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The perception of breast cancer and the factors influencing behavior of breast cancer screening in the women of the working and/or mother.
No full text【目的】就労・母親世代の一般女性の乳がんに対する認識およびその検診の受診行動に影響する要因を明らかにした。【方法】一般女性を対象としてインタビューを行い、逐語録を作成して意味内容の類似性に従い分類した。【結果】対象者10名は24～36（平均年齢32.3）歳。乳がんに対する認識として、治る病気を自分で見つけることができること、身近な存在の人のがん体験を通してがんのことについて興味をもつことなどが明らかになった。検診受診行動の阻害要因として授乳、情報不足など、促進要因として費用の補助、必要性を実感することがわかった。【考察】検診の利点を認識して定期的に受診行動がとれていた場合においても、妊娠、出産、授乳などのライフイベントで乳がん検診を中断してしまったり、費用や情報不足が受診行動を阻害していた。乳がん検診の啓発活動における課題は、検診による安心感、がん体験者との交流、費用の補助、具体的な情報収集方法などを考慮することが考えられた。Purpose: The purpose of this study was the perception of breast cancer and the factors influencing behavior of breast cancer screening. Method: Interviews were conducted for women, and verbatim transcripts were prepared and classified according to semantic content similarity. Results： 10 women were between 24 to 36 years old (average age,32.3). Regarding perception of breast cancer, it was clear that it was possible for people to be influenced by having been cured of a disease, and to be interested in cancer through the cancer experience of people close to them. It was found to be necessary to subsidize expenses as a promoting factor, and lack of information were identified as obstacles in the behavior of medical examinations. Conclusions: Even if medical examination were regular and the benefits of them were recoginized,or interrupted by life events such as pregnancy, childbirth, the lactation, cost and lack of information affected medical examination behavior. Problem in breast cancer screening awareness‾raising activities included the need to consider security during examination, interacting with people with the cancer experience, cost subsidies, and the specific information collection method
手術部位感染の予測因子としての肝切除術後早期のドレーン排液培養の有用性
Get PDFPurposes: The relationship between the results of bacterial drainage fluid cultures in the early postoperative period after liver resection and the development of surgical site infections (SSIs) is unclear. We evaluated the diagnostic value of bacterial cultures of drainage fluid obtained on postoperative day (POD) 1 after liver resection. Methods: The cases of all consecutive patients who underwent elective liver resection from January 2014 to December 2016 were analyzed. The association between a positive culture result and the development of SSIs was analyzed. Results: A total of 195 consecutive patients were studied. Positive drainage fluid cultures were obtained in 6 patients (3.1%). A multivariate analysis revealed that a positive drainage fluid culture was an independent risk factor for SSIs (odds ratio: 8.04, P = 0.035), and combined resection of the gastrointestinal tract was a risk factor for a positive drainage fluid culture (P = 0.006). Among the patients who did not undergo procedures involving the gastrointestinal tract, there was no association between drainage fluid culture positivity and SSIs. Conclusions: The detection of positive culture results for drainage fluid collected on POD 1 after liver resection was associated with SSIs. However, among patients who did not undergo procedures involving the gastrointestinal tract, it was not a predictor of SSIs.博士（医学）・乙第1466号・令和2年9月30日© Springer Nature Singapore Pte Ltd. 2018This is a post-peer-review, pre-copyedit version of an article published in Surgery today. The final authenticated version is available online at: http://dx.doi.org/10.1007/s00595-018-1629-8
重症心身障害児における低栄養のリスク因子についての検討
Get PDFBackground: Children with severe motor and intellectual disabilities (SMID) are at a high risk of malnutrition and often require tube feeding to maintain their nutritional status. However, determining their energy requirements is difficult since inadequate dietary intake, severe neurological impairment, respiratory assistance, and cognitive impairment are all factors that affect malnutrition in SMID. Aim: This study investigated the factors affecting malnutrition and identified problems affecting the nutritional status of children with SMID. Methods: Forty-two children with SMID with oral motor dysfunction who were receiving home medical care at one of four hospitals were enrolled. Their nutritional status was assessed using a 3-day dietary record, anthropometric measurements, and laboratory tests. The clinical findings associated with malnutrition were compared, and a body mass index (BMI) z-score less than -2SD was defined as malnutrition. The relationship between BMI z-score and other potential predictors was also investigated. Results: Thirty-three (79%) children received tube feeding, and 20 (48%) experienced malnutrition. The median age of the malnourished children was older than that of non-malnourished children. Respiratory assistance was significantly correlated with higher BMI z-score, independent of other potential confounders such as nutrition method, muscle tonus, and energy intake. Cholesterol levels were significantly higher in children receiving a standard infant formula beyond 3 years of age than in those who switched to enteral formula before 3 years of age. Conclusions: Malnutrition in children with SMID was mainly associated with age or respiratory condition. Energy requirements should be regularly re-evaluated with considering these factors.博士（医学）・甲第761号・令和2年12月24日Copyright © 2020 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved
頚動脈プラーク摘出標本を用いた近赤外線分光法によるプラーク分布と病理学的評価の整合性
Get PDFCarotid artery stenting (CAS) is performed as a treatment for carotid artery stenosis. However, lipid-rich plaques cause embolic complications and sequelae. Near-infrared spectroscopy (NIRS) can identify lipid components by applying a near-infrared absorption pattern, and the distribution of lipid components can be evaluated as the maximum lipid core burden index (maxLCBI). Intravascular ultrasound (IVUS) equipped with NIRS has been clinically applied recently, and its diagnostic usefulness and validation have been reported for coronary arteries; however, its consistency with actual pathological diagnosis in carotid artery lesions has not been validated. In this study, we investigated the consistency between the maxLCBI values and histopathological diagnoses. Patients with cervical carotid artery stenosis who underwent carotid endarterectomy (CEA) were examined in this prospective study. Pathological diagnosis was determined after NIRS evaluation, which was performed on the extracted plaques ex vivo. The histological slices of decalcified and paraffin-embedded sections were stained by hematoxylin-eosin (HE) and Elastica van Gieson (EVG), and for low-density lipoprotein (LDL), C-reactive protein (CRP), CD68, and glycophorin A. The correlation between maxLCBI values and histological findings. Seventy lesions assessed by NIRS were pathologically analyzed. There was a positive linear correlation between maxLCBI values and pathological findings as determined by HE (angle), HE (area%), EVG, CRP, and CD68 staining (respectively, r = 0.624, p <0.001; r = 0.578, p <0.001; r = 0.534, p <0.001; r = 0.723, p <0.001; r = 0.653, p <0.001). In conclusion, the maxLCBI values assessed by NIRS showed a significant positive linear correlation with pathological evaluations in carotid lesions. The maxLCBI values in carotid arteries are consistent with pathological evaluations.博士（医学）・乙第1482号・令和2年12月24日Copyright© 2020 by The Japan Neurosurgical Society This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License(https://creativecommons.org/licenses/by-nc-nd/4.0/)
腓骨皮弁による下顎骨再建術術後のインプラント周囲軟組織における治療方法の検討
Get PDFIn maxillofacial reconstruction implant treatment, unsatisfactory soft tissue treatment of the area around the implant may lead to inflammation. As a result, appropriate soft tissue treatment is critical. To the best of our knowledge, there are no studies that compare the different tissue treatment methods available. Hence, in this study, we compare three soft tissue treatment methods around implants after mandibular reconstruction is achieved with a fibula-free flap. Out of 33 patients who underwent mandible reconstruction using fibula-free flaps between 2006 and 2015, 5 were selected for this study. A total of 17 implants were used for treatment by the final prosthetics of the five patients. Three soft tissue treatment methods with free gingival graft (FGG) were evaluated, namely, installing a splint in a modified abutment to protect the wounded area during a palatal mucosa transplant (method 1), installing a splint or dentures to a locator abutment (method 2), and the use of screw-in fixed dentures (method 3). The method that could guarantee the widest keratinized mucosa was the screw-in fixed denture method. The results of our study indicated that employing screw-in fixed dentures for FGG may be a useful soft tissue treatment for mandible reconstruction implants.博士（医学）・乙第1491号・令和2年12月24日Copyright © 2020 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/)
口腔癌細胞株におけるcetuximabを介した抗体依存性細胞障害(ADCC)活性と細胞表面EGFR発現との関連
Get PDFBACKGROUND/AIM: Cetuximab treatment targets the epidermal growth factor receptor (EGFR) overexpressed in oral cancer. This study aimed to investigate the anti-tumour activity of cetuximab against oral cancer cell lines with respect to antibody-dependent cell-mediated cytotoxicity (ADCC), and determine the correlation between ADCC and EGFR expression. MATERIALS AND METHODS: EGFR expression in oral cancer cells was measured by quantitative flow cytometric analysis and immunohistochemistry. ADCC activity was measured by 4-h calcein release assays. RESULTS: Cetuximab-mediated ADCC against oral cancer cells was detectable at a concentration of 0.1 μg/ml. A high correlation was observed between the number of EGFR molecules on the surface of oral cancer cells and ADCC (correlation coefficient: 0.847; p=0.032). CONCLUSION: ADCC is an important mechanism underlying the therapeutic effect of cetuximab, and EGFR expression in tumour cells might serve as a predictive marker to evaluate the effect of cetuximab treatment.博士（医学）・甲第721号・令和元年9月27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.13238"（※全文閲覧は学内限定