日本美術における「陽物くらべ」絵巻物の歴史学

Representation of larger-than-life phalluses is one of shunga\u27s most memorable features. Such depiction is often explained to have originated in so-called kachi-e, a painting of a phallic contest (yobutsu kurabe) among men with surrealistically huge male members. However, what kachi-e precisely is, including its origin, evolution, and range of variety has been left unstudied. This article\u27s aim is to document kachi-e\u27s development from the earliest known form through its variations over the centuries, as well as to consider how the perception and depiction of this theme changed in visual and literary sources. The initial focus is on the oldest extang kachi-e example, Kachi-e emaki preserved in the Mitsui Memorial Museum in Tokyo, which consists of two parts: a phallic contest and farting battles (hohi gassen). The Mitsui handscroll is most likely a combination of two faithful copies of medieval originals. Literary sources of the medieval period provide some insight into attitudes towards having a large phallus, but indicate no specific benefit physiologically or personally. Fascination for kachi-e continues throughout the Edo period until the early Meiji era. The current Mitsui handscroll was highly appreciated due to its attribution as Toba Sojo\u27s authentic work and copied by prominent artists with antiquarian interests, while having a large phallus was positively valued. In some later versions female protagonists are poised on the otherside of men in an "intercourse battle." These new elements indicate that the kachi-e were appropriated into popular shunga discourse in the Edo period. These new phallic contest representations also kept the original humorous tone with an ironical view towards the common admiration of large male genitals

Pregnancy outcomes of women who received conservative therapy for endometrial carcinoma or atypical endometrial hyperplasia

Case: Approximately 3%‐25% of cases of endometrial carcinoma (EC) or atypical endometrial hyperplasia (AH) occur in women aged <40 years and conservative treatment with high‐dose medroxyprogesterone acetate (MPA) is administered to women who wish to preserve their fertility. Here is reported the pregnancy outcomes of patients with EC or AH who received MPA therapy at Tokushima University Hospital, Tokushima, Japan. The frequency of pregnancy and live births among the patients with EC or AH who received conservative treatment, followed by fertility treatment, were analyzed retrospectively. Outcome: Twelve patients underwent fertility examinations and received fertility treatment immediately after the completion of conservative treatment for EC or AH. One patient had the complication of severe diabetes and total embryo cryopreservation was performed before her diabetes was treated. Among the other 11 patients, 8 (72.7%) became pregnant at least once and 6 (54.5%) experienced at least 1 live birth. Three patients (25.0%) suffered disease recurrence during or after the infertility treatment and all of the recurrences occurred in the EC cohort. Conclusion: When patients with EC or AH wish to preserve their fertility, it is recommended that prompt and effective fertility treatment, including assisted reproductive technology, should be initiated just after conservative treatment because EC and AH exhibit relatively high recurrence rates among conservatively treated patients

ハナノキ ニ カッショクマルハンビョウ ヲ ヒキオコス Phyllosticta minima ノ シュトクイテキ プライマー ヲ モチイタ PCRホウ ニ ヨル ケンシュツ

ハナノキはカエデ属の日本固有種で，愛知県，岐阜県および長野県の限られた地域に自生している。本樹木は，個体数が減少していることから環境省レッドリストの絶滅危惧II類に選定され，その種の存続が危ぶまれている。植物病原菌Phyllosticta minimaによって引き起こされる褐色円斑病は，ハナノキに深刻な被害を与え，天然更新の阻害要因となっていることが考えられている。本研究では，ハナノキ罹病組織から病原菌を特異的に検出し，病害防除の上で重要となる感染経路を特定する目的で，種特異的プライマーを設計した。種特異的プライマーPmiFおよびPmiRは，P. minimaのrDNA ITS領域の塩基配列から設計され，分離菌株由来の全DNAを用いたPCR法で，その特異性が確認された。愛知県名古屋市で採集されたハナノキ組織から病原菌の検出を試みたところ，罹病葉のみならず潜在的に感染している無病徴の葉からも病原菌の検出が確認された。さらに，東京都八王子市に植栽されたハナノキの葉，葉柄，小枝，冬芽および腋芽について調査した結果，それぞれの組織から病原菌が検出された。P. minimaは6月から7月頃に罹病葉から腋芽（冬芽）へ感染，潜伏して，翌年の第一次感染源となることが明らかとなった。Acer pycnanthum is a maple tree indigenous to Japan, which grows in limited areas of the Aichi, Gifu, and Nagano Prefectures. A. pycnanthum is currently an endangered species, with a declining population. This tree is considered to be a vulnerable species according to the Red List of the Ministry of the Environment. Leaf spot disease caused by Phyllosticta minima, a phytopathogenic fungus, inflict severe damage on A. pycnanthum. These fungi secrete inhibitory factors, which have been suggested to repress natural regeneration. In the present study, we designed species-specific primers with the aim of specifically detecting pathogens in tissue samples of A. pycnanthum, thereby identifying infection routes crucial for disease control. The species-specific primers PmiF and PmiR, which were designed based on the sequence of the P. minima rDNA Internal Transcribed Spacer region, were verified for their specificity in PCR tests using the total DNA of isolated strains. In A. pycnanthum tissue samples from Hachioji, Tokyo and Nagoya, Aichi Prefecture, pathogenic fungi were isolated not only from affected but also asymptomatic leaves. Furthermore, in trees planted at Hachioji, Tokyo, pathogens were observed in tissue samples of leaves, petioles, twigs, winter buds, and axillary buds. These results suggest that P. minima infects axillary (winter) buds from June to July via previously infected leaves, thus becoming latent and finally triggering primary infections in the following year

R-mini CHP in ≥80-year-old Patients with Diffuse Large B-cell Lymphoma: A Multicenter, Open-label, Single-arm Phase II Trial Protocol

In very-elderly diffuse large B-cell lymphoma (DLBCL) patients, treatment intensities must be lowered due to the risks of comorbidities and organ function deterioration, and treatment outcomes are worse compared to younger patients. Very-elderly patients are often excluded from DLBCL clinical trials, and optimal treatments and dosages are not established. In this clinical trial, we examined the efficacy and safety of 6 courses of R-mini CHP therapy (cf., CHOP [cyclophosphamide, doxorubicin, vincristine, and prednisone]) in which vincristine is omitted to avoid the peripheral neuropathy that reduces elderly patients’ quality of life, as remission induction therapy in DLBCL patients aged≥80 years

Use of the Hydrogen Breath Test to Determine the Influence of Antibiotic Prophylaxis on Intestinal Flora

Purpose: This experimental study was designed to use the hydrogen (H2) breath test to investigate changes in the intestinal flora of patients that were administered prophylactic antibiotics for 48 hours after surgery. Methods: Altogether, 22 patients were divided into two groups and the antimicrobial prophylactics, cefazolin (3.0 g/day) or sulbactam/ampicillin (4.5 g/day), were administered on induction of anaesthesia for 48 hours after surgery. End expiratory breath samples were collected on the morning of the day of surgery and every morning for 1-6 days after surgery. Results: H2 breath concentration significantly decreased in each group on day 1 (cefazolin: 1.20 ± 0.39 ppm vs. sulbactam/ampicillin: 1.17 ± 0.34 ppm). On day 2, the H2 concentration in the sulbactam/ampicillin group was significantly lower than the cefazolin group (cefazolin: 6.4 ± 2.2 ppm vs. sulbactam/ampicillin: 1.0 ± 0.4 ppm, p < 0.05). H2 concentration was still lower in the sulbactam/ampicillin group (1.3 ± 0.3 ppm vs. 3.3 ± 1.0 ppm, p = 0.10) on day 3. On days 4-6, H2 concentration was essentially the same for both groups. Discussion: Colonic anaerobes are thought to be a reservoir of resistant organisms and prolonged antimicrobial treatment is a major cause for the development of resistance. Surgical prophylaxis is basically recommended for use within 24 hours after surgery. The breath H2 concentration in both groups significantly decreased 24 hours after administration. These results suggest that both antibiotics influence the activity of colonic anaerobes and the duration of surgical antibiotic prophylaxis should be as short as possible