Parental satisfaction and seizure outcome after corpus callosotomy in patients with infantile or early childhood onset epilepsy

AbstractPurposeTo elucidate the benefit of corpus callosotmy in terms of parental satisfaction and seizure outcome.MethodThis study included 16 consecutive patients with infantile or early childhood onset epilepsy who underwent total corpus callosotomy for alleviation of seizures. Questionnaires were sent anonymously to the parents asking about relative changes in seizures and about parental satisfaction for the post-operative outcome.ResultsThe improvements in frequency, intensity, and duration of seizures were correlated with the level of satisfaction (Spearman's rank-order correlation coefficient, ρ=0.87, 0.93, and 0.75, respectively). The highest level of satisfaction was only seen in patients who achieved freedom from all seizures or drop attacks.ConclusionComplete seizure freedom and freedom from drop attacks are important goals of corpus callosotomy for parental satisfaction. These factors should be considered in assessing post-operative outcome after corpus callosotomy

急性期医療を受ける患者の願い

目的：患者の地域での暮らしの希望と療養上の目標を中心に構造化した看護のプロセス”Nursing Care for Patient Goals”（NCPG）に患者の視点から示唆を得るため急性期医療を受ける患者が看護師に知ってほしい情報と療養の目標に対して求める看護を明らかにした． 方法：１特定機能病院において入院中または入院予定の20歳以上の患者を対象として質問紙調査を２回（2017年，2018年）に実施した．調査内容は基本属性，調査Ⅰ（2017年）は先行研究を基に抽出した患者情報23項目について看護師に知って欲しいと思う程度，最も大事と思う項目とその選択理由，調査Ⅱ（2018年）は自分の療養の目標について求める看護であった．統計分析は記述統計，因子分析，t 検定を用いた．自由記述によるデータは質的記述的分析を行った． 結果：調査Ⅰの有効回答数は448名で，看護師に知ってほしい自分の情報として【第１因子：社会的役割と環境】【第２因子：病気の理解・受け入れと心理】【第３因子：身体的状態と生活の仕方】【第４因子：暮らしの希望と自己決定】が抽出された．65歳未満と比較して65歳以上の対象者は第１因子が高い傾向にあった．また第４因子を最も大事と思う項目の選択理由について， “希望・目標がなきゃ生きていけない” という表現が特徴として出された．調査Ⅱの有効回答数は416名で，多数の対象者が自分の目標を医療者と共有することが重要だと感じており，受けたい看護として，傍にいて寄り添う看護，治療・症状への専門的な看護，地域での暮らしの自立への看護が抽出された． 結論：患者の視点から看護師に知ってほしい情報として４つの因子と自分の目標を分ってほしいとする対象者の願いは，希望と目標を基盤としたNCPG の考え方と一致しており，目標達成のために受けたい看護の３つの視点が示唆された．Objective : This study aimed to identify information on care of patients receiving acute care for life in community from the patientsʼ perspective and to obtain suggestions for “Nursing Care for Patient Goals”（NCPG）. Method : The subjects were patients receiving acute care and aged 20 years and above. They were given self-administered questionnaires. Survey Ⅰ（2017）consisted of a questionnaire that was based on previously collected qualitative data and comprised 23 Likert-scale questions and free descriptive questions on the reasons for selecting the most important item. Survey Ⅱ（2018）consisted of questionnaire that was comprised of three Likert-scale questions on goals and a free descriptive question on care for the achievement of goals. Statistical analysis included descriptive statistics, factor analysis, and t-test. Data from free-text descriptions were analyzed using qualitative descriptive analysis. Results : Survey Ⅰ : data from 448 valid responses were subjected to factor analysis to determine the factor structure. The following factors were identified from the patientsʼ perspectives: 1） social role and environment, 2） understanding/acceptance and psychological state, 3） physical condition and life, and 4） hope and decision-making for life. In addition, a qualitative and inductive approach was employed to analyze participantsʼ descriptive responses about the reason for selecting the most important item. The characteristic description of why participants selected “hope and decision-making of life” was “I cannot live without hope.” Survey Ⅱ : data from 416 valid responses were analyzed. The majority of participants felt it was important to share their goals with their healthcare professionals. A qualitative and inductive approach was employed to analyze the participantsʼ descriptive responses to care for goals achievement. The care desired by participants was categorized as “being with”, “professional care”, and “self-care support”. Conclusion : The factors that patients wanted nurses to know were consistent with the components of “NCPG.” The care that patients desire to achieve their goals was clarified

患者の希望を地域につなぐための患者状態とニーズ

目的：急性期医療を受ける患者の地域での生活を視野に入れた看護を展開するために患者の情報と看護の視点について明らかにすることを目的とした． 方法：特定機能病院に勤務する中堅以上の看護師３３名を対象に，地域での生活を視野に入れた患者の情報と看護の視点についてフォーカス・グループ・インタビューを行い分析した． 結果及び考察：急性期医療を受ける患者の地域での生活に必要な情報と看護の視点として，コアカテゴリー《地域での生活を可能にするニーズ》が抽出された．さらに地域での生活を可能にするための状態とニーズとして【身体・生理的な状態とニーズ】，【生活の自立と安全の状態とニーズ】，【病気の受け入れと心理的反応の状態とニーズ】，【社会的環境の状態とニーズ】，【医療・療養への自己決定の状態とニーズ】の５つのカテゴリーに分類された．これらより，患者の暮らしの希望，療養の目標，５つの視点の状態からニーズを導き看護を展開する看護の過程として，“Nursing Care for Patient Goals（” NCPG）を構造化した． 結論：地域包括ケアシステムの中において急性期医療を受ける患者の情報と看護の視点として地域での生活を可能にするための５つの状態とそのニーズが重視されていた．Objective : The aim of this study was to identify information and care perspectives of nurses for patients leaving an acute care hospital for life in the community, and to consider appropriate nursing care in the community-based integrated care system. Method : Focus group interviews were conducted with 33 nurses working in an acute care hospital. The data were analyzed using qualitative inductive analysis. Results & Discussion : The core category “Needs to enable patients to live in the community” was extracted as the information and care perspective necessary for patients receiving acute care to leave hospital for life in the community. The information and care perspectives were classified into five conditions : physical/physiological condition and needs, life independence and safety status and needs, acceptance of/emotions about illness and needs, social environment and needs, and decision-making and needs. “Nursing Care for Patient Goals” was structured as a nursing process. Conclusion : We identified five conditions and their needs that would enable patients receiving acute care to leave hospital for life in the community

Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples

Funder: NCI U24CA211006Abstract: The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts

Preferential radiosensitization to glioblastoma cancer stem cell‑like cells by a Hsp90 inhibitor, N‑vinylpyrrolidone‑AUY922

The present study examined the radiosensitization induced by a heat shock protein 90 inhibitor, N‑vinylpyrrolidone (NVP)‑AUY922, in CD133‑positive cells in a hypoxic area of T98G spheroids. CD133‑positive cells that are induced in the hypoxic microenvironment of spheroids have previously been reported to exhibit cancer stem cell‑like properties. The present study used CD133‑positive cells from a glioblastoma cell line (T98G) as cancer stem cell‑like cells. CD133‑positive and negative cells were sorted from T98G spheroids using fluorescence‑activated cell sorting and used for colony formation assay. Colony formation assay results indicated that NVP‑AUY922 enhanced radiosensitivity more strongly in CD133‑positive cells compared with CD133‑negative cells. This result showed that NVP‑AUY922 was a preferential radiosensitization candidate targeting glioblastoma cancer stem cells. The mechanisms underlying radiosensitization by NVP‑AUY922 are discussed in relation to the properties of cancer stem cells. Overall, HIF‑1α inhibition by NVP‑AUY922 may induce higher sensitization of cancer stem cells to radiation

Glioblastoma cell line shows phenotypes of cancer stem cells in hypoxic microenvironment of spheroids

In this study, we examined the phenotypes of CD133-positive cells that were induced in a hypoxic microenvironment of spheroids formed using a glioblastoma cell line (T98G). Colony-formation assay showed that spheroid CD133-positive cells (SCPCs) were more resistant to X-rays and Temozolomide(TMZ) than spheroid CD133-negative cells (SCNCs) sorted from T98G spheroids. In contrast, the sensitivity to X-rays and TMZ was not different between hypoxic cells and normoxic cells of T98G spheroids ina colony-formation assay using green fluorescent protein (GFP) reporter-transfectants to monitor hypoxia.This result suggests that the difference in the sensitivity to X-rays and TMZ between SCPCs and SCNCs did not result from hypoxia. Transwell membrane assay indicated that the migration and inversion ability of SCPCs was higher than that of SCNCs. These results, including the findings obtainedpreviously regarding nestin positivity in SCPCs, strongly suggest that SCPCs are cancer stem cell (CSC)-like cells. Additionally, based on experiments of monolayer culture of T98G cells, it was shown that hypoxia or low pH culture condition is not sufficient for the induction of SCPCs. The three-dimensionalcell structure might be a critical factor for SCPC induction