母子分離の母親のオキシトシンレベルと子どもへの愛着形成に関する研究

産後1か月～12ヶ月までの母親61名に、血中および唾液中オキシトシン（OT）濃度の測定を行った。測定は①授乳前、②授乳中、③授乳終了後30分、④授乳終了後60分の合計4回実施した。その結果、授乳中にOTの有意な上昇を認めた。また、産後1ヶ月の母親のOTレベルは、その他の時期と比較し、有意に高い事が明らかとなった。授乳前と比較した授乳中のOTの上昇率とEPDS、STAIの得点との間に有意な負の相関を認めた。SRS-18、MIBS-Jとは有意な相関は認められなかった。本研究の主目的であった母子分離の母親との比較検証については、倫理的配慮より実施しなかった。Oxytocin levels in the serum and saliva of 61 mothers who are one month to twelve months after birth were evaluated. The measurement was carried out in a total of four times: before feeding, during feeding, after feeding for 30 minutes, and after for one hour. As a result, an increase in oxytocin level was observed during lactation. A significant correlation was obserbed between one month and another periods.It was found that there is significant negative colleration between the rate of rise oxytocin and Edinburgh Postnatal Depression Scale(EPSD)and State-Trait Anxiety Inventory(STAI) scoers. But ther was no significant colleration between the rate of rise oxytocin and Stress Response Scale 18(SRS-18) and Maternal Attachment Inventory Japanese Version (MIBS-J) score.研究課題/領域番号:19K21448, 研究期間(年度):2018-08-24 – 2020-03-31出典：「母子分離の母親のオキシトシンレベルと子どもへの愛着形成に関する研究」研究成果報告書　課題番号19K21448（KAKEN：科学研究費助成事業データベース（国立情報学研究所））（https://kaken.nii.ac.jp/report/KAKENHI-PROJECT-19K21448/19K21448seika/)を加工して作

早産で子どもの誕生を迎えた父親の困難な体験とレジリエンス―はじめて子どもをもつ父親の語りから―

Purpose: The purpose of this study was to elucidate the difficulties experienced by fathers upon the premature birth of their first child, as well as their resilience, based on their narratives. Methods: We conducted semi-structured interviews with nine fathers whose first child was born prematurely. Each father was given the opportunity to talk freely about the difficulties he had experienced when his child was born and how he overcame them. The data obtained from the interviews were analyzed using a hermeneutic phenomenological approach. Results: Upon the premature birth of their first child, the fathers experienced the following difficulties: unrealistic feelings of having met an alien from another planet, a feeling of being compelled to be constantly busy, a constant fear of facing obstacles associated with the situation and a fear of death, a conflict with morality and ethics, and an uncomfortable feeling of being in a place where they could not fit in. The fathers expressed the following ideas, which were examples of resilience during the recovery process: trust in the strength of their child and the people around them and leaving things to them (omit?), thinking positively about things and assigning significance to the birth of their child, looking at the situation from a wider perspective, and maintaining a moderate psychological distance. Conclusion: The interviews showed that the fathers almost did not believe that their child had been born prematurely and therefore, could not accept the reality of their experience. However, they trusted the strength of their children, their wives, and the healthcare professionals, and supported their families by looking for opportunities to become involved. It is important that healthcare professionals acknowledge the experience of fathers whose children are born prematurely, provide support to help them assign subjective significance to the birth of their child, and help them to find their strength

Participatory art activities increase aalivary oxytocin secretion of ASD children

Autism spectrum disorder (ASD) occurs in 1 in 160 children worldwide. Individuals with ASD tend to be unique in the way that they comprehend themselves and others, as well as in the way that they interact and socialize, which can lead to challenges with social adaptation. There is currently no medication to improve the social deficit of children with ASD, and consequently, behavioral and complementary/alternative intervention plays an important role. In the present pilot study, we focused on the neuroendocrinological response to participatory art activities, which are known to have a positive effect on emotion, self-expression, sociability, and physical wellbeing. We collected saliva from 12 children with ASD and eight typically developed (TD) children before and after a visual art-based participatory art workshop to measure the levels of oxytocin, a neuropeptide involved in a wide range of social behaviors. We demonstrated that the rate of increase in salivary oxytocin following art activities in ASD children was significantly higher than that in TD children. In contrast, the change rate of salivary cortisol after participatory art activities was similar between the two groups. These results suggest that the beneficial effects of participatory art activities may be partially mediated by oxytocin release, and may have therapeutic potential for disorders involving social dysfunction

Effect of switching from sevelamer hydrochloride to lanthanum carbonate on metabolic acidosis in dialysis patients

Treatments for hyperphosphatemia in dialysis patients include dietary therapy and oral administration of phosphate binders; however, it has recently been suggested that oral administration of sevelamer hydrochloride, a phosphate binder, may cause metabolic acidosis. Owing to the decreased supply of sevelamer hydrochloride after the Eastern Japan Great Earthquake Disaster on March 11, 2011, hyperphosphatemia patients switched to another phosphate binder, lanthanum carbonate. Here, we retrospectively evaluated the effect of this medication substitution on metabolic acidosis in patients on maintenance hemodialysis. 32 patients, who underwent maintenance hemodialysis at Nagasaki Kidney Center in Japan, were enrolled in our study and followed to evaluate the effect of switching medication on metabolic acidosis at 3 months after switching from sevelamer hydrochloride to lanthanum carbonate. The mean dose of sevelamer hydrochloride prior to the earthquake disaster was 3 g/day, and the mean dose of lanthanum carbonate thereafter was 0.9 g/day. Three months after the medication was changed, the concentration of bicarbonate ion did not increase significantly (p = 0.186), whereas pH and base excess increased significantly (p = 0.007 and p = 0.036, respectively). In this study, although the HCO3 - level was not significantly changed, the pH and base excess were significantly increased. Our findings indicate that lanthanum carbonate ameliorates metabolic acidosis

Cytology Reporting System for Lung Cancer from the Japan Lung Cancer Society and the Japanese Society of Clinical Cytology: An Extensive Study Containing More Benign Lesions

Introduction: The Japan Lung Cancer Society (JLCS) and the Japanese Society of Clinical Cytology (JSCC) have proposed a new four-tiered cytology reporting system for lung carcinoma (JLCS-JSCC system). Prior to the proposal, the Papanicolaou Society of Cytopathology (PSC) had proposed a revised reporting system (PSC system), which comprises the “neoplastic, benign neoplasm, and low-grade carcinoma” category (N-B-LG category), in addition to the 4 categories of the JLCS-JSCC system. This study aimed to evaluate the interobserver agreement of the JLCS-JSCC system with an additional dataset with more benign lesions in comparison with the PSC system. Methods: We analyzed 167 cytological samples, which included 17 benign lesions, obtained from the respiratory system. Seven observers classified these cases into each category by reviewing one Papanicolaou-stained slide per case according to the JLCS-JSCC system and PSC system. Results: The interobserver agreement was moderate in the JLCS-JSCC (k = 0.499) and PSC (k = 0.485) systems. Of the 167 samples, 17 samples were benign lesions: 7 pulmonary hamartomas, 5 sclerosing pneumocytomas, 2 squamous papillomas, one solitary fibrous tumor, one meningioma, and one lymphocytic proliferation. There were diverse sample types as follows: 11 touch smears, 3 brushing smears, 2 aspirations, and one sputum sample. Fourteen samples (82.3%) were categorized into “negative” or “atypical” by more than half of the observers in the JLCS-JSCC system. Conversely, 3 samples were categorized as “suspicious” or “malignant” by more than half of the observers in the JLCS-JSCC system. On the other hand, 11 samples (64.7%) were categorized into the N-B-LG category by more than half of the observers in the PSC system. Conclusions: The concordance rate in the JLCS-JSCC system was slightly higher than that in the PSC system; however, the interobserver agreement was moderate in both the JLCS-JSCC and PSC systems. These results indicate that both the JLCS-JSCC and PSC systems are clinically useful. Therefore, both systems are expected to have clinical applications. It may be important to integrate the 2 systems and construct a universal system that can be used more widely in clinical practice

退院調整場面を焦点化した多職種協働・地域連携教育の検討: アクティブラーニングを用いて

The increasing complexity of clinical medicine and the reduction of hospitalization periodsmake it essential to provide education about support after a patient is discharged, takinginto consideration multidisciplinary collaboration and community-based cooperation. Whilethey first carried out introductory education for clinical practice for third-year studentsincluding team-based learning （TBL） with 5 cases focused on discharge coordinationsituations, and a poster tour（ jigsaw method）. This study examinedthe relations between classroom design and student learning, and analyzed the educationcontents.The data used in this study were reports of 75 students and their responses to a selfadministeredquestionnaire. We conducted quantitative text analysis using KH Coder [ver.3],and the survey responses were statistically aggregated.Content analysis of the reports indicated the following: total number of sentences, 853;total number of paragraphs, 78; and number of extracted words, 33322. Of the extractedwords, those that appeared most frequently were “patient”（ kanja, 556 times）, “discharge”（taiin, 400 times）, “nursing”（ kango, 330 times）, “support”（ shien, 329 times）, “to think”（kangaeru, 326 times）, “type of occupation”（ shokushu, 269 times）, “local region”（ chiiki,207 times）, “cooperation” （renkei, 202 times）, “lifestyle” （seikatsu, 188 times）, and“information” （joho, 114 times）. Furthermore, nursing-cooperation-local region-necessityformed one co-occurrence network, while patient-support-care and discharge-type ofoccupation-information were linked.We used a concordance function to analyze in what context words seen as related tocooperation were used. The results indicated that the word “mediation” （hashiwatashi）was used for multidisciplinary mediation, mediation between hospital wards and localregions, and mediation between patients and their families. The word “match”（ awaseru）was used in the sense of matching something to a person’s needs or situation, as well asin the sense of pooling efforts and collaborating. We extracted 143 instances of the word“case” （jirei） from the reports, and considering the prevalence of many specific names ofprofessions, they appear to have been able to discuss multidisciplinary collaboration andcommunity-based cooperation in a real and concrete way.The survey results indicated that 100% of respondents were greatly interested or interestedin multidisciplinary collaboration and community-based cooperation, and that 100% had agood understanding of it. Meanwhile, TBL self-monitoring indicated that respondents hadacquired “the ability to discover issues and problems” and “the ability to propose issuesand problems.” However, approximately 10% of responses stated that there was littleacquisition of skills such as “discussion,” “the ability to create materials,” “presentationskills,” and “reflection.” Overall, we found the class design for TBL using cases focused ondischarge coordination to be valid

DOCK2 is involved in the host genetics and biology of severe COVID-19

「コロナ制圧タスクフォース」COVID-19疾患感受性遺伝子DOCK2の重症化機序を解明 --アジア最大のバイオレポジトリーでCOVID-19の治療標的を発見--. 京都大学プレスリリース. 2022-08-10.Identifying the host genetic factors underlying severe COVID-19 is an emerging challenge. Here we conducted a genome-wide association study (GWAS) involving 2, 393 cases of COVID-19 in a cohort of Japanese individuals collected during the initial waves of the pandemic, with 3, 289 unaffected controls. We identified a variant on chromosome 5 at 5q35 (rs60200309-A), close to the dedicator of cytokinesis 2 gene (DOCK2), which was associated with severe COVID-19 in patients less than 65 years of age. This risk allele was prevalent in East Asian individuals but rare in Europeans, highlighting the value of genome-wide association studies in non-European populations. RNA-sequencing analysis of 473 bulk peripheral blood samples identified decreased expression of DOCK2 associated with the risk allele in these younger patients. DOCK2 expression was suppressed in patients with severe cases of COVID-19. Single-cell RNA-sequencing analysis (n = 61 individuals) identified cell-type-specific downregulation of DOCK2 and a COVID-19-specific decreasing effect of the risk allele on DOCK2 expression in non-classical monocytes. Immunohistochemistry of lung specimens from patients with severe COVID-19 pneumonia showed suppressed DOCK2 expression. Moreover, inhibition of DOCK2 function with CPYPP increased the severity of pneumonia in a Syrian hamster model of SARS-CoV-2 infection, characterized by weight loss, lung oedema, enhanced viral loads, impaired macrophage recruitment and dysregulated type I interferon responses. We conclude that DOCK2 has an important role in the host immune response to SARS-CoV-2 infection and the development of severe COVID-19, and could be further explored as a potential biomarker and/or therapeutic target

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead