Neck Dissection for Thoracic Esophageal Squamous Cell Carcinoma

Subtotal esophagectomy with extended lymph node dissection is a standard procedure for thoracic esophageal squamous cell carcinoma. Three-field lymphadenectomy, including neck dissection, is a standard type of lymph node dissection for complete clearance of tumor cells. Based on various series of analyses for lymph node metastases, the appropriate indication for neck dissection has been clarified. Herein, we describe the established techniques of neck dissection and review recent topics of three-field lymph node dissection for thoracic esophageal squamous cell carcinoma

The Effect of Alternating Current Iontophoresis on Rats with the Chronic Constriction Injury to the Infraorbital Nerve

This study aimed to examine the effect of AC iontophoresis on rats with the chronic constriction injury (CCI) to the infraorbital nerve by animal experiments. CCI model rats were divided into four groups, namely, rats that received general anesthesia for 60 min except AC IOP (CCI: n = 5), AC IOP with 0.9% physiological saline for 60 min (CCI + saline AC IOP: n = 5), AC IOP with 4% lidocaine hydrochloride for 60 min (CCI + lidocaine AC IOP: n = 5), and attachment of two electrodes soaked with 4% lidocaine hydrochloride to the facial skin for 60 min (CCI + attach lidocaine: n = 5). In the CCI + lidocaine AC IOP group, an elevated withdrawal threshold was observed after AC IOP, and the duration of efficacy was longer compared with that in the CCI + saline AC IOP and CCI + attached lidocaine groups. A significant decrease in the number of Fos-like immunoreactive (LI) cells was observed in the CCI + lidocaine AC IOP group compared with that in the CCI group. These findings suggest that the effect of CCI + lidocaine AC IOP group may be caused by active permeation of lidocaine into the facial skin and electrical stimulation of the trigeminal nucleus

Acoustic features and evaluation of singing production by nursery school teachers (I)

本研究は，幼稚園や保育園・所などの保育現場で歌われる保育者の歌声を採取し，印象評 価実験と音響分析により，どのような歌声が保育現場にふさわしいのか検討したものである。 音圧，ピッチ，フォルマントの各音響特徴と照らし合わせたところ，安定した基本周波数や ３～４kHz 付近の明確なスペクトルピーク，緩やかな音圧の推移が「美しい」印象を与え ていること，第３フォルマントと第４フォルマントの接近の有無，高周波数帯域でのエネル ギーの濃淡が，個性的な声質に影響を与えていることが示唆された。さらに大学生が判断す る「良い」声と，子どもたちが「歌ってほしい」声との間にかなりの共通点が認められた。 保育者の歌声に関して偏ったプロトタイプが形成されることのないよう，保育現場でのお手 本のあり方について慎重を期すべきであるとの提案をおこなった

社会人経験のある看護学生についての文献レビュー

景気低迷等の社会情勢などから一旦看護職以外の職業を経験し，看護学校に入学する「社会人経験のある学生 （以下　社会人経験者）」の増加が予測される．近年，社会人経験者が助産師教育課程にも入学してくるようになっ た．社会人経験者は入学動機が明確であり，職業経験からコミュニケーション技術が優れている点もあるが，異年 齢の学生や実習における指導者との人間関係などに苦慮している現実がある．看護学生の社会人経験者の研究はあ るが，助産師学生の社会人経験者の研究は皆無であるため，まず看護学生で社会人経験者についての文献レビュー を行い，指導や学生生活についての今後の課題を検討した．先行文献39件の殆どが質的研究で，研究内容は26コー ド，4カテゴリーに分けられた．4カテゴリーは「学生指導」「キャリアデザイン」「学生生活」「新卒看護師」であっ た．社会人経験者には出産育児経験者がおり，子育て後のキャリアデザインについて追究する余地があること，人 間関係について指導者，教員を対象とした研究が少ないことから今後は対象者を変えた社会人経験者に客観的な視点からの研究が期待される．また分析方法としてはグランデッド・セオリーアプローチによるものが期待される．As a results of the business stagnation in the general social situation, it is predicted that there will be an increase in the number of students who have once experienced employment other than the nursing professionals and that they will enroll in nursing schools as students with experiences as working adults (hereinafter referred to as people with employment experiences).　In recent years, people with employment experiences have also begun to enroll in birthing assistant education courses.　The purposes of enrollment by people with employment experiences are clear and also they have outstanding communication skills derived from their professional experiences, however, they actually have difficulties in human relations with multiage students and instructors in practical trainings.　Though there are studies on nursing students with employment experiences, studies on birthing assistant students with employment experiences are nonexistent.　Therefore, we carried out a review of materials concerning nursing assistant students with employment experiences, and considered the future problems of their instructor and student life.　The former 39 materials were mostly of quality studies, and the contexts of those studies were divided into 26 codes and 4 categories.　The 4 categories were student guidance. career guidance. student life. and newly graduated nurses. Among the people with employment experiences, there are those who have birthing and childrearing experience, so there is a margin for pursuing career design after their child-rearing, and since there are very few studies on instructors and teachers concerning human relations, hopes are held for studies of people with employment experiences in terms of changing the subjects of such studies.　Also it is expected that the analysis is performed based on the Grounded Theory Approach (GTA) as the analysis method

臨床経験のある助産師学生についての研究 : 学生生活の実際と臨床経験が及ぼす影響

臨床経験のある助産師学生が1年課程の助産師養成機関への入学動機，入学準備，及び入学してから直面した事 などを分析し，助産師教育における課題と対応策を検討する目的で5名にインタビューを行った．その結果入学動 機は3つのカテゴリー「夢を追って」「機会を得て」「モデルの存在」で構成された．入学後に直面した事は3つの カテゴリー「久しぶりの勉強」「実習の大変さ」「家族の理解」から構成されていた．臨床経験と実習については2 つのカテゴリー，「実習における強み」「実習における弱み」で「異年齢の学生との相互作用」については， 2つで 「学生同士の世代間相違」「相互作用」であった． 　対象者5名は看護師になる時から助産師になる計画をしており，子育て等で一旦進学希望を延長しても経済的な 基盤や家族内の調整などに苦慮していた．また入学後は，現役の学生と相互作用でパソコンスキル等を高め，実習 においては学生になりきろうと努力して学生生活を送っていた．At a birthing assistant training school offering a one-year program, analysis was made for birthing assistance students who have previous clinical experience, in terms of their enrollment motivations for entering the school, and matters faced after enrollment.　The study thus carried out interviews with five such students for the purpose of investigating the problems and the countermeasures toward solving those problems in birthing assistant education.　As a result, it was found that enrollment motivations consisted of three categories; (1) following one's dreams. (2) obtaining the opportunity and (3) existence of a role model. It was found that matters faced after enrollment consisted of three categories; (1) studying for the first time in a long time (2) practical training problems. and (3) understanding of one's family . 　The category which is two about clinical experience and a practical training; The advantage in the practical training , and The weak point in the practical training .　The category which is two about students of the different age communication, Difference during the generation and the interaction . 　The five subjects had been planning to become birthing assistants since they became nurses, but they had experienced such problems as putting off entering further education facilities due to such matters as child-rearing as well as their economic stability and coordination with family members.　In addition, after enrollment, they actively communicated with other students who had directly entered the school without suspension, enhanced their PC skills, and made concerted efforts to become just a student in the practical training

Urinary FSH in postmenopausal women

The change in follicle-stimulating hormone (FSH) during the menopausal transition and associations of FSH with various diseases have been assessed by using blood samples. We examined cross-sectionally the variation of FSH levels, associations of estrone and estradiol with FSH, and associations of BMI with these hormones by using urinary samples from peri- and postmenopausal women in Japan. Of 4472 participants in the Urinary Isoflavone Concentration Survey of the Japan Nurses’ Health Study, we analyzed urinary levels of estrone, estradiol and FSH in 547 women aged from 45 to 54 years. Urinary FSH levels varied widely in postmenopausal women and the pattern of change in urinary FSH levels seems to be similar to that in blood FSH levels in previous studies. There were no significant differences in age, body mass index (BMI), estradiol, estrone and estradiol/estrone ratio among three groups according to the tertile of FSH. In postmenopausal women, there were significant associations of BMI with levels of estrone and estradiol, but there was no significant association of BMI with FSH. Studies using urinary samples will allow us to establish a study project as a large-scale population-based study to determine associations between FSH and various diseases after menopause

Study of Sustained Blood Pressure-Lowering Effect of Azelnidipine Guided by Self-Measured Morning and Evening Home Blood Pressure: Subgroup Analysis of the At-HOME Study

BACKGROUND: Morning hypertension is a risk factor for cardiovascular and cerebrovascular events, and consequently diagnosis and control of morning hypertension are considered very important. We previously reported the results of the Azelnidipine Treatment for Hypertension Open-label Monitoring in the Early morning (At-HOME) Study, which indicated that azelnidipine effectively controlled morning hypertension. OBJECTIVES: The objective of this At-HOME subgroup analysis was to evaluate the sustained blood pressure (BP)-lowering effect of azelnidipine, using mean morning and evening systolic BP [ME average] and morning systolic BP minus evening systolic BP (ME difference). METHODS: We analyzed the self-measured home BP data (measured in the morning and at bedtime) from this 16-week prospective observational study to clarify the effect of morning dosing of azelnidipine (mean [± standard deviation] maximum dose 14.3 ± 3.6 mg/day). A subgroup of patients from the At-HOME Study who had an evening home BP measurement within 28 days prior to the baseline date were used for efficacy analysis (n = 2,546; mean age, 65.1 years; female, 53.6 %). RESULTS: Home systolic BP/diastolic BP levels in the morning and evening were significantly lowered (p < 0.0001) by −19.4 ± 17.1/−10.3 ± 10.6 and −16.9 ± 17.0/−9.4 ± 10.6 mmHg, respectively. Home pulse rates in the morning and evening were also significantly lowered (p < 0.0001) by −3.5 ± 7.8 and −3.5 ± 7.3 beats/min, respectively. At baseline, patients whose ME average was ≥135 mmHg and whose ME difference was ≥15 mmHg (defined as morning-predominant hypertension) accounted for 20.4 % of the study population. However, at the end of the study, the number of such patients was significantly reduced to 7.9 % (p < 0.0001). Patients whose ME average was ≥135 mmHg and whose ME difference was <15 mmHg (defined as sustained hypertension) accounted for 71.1 % of the study population at baseline. This was reduced significantly to 42.8 % at the end of the study (p < 0.0001). ME average decreased significantly from 153.8 ± 15.5 mmHg to 135.6 ± 11.9 mmHg, and ME difference also decreased significantly from 6.7 ± 13.1 mmHg to 4.7 ± 10.8 mmHg (both p < 0.0001). CONCLUSION: These results suggest that azelnidipine improved morning hypertension with its sustained BP-lowering effect. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s40268-013-0007-7) contains supplementary material, which is available to authorized users

Association between FSH, E1, and E2 levels in urine and serum in premenopausal and postmenopausal women

Objective: We aimed to establish correlations for the levels of follicle-stimulating hormone (FSH), estrone (E1) and estradiol (E2) between urine and serum in premenopausal and postmenopausal women using immunoassays. Methods: In this study of 92 women (61 postmenopausal, 31 premenopausal), both urine and blood specimens were collected on the same day and stored at 4 °C for analysis by chemiluminescent immunoassay, radioimmunoassay and/or electrochemiluminescent immunoassay. Results: There were correlations in the levels of FSH, E1 and E2 between urine and serum in both postmenopausal (r = 0.96 for FSH, r = 0.91 for E1, r = 0.80 for E2) and premenopausal (r = 0.98 for FSH, r = 0.92 for E1, r = 0.90 for E2) women. It is indicated that the correlations were stronger in the premenopausal group compared with the postmenopausal group, especially for FSH. Conclusion: The levels of FSH, E1 and E2 in urine correlated with those in the serum in premenopausal and postmenopausal women. Urine samples could be used instead of serum samples to measure hormone levels, which would reduce the difficulty of conducting large survey studies

液状化細胞診材料を用いた遺伝子解析による腫瘍特異的遺伝子検出感度の検討

Liquid-based cytology (LBC) analysis of sputum is a useful diagnostic and prognostic tool for detecting lung cancer. DNA and RNA derived from lung cancer cells can be used for this diagnosis. However, the quality of cytological material is not always adequate for molecular analysis due to the effect of formalin in the commercially available fixation kits. In this study, we examined DNA and RNA extraction methods for LBC analysis with formalin fixation, using lung carcinoma cell lines and sputum. The human non-small cell lung cancer cell lines were fixed with LBC fixation reagents, such as CytoRich red preservative. Quantification of thyroid transcription factor-1 (TTF-1) and actin mRNA, epidermal growth factor receptor (EGFR) DNA in HCC827, H1975, and H1299 cells, and mutation analysis of EGFR in HCC827 and H1975 cells were performed by quantitative PCR (qPCR) and fluorescence resonance energy transfer (FRET)-based preferential homoduplex formation assay (F-PHFA) method, respectively. mRNA and DNA extracted from cell lines using RNA and/or DNA extraction kits for formalin-fixed paraffin-embedded (FFPE) fixed with various LBC solutions were efficiently detected by qPCR. The detection limit of EGFR mutations was at a rate of 5% mutated positive cells in LBC. The detection limit of the EGFR exon 19 deletion in HCC827 was detected in more than 1.5% of the positive cells in sputum. In contrast, the detection limit of the T790M/L858R mutation in H1975 was detected in more than 13% of the positive cells. We also detected EGFR mutations using next generation sequencing (NGS). The detection limit of NGS for EGFR mutation was lower than that of the F-PHFA method. Furthermore, more than 0.1% of positive cells could be cytomorphologically detected. Our results demonstrate that LBC systems are powerful tools for cytopathological and genetic analyses. However, careful attention should be paid to the incidence of false negative results in the genetic analysis of EGFR mutations detected by LBC.博士（医学）・甲第750号・令和2年6月30日© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/)

Gene Expression and Protein Synthesis in Mitochondria Enhance the Duration of High-Speed Linear Motility in Boar Sperm

Sperm motility patterns are continuously changed after ejaculation to fertilization in the female tract. Hyperactivated motility is induced with high glucose medium in vitro or the oviduct fluids in vivo, whereas sperm maintain linear motility in the seminal plasma or the uterine fluids containing low glucose. Therefore, it is estimated that sperm motility patterns are dependent on the energy sources, and the mitochondrial oxidative phosphorylation is activated to produce ATP in low glucose condition. To elucidate these hypotheses, boar sperm was incubated in different energy conditions with the transcription and translation inhibitors in vitro. Sperm motility parameters, mitochondrial activity, ATP level, gene expression and protein synthesis were analyzed. Sperm progressive motility and straight-line velocity were significantly increased with decreasing glucose level in the incubation medium. Moreover, the mitochondrial protein turnover meaning transcription and translation from mitochondrial genome in sperm is activated during incubation. Incubation of sperm with mitochondrial translation inhibitor (D-chloramphenicol) suppressed mitochondrial protein synthesis, mitochondrial activity and ATP level in sperm and consequently reduced the linear motility speed, but not the motility. Thus, it is revealed that the mitochondrial central dogma is active in sperm, and the high-speed linear motility is induced in low glucose condition via activating the mitochondrial activity for ATP generation.This work was supported in part by Livestock Promotional Funds of Japan Racing Association (JRA) grant no. H30-279 and by Hiroshima Cryopreservation Service Co., grant no. H30-1 (to MS). ZZ was supported by China Scholarship Council during a visit of “Zhendong Zhu” to Hiroshima University (#CSC201706300110).The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fphys.2019.00252/full#supplementary-materia