Evaluation of Gastroesophageal Reflux and Gastroesophageal Reflux Disease with Esophageal Endoscopy and Histology in Children

Objectives:The roles of esophageal endoscopy and mucosal biopsy in making diagnoses of gastroesophageal reflux( GER) and gastroesophageal reflux disease( GERD) were retrospectively examined in children.Methods:Thirty-four patients, whose ages ranged from 1 month to 18 years (median, 4 years), underwent diagnostic evaluation of GER/GERD. Group I patients( n=5) had symptoms suggesting GER, but had no underlying abnormalities. Group II patients( n=23) had chronic symptoms suggesting GERD and underlying abnormalities, neurologic impairment( n=22) and post-repair of esophageal atresia( n=1). Group III patients( n=6) were neurologically impaired but had no symptoms and underwent evaluation as a preoperative examination of gastrostomy placement. Reflux esophagitis was endoscopically graded according to the modified Los Angeles classification and grouped into grades?M, A, and?B. The results of GER studies and the histologic findings of reflux esophagitis were compared between these groups.Results:The parameters of 24-h pH monitoring were significantly higher in patients with grade?B than grade?M, and endoscopic grades improved after antireflux surgery along with the improvements in reflux index. There were no significant correlations between the endoscopic grade and the percentages of patients in whom histologic findings of reflux esophagitis were present.Conclusion:Esophageal endoscopy is useful for examining the severity of reflux esophagitis and monitoring the effect of treatment in children with GER/GERD. The modified Los Angeles classification can also be used for that purpose. Although treatment is seldom influenced by the results, histologic evaluation of the esophageal mucosa should be performed to exclude other disorders

Complete remission of diabetes with a transient HDAC inhibitor and insulin in streptozotocin mice

Despite the growing epidemic worldwide, diabetes is an incurable disease. We have been focusing on why diabetes manifests refractoriness to any therapy. We recently found that abnormal bone marrow-derived cells (BMDCs), namely, Vcam-1+ST-HSCs, was a key mechanism for diabetic complications. We then hypothesize that those aberrant BMDCs sustainedly impair pancreatic β cells. Here we show that eliminating abnormal BMDCs using bone marrow transplantation results in controlling serum glucose in diabetic mice, in which normoglycemia is sustained even after cessation of insulin therapy. Alternatively, abnormal BMDCs exhibiting epigenetic alterations are treated with an HDAC inhibitor, givinostat, in diabetic mice. As a result, those mice are normoglycemic along with restored insulin secretion even following the cessation of both insulin and givinostat. Diabetic cell fusion between abnormal BMDCs and resident cells is significantly blocked by the combination therapy in the pancreatic islets and thymus while surgical ablation of the thymus completely eliminates therapeutic protection in diabetic mice. In conclusion, diabetes is an epigenetic stem cell disorder with thymic disturbances. The combination may be applied to patients aiming at complete remission from diabetes in clinical medicine.journal articl

英国における日本語教育の再考―異文化理解をめぐる学習者及び日本語教師の意識調査から = Revisiting Japanese Language Education in the UK: A survey on learners’ and teachers’ perceptions regarding intercultural understanding

世界のグローバル化に伴い、以前にも増して異なる文化や価値観を持つ人々が共生するようになり、外国 語教育では単に言語を的確に使えるだけではなく、相手の文化を理解し、自己の文化との違いを受け入れる能力、つまり異文化間コミュニケーション能力（intercultural communicative competence, ICC）が求められるようになった（Byram et al. 2013）。英国の高等教育においても、人の移動が頻繁になりかつ世界情勢が不安定な中にあって、異文化に対する寛容性や関心の高い人材を育てるための教育がますます強く望まれるようになった（Bothwell 2016）。しかし、言語教育の実践では、未だに言語とコミュニケーションを中心とした授業が行われている場合が多い（Byram et al. 2013）。また、異文化間能力（intercultural competence, IC）は必ずしも自然に身につくわけではないとも言われており、意識的なトレーニングの必要性が唱えられている（Behrnd & Porzelt 2012)。本発表は、英国の日本語教育の現場においてどの程度 IC 及び ICC の養成が意識されているかに関する基礎的調査の報告である。英国で活躍している日本語教師（n=34）と日本語を専攻し、日本に留学した経験のある大学学部生（n=38）に彼らの動機や異文化理解に関する意識、日本語教師または話者としての社会的貢献について、オンラインアンケートを行い、詳細な記述を求めた。Byram（1997）の ICC モデルに照らし合わせて学生回答者のコメントを分析した結果、全体として“critical cultural awareness”の不足が目立った。自らを異文化に対する寛容性が高いと評価した学生が多かったものの、その根拠として挙げられた理由からは、異文化理解への自己認識にかなりの差が見られた。また、英国の大学の「多文化コミュニティー」としての側面に対する認識が高いとはいえないことが窺えた。一方教師は、英国の大学の「多文化コミュニティー」としての側面に対する認識は高く、日本語教育の実践の場が、異文化理解能力開発のために有益な教育効果をもたらすことを十分理解していることがデータから観察された。しかし、「多言語多文化社会を意識した教育を行っているか」という問いに対しては、具体的な教育実践に言及した回答が少なく、日本文化について紹介する際に自己の文化と照らし合わせて話し合う程度で IC 及び ICC の養成がカリキュラムに含まれている場合は少ないことが分かった。つまり、教師のビリーフと実践の間には乖離が見られた。以上の結果を踏まえ、英国における日本語教育の現場で IC 及び ICC を高めるために何ができるかを考えたい。= With the advance of globalisation we are living in an increasingly diverse society where people with different cultures and values coexist. Foreign language education has also taken a ‘cultural turn’ (Byram et al. 2013) by which, in addition to learning to use the target language accurately and appropriately, gaining intercultural communicative competence (ICC), i.e., understanding and accepting other cultures, has become a central theme. In the age of international mobility and instability, it became required in higher education in the UK to train students to be tolerant and be interested in other cultures (Bothwell 2016). In reality, however, language and communication continue to be the main focus in many language classrooms and ICC has not been integrated as one of the learning objectives (Byram et al. 2013). Studies have also shown that intercultural competence (IC) does not always develop naturally through the experience of studying abroad, and suggest the need for intercultural training prior to studying abroad (Behrnd & Porzelt 2012). This study is a fundamental research on the awareness of IC and ICC in Japanese Language education in the UK. An online questionnaire was administered to each group. The questions focused on their motives for teaching or learning Japanese, how they perceived IC and ICC and what they thought their contribution to society was. Some questions asked the participants to explain in detail and a total of 34 teachers and 38 university students, who are majoring in Japanese and have studied abroad in Japan, participated. The results from analysing the student questionnaire using Byram’s ICC Model (1997) showed that in general many of the students lacked “critical cultural awareness”. Although many of them thought that they were tolerant to other cultures, there was a big difference in their self-awareness to IC. The results also showed that many of the students did not recognize British Universities as a ‘multicultural society’. The results from analysing the teacher questionnaire showed that many recognized British Universities as a ‘multicultural society’ and fully understood that the classrooms of Japanese language education could improve IC and ICC effectively. However, to the question, ‘Are you teaching students to have an awareness of our multilingual or multicultural society?’ only a few teachers provided concrete examples of IC and ICC related teaching, and few curricula included the training of IC and ICC. That is, there was a separation of teachers’ belief and actual teaching. Based on the results above, we would like to consider what we can do in order to improve IC and ICC for Japanese language education in the UK

Mucin-producins Lung Cancer and Response to Gefitinib.

A53-year-01d woman who was hypoxemic due to primary lung adenocarcinoma with both pleuritis and pericarditis carcinomatosa was treated with gefitinib，an inhibitor of the epithelial growth factor receptor (EGFR) tyrosine kinase.The tumor seemed to produce mucin because the extremely high serum KL-6 and almost normal Sp-D values on admission.After 3 days of treatment，the patient became asymptomatic and oxygen was discontinued.The response to this drug was remarkable on chest CT findings.Mucin overproduction could offer a candidate marker to determine the patient subset displaying good responseto gefitinib

Hydrogenated Borophene Shows Catalytic Activity as Solid Acid

Hydrogen boride (HB) or hydrogenated borophene sheets are recently realized two-dimensional materials that are composed of only two light elements, boron and hydrogen. However, their catalytic activity has not been experimentally analyzed. Herein, we report the catalytic activity of HB sheets in ethanol reforming. HB sheets catalyze the conversion of ethanol to ethylene and water above 493 K with high selectivity, independent of the contact time, and with an apparent activation energy of 102.8 ± 5.5 kJ/mol. Hence, we identify that HB sheets act as solid-acid catalysts

Minimal change nephrotic syndrome associated with gefitinib and a successful switch to erlotinib.

著作権は日本内科学会に帰属するMinimal change nephrotic syndrome (MCNS) is a common form of nephrotic syndrome (NS). We herein present the case of a 57-year-old woman with advanced lung adenocarcinoma treated with the tyrosine kinase inhibitor (TKI) gefitinib who developed NS. A renal biopsy revealed minor glomerular abnormalities, and the patient's symptoms improved exclusively with the discontinuation of gefitinib. Therefore, we diagnosed her with MCNS associated with gefitinib treatment. A few months later, however, she developed recurrent lung tumors. Following the challenging initiation of the TKI erlotinib, she achieved remission without proteinuria. We thus conclude that erlotinib is a potential treatment option in patients with NS associated with gefitinib therapy

チバ キャンパス サンガクブ ニオケル タショクシュ レンケイ キョウイク ドウニュウ ニ ムケタ ケントウ : ソツギョウセイ オ タイショウ ト シタ カイコテキ インタビュー チョウサ ヨリ

【目的・方法】総合福祉学部、コミュニティ政策学部、看護栄養学部の三学部で専門職連携教育のプログラムを構築するための基礎的資料を得ることを目的に、社会福祉学科卒業生２名、コミュニティ政策学科卒業生１名、看護学科卒業生１名の協力を得て、2018年８月に多職種連携教育の経験およびニーズに関するグループインタビュー調査を実施した。【結果】インタビューデータはテキスト化、セグメント（切片）化したうえで、意味内容からコード化・カテゴリ化した。その結果、本調査対象の卒業生は、福祉を基盤とした大学の文化を背景にして、福祉の実践者としての周囲からの期待と、福祉マインドを体現する先輩や実務経験のある教員の存在を、専門職としての多職種連携を推進する力としており、またそれぞれの実践に他学部学生との交流経験が生かされていた。【結論】本学における多職種連携教育プログラムでは、学生間の交流を促進するような、初年次での学部を超えたキャンパス共通の科目をもうけること、他学部他学科の学生による合同演習を含む多職種連携に関する科目をカリキュラムに組み込むことの必要性が示された

Malfunctioning CD106-positive, short-term hematopoietic stem cells trigger diabetic neuropathy in mice by cell fusion.

Diabetic neuropathy is an incurable disease. We previously identified a mechanism by which aberrant bone marrow-derived cells (BMDCs) pathologically expressing proinsulin/TNF-α fuse with residential neurons to impair neuronal function. Here, we show that CD106-positive cells represent a significant fraction of short-term hematopoietic stem cells (ST-HSCs) that contribute to the development of diabetic neuropathy in mice. The important role for these cells is supported by the fact that transplantation of either whole HSCs or CD106-positive ST-HSCs from diabetic mice to non-diabetic mice produces diabetic neuronal dysfunction in the recipient mice via cell fusion. Furthermore, we show that transient episodic hyperglycemia produced by glucose injections leads to abnormal fusion of pathological ST-HSCs with residential neurons, reproducing neuropathy in nondiabetic mice. In conclusion, we have identified hyperglycemia-induced aberrant CD106-positive ST-HSCs underlie the development of diabetic neuropathy. Aberrant CD106-positive ST-HSCs constitute a novel therapeutic target for the treatment of diabetic neuropathy