ニホン ニ オケ ルショクモツ アレルギー ジ ヲ モツ ハハオヤ ニカンスル ケンキュウ ノ ゲンジョウ

背景 わが国における育児環境は大きく変化し,乳幼児を育てる母親の育児不安や育児ストレスは深刻な状況にある.慢性疾患をもつ児の母親の育児ストレスは健康児の母親より強く,児側の要因が母親の育児不安やストレスと関連することが明らかにされている.乳幼児期に多く発症する食物アレルギー(以下FAとする)は,いまだ治療法の確立には至っておらず,除去食管理を担う母親には様々な負担が存在することが報告されている.食物アレルギー児(以下FA児とする)の母親への育児支援は重要な課題であり,日本における近年の疾患治療・検査の動向を反映させた支援の方向性を明らかにするために,母親の持つ問題の実態や研究の方向性を検討する必要がある.目的 日本におけるFA児をもつ母親の育児に関する研究の現状を明らかにし,今後の研究の方向性を検討する.方法 医学中央雑誌(Ver5.)を使用し,過去21年間(1991年-2012年9月)に発表された原著論文を対象に,「食物アレルギー」「母親or養育者or保護者」というキーワードを組み合わせて検索した.テーマ,シソーラス用語,研究目的およびその結果何が明らかになったのかという内容の類似性に基づき分類・分析し,FA児をもつ母親の育児に関連する問題の現状および,研究の方向性について検討した.結果 対象となった文献は,2002年以降発表されていたもので16件であった.研究内容は分類・分析の結果「食生活の困難・負担」に関するものが最も多く,その他に「不安」「ストレス」「生活の質」「疲労」「FAの意味」があった.母親のFAについての不安やFA児の養育上の様々な日常生活上の制限や社会生活の中での調整の困難さが母親の負担を高めていた.育児ストレスやQOLについては十分明らかにはなっていなかった.結論 1)先行研究において,FA児を持つ母親はFAに関する「食生活の負担・困難」「不安」「ストレス」「疲労」といった問題を抱えていた.2)FA児の母親の育児ストレスについては十分に解明されておらず,その実態及び関連要因について明らかにする必要がある.3)FA児の母親のQOL関連の研究は近年になってみられていたがFA児の母親のQOLの概念や構成因子,関連要因は明らかになっておらず今後研究を進める必要がある.4)母親への支援を検討するにあたって,育児ストレスや不安の軽減・QOLの向上のための促進因子を明らかにし,母親の育児支援の方向性について検討を行う必要がある.Background It is suggested that mothers with infants suffering from various food allergies( FAs)have to face a considerable burden.Childcare support given to mothers with food allergic (FA) infants is an important issue. Objectives We investigate the current situation of studies regarding childcare of mothers with FA infant in Japan,and we also analyze the direction of future research. Methods Medical central magazine (Ver5.) was used.A search of the previous 21 years publication was carried out using the keywords of "food allergy," and "mother or caregiver or guardian." Analysis of the search results was conducted.We analyzed the current situation of problems related to the childcare of mothers withFA infants and the direction of future research. Results and Discussion There were 16 cases in the target literature.Most of the study content related to "difficulty and problem of eating habits," and the other content concerned "anxiety," "stress," "quality of life," and "fatigue." Anxiety of a mother toward FAs and care of FA infants,and the difficulties faced due to restriction and adjustment of childcare increased a mother\u27s burden.There is no clear understanding on childcare stress and the QOL of mothers with FA infants. Conclusion 1) In previous studies,mothers acknowledged the problems of "burden and difficulties of eating habits," and the "anxiety," "stress," and "fatigue" related to FAs.2) There is no clear clarification on the current condition of mother\u27s stress with respect to childcare and the associated factors.3) There is no clear understanding on the concept of the QOL of mothers,contributory factors,and associated factors.4) There is a need to clarify the influencing factors related to the reduction of a mother\u27s stress and anxiety of FA childcare and QOL improvemen,as well as the direction of childcare support for mothers

Annexin A1-Binding Carbohydrate Mimetic Peptide Targets Drugs to Brain Tumors

Annexin A1 (Anxa1) is expressed specifically on the surface of the tumor vasculature. Previously, we demonstrated that a carbohydrate-mimetic peptide, designated IF7, bound to the Anxa1 N-terminal domain. Moreover, intravenously injected IF7 targeted the tumor vasculature in mouse and crossed tumor endothelia cells to stroma via transcytosis. Thus, we hypothesized that IF7 could overcome the blood–brain barrier to reach brain tumors. Our studies in brain tumor model mice showed that IF7 conjugated with the anti-cancer drug SN38 suppressed brain tumor growth with high efficiency. Furthermore IF7-SN38-treated mice mounted an immune response to brain tumors established by injected tumor cells and shrank those tumors in part by recruiting cytotoxic T-cells to the injection site. These results suggest that Anxa1-binding peptide IF7 represents a drug delivery vehicle useful to treat malignant brain tumors. This chapter describes the unique development of IF7-SN38 as a potential breakthrough cancer chemotherapeutic

Tubo-ovarian abscess in a patient with cri du chat syndrome: A case report

A tubo-ovarian abscess is an infection that occurs as a sequela of pelvic inflammatory disease. There is no reported association between a tubo-ovarian abscess and cri du chat syndrome in the medical literature. Herein, we report the case of a 44-year-old woman with cri du chat syndrome who was subsequently diagnosed with a tubo-ovarian abscess. After emergent laparotomy, simple total hysterectomy, and bilateral adnexectomy, the patient was discharged 13 days postoperatively without complications

Characteristics of urine spraying and scraping the ground with hind paws as scent-marking of captive cheetahs (Acinonyx jubatus)

Olfactory communication is common in felids. We observed two scent-markings, urine spraying and scraping the ground with hind paws during excretion, of 25 captive cheetahs. We analyzed the association of sniffing with the timing of urine spraying and scraping, and differences in these behaviors based on sex, age, and captive environment to understand the olfactory communication among cheetahs. Both scent-markings were strongly associated with sniffing, especially scraping, and the presence or absence of scent was thought to be a trigger. Both behaviors were observed only in adults; scraping was observed only in males. To our knowledge, this study was first to confirm the discharge of secretions from the anal glands during scraping. The frequencies of both behaviors were significantly higher in males kept in shared enclosures containing other individuals than in males kept in monopolized enclosures, while there was no difference in the frequencies among females. Female cheetahs are solitary and have non-exclusive home range, whereas male cheetahs are either solitary or live in coalition groups and there are territorial and non-territorial males. Our results could be attributed to the differences in sociality between the sexes and effect of the living environment

Neuroprotective response after photodynamic therapy: Role of vascular endothelial growth factor

Background: Anti-vascular endothelial growth factor (VEGF) drugs and/or photodynamic therapy (PDT) constitute current treatments targeting pathological vascular tissues in tumors and age-related macular degeneration. Concern that PDT might induce VEGF and exacerbate the disease has led us to current practice of using anti-VEGF drugs with PDT simultaneously. However, the underlying molecular mechanisms of these therapies are not well understood. Methods: We assessed VEGF levels after PDT of normal mouse retinal tissue, using a laser duration that did not cause obvious tissue damage. To determine the role of PDT-induced VEGF and its downstream signaling, we intravitreally injected a VEGF inhibitor, VEGFR1 Fc, or a PI3K/Akt inhibitor, LY294002, immediately after PDT. Then, histological and biochemical changes of the retinal tissue were analyzed by immunohistochemistry and immunoblot analyses, respectively. Results: At both the mRNA and protein levels, VEGF was upregulated immediately and transiently after PDT. VEGF suppression after PDT resulted in apoptotic destruction of the photoreceptor cell layer in only the irradiated area during PDT. Under these conditions, activation of the anti-apoptotic molecule Akt was suppressed in the irradiated area, and levels of the pro-apoptotic protein BAX were increased. Intravitreal injection of a PI3K/Akt inhibitor immediately after PDT increased BAX levels and photoreceptor cell apoptosis. Conclusion: Cytotoxic stress caused by PDT, at levels that do not cause overt tissue damage, induces VEGF and activates Akt to rescue the neural tissue, suppressing BAX. Thus, the immediate and transient induction of VEGF after PDT is neuroprotective

A case of spontaneous parasitic myoma in a patient without a history of myomectomy treated laparoscopically

Parasitic myoma (PM) is a rare disease in which multiple leiomyomas are intraperitoneally formed. Recently, an increasing number of cases due to specimen morcellation during minimally invasive surgery has been reported. We present the first case of a PM identified intraoperatively during laparoscopic hysterectomy. A 40-year-old Japanese multiparous woman presented to our hospital with heavy menstrual bleeding. She had no history of previous surgery. Magnetic resonance imaging showed uterine myomas. As the patient did not wish for further pregnancy, she underwent oral gonadotropin-releasing hormone antagonist therapy followed by a total laparoscopic hysterectomy. Intraoperatively, we identified a thumb-sized tumor on the left side of the peritoneum. Histopathological examination showed evidence of benign leiomyoma

Transcriptional factors associated with epithelial-mesenchymal transition in choroidal neovascularization

Purpose: To investigate the transcriptional factors associated with epithelial-mesenchymal transition (EMT) in choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). Methods: Paraffin sections of CNV obtained from patients with AMD (n=12) were stained for transcriptional factors related to EMT, i.e., Snail, Slug, SIP1, and Twist. As a control, postmortem sections of ocular normal tissue were used. Furthermore, using a human retinal pigment epithelial (RPE) cell line (ARPE-19), reverse transcription–polymerase chain reaction (RT–PCR) and immunofluorescence microscopy were performed to explore the cellular localization and expression levels of EMT-associated transcriptional factors upon cytokine stimulation. Results: Of 12 specimens, 11 CNV tissues (91.6%) showed staining for Snail localized in cellular nuclei, particularly in those of RPE cells. Snail was strongly co-localized with α-smooth muscle antigen (SMA) in RPE cells. In contrast, postmortem human retina showed no Snail staining in RPE cells. Other transcriptional factors, Slug, Twist and SIP1 were not detected in CNV or normal human retina. In ARPE-19 cells, RT–PCR and immunofluorescence microscopy showed that Snail mRNA was upregulated by transforming growth factor (TGF)-β and VEGF stimulation. Furthermore, TGF-β induced relocalization of Snail to the nucleus in RPE cells. Conclusions: The current data indicate that Snail is a major transcriptional factor for EMT changes of RPE cells in human CNV

Introduction and utility of resuscitative endovascular balloon occlusion of the aorta for cases with a potential high risk of postpartum hemorrhage: A single tertiary care center experience of two cases

Postpartum hemorrhage is an important obstetric complication and the leading cause of maternal mortality worldwide. Occasionally, we encounter unexpected massive postpartum hemorrhage diagnosed for the first time after delivery. Therefore, it is essential to pay attention to patients with a high risk of postpartum hemorrhage. The authors report two cases of patients at high risk of postpartum hemorrhage that were successfully managed by resuscitative endovascular balloon occlusion of the aorta before cesarean section. Case 1: A 32-year-old woman with a history of cesarean section and who conceived using assisted reproductive technology was diagnosed with partial placenta previa at 25 weeks of gestation. Because of tocolysis failure, emergent cesarean section with resuscitative endovascular balloon occlusion of the aorta was performed at 36 weeks of gestation. Natural placental resorption was observed. She was discharged at 5 days after delivery without significant hemorrhage. Case 2: A 41-year-old woman with suspected placenta accreta spectrum due to a cesarean scar pregnancy was referred to our hospital at 33 weeks of gestation. A planned cesarean section with resuscitative endovascular balloon occlusion of the aorta was conducted at 37 weeks of gestation. There was no visual evidence of abnormal placental invasion of the myometrium, and natural placental resorption was observed. She was discharged at 5 days after delivery without significant hemorrhage

Key role for transforming growth factor-β in melanocyte stem cell immaturity and quiescence

Division of Stem Cell Medicin