A STUDY OF A FUCHSIAN SYSTEM OF RANK 8 IN 3 VARIABLES AND THE ORDINARY DIFFERENTIAL EQUATIONS AS ITS RESTRICTIONS

A Fuchsian system of rank 8 in 3 variables with 4 parameters is found. The singular locus consists of six planes and a cubic surface. The restriction of the system onto the intersection of two singular planes is an ordinary differential equation of order four with three singular points. A middle convolution of this equation turns out to be the tensor product of two Gauss hypergeometric equations, and another middle convolution sends this equation to the Dotsenko-Fateev equation. Local solutions of these ordinary differential equations are found. Their coefficients are sums of products of the Gamma functions. These sums can be expressed as special values of the generalized hypergeometric series ₄F₃ at 1

AKS inom vård av äldre ur Nordiska sjuksköterskors perspektiv : Utveckling av en ny arbetsmodell för AKS inom äldrevård

Den framtida hälso- och sjukvården i Norden kommer att ställas inför en rad nya utmaningar. Medellivslängden ökar och den åldrande befolkningen får mer krävande och komplexa behov. En högre kompetens inom främst vården av äldre är starkt efterfrågad. Ett led i att försöka bemöta det ökade behovet av komptens är införandet av avancerade kliniska sjuksköterskor (AKS) inom hälso-och sjukvården. AKS är specialistutbildade sjuksköterskor med masterexamen. En högre kompetens inom farmakologi, patofysiologi och klinisk undersökningsmetodik i samverkan med exempelvis geriatrik ger AKS en bättre utgångspunkt i arbetet med de åldrande patienterna och deras hälsa. Syftet med denna studie var att utifrån sjuksköterskors synvinkel studera hur problematiken ser ut inom dagens äldrevård i de nordiska länderna (Sverige, Danmark, Norge och Färöarna) samt på vilket sätt en AKS skulle kunna vara en resurs inom äldrevården och vilka arbetsuppgifter denne skulle kunna ha. Metoden som användes var kvalitativ semistrukturerad intervjustudie och det insamlade materialet bestod av 5 intervjuer med vidareutbildade sjuksköterskor ifrån respektive land. Innehållet analyserades sedan genom tematisk innehållsanalys. Resultatet mynnade ut i 3 huvudkatergorier: Dagens äldrevård, AKS arbetsuppgifter och det nya. Det visade sig att sjuksköterskorna upplevde många brister med dagens vård. Patienterna upplevdes vara tvungna att åka fram och tillbaka för bedömningar och behandlingar som många gånger kunnat utföras på plats om kompetens fanns tillgänglig. Behovet bland kollegor och övrig personal var även stort när det gäller konsultation, rådgivning och undervisning. AKS rollen upplevdes som något mycket positivt men känslan genomsyrades ändå av en stor ambivalens inför denna nya funktion. Utifrån resultatet och teoretiska studier utvecklades en arbetsmodell för AKS inom primär och hemsjukvård. Språk: Svenska Nyckelord: Advanced practice nurse and primary health-care, roles, development and experiences.The health organizations in the Nordic countries are going to experience big challenges in future. This is mainly concerning the abilities of providing care for elderly people. The Nordic countries and Europe is facing a growing amount of population over 65 years and older. They are demanding more efficient care and are often suffering from multiple variation of diseases in the same time the number of physicians and nurses with special education is decreasing. This has led to the need of educate nurses with more clinically demanding skills, the APN. The aim of this study was to explore the problems with elderly care of today and determine how the new role as APN can assist in improving the care. And also what kind of duties the APN would be responsible of. The method that was used was a qualitative semi structured interview study with 5 nurses as participants from the Nordic countries (Sweden, Norway, Denmark and the Faroe Irelands). The material was analyzed with a thematic content analysis. Findings in the study show that elderly people has a complex situation, they often have to move from one institution to another for examination and treatment when they instead would have been able to be taken care of in their home if the competence would have been high enough. Colleague nurses and other employees would appreciate the APN as a consult and adviser. The participants of the study had a very positive impression of this APN but still you could recognize some kind of ambivalence or hesitation among them for this new role. Together with the results of the study and scientific research a working model has been created for the APN in primary health care and homecare. Language: Swedish Keywords Advanced practice nurse and primary health-care, roles , development and experiences

Efficient generation of highly immunocompetent dendritic cells from peripheral blood of patients with hepatitis C virus-related hepatocellular carcinoma

Background & aims Immunotherapy using dendritic cells (DCs) is a promising cancer therapy. The success of this therapy depends on the function of induced DCs. However, there has been no consensus on optimal conditions for DC preparation in vitro for immunotherapy of hepatocellular carcinoma (HCC) patients. To address relevant issues, we evaluated the procedures to induce DCs that efficiently function in hepatitis C virus (HCV)-related HCC. Methods We studied immunological data from 14 HCC patients. The DC preparation and the surface markers were assessed by flow cytometric analysis. Four different additional activation stimuli (Method I, medium alone; Method II, with OK-432; Method III, with IL-1β + IL-6 + TNF-α; Method IV, with IL-1β + IL-6 + TNF-α + PGE2) were tested and the functions of DCs were confirmed by examination of the ability of phagocytosis, cytokine production and allogeneic mixed lymphocyte reaction (MLR). Results The numbers of DCs induced and their cytokine production ability were not different between healthy controls and HCC patients. T-cell stimulatory activity of DCs in MLR was significantly lower in HCC patients than in healthy controls. The maturation of DCs with OK-432 boosted production of cytokines and chemokines, such as IL-2, IL-12p70, IFN-γ, TNF-α, IL-13 and MIP1α, and restored T-cell stimulatory activity of DCs in MLR. Conclusions The clinically approved compound OK-432 is a candidate for highly immunocompetent DC preparation and may be considered as a key drug for immunotherapy of HCV-related HCC patients. © 2014 Published by Elsevier B.V

超吸水性ポリマー球状塞栓物質の高張食塩水を用いた膨潤抑制法の開発

PURPOSE: To analyze size changes of superabsorbent polymer (SAP) microspheres with the reduced expansion technique, and to evaluate pharmacological advantages of transarterial chemoembolization using cisplatin-loaded SAP microspheres with the reduced expansion technique. MATERIALS AND METHODS: In an in vitro study, diluted contrast materials containing different concentrations of sodium ions were examined to expand SAP microspheres and determined the reduced expansion technique. Size distributions of cisplatin-loaded SAP microspheres were analyzed. In an in vivo study, TACE was performed using cisplatin-loaded SAP microspheres with the reduced expansion and control techniques in 18 VX2 rabbits. RESULTS: The degree of expansion was reduced to the greatest extent by using a mixture of non-ionic contrast material and 10% NaCl at a 4:1 ratio. The mean diameter of the reduced expansion of cisplatin-loaded SAP microspheres was 188.4 μm, while that of the control expansion was 404.9 μm. The plasma platinum concentrations of the reduced expansion group at 5 min after TACE were significantly higher than those of the control expansion group (2.19 ± 0.77 vs. 0.75 ± 0.08 μg/mL, P = .01). The tumor platinum concentrations of the reduced expansion group at 1 h were significantly higher than those of the control expansion group (10.76 ± 2.57 vs. 1.57 ± 0.14 μg/g, P = .044). CONCLUSION: The expanding level of SAP microspheres can be reduced by using hypertonic saline. Cisplatin-loaded SAP microspheres with the reduced expansion technique have the advantages of achieving higher cisplatin tissue concentration in TACE for liver tumors.博士（医学）・甲第709号・令和元年6月26日© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018This is a post-peer-review, pre-copyedit version of an article published in Cardiovascular and interventional radiology. The final authenticated version is available online at: http://dx.doi.org/10.1007/s00270-018-1990-4

Myeloid-derived suppressor cells correlate with patient outcomes in hepatic arterial infusion chemotherapy for hepatocellular carcinoma

Hepatic arterial infusion chemotherapy (HAIC) has been employed as an alternative therapy to sorafenib for the patients with advanced hepatocellular carcinoma (HCC). In this study, we performed a comparative analysis of various immune cell responses including tumor-associated antigen (TAA)-specific T cells, regulatory T cells (Tregs) and myeloid-derived suppressor cells (MDSCs) in advanced HCC patients treated with HAIC. Thirty-six HCC patients were examined in the study. Interferon gamma enzyme-linked immunospot assays were performed to examine the frequency of TAA-specific T cells. The frequencies of Tregs and MDSCs were examined by multicolor fluorescence-activated cell sorting analysis. The treatment with HAIC using interferon (IFN)/5-fluorouracil (FU) or IFN/FU + cisplatin modulated the frequencies of various immune cells. In 22.2 % of patients, the frequency of TAA-specific T cells increased after HAIC. Although the frequency of Tregs decreased after HAIC, it was not associated with the prognosis of patients. An analysis of prognostic factors for overall survival identified diameter of the tumor (<3.0 cm), absence of major portal vein invasion, absence of distant metastasis, Union Internationale Contre Le Cancer tumor lymph node metastasis stage (I or II), neutrophil lymphocytic ratio (<2.1) and the frequency of MDSCs (<30.5 %) as factors that prolonged overall survival time after HAIC. Even in the group adjusted with progressive levels of tumors, patients with a low frequency of MDSCs had a significantly longer overall survival time. In conclusion, the frequency of MDSCs before the treatment is a prognostic factor in HAIC against HCC. © 2016 Springer-Verlag Berlin Heidelber