Assessment of Molecular Cytogenetic Methods for the Detection of Chromosomal Abnormalities

Some marker chromosomes and chromosome rearrangements are difficult to identify using G-bands by Giemsa staining after trypsin treatment (G-banding) alone. Molecular cytogenetic techniques, such as spectral karyotyping (SKY) and fluorescence in situ hybridization (FISH), can help to detect chromosomal aberrations precisely. We analyzed the karyotypes in 6 cases of multiple congenital abnormalities and 1 case of spontaneous abortion (case 2). Three cases (cases 1, 6, and 7) had marker chromosomes, and 4 cases (cases 2-5) had chromosomal rearrangements. The karyotypes in cases 1, 2, and 3 were determined using FISH with probes based on the clinical findings and family histories. Spectral karyotyping (SKY) analysis in cases 4-7 showed that this method is useful and saves time. The combination of SKY and FISH analyses defi ned the range of the ring chromosome in case 7. We demonstrated that a combination of G-banding, FISH, and SKY can be applied effectively to the investigation of chromosomal rearrangement and to the detection of marker chromosome origins. We suggest the use of these methods for prenatal diagnosis, in which the inherent time limitations are particularly important

Thrombocytopenia in Preterm Infants with Intrauterine Growth Restriction

Sick preterm infants often have thrombocytopenia at birth, and this is often associated with intrauterine growth restriction (IUGR), or birth weights less than the 10th percentile. The pathogenesis of the thrombocytopenia and its importance in IUGR are still unclear. We studied the characteristics of preterm IUGR infants with thrombocytopenia. Twenty-seven singleton Japanese preterm IUGR infants were born between January 2002 and June 2007 at Okayama University Hospital. Infants with malformation, chromosomal abnormalities, alloimmune thrombocytopenia, sepsis, and maternal aspirin ingestion were excluded. The infants were divided into group A (n&#65309;8), which had thrombocytopenia within 72h after birth, and group B (n&#65309;19), which did not. There were significant differences in birth weight, head circumference, umbilical artery (UA)-pulsatility index (PI), middle cerebral artery-PI, UA-pH, UA-pO2, and UA-pCO2. The infants in group A were smaller, had abnormal blood flow patterns, and were hypoxic at birth. We speculate that the infants with thrombocytopenia were more severely growth-restricted by chronic hypoxia. Thrombocytopenia is an important parameter for chronic hypoxia in the uterine.</p

児童の発達に基礎を置く食育プログラムの有効性の検討\n―スーパー食育スクール事業の取組から―

2015, this school researched “shokuiku” as a “super shokuiku school ”.In this research, in order to get closer to the school educational goal wishing for better development of the mind and body, I proposed a dietary education program based on the mind and body development of the child based on the concept of developmental psychology.As a result, in 3.4th grade, you could see big transfiguration in the walking strength meter and blood inspection.Usefulness of the “shokuiku program” was effectiveAlso, in the fifth and sixth graders who had a viewpoint of mental development, although there was no major transformation, the sixth graders were significantly transforming "Fun of meals". The increase in the number of children who can express the relationship between meals and themselves with "emotion" feeling suggested that the food education program was useful for the formation of better eating habits in the future

Overexpression of Bcl2 in Osteoblasts Inhibits Osteoblast Differentiation and Induces Osteocyte Apoptosis

Bcl2 subfamily proteins, including Bcl2 and Bcl-XL, inhibit apoptosis. As osteoblast apoptosis is in part responsible for osteoporosis in sex steroid deficiency, glucocorticoid excess, and aging, bone loss might be inhibited by the upregulation of Bcl2; however, the effects of Bcl2 overexpression on osteoblast differentiation and bone development and maintenance have not been fully investigated. To investigate these issues, we established two lines of osteoblast-specific BCL2 transgenic mice. In BCL2 transgenic mice, bone volume was increased at 6 weeks of age but not at 10 weeks of age compared with wild-type mice. The numbers of osteoblasts and osteocytes increased, but osteoid thickness and the bone formation rate were reduced in BCL2 transgenic mice with high expression at 10 weeks of age. The number of BrdU-positive cells was increased but that of TUNEL-positive cells was unaltered at 2 and 6 weeks of age. Osteoblast differentiation was inhibited, as shown by reduced Col1a1 and osteocalcin expression. Osteoblast differentiation of calvarial cells from BCL2 transgenic mice also fell in vitro. Overexpression of BCL2 in primary osteoblasts had no effect on osteoclastogenesis in co-culture with bone marrow cells. Unexpectedly, overexpression of BCL2 in osteoblasts eventually caused osteocyte apoptosis. Osteocytes, which had a reduced number of processes, gradually died with apoptotic structural alterations and the expression of apoptosis-related molecules, and dead osteocytes accumulated in cortical bone. These findings indicate that overexpression of BCL2 in osteoblasts inhibits osteoblast differentiation, reduces osteocyte processes, and causes osteocyte apoptosis

Overcoming minimal residual disease using intensified conditioning with medium-dose etoposide, cyclophosphamide and total body irradiation in allogeneic stem cell transplantation for Philadelphia chromosome-positive acute lymphoblastic leukemia in adults

BACKGROUND AIMS: An intensified conditioning regimen incorporating medium-dose etoposide (VP16) is an option for patients with acute lymphoblastic leukemia (ALL). However, the prognostic impacts of the addition of VP16 to cyclophosphamide (CY) and total body irradiation (TBI) in patients with Philadelphia chromosome-positive (Ph+) ALL with regard to minimal residual disease (MRD) status have not been elucidated. METHODS: The authors retrospectively compared the outcomes of patients with Ph+ ALL who underwent allogeneic transplantation following VP16/CY/TBI (n = 101) and CY/TBI (n = 563). RESULTS: At 4 years, the VP16/CY/TBI group exhibited significantly better disease-free survival (DFS) (72.6% versus 61.7%, P = 0.027) and relapse rate (11.5% versus 21.1%, P = 0.020) and similar non-relapse mortality (16.0% versus 17.2%, P = 0.70). In subgroup analyses, the beneficial effects of the addition of VP16 on DFS were more evident in patients with positive MRD status (71.2% versus 48.4% at 4 years, P = 0.022) than those with negative MRD status (72.8% versus 66.7% at 4 years, P = 0.24). Although MRD positivity was significantly associated with worse DFS in patients who received CY/TBI (48.4% versus 66.7%, P < 0.001), this was not the case in those who received VP16/CY/TBI (71.2% versus 72.8%, P = 0.86). CONCLUSIONS: This study demonstrated the benefits of the addition of VP16 in Ph+ ALL patients, especially those with positive MRD status. VP16/CY/TBI could be a potential strategy to overcome the survival risk of MRD positivity

特別支援学校における医療的ケアに関する多職種間の連携・協働が困難となる要因と看護師の配慮・工夫 ―看護師のインタビューから連携・協働を考える―

　特別支援学校では，看護師と教員がお互いの専門性を理解し，連携・協働していくことが求められるが，医療現場とは異なる教育の場での活動に戸惑いを感じる看護師も多い．そこで，本研究は，1．連携・協働が困難となる要因，2．効果的な連携・協働のための看護師の配慮・工夫，以上の2点を明らかにすることを目的に実施した．調査はA市の特別支援学校に勤務する看護師5名に半構成的インタビューを行い，インタビュー内容の逐語録からコード，サブカテゴリー，カテゴリーを順に抽出し，分析を行なった．その結果，連携・協働が困難となる要因では，看護に必要な情報の不足や学校での看護の専門性や役割分担に関連する要因が抽出された．また，効果的な連携・協働のための看護師の工夫・配慮としては，情報収集や情報共有，専門職間のお互いの理解とお互いの役割・立場を尊重する関係性に関連する内容が抽出された．学校で似通った役割が求められる看護師と養護教諭においても，看護師がお互いの役割や専門性を理解し，尊重しながら対応することで，それぞれの専門性を発揮できる協働につながると示唆された

特別支援学校における医療的ケアに関する養護教諭と看護師との連携・協働が困難となる要因と養護教諭の配慮・工夫 ―養護教諭のインタビューから効果的な連携・協働を考える―

　特別支援学校への看護師の配置が制度化され10年以上が経過した．養護教諭は，これまで自分たちが担っていた役割の一部を看護師と共有することになり，役割分担や連携に戸惑いがあったことが推察される．そこで，1．看護師との連携・協働が困難に感じる要因，2．効果的な連携・協働のための養護教諭の配慮・工夫を明らかにすることを目的に，看護師と共に特別支援学校で働いた経験のある養護教諭にインタビューを実施した．インタビュー内容の逐語録から，コード，サブカテゴリー，カテゴリーを順に抽出し分析を行った．その結果，看護師との連携・協働が困難に感じる要因では，特別支援学校における看護師の役割に関する要因と情報共有に関する要因に分類された．また，効果的な連携・協働のための配慮・工夫では，情報共有とコミュニケーションの方法に関する配慮・工夫，特別支援学校での看護師の立場に関する配慮・工夫，看護師の専門性の発揮に関する配慮・工夫に分類された．養護教諭と看護師が効果的な連携・協働を行っていくためには，養護教諭が，学校関係者と看護師を繋ぐ役割を担い，看護師が特別支援学校での看護師の専門性を発揮できるよう環境を整えていくことが必要であることが示唆された

SP7 Inhibits Osteoblast Differentiation at a Late Stage in Mice

RUNX2 and SP7 are essential transcription factors for osteoblast differentiation at an early stage. Although RUNX2 inhibits osteoblast differentiation at a late stage, the function of SP7 at the late stage of osteoblast differentiation is not fully elucidated. Thus, we pursued the function of SP7 in osteoblast differentiation. RUNX2 induced Sp7 expression in Runx2−/− calvarial cells. Adenoviral transfer of sh-Sp7 into primary osteoblasts reduced the expression of Alpl, Col1a1, and Bglap2 and mineralization, whereas that of Sp7 reduced Bglap2 expression and mineralization at a late stage of osteoblast differentiation. Sp7 transgenic mice under the control of 2.3 kb Col1a1 promoter showed osteopenia and woven-bone like structure in the cortical bone, which was thin and less mineralized, in a dose-dependent manner. Further, the number of processes in the osteoblasts and osteocytes was reduced. Although the osteoblast density was increased, the bone formation was reduced. The frequency of BrdU incorporation was increased in the osteoblastic cells, while the expression of Col1a1, Spp1, Ibsp, and Bglap2 was reduced. Further, the osteopenia in Sp7 or Runx2 transgenic mice was worsened in Sp7/Runx2 double transgenic mice and the expression of Col1a1 and Bglap2 was reduced. The expression of Sp7 and Runx2 was not increased in Runx2 and Sp7 transgenic mice, respectively. The expression of endogenous Sp7 was increased in Sp7 transgenic mice and Sp7-transduced cells; the introduction of Sp7 activated and sh-Sp7 inhibited Sp7 promoter; and ChIP assay showed the binding of endogenous SP7 in the proximal region of Sp7 promoter. These findings suggest that SP7 and RUNX2 inhibit osteoblast differentiation at a late stage in a manner independent of RUNX2 and SP7, respectively, and SP7 positively regulates its own promoter