A Comparative Study of Organ Donation after Brain Death in Japan and Australia

Objective : (1) To compare the status of organ donation from brain-dead donors in Japan and Australia. (2) To identify the possible reasons for the low rates of organ donation from brain-dead donors. Background : The shortage of available organs for transplantation has prompted many countries to develop a system for the use of organs from brain-dead donors, including Japan and Australia. Yet, there is a wide range of organ donation rates and policies between Japan and Australia in the current status of brain-dead organ donation. Discussion : Comparison of transplantation from brain-dead donors in Japan and Australia reveals significant differences with respect to the frequency of transplantation, legal regulations, organ donation policies and decision-making for consenting to cadaveric organ donation. These differences are determined by a variety of factors, including the policy on organ donation and medical infrastructure for Australia, and anthropological issues for Japan. Conclusion : Death education can be required in order for Japan to increase donation rates, whereas the improvement in the organ procurement system and its public acceptance are for Australia

The dilemma of nurses in the field of lifesaving：Literature review

The purpose of this study was to clarify the dilemmas that nurses have in the field of lifesaving through a literature review in Japan. As a result of analysis and discussion, it was found that there are four aspects to the dilemma that nurses have: “dilemma of giving priority to lifesaving,” “dilemma of performing the role as a nurse in a team,” “dilemma of the difficulty of practicing nursing under severe conditions,” and “dilemma of confronting oneself. It was inferred that these four aspects were related to each other. In addition, these dilemmas have two characteristics: social conflicts felt in the organization and intra-individual conflicts felt in oneself. Dilemmas are not necessarily harmful, even moderate dilemmas have positive aspects of functioning. By examining and managing dilemmas embraced by nurses, it is suggested that dilemmas can lead to their technical and spiritual growth, their improvement in the quality of nursing, and ultimately their organizational development

Delayed Methotrexate Elimination after Administration of a Medium Dose of Methotrexate in a Patient with Genetic Variants Associated with Methotrexate Clearance

Polymorphisms in methotrexate transporter pathways have been associated with methotrexate toxicities and clearance. Recent genome-wide association studies have revealed that the SLCO1B1 T521C variant is associated with methotrexate elimination. We present a case of a pediatric patient with acute lymphoblastic leukemia who suffered from persistently high plasma methotrexate concentrations and acute kidney injuries after the admin-istration of a medium dose of methotrexate. Subsequent genetic analysis showed that he was a carrier of dys-functional genetic variants associated with methotrexate clearance. This case highlights that polymorphisms of methotrexate transporter pathways can adversely affect methotrexate elimination in a clinically significant manner

Gastric function preserving esophagectomy for esophageal cancer

Although, the gastric roll is widely used for reconstruction after an esophagectomy for esophageal cancer, adverse effects such as the post operative disturbance of oral intake and the reflux of gastric juice have been reported. A function preserving surgical procedure, which is similar to that for stomach and colon cancer, has been developed for esophageal cancer. Gastric function can be preserved by using the intestine as the reconstructive organ after an esophagectomy. In this report, we described the procedure for an esophagectomy with pedunculated jejunal or right colonic interposition, collectively termed as a gastric function preserving esophagectomy (GPE). We believe that this procedure is minimally invasive with a low risk of postoperative digestive symptoms and weight loss

Let-7 MicroRNA Family Is Selectively Secreted into the Extracellular Environment via Exosomes in a Metastatic Gastric Cancer Cell Line

Background: Exosomes play a major role in cell-to-cell communication, targeting cells to transfer exosomal molecules including proteins, mRNAs, and microRNAs (miRNAs) by an endocytosis-like pathway. miRNAs are small noncoding RNA molecules on average 22 nucleotides in length that regulate numerous biological processes including cancer pathogenesis and mediate gene downregulation by targeting mRNAs to induce RNA degradation and/or interfering with translation. Recent reports imply that miRNAs can be stably detected in circulating plasma and serum since miRNAs are packaged by exosomes to be protected from RNA degradation. Thus, profiling exosomal miRNAs are in need to clarify intercellular signaling and discover a novel disease marker as well. Methodology/Principal Findings: Exosomes were isolated from cultured cancer cell lines and their quality was validated by analyses of transmission electron microscopy and western blotting. One of the cell lines tested, a metastatic gastric cancer cell line, AZ-P7a, showed the highest RNA yield in the released exosomes and distinctive shape in morphology. In addition, RNAs were isolated from cells and culture media, and profiles of these three miRNA fractions were obtained using microarray analysis. By comparing signal intensities of microarray data and the following validation using RT-PCR analysis, we found that let-7 miRNA family was abundant in both the intracellular and extracellular fractions from AZ-P7a cells, while low metastatic AZ-521, the parental cell line of AZ-P7a, as well as other cancer cell lines showed no such propensity. Conclusions/Significance: The enrichment of let-7 miRNA family in the extracellular fractions, particularly, in the exosome

A Boy Safely Treated with Tyrosine Kinase Inhibitors for Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia with Osteolysis

A three-year-old boy with Philadelphia chromosome-positive B-cell precursor acute lymphoblastic leukemia (Ph+ALL) presented with an osteolytic lesion in his right upper arm. Tyrosine kinase inhibitors (TKIs) such as imatinib and dasatinib are an essential component throughout the course of treatment for Ph+ALL. However, TKIs are reported to affect the bone metabolism. In the treatment course of the current patient, the osteolytic lesion quickly improved despite the continuous use of TKIs, even during the concomitant use of corticosteroids. This suggests that TKIs can be safely given with concomitant corticosteroids to children with Ph+ALL, even when osteolytic lesions are present