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Nutritional intervention against cancer-derived sarcopenia.
Get PDFMost patients with advanced cancer develop skeletal muscle atrophy called sarcopenia, which reduces treatment tolerance and social activity and worsens the prognosis. Glucose suppresses skeletal muscle atrophy in cancer-bearing mice, while promoting cancer growth. In contrast, medium-chain fatty acids reduce skeletal muscle atrophy and suppress cancer growth. Simultaneous administration of glucose and medium-chain fatty acids suppresses skeletal muscle atrophy and eliminates the tumor growth seen with glucose. Based on these findings, dietary intervention using a combination of glucose and medium-chain fatty acids is expected to be effective in suppressing sarcopema in cancer patients
本態性振戦に対するMRIガイド下集束超音波視床破壊術の臨床転帰に影響する因子は何か。
Get PDFObjective: Magnetic resonance imaging-guided focused ultrasound (MRgFUS) is a novel and useful treatment for essential tremor (ET); however, the factors impacting treatment outcome are unknown. The authors conducted this study to determine the factors affecting the outcome of MRgFUS. Methods: From May 2016 through August 2017, 15 patients with ET were admitted to Ohnishi Neurological Center and treated with MRgFUS. To determine the factors impacting treatment outcome, the authors retrospectively studied correlations between the Clinical Rating Scale for Tremor (CRST) improvement rate and age, disease duration, baseline CRST score, skull density ratio (SDR), skull volume, maximum delivered energy, or maximum temperature. Results: The mean CRST score was 18.5 ± 5.8 at baseline and 4.6 ± 5.7 at 1 year. The rate of improvement in the CRST score was 80% ± 22%. Younger age and lower baseline CRST score were correlated with a higher CRST improvement rate (p = 0.025 and 0.007, respectively). To obtain a CRST improvement rate ≥ 50%, a maximum temperature ≥ 55°C was necessary. There was no correlation between SDR and CRST improvement rate (p = 0.658). A lower SDR and higher skull volume required significantly higher maximum delivered energy (p = 0.014 and 0.016, respectively). A higher maximum temperature was associated with a significantly larger lesion volume (p = 0.026). Conclusions: Younger age and lower baseline CRST score were favorable outcome factors. It is important to assess predictive factors when applying MRgFUS.博士（医学）・乙第1468号・令和2年9月30日©AANS 2020, except where prohibited by US copyright law.発行元の規定により、本文の登録不可。本文は以下のURLを参照 "http://dx.doi.org/10.3171/2020.2.JNS192814"（※全文閲覧は学内限定
不登校行動のある子どもの健康に関連した生活の質に及ぼす自尊感情と精神医学的診断の影響
Get PDFBackground: School refusal behavior (SRB), which is the refusal to attend or remain in school, has been associated with emotional, psychological, and other behavioral problems, as well as a lower health-related quality of life (HRQOL). However, the effects of self-esteem and a psychiatric diagnosis in students with SRB on HRQOL are not yet known. Understanding these relationships could help to develop more effective therapeutic interventions. Methods: A total of 175 young people (aged 8-18 years old) who visited our medical centers and outpatient clinics participated in the study. This comprised the SRB group (n = 70) and an age- and sex-matched control group (n = 105). Information about any psychiatric diagnosis was collected from medical records, HRQOL was measured using the J-KIDSCREEN-52, SRB was assessed using the School Refusal Assessment Scale-Revised for Japanese Attendance at School, self-esteem was measured using the Rosenberg Self-Esteem Scale, children's mental health status was measured using the Strengths and Difficulties Questionnaire, and social support was measured using the Oslo 3-item Social Support Scale. We performed between-group comparisons and multiple regression analysis. Results: The SRB had a significantly lower HRQOL than the control group in several of the KIDSCREEN-52 dimensions. In the SRB group, 35.7% had chronic disease and 35.7% of their parents had health problems and were receiving treatment. The multiple regression analysis revealed that, within the SRB group, a psychiatric diagnosis was associated with a lower HRQOL. However, this was not the case for a diagnosis of autistic spectrum disorder. Self-esteem positively affected HRQOL in six dimensions of the KIDSCREEN-52 within the SRB group. Conclusion: Our results could inform the development of support strategies for young people with SRB. Namely, support that enhances self-esteem could be used to increase HRQOL in young people with SRB. Furthermore, the presence of psychiatric disorders should be assessed as early as possible.博士（医学）・乙第1473号・令和2年9月30日© 2020 Matsuura et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.
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成人期自閉スペクトラム症における逆境的小児期体験の事象関連電位への影響
Get PDFChildhood maltreatment is defined as experiencing of physical, emotional and sexual abuse and neglect in childhood. Maltreatment in childhood leads to substantial psychosocial problems later in life in the general population. Individuals with autism spectrum disorder (ASD) have a higher risk of experiencing stressful and traumatic events, such as maltreatment, during childhood. Although childhood maltreatment reportedly leads to psychosocial problems in adults with ASD, the biological associations between childhood experiences and brain function in this population remain understudied. Here, we evaluated the relationships between childhood experiences and event-related potential (ERP) components during the auditory odd-ball task in adults with ASD (N = 21) and typically developed (TD) individuals (N = 22). We found that the higher the severity of sexual abuse, the larger the amplitude of P300 at Fz, Cz, C3, and C4 in individuals with ASD. Conversely, the severity of child maltreatment was associated with P300 latency at Cz and C3 in TD individuals. Moreover, full IQ was significantly associated with the MMN amplitude at Fz, Cz, C3, and C4 in TD individuals. These findings provide the first evidence that ERPs could be used to study the impacts childhood experiences on the brain of individuals with ASD and that childhood sexual abuse has salient impacts on brain function in this population.博士（医学）・甲第762号・令和2年12月24日Copyright © The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
内視鏡超音波ガイド下穿刺吸引の液状検体の残余を用いたK-ras 遺伝子検査は正診率を高める
Get PDFBackground: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) technology is widely used for the diagnosis of pancreatic masses. However, in some cases, inadequate tissue volume or difficulty of morphological diagnosis are constraining factors for adequate cytopathological evaluation. K-ras mutation is the most frequently acquired genetic abnormality, occurring in approximately 90% of all patients with pancreatic ductal adenocarcinoma (PDAC). In the present study, the clinical utility of residual liquid-based cytology (LBC) specimens obtained using EUS-FNA for K-ras mutation analysis was evaluated. Methods: In this study, 81 patients with pancreatic lesions were examined. The cell block (CB) specimens separated from EUS-FNA samples were morphologically evaluated by hematoxylin-eosin (HE) staining. Final diagnoses were confirmed by CB specimens, surgical resection specimens, diagnostic imaging, and clinical follow-up. Genomic DNA of residual LBC specimens stored at 4°C for several months were extracted and assessed for K-ras mutations using a fluorescence resonance energy transfer-based preferential homoduplex formation assay. Results: K-ras mutation analysis using residual LBC samples was successful in all cases. The sensitivity, specificity, and accuracy of CB examination alone were 77.4%, 100%, and 81.3%, respectively, and those of the combination of CB examination and K-ras mutation analysis were 90.3%, 92.3%, and 90.7%, respectively. Furthermore, K-ras mutations were detected in 8 (57.1%) of 14 PDAC samples for which the CB results were inconclusive. Conclusion: These findings suggest that K-ras mutation analysis using residual LBC specimens improves the diagnostic accuracy of EUS-FNA.博士（医学）・乙第1492号・令和2年12月24日Copyright: © 2018 Sekita-Hatakeyama et al. This is an open access article distributed under the terms of the Creative Commons Attribution License(https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Investigation of The Cause of Death in Inpatients with Dementia in Akitsu Konoike Hospital.
Get PDFThe mortality rate of patients with dementia is known to be higher than that of the general population. Pneumonia is one of the most common causes of death in patients with dementia, and proper intervention is important for clinical outcomes. To date, it remains unclear whether there are differences in the risk factors of pneumonia among different types of dementia. Here, we investigated the primary cause of death in patients with dementia admitted at Akitsu Konoike Hospital. Furthermore, Cox regression analyses were performed to evaluate the risk factors associated with death by pneumonia among patients with Alzheimer's dementia (AD), vascular dementia (VaD), and other conditions. We found that pneumonia was one of the most common causes of death in all of the current samples. Additionally, poor outcomes were associated with the Barthel index in AD and aging or short disease duration in VaD. These results suggest that considering the diagnostic differences in death by pneumonia is important for clinical treatment of patients with dementia
ガンマデルタT細胞を介したミノドロン酸の非小細胞肺癌細胞株に対するアポトーシス誘導効果の検討
Get PDFBackground/aim: Non-small cell lung carcinoma (NSCLC) is one of the leading causes of cancer-related death worldwide. Recent studies showed that nitrogen-containing bisphosphonates (N-BPs) directly and indirectly prevent proliferation, induce apoptosis, and inhibit metastasis of various types of cancer cell. In order to investigate the effect of combining minodronic acid (MDA) with γδ T-cells, NSCLC cells were treated with five concentrations of MDA. Materials and methods: NSCLC cells were cultured with different concentrations of MDA alone or in combination with γδ T-cells for 24 h. Results: MDA with γδ T-cells had differential apoptotic effects on the NSCLC cell lines. The cells showed significant apoptotic effects in the presence of MDA in a dose-dependent manner. Conclusion: This study is the first to report an indirect effect of MDA against NSCLC. We report the induction of apoptosis by MDA in combination with γδ T-cells.博士（医学）・乙第1446号・令和元年12月5日Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.発行元の規定により、本文の登録不可。本文は以下のURLを参照 "http://dx.doi.org/10.21873/anticanres.11174"（※全文閲覧は学内限定