year local control, overall survival, and progression-free survival rates were 71%, 53%, and 29%, respectively. C-ion RT may be a definitive treatment option for patients with gynecological MM.

Abstract. Background Post-mastectomy radiation therapy (PMRT) improves local control and survival in patients with breast cancer with a high risk of recurrence (those with advanced tumor and/or multiple lymph node metastases). PMRT reduces locoregional and distant recurrence in patients with axillary dissection and in those with axillary sampling, and radiation dermatitis is its most problematic adverse event (1). Almost all reports have used a bolus to maximize the radiation dose for the chest-wall surface and to decrease the risk of local recurrence, disregarding the radiation dermatitis problem (2). However, the use of a bolus has been reported to increase the frequency of severe radiation dermatitis (3). Few reports have compared the clinical outcomes of PMRT between patients using a bolus and those not using one, and no reports have analyzed the chest-wall dose surface histogram (DSH) parameters for PMRT. Therefore, a retrospective analysis of clinical outcomes in PMRTs without bolus was conducted and the DSH parameters between irradiation plans with and without virtual boluses were compared. Patients and MethodsPatients. Between October 2011 and December 2016, 55 patients with breast cancer received PMRT at the Gunma University Hospital. Among these patients, three who received boost irradiation with electron beams were excluded because of the difficulty in recreating the precise dose distribution of electron beams using our radiation treatment planning system (RTPS) of the XiO version 4.5 software (ELEKTA, Stockholm, Sweden). Thus, 52 patients with breast cancer who received PMRT were retrospectively analyzed, and all patients were treated with 6 MV X-ray beams without bolus. Patient characteristics are summarized in Table I. Histologically, 46 patients had invasive ductal carcinoma, three had invasive lobular carcinoma, and four had other breast cancer types. Breast cancer subtypes were defined according to the status of estrogen receptor (ER), progesterone receptor (PgR), human epidermal growth factor receptor 2 (HER2), and the Ki-67 index. Twenty-four patients had luminal A (ER-positive and/or PgR-positive, HER2-negative, and Ki-67 <20%), 20 had luminal B (luminal type other than luminal A), four had HER2-enriched (ER-negative, PgR-negative, and HER2-positive), and four had triple-negative (ER-negative, PgRnegative, and HER2-negative) cancer subtypes. Twelve patients had 961