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Clinicopathological characteristics and mutational landscape of APC, HOXB13, and KRAS among Rwandan patients with colorectal cancer
Get PDF浜松医科大学博士（医学）doctoral医学系研究科thesi
Early enteral nutrition with arginine compensates for negative nitrogen balance in patients undergoing curative total gastrectomy
Get PDF浜松医科大学博士（医学）doctoral医学系研究科thesi
The process of becoming independent while balancing health management and social life in adolescent and young adult childhood cancer survivors
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①Keyword
②Table 1.
③Table 2.Aim: This study aimed to elucidate the process of how adolescent and young adult childhood cancer survivors (CCSs) become independent while balancing health management and social life with a view to providing long-term support.
Methods: Semi-structured interviews were conducted with 22 Japanese CCSs aged 16–25 years. The data were then qualitatively analyzed using the modified grounded theory approach.
Results: Seven “categories” and 35 ‘concepts’ were generated. The connections among these categories and concepts revealed the process of becoming independent while balancing health management and social life. The first phase in the process is “coordination within constraints,” which includes ‘consciousness and worries about deteriorating health’ and ‘adjustments to balance schoolwork and treatment.’ This phase changes into “challenges to being free and normal” and “release from constraints.” Psychological development then occurs as “gratitude toward surrounding people” and “sustenance from experiencing a rare illness.” However, CCSs also “face worries about the persistent effects of cancer,” including ‘awareness of the necessity to continue hospital visits even into adulthood.’ Through these experiences, CCSs reach the phase of “finding a way to live with oneself,” which integrates health management with social life.
Conclusions: These findings may help parents and health, education, and social-care professionals anticipate and share changes in CCSs’ physical condition, daily life, and psychosocial development. CCSs need support in terms of coordinating cancer therapy and school life, trying what they want to do, self-managing their own health condition, and forming their identity, including making sense of their illness experience.journal articl
Clinicopathological characteristics and mutational landscape of APC, HOXB13, and KRAS among Rwandan patients with colorectal cancer
Get PDF浜松医科大学博士（医学）doctoral医学系研究科Cancer research in Rwanda is estimated to be less than 1% of the total African cancer research output with limited research on colorectal cancer (CRC). Rwandan patients with CRC are young, with more females being affected than males, and most patients present with advanced disease. Considering the paucity of oncological genetic studies in this population, we investigated the mutational status of CRC tissues, focusing on the Adenomatous polyposis coli (APC), Kirsten rat sarcoma (KRAS), and Homeobox B13 (HOXB13) genes. Our aim was to determine whether there were any differences between Rwandan patients and other populations. To do so, we performed Sanger sequencing of the DNA extracted from formalin-fixed paraffin-embedded adenocarcinoma samples from 54 patients (mean age: 60 years). Most tumors were located in the rectum (83.3%), and 92.6% of the tumors were low-grade. Most patients (70.4%) reported never smoking, and 61.1% of patients had consumed alcohol. We identified 27 variants of APC, including 3 novel mutations (c.4310_4319delAAACACCTCC, c.4463_4470delinsA, and c.4506_4507delT). All three novel mutations are classified as deleterious by MutationTaster2021. We found four synonymous variants (c.330C>A, c.366C>T, c.513T>C, and c.735G>A) of HOXB13. For KRAS, we found six variants (Asp173, Gly13Asp, Gly12Ala, Gly12Asp, Gly12Val, and Gln61His), the last four of which are pathogenic. In conclusion, here we contribute new genetic variation data and provide clinicopathological pertinent to CRC in Rwanda.doctoral thesi
Safety and accuracy of neonatal continuous glucose monitoring
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Hypoglycemia is a significant problem for all neonates and requires minimally invasive and reliable monitoring. The primary objective of this study is to verify the safety and accuracy of continuous glucose monitoring (CGM) of full-term neonates using Freestyle® Libre, a flash glucose monitoring (FGM) device.
Methods
The study was conducted on twenty neonates. Shortly after birth, we placed the FGM sensor on the outside of the neonates’ thighs. We scanned the CGM values at 60, 120, 180 and 360 min after birth and simultaneously obtained blood glucose values with plantar capillaries by heel puncture. The neonates wore the sensors for up to 6 hours and then they were removed.
Results
Out of the 75 data points to be measured, 65 points (86.7%) were obtained by scan. There was no change in the sensor attachment site in 12 of 18 completed cases in this study, but we observed slight induration in 4 cases (22.2%) and slight redness in 1 case (5.5%) at the sensor puncture site. A moderate correlation was observed between the CGM and blood glucose values. The CGM values tended to be low at 120, 180, and 360 min after birth, and tended to be high only at 60 min after birth.
Conclusions
The CGM device was safe to wear on the neonate, and the CGM data correlated well with blood glucose levels. There is dissociation between CGM data and blood glucose levels in the acute period soon after birth when the blood glucose levels change rapidly.journal articl
Influence of daily versus alternate-day dosing of vonoprazan on intragastric pH, serum gastrin, and the antiplatelet function of clopidogrel: Influence of alternate-day dosing of vonoprazan
Get PDF浜松医科大学博士（医学）doctoral医学系研究科thesi
Therapeutic effects of KCC2 chloride transporter activation on detrusor overactivity in mice with spinal cord injury
Get PDF浜松医科大学博士（医学）doctoral医学系研究科thesi
Nutritional management in patients undergoing online hemodiafiltration
Get PDFわが国で主流である前希釈オンラインHDFは補液量が多いため，濾液中へのアミノ酸，アルブミン，水溶性ビタミン，微量元素などの喪失が懸念される．しかし，血液透析とオンラインHDFを比較した報告では，オンラインHDFによって栄養指標は悪化しておらず，むしろ骨格筋量が保持される可能性がある．一方で，低栄養リスクが高い高齢者では，アルブミン喪失の少ないヘモダイアフィルタを選ぶなどの工夫が必要となる．さらに食事摂取量が少ない場合には，透析来院時の食事提供や透析時静脈栄養を検討する．journal articl
胎児適応で選択的帝王切開分娩となった褥婦の出産体験の振り返りを通してケア方法を検討する
Get PDF目的：胎児適応で選択的帝王切開分娩となった褥婦の分娩体験の思いを明らかにして、看護の示唆を得る。
方法：当院で胎児適応の選択的帝王切開分娩を行い、同意が得られた術後4～7日目の褥婦9名を対象に、独自に作成したインタビューガイドを用いた半構造化面接を行った。出産体験に対する思いと看護師のケアに対する思いに焦点を当て文章を抽出し、コード化、カテゴリー化を行って内容分析をした。
結果：胎児適応で帝王切開分娩となった褥婦の出産体験として【帝王切開の可能性の認識】【帝王切開のイメージと情報収集】【経腟分娩への憧れ】【帝王切開の納得】【帝王切開決定時点で不安や恐怖は少ない】【帝王切開前日から直前にかけて不安や恐怖が増大】【産声や母児対面で産まれたことを実感し、安心する】【術後の想像以上の痛みの辛さ】【無事に出産できたことに安堵】の9つのカテゴリーが抽出された。看護ケアについては【安心】【嬉しさ】【感謝】【指導やケアの充実】【指導やケアの不足感】の5つのカテゴリーが抽出された。
考察：胎児適応で帝王切開分娩となった褥婦は双胎や胎児疾患がわかった時点で帝王切開の可能性の認識をし、児のために必要なこととして帝王切開の納得をする。帝王切開の説明を受けた時点では帝王切開に対する不安感は少なく、直前に不安や恐怖感が増大する。術中、特に麻酔時に不安・恐怖感が強く、助産師や麻酔科医師の存在の安心感を得ていた。児が無事に出生できたことを実際に目にすることで実感しており、母児面会の支援は重要である。journal articl