ショクドウ ソウカン ニヨル フンゴウブ カンゼン リカイ オ カイケッチョウ サイケン デ シュウフクシタ ショクドウ セツジョ ノ 1レイ

症例は60 歳代, 男性. 身長162.6 cm, 体重40.0 kg, Body Mass Index（BMI）15.1 kg / m2であり, 既往歴に慢性閉塞性肺疾患（COPD）を認めた. 胸部上部食道癌 T1b N0 M0 Stage Iに対して食道亜全摘, 3領域リンパ節郭清, 胸骨後胃管再建を施行した.術当日に抜管したが, 術後肺炎に伴う呼吸不全のため, 術後6日目に気管内挿管を試みたが、食道挿管となった．再挿管, 人工呼吸管理の後に軽快し術後13日目に抜管となったが, 術後透視で吻合部周囲に造影剤漏出を認めた. 2ヶ月間の保存的加療で造影剤漏出は消失したが吻合部に長径4 cmの高度狭窄を認めた．内視鏡的拡張術での改善は困難であり, 術後243日目に消化管再建術を施行した. 手術所見として, 第2肋間より頭側の胸骨を切除したところ, 胃管の口側断端は第2肋間の高さの胸骨後面に位置していた.食道断端までは肉芽で置換されていた.胸骨前経路回結腸再建を施行し, 再建術後 8日目に食事を開始し, 合併症なく再建術後30日目に退院となった. 回結腸再建後2年経過後も食道癌の再発は認めず, 通過障害なく経口摂取のみでの生活が可能となっている．A 60s-year-old man underwent endoscopic screening during which a tumor was detected in the upper thoracic esophagus, which was diagnosed as T1bN0M0 Stage I esophageal squamous cell carcinoma. He had a history of chronic obstructive pulmonary disease. He underwent subtotal esophagectomy with 3 field lymph node dissection. Reconstruction was performed by gastric tube through the posterior sternal route. Extubation was performed on the day of surgery. Respiratory failure by postoperative pneumonia occurred, and ventilatory management was performed on the sixth postoperative day. However, the intubation was put into the esophagus. He became well and extubation was performed on the 13th postoperative day. Postoperative fluoroscopy showed contrast leakage around the anastomotic site. After 2 months of conservative treatment, the contrast leak disappeared, but there was a severe stenosis of 4 cm in length at the anastomosis. Endoscopic dilatation was not sufficient to improve the stenosis. Gastrointestinal reconstruction was performed on the 243rd postoperative day. The cephalic sternum was resected, and the gastrointestinal canal opening margin was located on the posterior surface of the sternum, at the level of the second intercostal space. The segment was replaced by a granulation. The patient underwent anterior sternal ileocolic reconstruction. Oral intake started on the 8th day after the reconstruction, and hospital discharge was on the 30 th day after the reconstruction without any complications. Two years after ileocolic reconstruction, there has been no cancer recurrence, and he lives well on oral intake only

E3 Ubiquitin Ligase NEDD4 Affects Estrogen Receptor α Expression and the Prognosis of Patients with Hormone Receptor-Positive Breast Cancer

Neural precursor cell-expressed developmentally downregulated 4–1 (NEDD4) is an E3 ligase that leads to the degradation of proteins, including estrogen receptor α. We evaluated whether the expression level of NEDD4 affected the outcome of breast cancer patients. We performed a retrospective cohort study enrolling 143 patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative early breast cancer. Of the 66 patients with high NEDD4 mRNA levels (high NEDD4 group) and 77 patients with low NEDD4 mRNA levels (low NEDD4 group), 98.4% and 96.1%, respectively, of the patients had received neoadjuvant/adjuvant hormone therapy. Disease-free survival and overall survival were significantly longer in the low NEDD4 group than in the high NEDD4 group (p = 0.048 and p = 0.022, respectively). Western blotting revealed a high expression of estrogen receptor α in the NEDD4-knockdown culture cells. The proliferation of NEDD4-knockdown cells treated with tamoxifen or estradiol deprivation was suppressed, compared with that of NEDD4-expressing cells. Knockdown of NEDD4 in breast cancer cells induced the accumulation of estrogen receptor α and increased sensitivity to hormone therapy. In summary, this mechanism may lead to a better prognosis in hormone receptor-positive breast cancer patients with a low expression of NEDD4

Additional file 1: Figure S1. of A mutation in the low voltage-gated calcium channel CACNA1G alters the physiological properties of the channel, causing spinocerebellar ataxia

Brain MRI of the patient 2-III-1. The left panel shows the T1-weighted sagittal image, and the right panel shows the T1-weighted axial image. Marked cerebellar vermian atrophy was observed. (PPTX 1622 kb

Additional file 5: Figure S3. of A mutation in the low voltage-gated calcium channel CACNA1G alters the physiological properties of the channel, causing spinocerebellar ataxia

Morphological measurement of differentiated Purkinje cells. Dendritic field area (A) and diameter of cell soma (B) were measured in differentiated Purkinje cells. Data are presented as the mean ± SD. Statistical significance was assessed by unpaired t-test. (PPTX 274 kb

Additional file 2: Table S1. of A mutation in the low voltage-gated calcium channel CACNA1G alters the physiological properties of the channel, causing spinocerebellar ataxia

Summary of exome sequencing. (XLSX 42 kb

Additional file 3: Table S2. of A mutation in the low voltage-gated calcium channel CACNA1G alters the physiological properties of the channel, causing spinocerebellar ataxia

Candidate variants. (XLSX 35 kb

教職課程履修における情報保障：「日本国憲法」における合同テレビ会議形式授業の試み

教職課程の教育は平成23 年度から開始され，現26 年度は完成年度の教育が行われている。日本憲法は両学部共通の教職課程の必修科目である。開始年度から日本国憲法は合同授業形式で実施されてきたが24 年度からはテレビ会議システムによる遠隔合同授業となっている。本学でも他に例をみない授業形態であり，遠隔教育やモダリティの異なる情報保障のための学生自身による自発的な取り組みも生まれてきた。本論では，日本国憲法におけるテレビ会議授業の情報保障の取り組みについて報告する