日本人におけるβ[3]-アドレナリン受容体遺伝子変異と脱共役蛋白質-1遺伝子多型性の意義 : 肥満,高血圧,脂質代謝異常および耐糖能異常との関連について

取得学位：博士(医学), 学位授与番号：医博乙第1504号，学位授与年月日：平成11年12月1日,学位授与年：199

Fatal Cytomegalovirus Pneumonia and Associated Herpes Virus Infection in a Relapsed/Refractory Multiple Myeloma Patient Treated with Bortezomib plus Dexamethasone

Multiple myeloma (MM) remains a largely incurable disease in the long term despite positive responses to first-line chemotherapy. Herein we report the case of a 68-year-old woman who died following treatment with bortezomib plus dexamethasone for refractory MM. The combination was associated with significant antitumor activity, but bacterial pneumonia/sepsis was followed by bilateral cytomegalovirus pneumonia with herpes simplex co-infection, and this was almost certainly the cause of death. Physicians need to pay careful attention when treating patients with refractory MM with bortezomib plus dexamethasone, and to be mindful that antiviral therapy may be needed in some cases

99m-Technetium galactosyl human serum albumin scanning to evaluate liver function after stereotactic body radiotherapy for hepatocellular carcinoma: A case report

The primary choice among treatment options for liver malignancies is surgery. However, if surgery cannot be performed, Stereotactic body radiotherapy (SBRT) may be effective. 99m-technetium galactosyl human serum albumin (GSA) single-photon emission computed tomography (SPECT) imaging is useful for the assessment of liver function before surgery. We report the case of a 77-year-old man who had undergone SBRT for hepatocellular carcinoma of the left lobe of the liver 2 years previously. Follow-up revealed a 15-mm hepatocellular carcinoma at the edge of the right lobe of the liver. 99m-technetium GSA SPECT was performed before SBRT to confirm that there was no accumulation in the left lobe and to ensure that there was good function of the right lobe. Three months after SBRT, the tumor had responded, and decreases in GSA accumulation were observed in line with the radiation beam. Because hepatocellular carcinoma often relapses, it is important to assess the anatomic site of liver dysfunction before and after radiation. This case demonstrates that 99m-technetium GSA SPECT is useful for this purpose

Changes in Knowledge Levels through Lectures on Radiotherapy to Nursing Students in Japan

Background:Recently, the number of patients choosing radiotherapy is increasing in Japan. It is necessary for even nurses to have knowledge of radiotherapy. We measured the degree of awareness with a lecture on how a nursing student can obtain knowledge of radiotherapy.Materials and methods: Forty nursing students who were in their third year and preparing for their national nursing certification in two months were recruited. The 90-min lecture covered a range of topics from general theories to specific concepts. The students were not informed that they would be required to fill a survey at the end of the lecture. This was to avoid bias that could occur from knowing in advance that a survey would be conducted.Results: The following items below were particularly remarkable. The distinction between the radiologist and the radiation oncologist. The radiotherapy is a local therapy. The pain from bone metastasis could be relieved.Conclusion: Students had very little knowledge on radiotherapy before the lecture. the results of this study indicated the need to increase the number of lectures on radiotherapy for nursing as well medical students. As the number of radiotherapy patients increases

Comparison of Conventional 2D CC (Cranio-Caudal) + MLO (Medio-Lateral Oblique) Bi-Directional Photography and 2D-MLO + DBT-MLO (Digital Breast Tomosynthesis) in Mammography Examination

Introduction: Mammography (MMG) is an excellent examination for breast cancer detection and is widely used in both screening and clinical practice. However, the breast thickness and background the concentration of the mammary gland is large among individuals, and the mammary gland and cancer may overlap and it may not be possible to point out a lesion. In recent years, digital breast tomosynthesis (hereinafter referred to as DBT) has been introduced to solve these problems, and its usefulness has been reported in clinical practice. Therefore, in anticipation of a higher cancer detection rate etc., we compared the conventional 2D CC + MLO 2-way MMG examination with 2DMLO + DBTMLO 2-way MMG examination.Materials and Methods: The combination of 2D CC + MLO and 2DMLO + DBTMLO was read for 95 cases of breast cancer taking 2D CC and MLO and DBT MLO from May 2016 to October 2017. It was judged that the category 3 or more required detailed examination, cancer detection, and cancer detection rates were compared. Subjects were 28 to 87 years of age (median: 55 years), breast composition: high concentration 15.8% (15 cases), heterogeneous high concentration 47.4% (45 cases), mammary gland 28.4% (27 cases), Fatty was 8.4% (8 cases).Results: The cancer detection rate was 87% for the 2D CC + MLO combination and 94% for the 2DMLO + DBTMLO combination in 95 cases of breast cancer. The interpretation time was 95 minutes for the 2D CC + MLO combination and 110 minutes for the 2DMLO + DBTMLO combination.The breast cancer detected only by the combination of 2D CC + MLO was scattered in 1 case and was classified as Category 3 by FAD. Breast cancer detected only by the combination of 2DMLO + DBTMLO: 8 cases with uneven distribution of breast composition, 3 cases with scattered mammary gland, 3 cases with 5 cases with disordered construction, Category 4 with 3 cases with FAD was.Conclusion: Both 2D CC + MLO combination and 2DMLO + DBTMLO combination are considered useful for screening MMG examination. In particular, we would like to consider the introduction to medical examinations for the addition of MMG in DBT, but the issue of the amount of image information, the problem of exposure to radiation, the direction of imaging, the establishment of interpretation methods etc. are future issues

Health consciousness and cervical cancer screening rates in HPV-unvaccinated girls: comparison from HPV-recommended and HPV-recommendation-suspended program periods

In Japan, the vast majority of females between 13 and 24 are now unvaccinated for HPV and thus unprotected from HPV-caused cervical cancer. We analyzed the differences among these unvaccinated females regarding their understanding of the HPV vaccine, its role in cervical cancer prevention, and their need for cervical cancer screening–based on whether they refused vaccination when their government’s recommendation for HPV vaccination was still in effect (vaccination-recommended group)–or during the last 7 years, while the government suspension was in effect (recommendation-suspended group). The vaccination-recommended group understood more about the HPV vaccine and the best timing for HPV vaccination than the recommendation-suspended group (p < .0001 and p = .002, respectively). We found that girls in the vaccination-recommended group had more chances to talk with the family about cervical cancer and they were more afraid of acquiring the disease (p < .0001 and p < .0001, respectively). The girls in the recommendation-suspended group tended to feel more inhibited from talking about cervical cancer with friends and acquaintances (p = .0262). The cervical cancer screening rate of the vaccination-recommended group was significantly higher (p = .014)

Usefulness of diffusion-weighted magnetic resonance imaging for evaluating the effect of hemostatic radiotherapy for unresectable gastric cancer

There are several reports that vouch for the usefulness of diffusion-weighted image (DWI) in making a diagnosis before treatment. However, no study has evaluated the effect of radiotherapy (RT) for unresectable gastric cancer. In the present case report, we evaluated the effectiveness of RT using DWI. An 81-year-old man was hospitalized with a broken bone and then diagnosed with advanced gastric cancer with breeding. He had chorionic renal failure and surgery was impossible. Further, contrast-enhanced computed tomography and magnetic resonance imaging (MRI) were not performed due to renal failure, whereas palliative RT was performed. We followed up the patient using blood test and MRI (DWI) to estimate whether bleeding had stopped or not after radiotherapy. Hemostasis effect was found after 2 weeks of RT. In DWI examination, there was a decrease in the tumor signal intensity 30 days after RT. Similarly, at day 60, the tumor signal intensity further decreased on DWI and the blood test results indicated no progression of anemia. At 4 months after the RT, the patient died because of respiratory failure without any bleeding. DWI is useful not only for the initial diagnosis but also for evaluating the effectiveness of RT.Trial registration: National clinical study registered number: UMIN000026362

Two types of Lyman-alpha emitters envisaged from hierarchical galaxy formation

From multi-wavelength observations of LAEs,we know that while many LAEs appear to be young and less massive,a noticeable fraction of LAEs possess much older populations of stars and larger stellar mass.How these two classes of LAEs are concordant with the hierarchical galaxy formation scenario has not been understood clearly so far.In this paper,we model LAEs by three-dimensional cosmological simulations of dark halo merger in a CDM universe.As a result,it is shown that the age of simulated LAEs can spread over a wide range from 2*10^6yr to 9*10^8yr.Also,we find that there are two types of LAEs, in one of which the young half-mass age is comparable to the mean age of stellar component,and in the other of which the young half-mass age is appreciably shorter than the mean age.We define the former as Type 1 LAEs and the latter as Type 2 LAEs.A Type 1 corresponds to early starburst in a young galaxy,whereas a Type 2 does to delayed starburst in an evolved galaxy,as a consequence of delayed accretion of a subhalo onto a larger parent halo.Thus,the same halo can experience a Type 2 LAE-phase as well as a Type 1 LAE-phase in the merger history.Type 1s are expected to be younger than 1.5*10^8yr,less dusty,and less massive with stellar mass M*<10^8 Msun,while Type 2s are older than 1.5*10^8yr,even dustier,and as massive as M*~10^8-10^10Msun.The fraction of Type 2s in all LAEs is a function of redshift.Type 2s discriminated clearly from Type 1s in two color diagram of z'-H vs J-K.We find that the brightness distribution of LyA in Type 2s is more extended than the main stellar component,in contrast to Type 1s.This is not only because delayed starbursts tend to occur in the outskirts of a parent galaxy,but also because LyA photons are effectively absorbed by dust in an evolved galaxy.Hence,the extent of LyA emission may be an additional measure to distinguish Type 2s from Type 1