Bioethics and the Experiences of Hansen’s Disease Survivors

Historically, Hansen’s disease patients suffered from discrimination because their physical features changed due to the bacterium Mycobacterium leprae (M. leprae) and made them “ugly” in the eyes of society. Former Japanese governments saw them as a national disgrace and forced them to reside in leprosaria. Since the law requiring isolation continued after the silver bullet was developed, survivors could not leave the leprosaria and return to society. Currently, survivors’ average age is 82 and they live in 13 national sanatoriums. When they pass away, the history of Hansen’s disease in Japan will end, so we must record their experiences. We conducted qualitative and inductive studies with survivors. In this chapter, we reconstruct them from the perspective of bioethics and propose several theories surrounding them: (1) How former leprosaria and medical administrations in Japan threatened bioethical principles; (2) the wisdom of aging survivors, who lived through extreme situations, and what real restoration of their rights might look like; and (3) the ethical dilemmas of how we will care for the survivors—who have multiple severe sequelae—until they all pass away. Finally, we will introduce our ethical nursing practices in relation to caring and understanding via holism

Investigation of Effective Modification Treatments for Titanium Membranes

Titanium membranes are used for guided bone regeneration in implant therapy. However, as a bioinert material, titanium does not have the ability to accelerate bone formation. Various titanium surface treatments to confer bioactivity have been demonstrated; however, there are concerns about the influence of chemical treatments for thin titanium membranes. This study investigated the influence of surface modifications on the structure of titanium membranes. Titanium membranes of 20 μm thickness were treated with acid or alkali solutions, and we evaluated their surface structure, wettability, thickness, and mechanical strength compared to non-treated membranes. Alkali-treated titanium membranes displayed the formation of nanoscale pore structures on their surfaces, enhanced hydrophilicity, and almost same thickness compared with acid-treated membranes. Furthermore, the tensile strength of alkali-treated membranes was comparable to non-treated membranes. These results suggest that alkali treatment is an appropriate surface modification method for titanium membranes

Enhanced Nox1 expression and oxidative stress resistance in c-kit-positive hematopoietic stem/progenitor cells

Although stem cells are generally thought to be resistant to oxidative stress, the fact and in detail molecular mechanism are still to be clearly identified. We herein tried to understand the overall characterization of redox regulatory signaling in hematopoietic stem cells. We purified c-kit-positive hematopoietic stem/progenitor cells from the bone marrow of healthy mice, and then evaluated their redox regulatory property. Compared to the c-kit-negative matured mononuclear cells, c-kit-positive stem/progenitor cells showed lower basic levels of intracellular reactive oxygen species, faster clearance of the accumulated intracellular reactive oxygen species, and higher resistant to oxidative stress. An overall view on the gene expression profile associated with redox regulation showed to be widely differed between cell types. We confirmed that the c-kit-positive stem/progenitor cells expressed significantly higher of Nox1 and catalase, but less of lactoperoxidase than these matured mononuclear cells. Our data suggests that stem cells keep specific redox regulatory property for defensing against oxidative stress

Investigation of Effective Modification Treatments for Titanium Membranes

Titanium membranes are used for guided bone regeneration in implant therapy. However, as a bioinert material, titanium does not have the ability to accelerate bone formation. Various titanium surface treatments to confer bioactivity have been demonstrated; however, there are concerns about the influence of chemical treatments for thin titanium membranes. This study investigated the influence of surface modifications on the structure of titanium membranes. Titanium membranes of 20 μm thickness were treated with acid or alkali solutions, and we evaluated their surface structure, wettability, thickness, and mechanical strength compared to non-treated membranes. Alkali-treated titanium membranes displayed the formation of nanoscale pore structures on their surfaces, enhanced hydrophilicity, and almost same thickness compared with acid-treated membranes. Furthermore, the tensile strength of alkali-treated membranes was comparable to non-treated membranes. These results suggest that alkali treatment is an appropriate surface modification method for titanium membranes

Primary Oral Mucormycosis Due to Rhizopus microsporus after Allogeneic Stem Cell Transplantation

We herein report a rare case of oral mucormycosis following allogeneic hematopoietic stem cell transplantation. Oral mucormycosis due to Rhizopus microsporus manifested as localized left buccal mucositis with a 1-cm black focus before neutrophil recovery. Combination therapy with liposomal amphotericin B was initiated and surgical debridement was performed; however, the patient died due to progressive generalized mucormycosis. Considerable attention needs to be paid to the diagnosis and management of oral mucormycosis in post-transplant patients, thereby suggesting the importance of fully understanding the risk factors