DISCOVERY OF PREVENTIVE DRUGS FOR CDDP-INDUCED AKI

Cisplatin is effective against many types of carcinoma. However, a high rate of renal damage is a clinical problem. Thus, there is a need to establish a method to prevent it. Although various compounds have been reported to be effective against cisplatin-induced renal injury, there are no examples of their clinical application. Therefore, we attempted to search for prophylactic agents with a high potential for clinical application. We used Cascade Eye to identify genes that are altered during cisplatin-induced renal injury, Library of Integrated Network-based Cellular Signatures (LINCS) to identify drugs that inhibit changes in gene expression, and a large database of spontaneous adverse drug reaction reports to identify drugs that could prevent cisplatin-induced kidney injury in clinical practice. In total, 10 candidate drugs were identified. Using the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS), we identified drugs that reduce cisplatin-induced kidney injury. Fenofibrate was selected as a candidate drug to prevent cisplatin-induced kidney injury based on the FAERS analysis. A model was used to evaluate the efficacy of fenofibrate against cisplatin-induced renal injury. Studies using HK2 cells and mouse models showed that fenofibrate significantly inhibited cisplatin-induced renal injury but did not inhibit the antitumor effect of cisplatin. Fenofibrate is a candidate prophylactic drug with high clinical applicability for cisplatin-induced renal injury. Analysis of data from multiple big databases will improve the search for novel prophylactic drugs with high clinical applicability. For the practical application of these findings, evaluation in prospective controlled trials is necessary

看護学生の自尊感情と職業的アイデンティティとの関連から考える教育的支援

看護職の職業的アイデンティティは看護実践の基盤となるものであり,看護学生の職業的アイデンティティ形成を促す支援は重要である.本研究では,看護学生の特性自尊感情および職業的アイデンティティを測定し,この両者の関連と経年的な変化を明らかにすることによって,自尊感情に着目した支援について検討した.その結果,看護学生の自尊感情と職業的アイデンティティにはやや弱い正の相関を認め,職業的アイデンティティ得点は先行研究と同様,経年的に有意に低下していた.一方,自尊感情は卒業時に有意に高くなっており,これは臨地実習で能動的態度を求められたり自分の価値観や思考の特性を見つめながら他者を理解する経験をしたりすることが影響していると考えられた.その結果,繰り返し他者と自己,看護と自己との比較を促し承認を与えながら看護学生が自分の価値を感じられるような教育的支援が必要であることが示唆された

教員による臨地実習指導に対する看護学生の受けとめ方

看護学臨地実習での教育効果を上げる指導を模索するために,教員の指導を学生がどのように受けとめたかを調査した.調査は,2008年度の臨地実習を受けた看護学生112名を対象として実施した.有効回答率は79.3%であった.自己成長につながった指導を回答した学生は63.1%,受け入れられなかった指導を回答した学生は40.5%であった.得られた回答を,内容の類似性に基づいてサブカテゴリー化・カテゴリー化した.自己成長につながった指導は「方向性を示す指導」「視野をひろげる指導」「学生主体の指導」「経験の機会を設定する」「同行指導」「モデルを示す指導」「自己理解を促す指導」「頑張りを評価する指導」「気持ちを支える指導」の9カテゴリーに分類された.また,受け入れられなかった指導は「方向性が定まらない指導」「無理解な指導」「解釈的な指導」「指導のタイミング」「他者との比較」「実習目標の意識化を促す指導」「過度な期待」「学生が主体とならない指導」「感情的な指導」の9カテゴリーに分類された.教員の指導に対する学生の受けとめ方は,実習の方向性がみえるか否かがひとつの指標になって判断されると推察できた.また,学生が受け入れられなかった指導では,教員が学生の個別性や能力をどの程度理解し,考慮して指導していたかが関係していると推察できた

Transoral surgery for superficial head and neck cancer: National Multi‐Center Survey in Japan

Head and neck cancers, especially in hypopharynx and oropharynx, are often detected at advanced stage with poor prognosis. Narrow band imaging enables detection of superficial cancers and transoral surgery is performed with curative intent. However, pathological evaluation and real-world safety and clinical outcomes have not been clearly understood. The aim of this nationwide multicenter study was to investigate the safety and efficacy of transoral surgery for superficial head and neck cancer. We collected the patients with superficial head and neck squamous cell carcinoma who were treated by transoral surgery from 27 hospitals in Japan. Central pathology review was undertaken on all of the resected specimens. The primary objective was effectiveness of transoral surgery, and the secondary objective was safety including incidence and severity of adverse events. Among the 568 patients, a total of 662 lesions were primarily treated by 575 sessions of transoral surgery. The median tumor diameter was 12 mm (range 1–75) endoscopically. Among the lesions, 57.4% were diagnosed as squamous cell carcinoma in situ. The median procedure time was 48 minutes (range 2–357). Adverse events occurred in 12.7%. Life-threatening complications occurred in 0.5%, but there were no treatment-related deaths. During a median follow-up period of 46.1 months (range 1–113), the 3-year overall survival rate, relapse-free survival rate, cause-specific survival rate, and larynx-preservation survival rate were 88.1%, 84.4%, 99.6%, and 87.5%, respectively. Transoral surgery for superficial head and neck cancer offers effective minimally invasive treatment

P1-24: Neural Representation of Gloss in the Macaque Inferior Temporal Cortex

The variation of the appearance such as gloss provides one of the most important information for object recognition. However, little is known about the neural mechanisms related to the perception of gloss. We examined whether the neurons in the inferior temporal (IT) cortex of the monkeys are coding gloss of objects. We made visual stimuli which have various surface reflectance properties, and tested responses of IT neurons to these stimuli while a monkey was performing a visual fixation task. We found that there exist neurons in the lower bank of the superior temporal sulcus that selectively responded to specific stimuli. The selectivity was largely maintained when the object shape or illumination condition was changed. In contrast, neural selectivity was lost when the pixels of objects were randomly rearranged. In the former manipulation of the stimuli, gloss perceptions were maintained, whereas in the latter manipulation, gloss perception was dramatically changed. These results indicate that these IT neurons selectively responded to gloss, not to the irrelevant local image features or average luminance or color. Next, to understand how the responses of gloss selective neurons are related to perceived gloss, responses of gloss selective neurons were mapped in perceptual gloss space in which glossiness changes uniformly. I found that responses of most gloss selective neurons can be explained by linear combinations of two parameters that are shown to be important for gloss perception. This result suggests that the responses of gloss selective neurons of IT cortex are closely related to gloss perception