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可視・近赤外相互作用分光法は、子宮内膜症性嚢胞液中のヘモグロビン濃度を評価するために使用できる非侵襲的技術である
Get PDFHemoglobin concentrations in endometriotic cyst fluids have been found to be associated with distinct clinical manifestations, such as pelvic pain and infertility, as well as with malignant transformation. However, the measurement of the hemoglobin concentration in cyst fluid is an invasive procedure. The present study aimed to evaluate the usefulness of visible and near‑infrared interactance spectroscopy as a non‑invasive technique for estimating the hemoglobin concentration in endometriotic cystic fluid. Optical fibers were directly placed onto sliced raw pork (up to 10‑mm‑thick as an anatomical barrier on the cyst's surface) that covers a cuvette containing hemoglobin solution or endometriotic cyst fluid. Partial least square regression based on the second derivative using visible and near‑infrared interactance spectroscopy (wavelength region, 500‑1,200 nm) was used to estimate the hemoglobin concentration. The samples were categorized into the evaluation sets (i.e., calibration set) to create calibration curves and test sets (i.e., validation set) to validate equations. The cyst fluid at 5 mm of pork thickness achieved a high correlation between actual and predicted hemoglobin concentrations (calibration (R2=0.977) and validation (R2=0.874) data). However, the correlation slightly decreased at 10‑mm pork thickness (i.e., calibration (R2=0.979) and validation (R2=0.580) data). Interactance spectroscopy may thus be a non‑invasive tool which can be used to estimate the hemoglobin concentration in endometriotic cyst fluid when the anatomical barrier is 5 mm. This technology is a reliable modality for predicting the severity of dysmenorrhea and infertility, as well as malignant transformation, in a number of patients with endometriotic cysts. Such quantitative optical spectroscopic imaging technologies may enable the accurate diagnosis of the pathological processes in endometriotic cysts in clinical practice.権利情報：© 2023 Imanaka et al. This work is licensed under a Creative Commons Attribution 4.0 International (CC BY 4.0) License
ラットモデルにおける抜歯に起因するビスフォスフォネート関連顎骨壊死に対するβ-TCPの予防効果の検証
Get PDFAntiresorptive or antiangiogenic drugs can cause medication-related osteonecrosis of the jaw that is refractory. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) may be caused by procedures such as tooth extraction damage the alveolar bone, release bisphosphonates (BPs) and impede healing. This study investigated strategies for BRONJ prevention and molecular mechanisms of its onset. We assessed the effectiveness of filling extraction sockets with beta-tricalcium phosphate (β-TCP). Rats were administered zoledronic acid (ZA) 1.2 mg/kg once per week for 2 weeks, and a molar was extracted. They were randomly assigned to the β-TCP group (bone defects filled with 0.01 g of β-TCP) or control group. Tissue content measurements indicated 2.2 ng of ZA per socket in the β-TCP group and 4.9 ng in the control group, confirming BP distribution and BP adsorption by β-TCP in vivo. At 4 weeks after extraction, the β-TCP group had normal mucosal coverage without inflammation. Moreover, at 8 weeks after extraction, enhanced bone healing, socket coverage, and new bone formation were observed in the β-TCP group. Connective tissue in the extraction sockets suggested that local increases in BP concentrations may suppress the local autophagy mechanisms involved in BRONJ. Filling extraction sockets with β-TCP may prevent BRONJ.権利情報：© The Author(s) 2023. 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 licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence 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 licence, visit http://creativecommons.org/licenses/by/4.0/
前外側大腿皮弁における外側大腿回旋動脈下行枝の穿通枝と外側広筋運動枝との解剖学的位置関係
Get PDFBackground: The anterolateral thigh (ALT) flap, which is nourished by perforators from the descending branch of the lateral femoral circumflex artery (P), is one of the most commonly used flaps in soft tissue reconstruction. With the growing use of ALT flaps, attention toward donor-site morbidity has increased in recent years. Damage to the motor nerve branches of the vastus lateralis muscle (N) is one of the causes of donor-site morbidity, particularly muscle weakness. This study investigated the anatomical locations of the P and N in fresh-frozen cadaveric specimens. Methods: This study included 43 cadaver limbs. A silicone rubber compound (30 mL) was injected into the femoral artery to visualize the vessel. The locations of the P and motor points of N were measured to assess the risk of N injury during ALT flap harvesting. Results: There were one to six (mean, 2.7) P and two to seven (mean, 4) N. When the two most proximal perforators were used for flap harvesting, an average of 1.5 motor nerve branches (42%) was damaged because transection of the motor nerve branches was required for flap harvesting. In 33% of the limbs, only one motor nerve branch remained after the flap harvest. However, there were no cases where all motor nerve branches were severed. Conclusion: When an ALT flap with two perforators is harvested, weakness of the vastus lateralis muscle may occur in cases with a small number of motor nerve branches.権利情報：© 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal
Nurses' Implementation of Symptom and Drug Management Status for Perioperative Patients with Rheumatoid Arthritis Comparison of Nurses Engaged in Outpatient Work and Those Engaged in Ward Work
Get PDF目的：周術期関節リウマチ(RA) 患者に対する看護師の安全管理教育を検討するために，外来に従事している看護師（外来群）と病棟に従事している看護師（病棟群）を比較し，周術期RA患者の術前管理における症状観察および薬剤管理状況を明らかにした。
方法：対象は日本リウマチ財団登録医・看護師の在籍施設で過去3年間にRA 患者の看護に従事した看護師とした。Webによる質問調査を実施した。2,483数を配布し，368数の有効回答を得た。本研究の分析対象は周術期における看護経験者である165人とした。
結果：対象者165人は外来群75人，病棟群90人であった。外来群に比べて病棟群で手術部位および患者の 日常生活動作(activities of daily licing:以下 ADL) について有意に観察者の割合が多かった。ロジスティック回帰分析の結果，手術による中止薬の観察者は，外来群に比べて病棟群の方が以下の項目で有意に多かった；副腎皮質ステロイド(corticosteroids:以下CS) 内服状況， CS 内服患者の合併症，糖尿病合併や呼吸器合併症患者のCS 内服者の管理。両群ともに約70％の者がCS 内服者の生物学的抗リウマチ薬(bDMARDs) や分子標的型合成抗リウマチ薬（tsDMARDs) の投与者を観察していたことが明らかとなった。
結論：病棟群の看護師は外来群に比べて症状や中止薬をより適切に観察していたことが示唆された。したがって，周術期RA 患者の外来と病院の連携を念頭に置いた看護師の従事場所別の安全管理教育が必要である。Objectives: We investigated nurses'implementation of symptom and drug management, including biological DMARDs(bDMARDs)and targeted synthetic DMARDs(tsDMARDs),for perioperative patients with rheumatoid arthritis (RA).The differences between nurses engaged in outpatient work (group O; OG) and those engaged in ward work (group W; WG) were compared.
Methods: The subjects were nurses registered with the Japan Rheumatism Foundation and working at hospitals for RA care in the last 3 years. An online questionnaire on medication management and sympotoms observation (2483 questionnaires) was distributed and 368 responses were received.
Results: 165 subjects (75 in OG and 90 in WG) with valid responses were included in the analysis.Significantly more nureses monitored the daily activities of patients and monitored the surgical site in the WG compared to the OG.Logistic regression results showed that the following were significantly more monitored by the WG group compared to in the OG; corticosteroid (CS) compliance status, complications in patients taking CS, and management of patients taking CS with diabetic complications or respiratory complications.
Approximately 70%in both groups observed the administration bDMARDs or tsDMARDs in patients taking CS.
Conclusions: The results suggest that more nurses in the WG properly monitored symptoms and performed drug management compared with OG. Therefore, keeping perioperative RA outpatient clinic and hospital collaboration in mind, education on the safety of perioperative RA patients based on the location where nurses are engaged in needed
マウス脳梁グリア細胞の加齢や再ミエリン化に対する反応解析
Get PDFCells in the white matter of the adult brain have a characteristic distribution pattern in which several cells are contiguously connected to each other, making a linear array (LA) resembling pearls-on-a-string parallel to the axon axis. We have been interested in how this pattern of cell distribution changes during aging and remyelination after demyelination. In the present study, with a multiplex staining method, semi-quantitative analysis of the localization of oligodendrocyte lineage cells (oligodendrocyte progenitors, premyelinating oligodendrocytes, and mature oligodendrocytes), astrocytes, and microglia in 8-week-old (young adult) and 32-week-old (aged) corpus callosum showed that young adult cells still include immature oligodendrocytes and that LAs contain a higher proportion of microglia than isolated cells. In aged mice, premyelinating oligodendrocytes were decreased, but microglia continued to be present in the LAs. These results suggest that the presence of microglia is important for the characteristic cell localization pattern of LAs. In a cuprizone-induced demyelination model, we observed re-formation of LAs after completion of cuprizone treatment, concurrent with remyelination. These re-formed LAs again contained more microglia than the isolated cells. This finding supports the hypothesis that microglia contribute to the formation and maintenance of LAs. In addition, regardless of the distribution of cells (LAs or isolated cells), astrocytes were found to be more abundant than in the normal corpus callosum at 24 weeks after cuprizone treatment when remyelination is completed. This suggests that astrocytes are involved in maintaining the functions of remyelinated white matter.権利情報：© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022. This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s11064-022-03676-
日本における高校生物基礎教育と遺伝子組み換え食品の受容
Get PDFWhile many types of genetically modified (GM) food have become more available worldwide, the acceptance of GM food continues to be low. To increase this acceptance, various educational interventions have been conducted; however, conflicts remain about the safety and acceptability of GM food among laypeople, experts, and policymakers in several countries. Thus, this study aimed to clarify whether basic biology education influences Japanese people’s acceptance of GM food. We examined this idea by comparing individual experiences of high school biology education based on curriculum and proficiency level. We distributed online questionnaires to 1,594 people in Japan; 1,122 valid responses (70.4%) were obtained. Results showed that the acceptance rates of GM vegetables, fish, and meat were 33.6%, 29.0%, and 29.1%, respectively. Comparing the biology knowledge test scores according to different high school biology education levels (i.e., non-learners, basic, and advanced levels) showed no significant differences between the three age groups (20s, 30s, and 40s), which corresponded to different curricula (p = 0.90); however, there were significant differences between the high school biology education levels (p<0.01). Using logistic regression analysis, we then examined the effect of high school biology education on acceptance of GM food. The results showed no significant differences between different high school biology education levels but significantly lower acceptance by the 30s and 40s groups compared with the 20s group (p<0.05). This suggests that basic biology education alone is not sufficient to change people’s attitudes toward GM foods. These generational differences suggest factors other than high school biology curriculum affect different generations’ acceptance of GM foods. Overall, high school biology education did not directly affect acceptance of GM foods, although those who received a higher level of education had an increased knowledge of GM foods.権利情報：© 2023 Mine 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
糖尿病性腎症における，尿蛋白量と，糸球体および尿細管間質の組織学的変化が腎予後に与える影響の関連性
Get PDFBackground: Studies on kidney function and histological findings in diabetic nephropathy (DN) with low urinary protein (UP) are few. We examined the differential impact of histological changes on kidney outcomes between non-proteinuric and proteinuric DN. Methods: Patients diagnosed with DN by renal biopsy during 1981-2014 were divided into non-proteinuric (UP ≤ 0.5 g/day) and proteinuric (UP > 0.5 g/day) DN. The Cox proportional hazard model was used to examine the association of glomerular lesions (GLs) and interstitial fibrosis and tubular atrophy (IFTA) with end-stage kidney disease (ESKD) development after adjusting for relevant confounders. Results: The non-proteinuric and proteinuric DN groups included 197 and 199 patients, respectively. During the 10.7-year median follow-up period, 16 and 83 patients developed ESKD in the non-proteinuric and proteinuric DN groups, respectively. In the multivariable Cox hazard model, hazard ratios (HRs) [95% confidence intervals (CIs)] of GL and IFTA for ESKD in proteinuric DN were 2.94 [1.67-5.36] and 3.82 [2.06-7.53], respectively. Meanwhile, HRs [95% CIs] of GL and IFTA in non-proteinuric DN were < 0.01 [0-2.48] and 4.98 [1.33-18.0], respectively. IFTA was consistently associated with higher incidences of ESKD regardless of proteinuria levels (P for interaction = 0.49). The prognostic impact of GLs on ESKD was significantly decreased as proteinuria levels decreased (P for interaction < 0.01). Conclusions: IFTA is consistently a useful predictor of kidney prognosis in both non-proteinuric and proteinuric DN, while GLs are a significant predictor of kidney prognosis only in proteinuric DN.権利情報：© The Author(s), under exclusive licence to Japanese Society of Nephrology 2023. This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s10157-023-02433-
マウス内側前頭前野の高速スパイク型parvalbumin発現介在ニューロンの特定のサブタイプへの幼少期社会的孤立直後の影響
Get PDFA lack of juvenile social experience causes various behavioral impairments and brain dysfunction, especially in the medial prefrontal cortex (mPFC). Our previous studies revealed that juvenile social isolation for two weeks immediately after weaning affects the synaptic inputs and intrinsic excitability of fast-spiking parvalbumin-expressing (FSPV) interneurons as well as a specific type of layer 5 (L5) pyramidal cells, which we termed prominent h-current (PH) cells, in the mPFC. However, since these changes were observed at the adult age of postnatal day 65 (P65), the primary cause of these changes to neurons immediately after juvenile social isolation (postnatal day 35) remains unknown. Here, we investigated the immediate effects of juvenile social isolation on the excitability and synaptic inputs of PH pyramidal cells and FSPV interneurons at P35 using whole-cell patch-clamp recording. We observed that excitatory inputs to FSPV interneurons increased immediately after juvenile social isolation. We also found that juvenile social isolation increases the firing reactivity of a subtype of FSPV interneurons, while only a fractional effect was detected in PH pyramidal cells. These findings suggest that juvenile social isolation primarily disturbs the developmental rebuilding of circuits involving FSPV interneurons and eventually affects the circuits involving PH pyramidal cells in adulthood.権利情報：© The Author(s) 2022. Published by Oxford University Press. All rights reserved. This is a pre-copyedited, author-produced version of an article accepted for publication in [Cerebral Cortex] following peer review. The version of record [Cereb Cortex. 2023; 33(7): 3591-3606.] is available online at: https://doi.org/10.1093/cercor/bhac29
The power of podcasting: creating opportunities for medical students to speak with creativity and confifidence
Get PDFThe world is becoming increasingly globalized, and the medical field is no
different. This trend has substantial implications for medical professionals in
Japan who communicate and collaborate with their counterparts from other
countries. Not to mention the recent trend of increased foreign immigration
and tourism, which requires Japanese doctors to communicate with patients
in English. English education is compulsory from the 5th grade of elementary
school through the 3rd year of high school. However, the classes primarily
focus on textbook learning and less on a communicative approach; students
thus graduate high school but lack the ability and confidence to speak
English. The Clinical English Department at Nara Medical University has
created a curriculum that focuses more on creating opportunities for medical
students to build up their English speaking skills and to provide multiple
ways for the students to regularly communicate in English inside and outside
the traditional classroom-setting to foster self-efficacy. One example is the
Podcasts and Podcasting course that records and publishes student-created
podcast episodes focusing on student storytelling, crafted monologues, and
impromptu conversations on topics related to their studies, extracurriculars,
and Japanese culture. The unique course was imagined and birthed during the start of the COVID-19 pandemic in 2020 and has continued since. This paper
discusses the set-up and purpose of the podcast class, shares one studentʼs
views on this unique course, and describes some of the unexpected benefits
and incredible potential of podcasting
