Efficacy Of A Combination Of Transarterial Chemoembolization And Radiation Therapty For Patients With Hepatochellular Carcinoma Ineligible For Resection Or Radiofrequency Ablation.

Purpose: The local control rate of trans-arterial chemoembolization (TACE) for the patients with hepatocellular carcinoma (HCC) was unsatisfactory compared to resection or radiofrequency ablation (RFA). To increase the local control rate for tumors, we performed radiation therapy followed by TACE in our institution. The purpose of this study was to evaluate the efficacy and toxicity of the TACE and radiotherapy combination in HCC patients ineligible for resection or RFA. Material and Methods: Between January 2017 and April 2020, 33 patients with HCC ineligible for resection or RFA were treated with a combination of TACE and radiation therapy. Eight patients were initial cases, and 25 were recurrent or residual cases. A total dose of 40-60 Gy in 5-20 fractions was delivered to the 50-90% isodose line. Results: The median follow-up period was 16 months (range, 6-47 months); the objective response rate was 66.7%; and the 1- and 2-year overall survival rates, 72.7% and 62.5%, respectively. The objective response rate for HCCs <5 em was 79.2%; the 1- and 2-year overall survival rates, 91.7% and 62.5%, respectively; median progression-free survival, 13.5 months (range, 3-47 months), and the 1- and 2-year local progression-free survival rates, 95.8% and 85.7%, respectively. There was one case each of grade 2 radiation esophagitis and ascites after three months of irradiation. Conclusion: The combination of TACE and radiation therapy shows good local control and acceptable toxicity, particularly in HCCs <5 cm and may be a good treatment option

Description of three new bat-associated species of hard ticks (Acari, Ixodidae) from Japan

In Eurasia, the geographically most widespread ixodid tick species of the bat families Rhinolophidae Gray, Vespertilionidae Gray, and Miniopteridae Dobson were considered to belong to four species, Ixodes vespertilionis Koch, I. collaris Hornok, I. ariadnae Hornok, and I. simplex Neumann. Previous data attest that bat-associated tick species from Eastern Asia show remarkable genetic difference from the above four tick species, but in the absence of detailed morphological comparison these were regarded as conspecific. In this study we compensate for this lack of data on three bat-associated tick species, reporting their morphological comparison, as well as molecular and phylogenetic relationships. According to the results we describe the females of three tick species new to science, i.e., I. nipponrhinolophi Hornok &amp;amp; Takano, sp. nov., I. fuliginosus Hornok &amp;amp; Takano, sp. nov., and I. fujitai Hornok &amp;amp; Takano, sp. nov. In case of all three new tick species the cytochrome c oxidase subunit (coxI) gene showed remarkably high sequence differences from the species that they previously were thought to belong to, well exceeding the average limit delineating ixodid tick species. This, as well as observed morphological differences fully justify their taxonomical status as new species

DOCK2 is involved in the host genetics and biology of severe COVID-19

「コロナ制圧タスクフォース」COVID-19疾患感受性遺伝子DOCK2の重症化機序を解明 --アジア最大のバイオレポジトリーでCOVID-19の治療標的を発見--. 京都大学プレスリリース. 2022-08-10.Identifying the host genetic factors underlying severe COVID-19 is an emerging challenge. Here we conducted a genome-wide association study (GWAS) involving 2, 393 cases of COVID-19 in a cohort of Japanese individuals collected during the initial waves of the pandemic, with 3, 289 unaffected controls. We identified a variant on chromosome 5 at 5q35 (rs60200309-A), close to the dedicator of cytokinesis 2 gene (DOCK2), which was associated with severe COVID-19 in patients less than 65 years of age. This risk allele was prevalent in East Asian individuals but rare in Europeans, highlighting the value of genome-wide association studies in non-European populations. RNA-sequencing analysis of 473 bulk peripheral blood samples identified decreased expression of DOCK2 associated with the risk allele in these younger patients. DOCK2 expression was suppressed in patients with severe cases of COVID-19. Single-cell RNA-sequencing analysis (n = 61 individuals) identified cell-type-specific downregulation of DOCK2 and a COVID-19-specific decreasing effect of the risk allele on DOCK2 expression in non-classical monocytes. Immunohistochemistry of lung specimens from patients with severe COVID-19 pneumonia showed suppressed DOCK2 expression. Moreover, inhibition of DOCK2 function with CPYPP increased the severity of pneumonia in a Syrian hamster model of SARS-CoV-2 infection, characterized by weight loss, lung oedema, enhanced viral loads, impaired macrophage recruitment and dysregulated type I interferon responses. We conclude that DOCK2 has an important role in the host immune response to SARS-CoV-2 infection and the development of severe COVID-19, and could be further explored as a potential biomarker and/or therapeutic target

The whole blood transcriptional regulation landscape in 465 COVID-19 infected samples from Japan COVID-19 Task Force

「コロナ制圧タスクフォース」COVID-19患者由来の血液細胞における遺伝子発現の網羅的解析 --重症度に応じた遺伝子発現の変化には、ヒトゲノム配列の個人差が影響する--. 京都大学プレスリリース. 2022-08-23.Coronavirus disease 2019 (COVID-19) is a recently-emerged infectious disease that has caused millions of deaths, where comprehensive understanding of disease mechanisms is still unestablished. In particular, studies of gene expression dynamics and regulation landscape in COVID-19 infected individuals are limited. Here, we report on a thorough analysis of whole blood RNA-seq data from 465 genotyped samples from the Japan COVID-19 Task Force, including 359 severe and 106 non-severe COVID-19 cases. We discover 1169 putative causal expression quantitative trait loci (eQTLs) including 34 possible colocalizations with biobank fine-mapping results of hematopoietic traits in a Japanese population, 1549 putative causal splice QTLs (sQTLs; e.g. two independent sQTLs at TOR1AIP1), as well as biologically interpretable trans-eQTL examples (e.g., REST and STING1), all fine-mapped at single variant resolution. We perform differential gene expression analysis to elucidate 198 genes with increased expression in severe COVID-19 cases and enriched for innate immune-related functions. Finally, we evaluate the limited but non-zero effect of COVID-19 phenotype on eQTL discovery, and highlight the presence of COVID-19 severity-interaction eQTLs (ieQTLs; e.g., CLEC4C and MYBL2). Our study provides a comprehensive catalog of whole blood regulatory variants in Japanese, as well as a reference for transcriptional landscapes in response to COVID-19 infection

医療事務の学習における 遠隔授業のあり方についての考察 ── コロナ禍での新しい授業の形 ──

新型コロナウィルス（1）の感染予防のため、2020年度前期は対面による授業を行なうことが困難とな り、医療事務の授業においてはYouTube による遠隔授業を導入した。そこで、YouTube の特性を踏ま え、学生が内容を理解しやすい授業を提供するためには①スピードや音量に留意した説明、②パワーポ イントの活用、③課題の課し方の見直し、④学習支援SNS「Melly」を利用した質疑応答、以上の4 点 が有効ではないかという仮説を立て、これらの仮説に基づいた授業動画の収録・YouTube による授業 の配信を行った。その結果（当該授業を履修した学生を対象として実施したアンケート結果）を基に仮 説を検証し、今後の授業のあり方に役立てようとするものである

医療事務管理士ＩＢＴ試験に対応した学習法についての研究

　医療事務の資格認定試験にIBT方式が導入されて3年が経過した。従来の記述式から試験方式が変更になったことによって試験そのものにもいくつかの変化が生じた― ①問題数の増加、②問題の難易度の上昇、③試験中のほぼすべて動作をPC上で行うこと、の三点である。 　これらの変化に対応するとともに、試験に合格するためには、①回答スピードを上げる、②点数表の多用、③新しい試験環境への適応といった三点が必要であるという仮説をたて、これらの仮説に基づいた指導を行った。その結果（試験の合否結果や受験者（学生）へのアンケートなど）をもとに仮説検証し、今後の指導に役立てようとするものである

医療事務の資格試験――出題方式の変更と対策――

今日、各種の試験において従来の紙ベースによるものからインターネット回線を使用して、出題・回答ともにペーパーレスで実施されるIBT方式の導入が多くみられるようになった。医療事務業界でも昨年より技能認定振興協会が実施する、「医科医療事務管理士技能認定試験」においてIBT方式での受験を選択できるようになった。IBT方式での受験は、単なる形式上の変更に留まらず、試験の難易度から合格ラインといった試験そのものに関する事柄に至るまで様々な変化をもたらした。これらが変更になれば、当然受験前の準備や対策もそれに合わせて見直しが必要となる。本稿では従来型の紙ベースによる試験とIBT試験を様々な点から比較し、必要な対策を講じることによって当該試験の合格率を上げていこうとするものである

レセプトコンピュータ～より実践的・効果的に授業に取り入れるための一考察～

OA(oficeautomation),particularly receipt computers,is incorporated into almost every medical institution. The curriculum at this college must also accommodate this reality. It is important to have a more effective means　of incorporating these computers,rather than simply introducing receipt computers into the class-room. First, it is extremely important to select superior receipt computer software, but we surmise that even with the same software,the learning effect can differ significantly depending upon the usage method. So therefore, we fell there are various advantages in not changing the receipt computer software currently incorporated into this college, but instead changing the introduction method