RAF1-MEK/ERK pathway-dependent ARL4C expression promotes ameloblastoma cell proliferation and osteoclast formation

Ameloblastoma is an odontogenic neoplasm characterized by slow intraosseous growth with progressive jaw resorption. Recent reports have revealed that ameloblastoma harbours an oncogenic BRAFV600E mutation with mitogen-activated protein kinase (MAPK) pathway activation and described cases of ameloblastoma harbouring a BRAFV600E mutation in which patients were successfully treated with a BRAF inhibitor. Therefore, the MAPK pathway may be involved in the development of ameloblastoma; however, the precise mechanism by which it induces ameloblastoma is unclear. The expression of ADP-ribosylation factor (ARF)-like 4c (ARL4C), induced by a combination of the EGF-MAPK pathway and Wnt/beta-catenin signalling, has been shown to induce epithelial morphogenesis. It was also reported that the overexpression of ARL4C, due to alterations in the EGF/RAS-MAPK pathway and Wnt/beta-catenin signalling, promotes tumourigenesis. However, the roles of ARL4C in ameloblastoma are unknown. We investigated the involvement of ARL4C in the development of ameloblastoma. In immunohistochemical analyses of tissue specimens obtained from 38 ameloblastoma patients, ARL4C was hardly detected in non-tumour regions but tumours frequently showed strong expression of ARL4C, along with the expression of both BRAFV600E and RAF1 (also known as C-RAF). Loss-of-function experiments using inhibitors or siRNAs revealed that ARL4C elevation depended on the RAF1-MEK/ERK pathway in ameloblastoma cells. It was also shown that the RAF1-ARL4C and BRAFV600E-MEK/ERK pathways promoted cell proliferation independently. ARL4C-depleted tumour cells (generated by knockdown or knockout) exhibited decreased proliferation and migration capabilities. Finally, when ameloblastoma cells were co-cultured with mouse bone marrow cells and primary osteoblasts, ameloblastoma cells induced osteoclast formation. ARL4C elevation in ameloblastoma further promoted its formation capabilities through the increased RANKL expression of mouse bone marrow cells and/or primary osteoblasts. These results suggest that the RAF1-MEK/ERK-ARL4C axis, which may function in cooperation with the BRAFV600E-MEK/ERK pathway, promotes ameloblastoma development. (c) 2021 The Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd

東大式エゴグラム（第2版）を用いたアルコール使用障害者とのフィードバックセッションの試行

本研究の目的は， アルコール使用障害者A氏とのTEG- IIの結果の共有場面について振り返ることを通して， 心理アセスメント結果の共有がアルコール使用障害の治療に寄与する可能性を明らかにすることであった。また， 心理アセスメント結果の共有のあり方についても検討し, アルコール使用障害者への共有の手順についての一例を示した。アルコール使用障害者にとってTEG- IIの結果を共有することは， 日常生活上の振る舞い方や考え方のパターンを振り返る機会になることが明らかとなった。さらに， 視覚的な情報の提示に併せて検査者との対話を通じて結果について共有することで， アルコール使用障害者は日常生活上の困難場面への気づきの機会を得ており， 自身の振る舞い方や考え方を変える必要性に気づくことに繋がっていた。また， TEG- IIの結果を共有する上で，「予想エゴグラム」を作成する機会を設けることは， アルコール使用障害者の主体性を引き出す工夫として有益と考えられた。The main purpose of this research was to indicate the possibilities of treating alcohol use disorder (AUD) patients by sharing the results of a psychological assessment with them. This research comprised a case study that shared the result of the Tokyo University Type Egogram II (TEG-II) with AUD patient A . The second purpose of this paper was to suggest ways of sharing the results of the psychological assessment. By sharing the results of TEG-II, AUD patients received opportunities to introspect their personal behavior or ways of thinking in their daily lives. Moreover, by engaging in verbal communication with AUD patients, in addition to showing them visual information, it was found that the patients tended to notice the necessity of changing their social behavior or thoughts when they encounter challenging moments. In addition, creating an "expected egogram" while sharing the results ofTEG-II, was instructive for AUD patients and encouraged them to get more involved

アルコール使用障害の疾患概念の変遷とロールシャッハ・テスト研究

The purpose of this research is to observe the current standing and effectiveness of alcohol use disorder (AUD) diagnostic assessments by reviewing research into transitions in the disease concept and assessment of AUD. It also aims to use these insights to obtain an effective perspective to better understand and support AUD patients. Currently screening tests are the most widely used methods in discerning whether a patient has AUD. With regard to AUD assessment methods, extensive research is being conducted on the Rorschach Test and Thematic Apperception Test as alternatives for effectively diagnosing AUD. In particular, the sign approach under the Rorschach Test has been shown to be an effective alternative, and many studies have assessed method. However, researchers have not yet determined consistent attributes of or signs to discern AUD under this approach that could be used in assessments with an acceptable degree of confidence; therefore, many studies are now shifting toward more quantitative methods in diagnosing AUD

外界に注意の向きやすい視覚障害者の自体に注意を促す援助

転落事故による視覚障害と肢体不自由を抱えた30代女性のトレーニーに対し， 5泊6日の心理リハビリテイションキャンプで動作法を実施した。トレーニーは， 外界に注意が向きやすく, 課題の中で痛みを感じるとすぐに課題をやめてしまうなど， 自身の内面や身体に向き合いにくかった。そこでトレーナーは， 徐々に， 身体の感じについての質問を行ったり， トレーニーの痛いところを尋ね， その痛みに注意を向けて待つことを促したりする関わりを行った。すると次第に， トレーニーは身体の感じについての質問に答えたり，痛みに注意を向けて待ったりするようになり， 身体の緊張も弛むようになった。また， タテ系課題を行う際は， 目が見えないトレーニーに， トレーナーが身体を他動的に動かして適切な動きを伝えることに加えて，言葉で具体的に動きを伝えたり， 課題を一気に行うのではなく， いくつかの段階に分けて， 動きを達成できるように工夫を行った。すると， トレーニーはトレーナーが求める動きを理解し, 課題に懸命に取り組むようになった。このように， トレーニーが徐々に自身の身体に向き合い， 身体を介したやり取りを行えるようになるにつれ， トレーニーの他者交流も活発になった。The present study reports on a 36-year-old woman, who was blinded and whose body was paralyzed in a fall accident. The Dohsa method for improving her movement was used for 6 days in a psychological rehabilitation camp. While she usually attended to the external world, she did not pay much attention to her own body sensations. Additionally, she gave up the Dohsa-tasks when she experienced pain. Therefore, the camp trainer asked her about her body, and encouraged her to wait and experience her own pain. Then, she answered my questions about her body, and waited to release her muscle tension. Furthermore, when I performed the Tate-kei-Dohsa-tasks, I moved her body to demonstrate appropriate movement, convey the movement correctly, and set up a stepwise system for her to perform the tasks. Then, she understood the tasks and performed them well. Moreover, she was able to interact with others proactively, as she gradually directed her attention to her body and communicated with the trainer