Subtype and targeted therapy for TNBC

Triple-negative breast cancer (TNBC) is a heterogenous disease. For personalized medicine, it is essential to identify and classify tumor subtypes to develop effective therapeutic strategies. Although gene expression profiling has identified several TNBC subtypes, classification of these tumors remains complex. Most TNBCs exhibit an aggressive phenotype, but some rare types have a favorable clinical course. In this review, we summarize the classification and characteristics related to the various TNBC subtypes, including the rare types. Therapeutic methods that are suitable for each subtype are also discussed. Of the intrinsic breast cancer subtypes identified by gene expression analysis, the basal-like subtype specifically displayed decreased expression of an estrogen receptor (ER) and human epidermal growth factor receptor 2 (HER2) cluster. We also present results that characterize the TNBC and basal-like phenotypes. TNBC may be categorized into four major classes : basal-like, immune-enriched, mesenchymal, and luminal androgen receptor. Therapeutic strategies for each subtype have been proposed along with newly approved targeted therapies for TNBC, such as immune checkpoint inhibitors. Understanding the classification of TNBC based on gene expression profiling in association with clinicopathological factors will facilitate accurate pathological diagnosis and effective treatment selection

Poor Outcome due to the Plasmacytoid Variant of Urothelial Carcinoma

A 72-year-old man visited our hospital due to pollakiuria and lower abdominal pain. Urinary cytology was positive, and cystoscopy revealed diffuse edematous nonpapillary tumor. We performed transurethral biopsy, and clinical stage T3 plasmacytoid variant of urothelial carcinoma (PUC) was diagnosed. Although we planned for radical cystectomy, peritoneal dissemination and lung and pelvic lymph node metastases appeared 3 weeks after the initial visit. We also planned for chemotherapy; however, the metastases rapidly progressed, and he died 7 weeks after the biopsy. PUC is rare and shows an aggressive clinical course and poor prognosis

Visualization of the radiofrequency lesion after pulmonary vein isolation using delayed enhancement magnetic resonance imaging fused with magnetic resonance angiography

AbstractBackgroundThe radiofrequency (RF) lesions for atrial fibrillation (AF) ablation can be visualized by delayed enhancement magnetic resonance imaging (DE-MRI). However, the quality of anatomical information provided by DE-MRI is not adequate due to its spatial resolution. In contrast, magnetic resonance angiography (MRA) provides similar information regarding the left atrium (LA) and pulmonary veins (PVs) as computed tomography angiography. We hypothesized that DE-MRI fused with MRA will compensate for the inadequate image quality provided by DE-MRI.MethodsDE-MRI and MRA were performed in 18 patients who underwent AF ablation (age, 60±9 years; LA diameter, 42±6mm). Two observers independently assessed the DE-MRI and DE-MRI fused with MRA for visualization of the RF lesion (score 0–2; where 0: not visualized and 2: excellent in all 14 segments of the circular RF lesion).ResultsDE-MRI fused with MRA was successfully performed in all patients. The image quality score was significantly higher in DE-MRI fused with MRA compared to DE-MRI alone (observer 1: 22 (18, 25) vs 28 (28, 28), p<0.001; observer 2: 24 (23, 25) vs 28 (28, 28), p<0.001).ConclusionsDE-MRI fused with MRA was superior to DE-MRI for visualization of the RF lesion owing to the precise information on LA and PV anatomy provided by DE-MRI

基礎看護学実習I における学生の学び : 実習アンケートの分析から

基礎看護学実習Iにおける学生の学びや気づき、達成感などを把握するために実習終了後にアンケート調査を行っており、2年間の調査から以下のような結果を得た。実習到達度には年度差がみられたが、患者とかかわる体験を通して「看護への学びを深めていく動機づけとなる」目的は達成されていた。実習に対する満足感は看護あるいは看護師に対する関心を強化し、学習への動機づけを促進していた。今後の課題として(1).基礎看護学実習1での学生の状況を教員が共有し、次の段階の教育に生かすことができるようにすること(2).演習の効果を向上させるために、グループワークのルールや役割についての指導を行い、グループワークの作業過程を評価すること(3).初めて行う看護体験の個人差を少なくすること(4).体験が成功体験となるような支援の必要性が示唆された。In order to better understand what students learn and perceive, and the sense of achievement they gain from Basic Nursing Practicum I, a yearly study is conducted in the form of a self-reported questionnaire of nursing students after completion of this course. This paper looks at results from the past two years. Although there were differences in course achievement levels between the two years, through their experience of interacting with patients, students were able to achieve the goal of "motivation to learn more about nursing". Students found satisfaction in experiential learning in a clinical situation, which reinforced their interest in nursing and nurses, and strengthened their motivation to learn. The results of the present study suggest as follows: 1) All teachers should share student\u27s state of the basic nursing practicum I, and use it to next stages of various education. 2) In order to improve the effectiveness of nursing practice, it is necessary to give students more guidance about the rules of group work and their individual roles, and to assess group work tasks. 3) Efforts should be made to reduce initial disparities in individual performance due to in experience. 4) It is important to provide enough support so that students have a successful first experience in nursing practice

Research Activities in the Department of Nursing

Research activity at the Department of Nursing is overviewed from the point of research topics, the theme of the projects admitted for grant from the Ministry of Education and Science of Japan, and expected research topics, trying to clarify the needs and challenges of the Department from multilateral aspects in future research activities. The Department of Nursing, Aino University is currently divided into the five areas and further into 12 fields. On the other hand, according to the Scientific Research Grant Program (2015 fiscal year), the research topics in nursing science is subdivided into the five areas; a) basic nursing, b) clinical nursing, c) lifelong developmental nursing, d) elderly nursing, and e) community health nursing

Spindle Checkpoint Signaling Requires the Mis6 Kinetochore Subcomplex, Which Interacts with Mad2 and Mitotic Spindles

The spindle checkpoint coordinates cell cycle progression and chromosome segregation by inhibiting anaphase promoting complex/cyclosome until all kinetochores interact with the spindle properly. During early mitosis, the spindle checkpoint proteins, such as Mad2 and Bub1, accumulate at kinetochores that do not associate with the spindle. Here, we assess the requirement of various kinetochore components for the accumulation of Mad2 and Bub1 on the kinetochore in fission yeast and show that the necessity of the Mis6-complex and the Nuf2-complex is an evolutionarily conserved feature in the loading of Mad2 onto the kinetochore. Furthermore, we demonstrated that Nuf2 is required for maintaining the Mis6-complex on the kinetochore during mitosis. The Mis6-complex physically interacts with Mad2 under the condition that the Mad2-dependent checkpoint is activated. Ectopically expressed N-terminal fragments of Mis6 localize along the mitotic spindle, highlighting the potential binding ability of Mis6 not only to the centromeric chromatin but also to the spindle microtubules. We propose that the Mis6-complex, in collaboration with the Nuf2-complex, monitors the spindle–kinetochore attachment state and acts as a platform for Mad2 to accumulate at unattached kinetochores

Original Article Clinical outcomes and serum uric acid levels in elderly patients with amyotrophic lateral sclerosis aged ≥ 70 years

Abstract: Background: Amyotrophic lateral sclerosis is a slowly progressive fetal neurodegenerative disease in which clinical phenotype and nutritional status are considered prognostic factors. Advanced age has also been reported to carry a poor prognosis in amyotrophic lateral sclerosis. The elderly population is expected to increase in Japan, as well as in other countries in the near future. Whether late-onset amyotrophic lateral sclerosis affects the average lifespan or survival of patients and the nutritional status was related to survival remains an open question. Methods: We studied the survival of elderly 34 patients with clinically definite amyotrophic lateral sclerosis aged ≥ 70 years and investigated serum triglycerides, cholesterol, LDL/HDL ratio, and glucose. Serum uric acid was examined. Results: The average age at respiratory disorders or death as a whole was 77.5 ± 4.3 years. Survival did not differ significantly between different clinical phenotypes or between patients with and those without riluzole usage. Survival differed significantly between patients with and those without other complications. No biochemical parameter is correlated with outcome in this series, including elevated triglyceride or cholesterol levels and an increased LDL/HDL ratio. The survival correlated with the serum uric acid level (r = 0.407, p = 0.017). Conclusions: The onset of amyotrophic lateral sclerosis at ≥ 70 years of age might not be the key determinant of survival in patients with amyotrophic lateral sclerosis

スクワット運動における圧中心の移動による筋活動パターン

The squat exercise is a fundamental movement in athletic training and rehabilitation. In this study, we measured muscle activities in a normal squat posture (NSP) and a squat posture with the center of foot pressure (COP) intentionally shifted forward as far as possible (FSP). Ten healthy men performed double-limb squats, adopting the NSP and FSP, with three knee flexion angles (30, 60, and 90 degrees). The muscle activities of the vastus medialis (VM), semitendinosus (ST), tibialis anterior (TA), and gastrocnemius muscle lateral head (GL) were measured using surface electromyography, and activity patterns were analyzed. Compared to that for the NSP, the COP was significantly shifted forward in the FSP by at least 30% of the foot length for all knee flexion angles (p < 0.05). At all knee flexion angles, VM muscle activity significantly decreased, while GL muscle activity increased, in the FSP compared to that for the NSP (p < 0.05). In addition, ST muscle activity increased significantly in the FSP compared to that for the NSP at knee flexion angles of 30 and 60 degrees (p < 0.05). TA muscle activity significantly decreased in the FSP compared to that for the NSP at only 90 degrees of knee flexion (p < 0.05). These results demonstrate that muscle activity patterns vary significantly according to squat posture. Thus, the active control of the COP position during the squat can be a new training approach in targeting specific muscle groups.博士（医学）・甲第723号・令和元年12月5日©Journal of Sports Science and Medicine (2019)This work is licensed under a Creative Commons License CreativeCommons Attribution-NonCommercial-NoDerivatives 4.0 International License(https://creativecommons.org/licenses/by-nc-nd/4.0/