大腸癌肝転移におけるCD200発現の臨床的意義

Background: Approximately 30% of patients diagnosed with colorectal cancer (CRC) develop liver metastases. We evaluated the role of CD200, a potent immunosuppressive molecule, in colorectal liver metastases (CRLM). Methods: We examined 110 patients who underwent curative liver resection for CRLM at our institution between 2000 and 2016. Based on the results of immunohistochemical analysis, the patients were divided into high-CD200 (n = 47) and low-CD200 (n = 63) expression groups. The relationships between CD200 expression and various clinicopathological outcomes were investigated. Results: The overall survival (OS) of patients in the high-CD200 group was significantly worse than that in the low-CD200 group (p = 0.009). Multivariate analysis showed that the independent prognostic factors in CRLM were maximum tumor size > 30 mm (p = 0.002), preoperative carcinoembryonic antigen level > 20 ng/mL (p < 0.001), primary CRC N2-3 (p = 0.049), and high-CD200 expression (p = 0.004). Furthermore, CD4+, CD8+, and CD45RO+ tumor-infiltrating lymphocytes in CRLM were significantly higher in the low-CD200 group than in the high-CD200 group (p = 0.005, p = 0.001, and p < 0.001, respectively). In addition, patients who had received preoperative chemotherapy had higher CD200 expression than those who had not received preoperative chemotherapy, and OS was significantly worse in patients in the high-CD200 group who had received preoperative chemotherapy. Conclusions: CD200 expression was an independent prognostic factor in CRLM. CD200 may play a critical role in tumor immunity in CRLM, and can therefore be used as a potential therapeutic target in CRLM.博士（医学）・乙第1497号・令和3年3月15日© 2021. Society of Surgical Oncology.© Springer Nature Singapore Pte Ltd. 2020This is a post-peer-review, pre-copyedit version of an article published in Annals of Surgical Oncology. The final authenticated version is available online at: https://doi.org/10.1245/s10434-020-09471-w

筋強直性ジストロフィー1型における脳卒中に関する危険因子の臨床的特徴

Objective: Myotonic dystrophy type 1 (DM1) is a rare autosomal dominant disorder with highly variable phenotypic expression. Some patients have diabetes mellitus, dyslipidemia, and/or arrhythmias, which are risk factors for stroke. However, the mechanism of stroke is poorly understood in patients with DM1. We studied the characteristics of risk-factor profiles for stroke associated with DM1. Patients and methods: We studied 77 patients with DM1 (45 men and 32 women) on the basis of the patients’ clinical histories and laboratory and genetic examination results. Results: The analysis showed that 26 patients (34%) had dyslipidemia, and 16 (21%) had diabetes. Arrhythmias were diagnosed in 46 patients (61%), including 11 (14%) with atrial fibrillation and 9 (12%) with conduction defects. Echocardiographic abnormalities were found in 28 patients (37%). Eight patients (11%) met the criteria for metabolic syndrome. We identified 2 patients (2.6%) with ischemic stroke caused by cardiogenic embolism among 77 patients with DM1. One had paroxysmal atrial fibrillation and sick sinus syndrome, and the other had cardiac dysfunction with an ejection-fraction of 35% and dyslipidemia. Both patients had highly expanded numbers of CTG repeats (1000 and 1500). Conclusion: To our knowledge, this is the first study to report a comprehensive analysis of risk-factor profiles for stroke in patients with DM1. Stroke is a relatively rare, but severe complication of DM1. Our results indicate that it is important to manage risk factors for stroke, especially cardiac involvement and arrhythmias.博士（医学）・乙第1392号・平成29年3月15日Copyright: © 2016 Sugie M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Low-temperature photoreaction cycle of phoborhodopsin (sensory rhodopsin II) from Halobacterium salinarium

There are four types of retinal proteins in the membrane of Halobacterium salinarum. Bacteriorhodopsin (BR) and halorhodopsin (HR) convert light energy into electrostatic gradients that can be used by the cell as an energy source to produce ATP. Sensory rhodopsin I (SR I) and phoborhodopsin (pR) enable the cells to migrate toward an environment optimal for light energy harvesting while avoiding potentially damaging shorter wavelength light. In the present work, low temperature photoreaction cycle of pR expressed in E. coli was studied. Comparing to the previous results, the new findings in the present work are: (i) The K-like intermediate was found to be a mixture of two photoproducts. (ii) Formation of an L-like intermediate (P482) was observed. (iii) Upon light irradiation, formation of a long lived shorter wavelength photoproduct (P370) was observed at 20 ℃.特集 : 「資源、新エネルギー、環境、防災研究国際セミナー

根治切除後の結腸癌StageⅡ、StageⅢ、及び大腸癌肝転移における原発部位が与える影響

Purpose: Primary tumor location of colon cancer has been reported to affect the prognosis after curative resection. However, some reports suggested the impact was varied by tumor stage. This study analyzed the prognostic impact of the sidedness of colon cancer in stages II, III, and liver metastasis after curative resection using propensity-matched analysis. Methods: Right-sided colon cancer was defined as a tumor located from cecum to splenic flexure, while any more distal colon cancer was defined as left-sided colon cancer. Patients who underwent curative resection at Nara Medical University hospital between 2000 and 2016 were analyzed. Results: There were 110 patients with stage II, 100 patients with stage III, and 106 patients with liver metastasis. After propensity matching, 28 pairs with stage II and 32 pairs with stage III were identified. In the patients with stage II, overall survival (OS) and recurrence-free survival (RFS) were not significantly different for right- and left-sided colon cancers. In the patients with stage III, OS and RFS were significantly worse in right-sided colon cancer. In those with liver metastasis, OS of right-sided colon cancer was significantly worse than left-sided disease, while RFS was similar. Regarding metachronous liver metastasis, the difference was observed only in the patients whose primary colon cancer was stage III. In each stage, significantly higher rate of peritoneal recurrence was found in those with right-sided colon cancer. Conclusion: Sidedness of colon cancer had a significant and varied prognostic impact in patients with stage II, III, and liver metastasis after curative resection.博士（医学）・乙第1495号・令和3年3月15日Copyright © 2021 The Korean Society of Coloproctology.This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited

A community intervention trial of multimodal suicide prevention program in Japan: A Novel multimodal Community Intervention program to prevent suicide and suicide attempt in Japan, NOCOMIT-J

<p>Abstract</p> <p>Background</p> <p>To respond to the rapid surge in the incidence of suicide in Japan, which appears to be an ongoing trend, the Japanese Multimodal Intervention Trials for Suicide Prevention (J-MISP) have launched a multimodal community-based suicide prevention program, NOCOMIT-J. The primary aim of this study is to examine whether NOCOMIT-J is effective in reducing suicidal behavior in the community.</p> <p>Methods/DesignThis study is a community intervention trial involving seven intervention regions with accompanying control regions, all with populations of statistically sufficient size. The program focuses on building social support networks in the public health system for suicide prevention and mental health promotion, intending to reinforce human relationships in the community. The intervention program components includes a primary prevention measures of awareness campaign for the public and key personnel, secondary prevention measures for screening of, and assisting, high-risk individuals, after-care for individuals bereaved by suicide, and other measures. The intervention started in July 2006, and will continue for 3.5 years. Participants are Japanese and foreign residents living in the intervention and control regions (a total of population of 2,120,000 individuals).</p> <p>Discussion</p> <p>The present study is designed to evaluate the effectiveness of the community-based suicide prevention program in the seven participating areas.</p> <p>Trial registration</p> <p>UMIN Clinical Trials Registry (UMIN-CTR) UMIN000000460.</p

Characteristics and distribution of stone monuments at the Higashi-Hiroshima Campus of Hiroshima University

本研究では，広島大学東広島キャンパスを対象として，悉皆調査によりすべての石碑の分布や属性，特徴を明らかにすることで，石碑が有する文化的・歴史的価値を議論する契機となることを目的とした。調査の結果，147基の石碑を確認し，その分布は教育学部と工学部でそれぞれ4割に達し，学部の偏りが顕著であること，建立年代に着目すると，東広島キャンパスの移転前の石碑は103基と全体の約7割で，多くが移転前に建立されたことなどが明らかとなった。広島大学は，医学系学部・研究科・施設をのぞくすべての学部などが東広島キャンパスに移転すると同時に石碑も集まることになった。移設により元々建立された地から離れたことで建立当初の意義を失った側面もあるが，多数の石碑が一つのキャンパスに移設されたことで散逸を防ぎ，前身校から新制広島大学，そして統合移転から現在までの歴史を繋ぐ貴重な資料となり得ることが示唆された

Competency of Education for Interntional Understanding: By analyzing Dircke Geography: For Bilingual Classes in Germany

This paper aims to clarify the characteristics of learning units on Education for International Understanding (EIU) and their structure, appropriate geographical teaching materials on EIU, streategies for competence acquisition, and perspectives of ESD within learning units on EIU by analyzing two learning units “Globalisation” and “Global Disparities” in the geography textbook for bilingual lesson ”Diercke Geography: For Bilingual Classes”. The results of the analysis showed that 1)“Globalisation” focuses on the theories of globalisation and “Global Disparities” aims to learn not only theories but also regionl images; 2) Competency is repeatedly acquired through different learning activities ; 3) “Global Disparities” is designed from the viewpoint of “think globally, act locally”

Analysis for the units of regional geography on UK’s geography textbook: The case study of “Geog 4th edition”

In Britain, the volume of “Regional Geography” was decreased in “the National Curriculum”. The aim of this paper is to cralify the contents of “Regional Geography” in Britain. We analyzed the geographical school textbook “Geog 4th edition” by Oxfor University Press. We find that “Geog” has only 2 or 3 case studies in each grade. The students don’t learn all of the world in geographical class. That is because it is important to learn the geographical skill