卵巣子宮内膜症性嚢胞の嚢胞液鉄濃度が不妊に及ぼす影響について

The causes of infertility in women with endometriosis may range from anatomical distortions to various pathophysiological disturbances. The aim of the present study was to examine the effects of the cyst fluid (CF) concentration of iron on infertility in patients with ovarian endometrioma (OMA). Patients with histologically confirmed OMA were enrolled at the Department of Obstetrics and Gynecology, Nara Medical University Hospital between 2013 and 2019. The patients were divided into 2 groups, namely women experiencing current infertility (infertile group) and those without complaints of infertility (non‑infertile group). There were 2 types of patients in the infertile group: Patients who failed to achieve a clinical pregnancy following ≥12 months of regular unprotected sexual intercourse and those who had already been treated at fertility clinics. The CF concentration of iron was measured by the inductively coupled plasma‑optical emission spectrometry (ICP‑OES) method. The clinical data were analyzed retrospectively. A total of 77 patients were enrolled in the present study. Among these, 32 (41.6%) patients had infertility. When compared with the non‑infertile women, the infertile women were significantly younger (median age, 35 years; range, 24‑47 years; vs. median age, 40 years; range, 21‑53 years; respectively; P=0.003). The CF concentrations of iron (median, 324.8 mg/l; range, 71.3‑1046.3 mg/l; vs. median, 226.5 mg/l; range, 65.3‑737.5 mg/l; respectively; P=0.019) were significantly higher in the infertile group compared with the non‑infertile group. Multivariate logistic regression analysis indicated that age at diagnosis (≤38 years), the CF concentrations of iron (>326.6 mg/l) and the infertility index (iron/age ratio, >8.37) were independent risk factors for endometriosis‑related infertility. Multivariate analysis revealed that age (HR, 6.44; 95% CI, 2.06‑20.12) and iron (HR, 4.90; 95% CI, 1.48‑16.22) were independent factors for the identification of patients with OMA who presented with a complaint of infertility. In addition, the infertility index (iron/age ratio, >8.37; HR, 4.85; 95% CI, 1.01‑23.27) was an important predictor of infertility. ROC curve analysis also revealed that the areas under the ROC (AUC) for age, iron and infertility index were 0.699, 0.666 and 0.731, respectively. On the whole, the findings of the present study demonstrate that age at diagnosis and the CF concentration of iron may be potentially effective markers for predicting infertility in women with OMA.博士（医学）・乙第1500号・令和3年3月15日Copyright © Nagayasuet al. This is an open access article distributed under theterms of CreativeCommons Attribution License(https://creativecommons.org/licenses/by-nc-nd/4.0/)

Association between periodontal condition and kidney dysfunction in Japanese adults : A cross‐sectional study

Recent studies have demonstrated that chronic kidney disease (CKD) may be associated with the progression of periodontal disease. Diabetes mellitus (DM) is a major risk factor for CKD. The objective of this study was to clarify the relationship between periodontal condition and kidney dysfunction in patients who had kidney failure with or without DM. One hundred sixty‐four patients with kidney dysfunction were enrolled (male: N = 105; female: N = 59), and the relationship between periodontal condition and kidney dysfunction was analyzed in a cross‐sectional study. The subjects were divided into three groups: (a) patients with DM, (b) dialysis patients with nephropathy due to various kidney diseases, and (c) dialysis patient with nephropathy due to DM (diabetic nephropathy). Then, the effect of DM on the periodontal condition was analyzed. The patients were also stratified by CKD stage (into G1–G5) using the estimated glomerular filtration rate (eGFR), and the G5 group was divided in patients with or without DM. Correlations between eGFR and parameters of periodontal condition were calculated in patients from G1 to G4. The number of missing teeth was significantly higher in dialysis patients with diabetic nephropathy than in patients with DM, whereas alveolar bone loss did not show a significant difference among the three groups. In addition, the G5 patients with DM had a significantly higher number of missing teeth than the other CKD groups, whereas alveolar bone loss did not show a significant difference. In G5 patients with DM, Community Periodontal Index and Oral Hygiene Index scores were significantly higher than in G1‐4 patients with DM. There was a significant negative correlation between eGFR and the number of missing teeth. Patients with diabetic nephropathy have a higher rate of periodontal problems such as missing teeth in Japanese adults

Curated genome annotation of Oryza sativa ssp. japonica and comparative genome analysis with Arabidopsis thaliana

We present here the annotation of the complete genome of rice Oryza sativa L. ssp. japonica cultivar Nipponbare. All functional annotations for proteins and non-protein-coding RNA (npRNA) candidates were manually curated. Functions were identified or inferred in 19,969 (70%) of the proteins, and 131 possible npRNAs (including 58 antisense transcripts) were found. Almost 5000 annotated protein-coding genes were found to be disrupted in insertional mutant lines, which will accelerate future experimental validation of the annotations. The rice loci were determined by using cDNA sequences obtained from rice and other representative cereals. Our conservative estimate based on these loci and an extrapolation suggested that the gene number of rice is ~32,000, which is smaller than previous estimates. We conducted comparative analyses between rice and Arabidopsis thaliana and found that both genomes possessed several lineage-specific genes, which might account for the observed differences between these species, while they had similar sets of predicted functional domains among the protein sequences. A system to control translational efficiency seems to be conserved across large evolutionary distances. Moreover, the evolutionary process of protein-coding genes was examined. Our results suggest that natural selection may have played a role for duplicated genes in both species, so that duplication was suppressed or favored in a manner that depended on the function of a gene

ショウガッコウ ガイコクゴ カツドウ ニオケル ヒョウカ ニ カンスル ジッセン ケンキュウ : キョウイク ジッセン フィールド ケンキュウ ニ モトズイテ

鳴門教育大学大学院では，学校現場における今日的課題について協力学校とともに実践的研究を行う授業「実践フィールド研究」が設定されている。本実践報告では，平成21年度大学院生による「実践フィールド研究」に基づいた実践を報告するものである。平成23年度の小学校外国語活動の本格実施に先駆けて，本学附属小学校では長年英語学習として関連授業に取り組んできた。しかし，評価に関する課題についてはまだ十分検討されておらず本実践において，その可能性について実践研究を行うこととした。また，前年度の継続研究として，全国全ての5，6年生に配付された『英語ノート』の活用についても併せて取り組んでおり，本報告ではこの二点について報告する。特に評価に関しては，最も小学校現場で多く使われている「自己評価」のあり方，実施の際の留意点について検討するとともに「学びのための自己評価」の可能性についても提案する。最後に，次年度へ向けての改訂版振り返りカードの提案も行う

Myeloblasts transition to megakaryoblastic immunophenotypes over time in some patients with myelodysplastic syndromes.

ObjectivesIn myelodysplastic syndromes (MDS), neoplastic myeloblast (CD34+CD13+CD33+ cells) numbers often increase over time, leading to secondary acute myeloid leukemia (AML). In recent studies, blasts in some MDS patients have been found to express a megakaryocyte-lineage molecule, CD41, and such patients show extremely poor prognosis. This is the first study to evaluate whether myeloblasts transition to CD41+ blasts over time and to investigate the detailed immunophenotypic features of CD41+ blasts in MDS.MethodsWe performed a retrospective cohort study, in which time-dependent changes in blast immunophenotypes were analyzed using multidimensional flow cytometry (MDF) in 74 patients with MDS and AML (which progressed from MDS).ResultsCD41+ blasts (at least 20% of CD34+ blasts expressing CD41) were detected in 12 patients. In five of these 12 patients, blasts were CD41+ from the first MDF analysis. In the other seven patients, myeloblasts (CD34+CD33+CD41- cells) transitioned to megakaryoblasts (CD34+CD41+ cells) over time, which was often accompanied by disease progression (including leukemic transformation). These CD41+ patients were more frequently observed among patients with monosomal and complex karyotypes. CD41+ blasts were negative for the erythroid antigen, CD235a, and positive for CD33 in all cases, but CD33 expression levels were lower in three cases when compared with CD34+CD41- blasts. Among the five CD41+ patients who underwent extensive immunophenotyping, CD41+ blasts all expressed CD61, but two cases had reduced CD42b expression, three had reduced/absent CD13 expression, and three also expressed CD7.ConclusionsMyeloblasts become megakaryoblastic over time in some MDS patients, and examining the megakaryocyte lineage (not only as a diagnostic work-up but also as follow-up) is needed to detect CD41+ MDS. The immunophenotypic features revealed in this study may have diagnostic relevance for CD41+ MDS patients

A CD41 false-positive case analyzed by imaging FCM.

[Left panel] A cytospin slide prepared from the FCM sample showing that platelets adhered to various cells (arrows). [Middle panel] A: Singlet events were displayed on the FSC versus SSC plot, and cells with low SSC were gated. A P1 gate was used to identify platelets. B: Low SSC cells (gated in panel A) were displayed on the CD34 versus CD45 plot. CD34+ blasts (red dots) and CD45-bright cells were gated. C: CD45-bright cells in Panel B were displayed on SSC versus CD45 plots, and lymphocytes (blue dots) were gated. D: Events in P1 (Panel A) were displayed on SSC versus CD41 plots and platelets (CD41+ cells) were gated. E: CD34+ blasts were displayed on the CD41 versus CD33 plot. CD41+ blasts (BL41+) and CD41- blasts (BL41-) were gated. F: Lymphocytes were displayed on the CD41 versus CD33 plot. CD41+ lymphocytes (Ly41+) and CD41- lymphocytes (Ly41-) were gated. [Right panel] Images of various cell fractions gated in the middle panel. A: Platelets. B: CD41+ blasts. C: CD41- blasts. D: CD41+ lymphocytes. E: CD41- lymphocytes. The arrow head indicate RBC ghost, which is observed in every cell fraction. The arrows indicate platelets adhering to leukocytes, which caused false CD41-positivity in leukocytes. Platelet adherence was observed in CD41-positive cell fractions (B and D), but not in CD41-negative cell fractions (C and E). Note that because the imaging FCM captures cell images from one direction, platelet adherence to the back surface of leukocytes was not detected. (DOCX)</p

Characteristics of CD41+ patients.

ObjectivesIn myelodysplastic syndromes (MDS), neoplastic myeloblast (CD34+CD13+CD33+ cells) numbers often increase over time, leading to secondary acute myeloid leukemia (AML). In recent studies, blasts in some MDS patients have been found to express a megakaryocyte-lineage molecule, CD41, and such patients show extremely poor prognosis. This is the first study to evaluate whether myeloblasts transition to CD41+ blasts over time and to investigate the detailed immunophenotypic features of CD41+ blasts in MDS.MethodsWe performed a retrospective cohort study, in which time-dependent changes in blast immunophenotypes were analyzed using multidimensional flow cytometry (MDF) in 74 patients with MDS and AML (which progressed from MDS).ResultsCD41+ blasts (at least 20% of CD34+ blasts expressing CD41) were detected in 12 patients. In five of these 12 patients, blasts were CD41+ from the first MDF analysis. In the other seven patients, myeloblasts (CD34+CD33+CD41- cells) transitioned to megakaryoblasts (CD34+CD41+ cells) over time, which was often accompanied by disease progression (including leukemic transformation). These CD41+ patients were more frequently observed among patients with monosomal and complex karyotypes. CD41+ blasts were negative for the erythroid antigen, CD235a, and positive for CD33 in all cases, but CD33 expression levels were lower in three cases when compared with CD34+CD41- blasts. Among the five CD41+ patients who underwent extensive immunophenotyping, CD41+ blasts all expressed CD61, but two cases had reduced CD42b expression, three had reduced/absent CD13 expression, and three also expressed CD7.ConclusionsMyeloblasts become megakaryoblastic over time in some MDS patients, and examining the megakaryocyte lineage (not only as a diagnostic work-up but also as follow-up) is needed to detect CD41+ MDS. The immunophenotypic features revealed in this study may have diagnostic relevance for CD41+ MDS patients.</div

Emergence of CD41+ blasts with time in sequential analyses.

The data from three cases (Cases 2, 3, and 5 in Table 3) are shown. Panels A and B in each case show data when CD34+ blasts (red dots) were negative for CD41. The panels C-F in each case are data when CD34+ blasts (red dots) became positive for CD41 with time (D). Other cell fractions (green and blue dots) were negative for CD41 (E and F). (DOCX)</p

Case 6 analyzed by imaging FCM.

[Left panel] A: Singlet events were displayed on the FSC versus SSC plot, and cells with low SSC were gated. A P1 gate was used to identify platelets. B: Low SSC cells (gated in panel A) were displayed on the CD34 versus CD45 plot. CD34+ blasts (red dots) and CD45-bright cells were gated. C: CD45-bright cells in Panel B were displayed on SSC versus CD45 plots, and monocytes (green dots) were gated. D: Events in P1 (Panel A) were displayed on SSC versus CD41 plots and platelets (CD41+ cells) were gated. E: CD34+ blasts were displayed on the CD41 versus CD33 plot. CD41+ blasts (BL41+) and CD41- blasts (BL41-) were gated. F: Monocytes were displayed on the CD41 versus CD33 plot. CD41+ monocytes (Mo41+) and CD41- monocytes (Mo41-) were gated. [Right panel] Images of various cell fractions gated in the left panel. A: Platelets. B: CD41+ blasts. C: CD41- blasts. D: CD41+ monocytes. E: CD41- monocytes. Platelet adhesion was not observed in CD41-positive cell fractions (B and D), but also in CD41-negative cell fractions (C and E). (DOCX)</p