EGFRとMEKの阻害は、NTRK1融合遺伝子を有する腫瘍細胞の脳転移においてエヌトレクチニブ耐性を克服する

京都大学新制・課程博士博士(医学)甲第24781号医博第4973号新制||医||1066(附属図書館)京都大学大学院医学研究科医学専攻(主査)教授 中島 貴子, 教授 溝脇 尚志, 教授 武藤 学学位規則第4条第1項該当Doctor of Medical ScienceKyoto UniversityDFA

The correlation of chondrule texture and magnesium isotope abundance in Allende meteorite

The Mg isotope abundance of the individual chondrules in the Allende meteorite was measured by ion microprobe mass analysis. The amounts of ^Mg excess with respect to the terrestrial fractionation line were obtained for each chondrule. Barred olivine and glassy chondrules tend to have relatively large ^Mg excess, whereas porphyritic and radial pyroxene chondrules have relatively small ^Mg excess. The following three factors were taken into consideration in connection with the formation process of these chondrules in the Allende meteorite; (1) the temperature conditions at the formation of the chondrules, (2) the relative abundance of each chondrule type, (3) the amount of ^Mg excess in each chondrule type. It is shown that chondrules formed at high temperature or by rapid cooling have relatively large ^Mg excess and their relative abundance is small, whereas chondrules formed at low temperature or by slow cooling tend to have small ^Mg excess and their relative abundance is large. A model of chondrule formation process in the early solar nebula is proposed to explain the relations between factors (1)-(3)

Causal Model of Work Engagement among Registered Nurses and Licensed Practical Nurses Working in Long-Term Care Contexts in Japan

The objective of this study was to determine a causal process underlying work engagement, in which individual resources (i.e., resilience) and job resources influence work performance, mediated by work engagement in different types of nurses working in long-term care contexts. We investigated a work engagement causal model in which individual and job resources were set as antecedent factors, work engagement as a mediating factor, and work performance as the outcome, to clarify differences between registered nurses (RNs) and licensed practical nurses (LPNs) working in long-term care contexts. We conducted a questionnaire-based survey with 1,786 Japanese nurses working in long-term care contexts in the Tohoku region. Using 1,269 respondents, we examined the causal model using structural equation modeling (SEM) and multiple population analysis to compare between RNs and LPNs. The results revealed a process whereby individual and job resources influenced work performance, mediated by work engagement, in RNs. In other words, greater individual and job resources enhance pride in work and positive emotion (i.e., work engagement), and greater positive emotion improves work performance. This process was not equivalent in LPNs. In LPNs, the most significant factor affecting work performance was the direct effect of job resources; moreover, the mediating effect of work engagement was not supported. The results demonstrated that in order to improve performance among LPNs working in long-term care contexts, it is important to provide job resource support, as well as to facilitate positive emotion through pride in one’s work

Results from the Japan 2016 report card on physical activity for children and youth

Background: The Report Card on Physical Activity for Children and Youth aims to consolidate existing evidence, encourage more evidence-informed physical activity, and improve surveillance of physical activity. Methods: Application of Canada and Scotland Report Card methodology to Japan, adapted to Japanese circumstances and availability of data, and based on nationally representative surveys. Results: The 2016 Japan Report Card on Physical Activity for Children and Youth consists of Health Behaviors and Outcomes (7 indicators); and Influences on Health Behaviors (4 indicators). Three Health Behaviors and Outcomes received C grades (Participation in Sport; Sedentary Behavior; Recreational Screen Time; Physical Fitness), while two indicators could not be graded (Overall Physical Activity, and Active Play). The indicators Active Transportation (B) and Weight Status were favorable (A). In the Influences domain, Family Influence and Community and the Built Environment were graded as D, while the School & Childcare Settings and the Government Strategies and Investments were favorable (B). Conclusions: The Japan report card illustrated some favorable health behaviors, health outcomes, and influences. There is a need for more evidence especially on overall physical activity, active play, and community and the built environment

Establishment and implementation of an effective rule for the interpretation of computed tomography scans by emergency physicians in blunt trauma

INTRODUCTION: Computed tomography (CT) can detect subtle organ injury and is applicable to many body regions. However, its interpretation requires significant skill. In our hospital, emergency physicians (EPs) must interpret emergency CT scans and formulate a plan for managing most trauma cases. CT misinterpretation should be avoided, but we were initially unable to completely accomplish this. In this study, we proposed and implemented a precautionary rule for our EPs to prevent misinterpretation of CT scans in blunt trauma cases. METHODS: We established a simple precautionary rule, which advises EPs to interpret CT scans with particular care when a complicated injury is suspected per the following criteria: 1) unstable physiological condition; 2) suspicion of injuries in multiple regions of the body (e.g., brain injury plus abdominal injury); 3) high energy injury mechanism; and 4) requirement for rapid movement to other rooms for invasive treatment. If a patient meets at least one of these criteria, the EP should exercise the precautions laid out in our newly established rule when interpreting the CT scan. Additionally, our rule specifies that the EP should request real-time interpretation by a radiologist in difficult cases. We compared the accuracy of EPs’ interpretations and resulting patient outcomes in blunt trauma cases before (January 2011, June 2012) and after (July 2012, January 2013) introduction of the rule to evaluate its efficacy. RESULTS: Before the rule’s introduction, emergency CT was performed 1606 times for 365 patients. We identified 44 cases (2.7%) of minor misinterpretation and 40 (2.5%) of major misinterpretation. After introduction, CT was performed 820 times for 177 patients. We identified 10 cases (1.2%) of minor misinterpretation and two (0.2%) of major misinterpretation. Real-time support by a radiologist was requested 104 times (12.7% of all cases) and was effective in preventing misinterpretation in every case. Our rule decreased both minor and major misinterpretations in a statistically significant manner. In particular, it conspicuously decreased major misinterpretations. CONCLUSION: Our rule was easy to practice and effective in preventing EPs from missing major organ injuries. We would like to propose further large-scale multi-center trials to corroborate these results

Stable Iodine Distribution among Children after the 2011 Fukushima Nuclear Disaster in Japan: An Observational Study

福島第一原発事故後の安定ヨウ素剤配布後の実態調査を実施 --安定ヨウ素剤の情報提供・内服指示に関する課題が浮き彫りに--. 京都大学プレスリリース. 2019-01-10.Context: Intake of stable iodine helps prevent childhood thyroid cancer in nuclear emergencies but there is limited case information. Objective: We identified the intake rate and the factors associated with no intake among children who did not take stable iodine after the Fukushima disaster. Design: Retrospective observational study. Setting: Data were obtained from thyroid cancer screening performed in August–November 2017. Participants: Children in Miharu Town, Fukushima, Japan. Intervention: No intervention. Main Outcome Measures: We performed multilevel logistic regression analysis at the regional and individual levels. We qualitatively examined the reasons for no intake of stable iodine based on closed- and open-ended questions. Results: The rate of distribution was 94.9%, but the intake rate was only 63.5%. Intake was lower in those aged 0–2 years compared with those aged ≥3 years: odds ratio (OR), 0.21 [95% confidence interval (CI), 0.11–0.36]. Parents’ intake was positively associated with their children’s intake [OR, 61.0 (95% CI, 37.9–102.9)]. The variance partition coefficient for regions was 0.021, suggesting that the intake of stable iodine was more likely affected by individual than by regional factors. The main reasons for avoiding intake were concern about safety, issues related to distribution, drug information sharing, and instructions for intake. There were no claimed adverse effects. Conclusions: The distribution and consumption of stable iodine occurred without claims of adverse effects after the Fukushima disaster. To prepare for future nuclear emergencies, it is important to explain to both children and parents the need for intake of stable iodine, particularly among young children

Effects of levocabastine on lipid mediator release from guinea pig lung fragments.

The effects of levocabastine, a novel histamine H1-receptor antagonist, on lipid mediator release induced by antigen-antibody reaction from actively sensitized guinea pig lung fragments were studied. Levocabastine dose-dependently inhibited the release of leukotriene C4 from guinea pig lung fragments induced by antigen. A significant effect was observed with levocabastine at a concentration of 10(-4) M. On the other hand, levocabastine produced no effect on the release of leukotriene E4 or thromoboxane B2. From these findings, it was concluded that levocabastine may be useful for relieving the nasal obstruction in allergic rhinitis caused by inhibition of leukotriene C4 release.</p

Application Integration Control System for Multi-Scale and Multi-PhysicsSimulation

In the case of long-period and large-scale simulation, unexpected stop which is caused by execution time excess, outage of computers, outage of a network during file transfer and so on, become major issues. To avoid the stop of job execution and file transfer, we have developed Task Flow Control System that is a new control system for application integration with a fault tolerant API. If the computer is outage, the system designates an alternate computer, gathers necessary files and submits a new job. Each scheduler, file transfer and job condition can be flexibly defined in XML. This time, we applied the system to fluid-structure interaction analysis simulation. The result indicates that the system enables a user to easily execute multi-scale and multi-physics simulation using application integration