イタミ ニ マケナイ ガン ニ マケナイ タメニ シッテオクベキ コト : イタミ ノ ウッタエカタ カラ サイシン ノ ヤクブツ リョウホウ ニツイテ

In Japan, one of two people is diagnosed as cancer in a lifetime and cancer has been the leading cause of death for a long period. Then, Japanese government established the Cancer Control Act to improve cancer cure and care in 2007. Its law does not describe about only diagnosis and treatment, but also improving quality of life in cancer patients. And also, it describes that it must be duty to treat all symptoms including physical pain if necessary. The recuperation period has been prolonged due to improvement of diagnosis and treatment of cancer, so that many patients suffer from cancer related pain for a long period. Cancer related pain should seems to be chronic pain. It must be managed to improve prognosis and quality of life in cancer patients. In this article, WHO cancer pain relief with the pharmacotherapy for cancer related pain is described

Longitudinal morphological changes during recovery from brain deformation due to idiopathic normal pressure hydrocephalus after ventriculoperitoneal shunt surgery.

The present study aimed to examine time-dependent change in cerebrospinal fluid distribution and various radiological indices for evaluating shunt effectiveness in patients with idiopathic normal pressure hydrocephalus (iNPH). This study included 54 patients with iNPH who underwent MRI before and after ventriculoperitoneal shunt surgery. The volume of the total ventricles and subarachnoid spaces decreased within 1 month after shunting. However, more than 1 year after shunting, the volume of the total ventricles decreased, whereas that of the total subarachnoid spaces increased. Although cerebrospinal fluid distribution changed considerably throughout the follow-up period, the brain parenchyma expanded only 2% from the baseline brain volume within 1 month after shunting and remained unchanged thereafter. The volume of the convexity subarachnoid space markedly increased. The changing rate of convexity subarachnoid space per ventricle ratio (CVR) was greater than that of any two-dimensional index. The brain per ventricle ratio (BVR), callosal angle and z-Evans index continued gradually changing, whereas Evans index did not change throughout the follow-up period. Both decreased ventricular volume and increased convexity subarachnoid space volume were important for evaluating shunt effectiveness. Therefore, we recommend CVR and BVR as useful indices for the diagnosis and evaluation of treatment response in patients with iNPH

Dexterous hand-arm coordinated manipulation using active body-environment contact

Abstract-Human-symbiotic humanoid robots that can perform tasks dexterously using their hands are needed in our homes, welfare facilities, and other places. To improve their task performance, we propose a motion control scheme aimed at appropriately coordinated hand and arm motions. By observing human manual tasks, we identified active body-environment contact as a kind of human manual skill and devised a motion control scheme based on it. We also analyzed the effectiveness of active body-environment contact in glass-placing and drawer-opening tasks. We validated our motion control scheme through actual tests on a prototype human-symbiotic humanoid robot

重度大動脈弁狭窄症患者の大動脈弁置換術後における血小板機能および高分子量 von Willebrand 因子多量体の急速な回復

AIM: Patients with severe aortic stenosis (AS) may have bleeding episodes due to the loss of high-molecular-weight (HMW) von Willebrand factor multimers (VWFMs). The absence of HMW-VWFMs and bleeding tendency are usually corrected after aortic valve replacement (AVR). To investigate the process of VWFM recovery and symptoms in patients with severe AS, we analyzed changes in VWF antigen (VWF:Ag), ADAMTS13 activity (ADAMTS13:AC), and platelet thrombus formation under high shear stress conditions. METHODS: Nine patients with severe AS undergoing AVR were analyzed. RESULTS: Evident deficiency of HMW-VWFMs was observed in six patients before surgery, which was rapidly restored within 8 days after AVR. Median levels of VWF:Ag before surgery, on postoperative days (PODs) 1, 8, 15, and 22, and one year after AVR were 78.1%, 130%, 224%, 155%, 134%, and 142%, respectively. In contrast, ADAMTS13:AC was 50.5%, 35.5%, 25.5%, 25.1%, 30.3%, and 84.6%, respectively. Preoperative thrombus formation but not surface coverage was significantly lower than that on POD 22, which was considered as normal level in each patient. Compared with preoperative levels, thrombus volume was significantly lower on POD 1, but rapidly increased by POD 8. CONCLUSION: Bleeding tendency and loss of HMW-VWFMs observed in patients with severe AS before surgery was rapidly corrected after AVR. Instead, patients were in a VWF-predominant state between POD 8 and 22.博士（医学）・乙第1395号・平成29年3月15日Copyright © 2016 Japan Atherosclerosis Society本論文の著作権は日本動脈硬化学会が保持しています。This article is distributed under the terms of the latest version of CC BY-NC-SA defined by the Creative Commons Attribution License

752-5 Dose the “No Reflow” Phenomenon Immediately After Successful Direct Angioplasty Always Indicate Poor Functional Recovery?

Experimental studies have demonstrated that “no reflow” phenomenon after prolonged coronary occlusion indicates advanced myocardial necrosis. In clinical settings, previous studies have suggested that presence of “no reflow” phenomenon following thrombolysis is a useful predictor of poor functional recovery. To test the hypothesis that “no reflow” phenomenon is closely related to the recovery of regional wall motion in a reperfused AMI, we studied 42 myocardial segments in 18 patients with AMI who achieved successful direct angioplasty. MCE was performed immediately after direct angioplasty and repeated 2 weeks later with intracoronary injection of sonicated albumin. Contrast effect in each segment was scored as 0–2 (0, 1 and 2 denoting no, partial and homogeneous contrast effect, respectively). 2D-Echo was performed at day-1 and repeated 1 month later. Wall motion (WM) by 2D-Echo was scored as 0–3 (scores of 0 to 3 indicating dys/akinetic segments to normal. respectively). The relation between mean WM and MCE score immediately after direct angioplasty was as follows:MCE scoreday-l WM1 Month WMChange2 (n=20)1.1±0.8**1.7±0.7*,#0.6±0.91 (n=7)0.6±0.8*1.4±1.4#0.9±0.90 (n=15)0.0±0.00.8±1.0##0.8±1.0*p<0.01**p<0.001 vs. MCE score=0#p<0.05##p<0.01 vs. day-l WMSeven of 15 segments (47%) with MCE score=0 immediately after direct angioplasty showed functional recovery at 1 month later, and 6 of the 7 segments (86%) showed contrast enhancement at 2 weeks later restudy.ConclusionAbout one half of segments which showed no contrast enhancement immediately after direct angioplasty showed functional recovery at 1 month later, and the majority of these segments showed contrast enhancement at 2 weeks later restudy. The “no reflow” phenomenon by MCE immediately after successful direct angioplasty dose not always indicate poor functional recovery

Atg9a deficiency causes axon-specific lesions including neuronal circuit dysgenesis

Conditional knockout mice for Atg9a, specifically in brain tissue, were generated to understand the roles of ATG9A in the neural tissue cells. The mice were born normally, but half of them died within one wk, and none lived beyond 4 wk of age. SQSTM1/p62 and NBR1, receptor proteins for selective autophagy, together with ubiquitin, accumulated in Atg9a-deficient neurosoma at postnatal d 15 (P15), indicating an inhibition of autophagy, whereas these proteins were significantly decreased at P28, as evidenced by immunohistochemistry, electron microscopy and western blot. Conversely, degenerative changes such as spongiosis of nerve fiber tracts proceeded in axons and their terminals that were occupied with aberrant membrane structures and amorphous materials at P28, although no clear-cut degenerative change was detected in neuronal cell bodies. Different from autophagy, diffusion tensor magnetic resonance imaging and histological observations revealed Atg9a-deficiency-induced dysgenesis of the corpus callosum and anterior commissure. As for the neurite extensions of primary cultured neurons, the neurite outgrowth after 3 d culturing was significantly impaired in primary neurons from atg9a-KO mouse brains, but not in those from atg7-KO and atg16l1-KO brains. Moreover, this tendency was also confirmed in Atg9a-knockdown neurons under an atg7-KO background, indicating the role of ATG9A in the regulation of neurite outgrowth that is independent of autophagy. These results suggest that Atg9a deficiency causes progressive degeneration in the axons and their terminals, but not in neuronal cell bodies, where the degradations of SQSTM1/p62 and NBR1 were insufficiently suppressed. Moreover, the deletion of Atg9a impaired nerve fiber tract formation

Postoperative Urinary Retention in Japanese Elderly Males with a Femoral Neck or Trochanteric Fracture

We assessed risk factors for postoperative urinary retention (UR) in elderly males with femoral bone fractures: 169 Japanese males (mean age 81.95 ± 1.19 years) who had undergone hip surgery at a municipal hospital (Toyama, Japan). A multiple logistic regression analysis was used to test possible risk factors for UR: age, body mass index, serum albumin, cognitive impairment, activities of daily living (ADL), and history of diabetes mellitus (DM). UR occurred in 24 (14.2%) of the 169 patients. A multivariate logistic regression analysis with age adjustment showed that ADL (odds ratio [OR] 3.88; 95% confidence interval [CI]: 1.2-12.5, p=0.023) was significantly associated with the development of UR, and a history of DM showed marginal significance for UR occurrence (OR 0.36, 95%CI: 0.11-10, p=0.064). These results suggests that ADL is a risk factor for UR development in elderly males who have undergone surgery for femoral neck or trochanter fractures

Identification of 45 New Neutron-Rich Isotopes Produced by In-Flight Fission of a 238U Beam at 345 MeV/nucleon

A search for new isotopes using in-flight fission of a 345 MeV/nucleon 238U beam has been carried out at the RI Beam Factory at the RIKEN Nishina Center. Fission fragments were analyzed and identified by using the superconducting in-flight separator BigRIPS. We observed 45 new neutron-rich isotopes: 71Mn, 73,74Fe, 76Co, 79Ni, 81,82Cu, 84,85Zn, 87Ga, 90Ge, 95Se, 98Br, 101Kr, 103Rb, 106,107Sr, 108,109Y, 111,112Zr, 114,115Nb, 115,116,117Mo, 119,120Tc, 121,122,123,124Ru, 123,124,125,126Rh, 127,128Pd, 133Cd, 138Sn, 140Sb, 143Te, 145I, 148Xe, and 152Ba