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Carboplatin-Paclitaxel Chemoradiotherapy With 66 Gy For Elderly Patients With Locally Advanced Non-Small-Cell Lung Cancer.
Get PDFBackground/ Aim: The common radiation dose administered with chemoradiotherapy for stage III non-small-cell lung cancer (NSCLC) is 60 Gy. We aimed to examine the feasibility and effectiveness of carboplatin-paclitaxel chemoradiotherapy with 66 Gy for elderly NSCLC patients.
Patients and Methods: Forty-five patients with stage III NSCLC were enrolled from 2011 to 2014 at our hospital. They were divided into three groups according to their status and underwent different treatments. Overall survival (OS), progression-free survival (PFS), and local control (LC) were determined. Toxicity was evaluated with NCI-CTCAE ver. 4.0; intergroup differences were analysed statistically.
Results: The group receiving carboplatin-paclitaxel chemotherapy with 66 Gy showed the longest median OS (40.4 months), PFS (17.9 months), and LC (44.3 months). Toxicity was acceptable in all groups.
Conclusion: For elderly patients with stage III NSCLC, carboplatin-paclitaxel chemoradiotherapy with 66 Gy is suggested to be feasible and effective
RELATIONSHIP BETWEEN LOCOMOTOR ORGAN HEALTH STATUS AND PHYSICAL FITNESS TEST IN 5TH GRADE ELEMENTARY SCHOOL STUDENTS
Get PDFBackground: Physical fitness tests determine the current state of physical fitness and athletic ability among children, and the results are widely used as basic administrative data. In 2016, Japan introduced locomotor examinations for elementary school children. In this study, we conducted physical fitness tests and locomotor examinations to assess whether physical fitness is related to locomotor health.
Methods:We conducted physical fitness tests (8 items)a nd surveys on locomotor health status (7 items) among 259 girls and 309 boys. Then, we counted the number of children who required consultation with an orthopedic surgeon for a secondary examination.
Results: The physical fitness test results were normally distributed. According to the mean value，skewness, and kurtosis, we found no difference between these results and the distribution nationwide. The secondary examination was required in 39 (6.9%)children. A histogram of the physical fitness test results and the number of children requiring a secondary examination revealed no normal distribution，showing polarization between the peaks of the higher and lower parts of the physical fitness test results
Conclusions: Those with low physical fitness test results and impaired locomotor health may be affected by obesity, and those with high physical fitness test results and impaired locomotor health may be musculoskeletal overused.
Therefore，it is necessary to consider appropriate interventions int he future
A CASE OF FUNGAL TENOSYNOVITIS CAUSED BY CANDIDA PARAPSILOSIS THAT WAS DIFFICULT TO DIAGNOSE
Get PDFA 59-year-old woman presented with swelling of the distal interphalangeal (DIP) joint to base of the distal phalanx of the left middle finger for more than 2 years. The patient was suspected to have infectious tenosynovitis, but the causative microorganism could not be identified. The patient was treated diagnostically with antimicrobial agents，but the condition worsened again during treatment, and Candida parapsilosis was detected in the joint fluid culture. Although it took some time to make a definite diagnosis due to prior antimicrobial therapy at another hospital and failure to promptly perform a third debridement, a diagnosis of fungal tenosynovitis was finally made based on culture and histopathological findings
サリチル酸誘発耳鳴に対する牛車腎気丸の抑制効果の行動学的および免疫組織化学的な根拠
Get PDFMany people are affected by tinnitus, a sensation of ringing in the ear despite the absence of external sound. Goshajinkigan (GJG) is one of the formulations of Japanese traditional herbal medicine and is prescribed for the palliative treatment of patients with tinnitus. Although GJG is clinically effective in these patients, its behavioral effects and the underlying neuroanatomical substrate have not been modeled in animals. We modeled tinnitus using salicylate-treated rats, demonstrated the effectiveness of GJG on tinnitus, and examined the underlying neuronal substrate with c-Fos expression. Intraperitoneal injection of sodium salicylate (400 mg/kg) into rats for three consecutive days significantly increased false positive scores, which were used to assess tinnitus behavior. When GJG was orally administered one hour after each salicylate injection, the increase in tinnitus behavior was suppressed. The analysis of c-Fos expression in auditory-related brain areas revealed that GJG significantly reduced the salicylate-induced increase in the number of c-Fos-expressing cells in the auditory cortices, inferior colliculus, and dorsal cochlear nucleus. These results suggest a suppressive effect of GJG on salicylate-induced tinnitus in animal models.博士（医学）・甲第851号・令和4年9月28日Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/)
Development of the Competency of Problem Finding with Inquiry- Based Learning Approach as the Program of Teaching Assessment.
Get PDFIBL方式による看護アセスメント教育プログラムは、推論一論証の思考プロセスを開発する教育方法であり、(1)僅かな情報(2)主体的な知識の形成(3)限られた時間内での演繹・帰納思考の活用(4)問題的な状況(5)グループ活動と個人学習の組み合わせの特徴をもつ。IBLは、事実、仮説、必要な情報、調べる項目の4つの思考プロセスの繰り返し、仮説生成、情報追加、検証の活用を教育プログラムに組み込んでいる。各思考プロセスを学習者、教員双方が共有して可視化できる仕掛けがあり，学習者自身も視野の範囲、思考の課題などに自ら気づくことが容易となる。Our nursing assessment teaching model with Inquiry-Based Learning approach aims at raising awareness of reasoning process and acquisition of reasoning capability.This model has characteristics as follows:(1)limited information(2)independent building knowledge(3)deductive-inductive thinking within a limited time(4)problematic situation(5)combination of group activities and individual personal work.IBL approach focuses on repetition of four steps ofreasoning process:“fact”,“ hypothesis”,“necessary information”,and “items to be looked at”.IBL approach lets both teachers and learners be aware of learners' acquisition of reasoning capability. Consequently, it also has an advantage of making learners' acquisition of competency and literacy clear
アンジオテンシンII 受容体拮抗薬であるロサルタンは、レンバチニブによるヒト肝癌細胞への 細胞増殖抑制性および血管新生抑制効果の感性を向上させる
Get PDFMolecular targeted therapy with lenvatinib is commonly offered to advanced hepatocellular carcinoma (HCC) patients, although it is often interrupted by adverse effects which require a reduction in the initial dose. Thus, an alternative lenvatinib-based therapy to compensate for dose reduction is anticipated. This study aimed to assess the effect of combination of low-dose of lenvatinib and the angiotensin-II (AT-II) receptor blocker losartan on human HCC cell growth. In vitro studies found that losartan suppressed the proliferation by inducing G1 arrest and caused apoptosis as indicated by the cleavage of caspase-3 in AT-II-stimulated HCC cell lines (Huh-7, HLE, and JHH-6). Losartan attenuated the AT-II-stimulated production of vascular endothelial growth factor-A (VEGF-A) and interleukin-8 and suppressed lenvatinib-mediated autocrine VEGF-A production in HCC cells. Moreover, it directly inhibited VEGF-mediated endothelial cell growth. Notably, the combination of lenvatinib and losartan augmented the cytostatic and angiostatic effects of the former at a low-dose, reaching those achieved with a conventional dose. Correspondingly, a HCC tumor xenograft assay showed that the oral administration of losartan combined with lenvatinib reduced the subcutaneous tumor burden and intratumor vascularization in BALB/c nude mice. These findings support that this regimen could be a viable option for patients intolerant to standard lenvatinib dosage.博士（医学）・甲第813号・令和4年3月15日© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/)
短編映像教材視聴による学校教員のメンタルヘルスリテラシー教育の効果の検討
Get PDFBackground: Mental illness-related stigma represents a barrier to seeking and receiving appropriate mental health care. Mental health literacy (MHL) can improve mental health knowledge, decrease stigmatizing attitudes, and enhance help-seeking behavior. Starting from 2022, mental illness-related education is due to be introduced in high schools in Japan. For this current situation, we conducted a parallel group, randomized controlled trial to examine the effectiveness of MHL educational program for teachers. Methods: The educational program described in this study comprised a 50-min video lesson designed to improve teachers' MHL. All participants were schoolteachers and were assigned either to an educational group or a waitlist control group. The assessment was conducted for both groups twice: first at baseline and then at 1-h post-intervention. The outcome measures for this trial were changes in knowledge, attitudes, and intended behaviors. Results: The educational group showed a greater improvement in knowledge regarding mental health than did the control group. The program was not effective for decreasing stigma toward mental illness. However, the educational group showed an increased intention to assist students with depression. Limitations: No long-term follow-up was implemented, which means the persistence of the educational program's effect could not be determined. Further, we could not report whether the program induced a change in teachers' behaviors regarding providing support for their students. Conclusions: The short video-based MHL educational program could improve schoolteachers' MHL and increase their intention to assist students. These findings can help in the development of similar educational programs in countries/regions experiencing similar issues regarding mental health.博士（医学）・甲第833号・令和4年3月15日Copyright © 2021 Ueda, Yamaguchi, Matsuda, Okazaki, Morimoto, Matsukuma, Sasaki and Kishimoto. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY https://creativecommons.org/licenses/by/4.0/). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms
毒素培養がClostridioides difficile感染症の抗菌薬処方に与える影響 : diagnostic stewardshipの役割
Get PDFIntroduction : Toxigenic culture has been recommended as a sensitivity enhancement option for testing Clostridioides difficile infections (CDI). However, no studies have evaluated whether toxigenic culture impacts clinical decisions such as CDI treatment. Methods : At Nara Medical University Hospital, simultaneous testing of glutamate dehydrogenase antigen (A) and toxin A/B (T) by immunochromatography has been conducted since November 2013. Furthermore, toxigenic culture (C) has been adopted since April 2018. Therefore, patients tested for CD were divided into two groups: pre-period from April 2014 to March 2018 and post-period from April 2018 to March 2021. Patient data were retrospectively examined. Results : The study included 1262 and 1023 cases in the pre- and post-periods, respectively. A significant reduction in A+T+ cases could be observed with 64 (5.1 %) and 28 (2.7%) in the pre- and post-periods (P = 0.005), respectively. Of the 104 A+T- cases undergoing toxigenic culture in the post-period, 54 (51.9 %) were A+T-C+. The antimicrobial administration ratio for the A+T-C+ cases (68.5 %) was lower than that for the A+T+ patients (90.6 and 82.1 %, P = 0.014 and P = 0.417, in the pre- and post-periods, respectively), and was not significantly different from that of the A+T-patients (64.2 and 64.1 % in the pre- and post-periods, respectively) or from that of the A+ T-C-patients (64 %). Conclusion : This study showed that toxigenic culture does not necessarily affect the antibiotic administration ratio or duration. A coordinated approach under diagnostic stewardship for improved reporting and interpretation of toxigenic cultures would be necessary.博士（医学）・乙第1525号・令和4年3月15