根治的前立腺全摘標本における神経線維周囲浸潤の生化学的再発予知因子としての意義

著者らは, 臨床的限局性前立腺癌に対して術前内分泌療法を施行せずに根治的前立腺全摘除術を施行した202症例を対象に, 全摘標本における神経線維周囲浸潤の臨床病理学的意義を検討した.その結果, 1)神経線維周囲浸潤は131例(64.9%)に陽性であった.また, 神経線維周囲浸潤の存在は, 臨床病期, 病理学的病期, Gleasonスコア, 精嚢浸潤, リンパ節転移および腫瘍体積と有意に相関したが, 術前PSA値との相関は認めなかった. 2)経過観察期間(中央値34ヵ月)中, 20例に生化学的再発を認めたが神経線維周囲浸潤はこの内17例に陽性であった. 3)神経線維周囲浸潤陽性131例および陰性71例の5年生化学的非再発率は, それぞれ84.4%および94.3%であり統計学的有意差を認めた.神経線維周囲浸潤の他, 病理学的病期, 精嚢浸潤, リンパ節転移および腫瘍体積が生化学的非再発率と有意な相関を示した.しかし, 多変量解析の結果, これら5因子の内, 精嚢浸潤のみが生化学的再発の独立した予知因子であった.以上, これらのことからも, 根治的前立腺全摘標本における神経線維周囲浸潤の存在は, 種々の予後規定因子と有意な相関を示すが, 生化学的再発の独立した予知因子とは成りえない可能性が示唆されたThe objective of this study was to determine whether the presence of perineural invasion (PNI) in radical prostatectomy specimens could be a useful prognostic parameter in Japanese men with prostate cancer. Between January 1995 and September 2003, 202 Japanese men underwent radical retropubic prostatectomy for prostate cancer without any neoadjuvant therapies prior to surgery. We retrospectively analyzed the relationship between PNI in radical prostatectomy specimens and other prognostic factors, and also assessed the significance of PNI in biochemical recurrence after radical prostatectomy. The presence of PNI was significantly related to clinical stage, pathological stage, Gleason score, seminal vesicle invasion, lymph node metastasis and tumor volume, but not pretreatment serum prostate specific antigen value. During the observation period, biochemical recurrence occurred in 20 patients (3 in patients without PNI and 17 in those with PNI), and the biochemical recurrence-free survival rate in patients with PNI was significantly lower than that in patients without PNI. In addition to-PNI, pathological stage, seminal vesicle invasion, lymph node metastasis and tumor volume were significantly associated with the biochemical recurrence-free survival rate; however, among these five factors, only seminal vesicle invasion was an independent predictor of biochemical recurrence on multivariate analysis. Despite a significant association between several prognostic parameters, PNI was not an independent predictor of biochemical recurrence; therefore, it may not provide an additive effect to consider the presence of PNI in predicting the prognosis of Japanese men who underwent radical prostatectomy if there are other conventional parameters available

Chiral Magnetic Effect from Q-balls

We apply a generic framework of linear sigma models for revealing a mechanism of the mysterious phenomenon, the chiral magnetic effect, in quark-gluon plasma. An electric current arises along a background magnetic field, which is given rise to by Q-balls (non-topological solitons) of the linear sigma model with axial anomaly. We find additional alternating current due to quark mass terms. The hadronic Q-balls, baby boson stars, may be created in heavy-ion collisions.Comment: 4 pages, 3 figures, revtex; v2: minor revisio

The impact of rotating work schedules, chronotype, and restless legs syndrome/Willis-Ekbom disease on sleep quality among female hospital nurses and midwives: A cross-sectional survey

Background: Decreases in subjective sleep quality are prevalent among nurses and midwives engaged in rotating shift work. Objectives: The present study aimed to examine the relationship between differences in work schedules and subjective sleep quality among female nursing staff. Design: A cross-sectional survey design was used for descriptive and logistic regression analyses. Data collection was conducted from December 2016 to September 2017. Settings: Participants were recruited from five regional core hospitals in Japan. Participants: A total of 1253 nurses and midwives were included in the final analysis. Methods: Subjective sleep quality was assessed using the Japanese version of the Pittsburgh Sleep Quality Index. Chronotype and social jet lag were calculated for both work day and work-free day. Symptoms related to restless legs syndrome/Willis-Ekbom disease were assessed using the Japanese version of the Cambridge-Hopkins questionnaire short form 13. Participants with the urge to move their legs, though not fulfilling the restless legs syndrome/Willis-Ekbom disease criteria, were classified as having leg motor restlessness. Logistic regression analyses for poor sleep were adjusted for age, body mass index, smoking, drinking, menstruation status, the presence of premenstrual syndrome, and the presence of a spouse. Results: Rates of poor sleep (Pittsburgh Sleep Quality Index score ?6) among those working, day shifts, rotating 12.5 hour night shifts, rotating 16 hour night shifts, and three-shift rotations were 41.2%, 51.1%, 44.5%, and 60.4%, respectively. Approximately 40% of three-shift rotation workers experienced difficulty initiating sleep. Shift workers tended to exhibit evening chronotype, delayed sleep phase, and high social jet lag. The prevalence of restless legs syndrome/Willis-Ekbom disease was 2.5%. Leg motor restlessness was observed in. 15.5% of participants. The adjusted odds ratios (95% confidence interval) of three-shift work (vs. day shift), evening chronotype (vs. morning chronotype), and the presence of leg motor restlessness (vs. no leg motor restlessness) for those with poor sleep were 2.20 (1.47?3.30), 1.95 (1.29?2.94),and 1.66 (1.15?2.39), respectively. Conclusions: Regardless of the working schedules, rates of poor sleep were high among female hospital nurses and midwives. Our findings suggest that poor sleep quality is influenced by three-shift rotation, the evening chronotype, and leg motor restlessness

The impact of sleep–wake problems on health-related quality of life among Japanese nursing college students: a cross sectional survey

Aim: This study was conducted to examine the impact of sleep–wake problems on health-related quality of life of Japanese nursing college students.Methods: This cross-sectional study was conducted in 2019 on 150 third and fourth-year nursing college students from two locations in Japan. Insomnia severity was assessed using the Insomnia Severity Index (ISI) and health-related quality of life using the SF-8 questionnaire. The total sleep time (TST) was divided into 3 groups: < 6 h, 6–7 h (reference), and ≥ 7 h. The total ISI score was divided into 2 groups: ≥ 8 points and < 8 points (reference). Logistic regression analysis was performed to evaluate sleep–wake problems related to decline in mental health.Results: The median mental health indicated in the SF-8 questionnaire was divided into two groups, and the factors causing decline in mental health were investigated. The odds ratios (95% confidence interval) for adjusted ISI ≥ 8 and TST on weekdays < 6 h was 6.51 (2.96–14.30) and 3.38 (1.40–8.17), respectively. Mental health status was significantly lower when ISI ≥ 8 and even lower when TST < 6 h.Conclusion: Insomnia and short sleep duration are associated with decreased mental health status in nursing college students. Many tended to lack sleep on weekdays. Sleep–wake problems identified while in university should be comprehensively dealt with

Failure to detect Plasmodium vivax in West and Central Africa by PCR species typing

<p>Abstract</p> <p>Background</p> <p><it>Plasmodium vivax </it>is estimated to affect 75 million people annually. It is reportedly absent, however, from west and central Africa due to the high prevalence of the Duffy negative phenotype in the indigenous populations. Despite this, non-African travellers consistently return to their own countries with <it>P. vivax </it>malaria after visiting this region. An attempt was made, therefore, to detect the presence of <it>P. vivax </it>parasites in blood samples collected from the indigenous populations of west and central Africa.</p> <p>Methods</p> <p>Parasite species typing (for all four human malaria parasites) was carried out by PCR on 2,588 blood samples collected from individuals from nine African malaria-endemic countries.</p> <p>Results</p> <p>Most infections (98.5%) were <it>Plasmodium falciparum</it>, <it>Plasmodium malariae </it>was identified in 8.5% of all infections, and <it>Plasmodium ovale </it>in 3.9%. The prevalence of both parasites varied greatly by country. Only one case of <it>P. vivax </it>was detected from Sao Tome, an island off the west coast of Africa, confirming the scarcity of this parasite in Africa.</p> <p>Conclusion</p> <p>The prevalence of <it>P. vivax </it>in local populations in sub-Saharan Africa is very low, despite the frequent identification of this parasite in non-African travellers.</p

Cost-effective accurate estimates of adult chum salmon, Oncorhynchus keta, abundance in a Japanese river using a radio-controlled helicopter

This paper describes an attempt in 2008 to establish an aerial census of adult chum salmon using a small radio-controlled (RC) helicopter. The Moheji River, located in southern Hokkaido, was chosen because all the salmon in a stretch of the river between a weir and the estuary are seine-netted every morning for artificial propagation. Aerial photographs of the river were taken from a RC helicopter equipped with a digital single-lens reflex camera and polarized filter. To quantify salmon density within the census area, the number of salmon per aerial photograph was counted using image-processing software. Salmon could be clearly identified in photographs taken from an altitude of ∼30 m. Salmon numbers estimated by aerial census and seine-netting were significantly related. The results indicate that a small RC helicopter can be used to generate adult salmon abundance data in Japanese rivers

根治的恥骨後式前立腺全摘除術を施行した200症例の臨床病理学的検討

兵庫県立成人病センター開設以来, 前立腺癌に対して根治的恥骨後式前立腺全摘除術を施行した200症例の臨床病理学的検討を行った.その結果, 経過観察期間中に, 癌死4例および他因死11例を認めた.また, 生化学的再発をPSA>0.4ng/mlと定義すると, この間に23例(11.5%)に生化学的再発を認めた.5年生化学的非再発率, 疾患特異的生存率および全生存率は, それぞれ83.6, 97.7%および91.4%であった.多変量解析の結果, リンパ節転移の有無および臨床病期が, それぞれ疾患特異的生存率および全生存率の独立した予後規定因子であった.以上より, 局所進行性症例を含む手術可能な前立腺癌症例に対し, 根治的前立腺全摘除術を中心とした治療は良好な長期予後が得られることが示唆されたThe objective of this study was to retrospectively evaluate the clinicopathological outcome of radical retropubic prostatectomy (RRP) performed at a single institution in Japan. A consecutive series of 200 patients with prostate cancer who underwent RRP and pelvic lymphadenectomy between March 1985 and April 2003 were included in this study. The median age at RRP and the observation period were 69 years old and 43 months, respectively. Clinicopathological findings were reviewed to determine parameters providing predictive information about biochemical recurrence-free, cause-specific, and overall survivals. The pathological stage was pT0 in 7 patients (3.5%), pT2a in 43 (21.5%), pT2b in 58 (29.0%), pT3a in 42 (21.0%) pT3b in 36 (18.0%), and pT4 in 14 (7.0%). Lymph node metastasis was detected in 32 of 200 patients (16.0%). Forty-seven patients (23.5%) received neoadjuvant hormonal therapy, while 48 (24.0%) underwent hormonal therapy alone or hormonal therapy plus radiotherapy following RRP as an adjuvant treatment. During the observation period, 4 patients (2.0%) died of prostate cancer, 11 (5.5%) died of other diseases and biochemical recurrence occurred in 23 (11.5%), when biochemical recurrence was defined as prostate specific antigen (PSA) persistently greater than 0.4 ng/ml. Five-year biochemical recurrence-free, cause-specific, and overall survival rates were 83.6%, 97.7% and 91.4%, respectively. Furthermore, multivariate analyses showed that lymph node metastasis or clinical stage was an independent predictive factor for cause-specific or overall survival, respectively. These findings suggest that it would be possible to achieve a favorable cancer control for patients with localized prostate cancer, including locally advanced cases, by the RRP-based combination therapies