マウス胸腺脂肪化時期の検討

The thymus has an important role in the immune reaction. The lymphocytes localized both in thymic cortex and in medulla, known as T cells, proliferate in an environment of the epithelial reticular cells. T cells educated to react against non-self materials enter the circulation and function in peripheral immunity. Thymus of the mouse has almost developed and grown to its natal size by the 18 days gestation. After the birth thymus grows at a somewhat slower rate until puberty. It subsequently shows a decrease both in size and in weight. That is due to the decrease in the lymphocyte-accumulated region and to the partial replacement by fat tissue. The process is so-called age"involution". Fat cells are classified as connective-tissue cells. They must develop and proliferate in the capsule or in the trabecula of the thymus after birth, because no typical fat cells containing lipid droplets are observed at birth.We examined when fat cells appeared in the thymus after the birth. Fat cells are known to express leptin, so that the appearance of leptin mRNA was detected by the PCR method. The expression of leptin was detected as early as in the thymus of the 3 week-old mouse and increased with the age. It is sugested that fat tissue development begins immediately after the birth and precedes to the age involution in the thymus, although that the cortex and medulla develops until puberty

The Physical and Mental Health Status of the Homeless in a Cold Region of Japan: Alcohol Intake, Diet and Psychosocial Distress

This study sought to clarify the lifestyle and physical and mental health status of homeless people in a cold region of Japan. 28 participants who visited a soup kitchen completed the physical health check-up and questionnaire surveys in 2017. Five were invited to participate in semi-structured interviews in 2018. Mental health was evaluated using the General Health Questionnaire-28 (GHQ-28). The results revealed that a high proportion of homeless people did not consume enough food. Their meat, fish, and vegetables intake were limited, indicating that inappropriate eating habits may affect physical health. Furthermore, four people consumed meals once or less every two days, and all of them were living on the street. In addition, 18% (n = 5) answered that they often consumed alcohol in the daytime, and 68% (n = 19) had a total GHQ-28 score above the cut-off point (>5). In this regard, among those with a GHQ-28 score of >5, seven drank in the daytime even though they consumed meals once or less a day. Indeed, qualitative results revealed physical and psychosocial distress experienced, including limited access to food, anxiety for the future, lack of social support, and erosion of self-esteem. These findings suggest that restrictions on food selection due to financial insecurity, alcohol issues, and mental disorders may impact the food intake and subsequently lead to deteriorating physical health and living on the street may also significantly impact mental health among the homeless. which are helpful for health and social workers to develop necessary interventions targeted at this population

Sclerosing thymoma-like thymic amyloidoma with nephrotic syndrome: a case report

Abstract Background Primary localized amyloidosis presenting as an isolated mediastinal mass is extremely rare, especially in the thymus. Sclerosing thymoma is also an extremely rare anterior mediastinal tumor, pathologically characterized by extensive sclerotic lesions with hyalinization and calcification. Only 14 cases of sclerosing thymoma and five cases of thymic amyloidosis have been reported to date. Case presentation A 78-year-old Japanese woman was diagnosed as having sclerosing thymoma (Masaoka stage IVa pericardial dissemination)-like thymic amyloidoma. She was diagnosed as having either lung cancer or mediastinal tumor with pericardial dissemination, and received palliative treatment. Three years later, she was readmitted with a complaint of general malaise. Since minimal change nephrotic syndrome was suspected based on the disease onset and selectivity index of urinary protein, steroid pulse therapy was started. Subsequently, because a marked reduction in tumor size was observed during maintenance treatment with prednisolone, a thoracoscopic needle biopsy was performed for a definitive diagnosis. According to the pathological findings and clinical investigations, a final diagnosis of sclerosing thymoma (Masaoka stage IVa pericardial dissemination)-like thymic amyloidoma was made. Conclusions This is a case report of sclerosing thymoma-like thymic amyloidoma. Both sclerosing thymoma and thymic amyloidoma are extremely rare diseases: only 14 cases of sclerosing thymoma and five cases of thymic amyloidosis have been reported to date. In either diagnosis, our case is the first case in which marked reduction in tumor size was observed with steroid therapy. All reported cases of sclerosing thymomas underwent surgical resection, but steroid therapy to sclerosing thymoma has not been reported. It is still unknown whether steroid therapy is effective or not. The hyalinized components of sclerosing thymoma possibly contain amyloid deposits. The marked reduction in tumor size with steroid therapy may result in amyloid deposits. The association between sclerosing thymoma and thymic amyloidoma remains uncertain. Sclerosing thymoma should be stained with Congo red

Postintensive care syndrome family: A comprehensive review.

Publication status: PublishedFamilies of critically ill patients are predisposed to tremendous burdens when their relatives are admitted to the intensive care unit (ICU). Postintensive care syndrome family (PICS-F) can be described as a devastated life, encompassing psychological, physical, and socioeconomical burdens that begin with the emotional impact experienced by the family when the patient is admitted to the ICU. PICS-F was primarily proposed as a clinically significant psychological impairment, but it needs to be extended beyond the psychological impairment of the family to include physical and socioeconomical impairments in the future. The prevalence of physiological problems including depression, anxiety and post-traumatic syndrome is 20-40%, and that of non-physiological problems including fatigue is 15% at 6 months after the ICU stay. Assessment of PICS-F was frequently conducted at 3- or 6-month points, although the beginning of the evaluation was based on different assessment points among each of the studies. Families of ICU patients need to be given and understand accurate information, such as the patient's diagnosis, planned care, and prognosis. Prevention of PICS-F requires a continuous bundle of multifaceted and/or multidisciplinary interventions including providing a family information leaflet, ICU diary, communication facilitators, supportive grief care, and follow-up, for the patient and families from during the ICU stay to after discharge from the ICU. This is the first comprehensive review of PICS-F to address the concept, risk factors, assessment tools, prevalence, and management to prevent PICS-F to facilitate acute care physicians' understanding of PICS-F