ジョウシン ニ ハッセイシタ タケイ センシュ ノ 1レイ

多形腺腫は唾液腺腫瘍の中で最も発生頻度が高い腫瘍である. 小唾液腺にも発生する多形腺腫の中であるが, 口唇に発生することはまれである. 今回われわれは口唇腺に発生した多形腺腫の1例を経験したので文献的考察を加えて報告する. 患者は52歳女性で, 上唇の腫瘤精査目的に当院皮膚科を受診し, 上唇良性腫瘍と診断され, 当科へ紹介され受診した. 左側上唇粘膜下に11×9 mm大の弾性硬, 可動性良好な腫瘤を認め, 全身麻酔下に摘出術を施行した. 腫瘍は被膜に包まれており, 周囲組織との境界は明瞭であった. 病理組織学的検査所見では, 腫瘍は薄い線維性被膜に覆われ, 大小の腺管構造とその周囲に筋上皮細胞の増殖, および軟骨様組織の形成を認め, 多形腺腫との診断であった. 術後1年6か月経過した現在, 口唇の機能的, 形態的異常はみられず, 腫瘍の再発は認めていない. 多形腺腫には悪性転化の報告もあり, 今後も注意深く経過観察を行う必要があると考えられる.Pleomorphic adenoma is the most common type of salivary gland tumor. The lip is a rare site of onset for pleomorphic adenomas that occur in the minor salivary glands. Here, we report our experience in the treatment of a patient with pleomorphic adenoma of the labial gland along with a review of the literature.The patient was a 52-year-old female who was referred to our department after consultation at the dermatology department of our institution for detailed examinations of a mass in the upper lip and being diagnosed with a benign tumor of the upper lip. A firm, elastic, highly movable mass of 11 × 9 mm was found under the mucosa of the left upper lip, which was excised under general anesthesia. The tumor was surrounded by a capsule, and the boundary of the surrounding tissue was well-delineated. Histopathological examinations revealed a thin fibrous capsule, and the proliferation of myoepithelial cells and formation of cartilage-like tissue were observed in and around the large and small ductal structures. Consequently, the tumor was diagnosed as a pleomorphic adenoma. At present, 1.5 years after surgery, no functional and morphological abnormalities of the lip have been observed, and there has been no recurrence of the tumor. Since there have been reports of malignant transformation of pleomorphic adenomas, careful follow-up will be necessary in the future

シガ イカ ダイガク イガクブ フゾク ビョウイン ニオケル オーラル マネージメント システム ノ リンショウテキ ケントウ

当科では2014年から周術期口腔機能管理を目的に「オーラルマネージメントシステム」を稼働させている．2015年には患者に快適，安心，安全な周術期環境を提供することを目的とした，麻酔科医,薬剤師,歯科医師,歯科衛生士,看護師，管理栄養士,言語聴覚士など多職種からなる「周術期管理チーム」が発足し，当科はそのチームの一員として「オーラルマネージメントシステム」を使った口腔機能管理を担っている．今回われわれは，このシステムを利用して全身麻酔手術前の周術期口腔機能管理を実施した患者数の推移および依頼状況を把握するため臨床的検討を行った. 当院における2019年度の周術期口腔機能管理実施件数は1377件と2015年から比較して約1.6倍に増加し,実施率も34.5％と増加を認めた. 院内での啓蒙活動により,多職種における人々の口腔内に関する意識が高まり,周術期口腔機能管理実施件数や実施率の増加に繋がったと考えられた. その一方でマンパワーやチェア台数の不足などの課題も明らかとなった. 今回の調査結果を元に今後もシステムの発展に尽力する予定である.Since 2014, the Department of Oral and Maxillofacial Surgery at the Shiga University of Medical Science Hospital has been running an ‟Oral management system” specialized for oral management in the perioperative period. In 2015, the ‟Perioperative management team” was formed with the aim of providing a safe perioperative environment for patients. The team comprises anesthesiologists, pharmacists, dentists, dental hygienists, nurses, dietitians, speech pathologists, and other professionals, and manages the oral functions of patients. In this study, we report the statuses of requests and rate of adoption of the ‟Oral management system” in every department. In 2019, the number of cases of perioperative oral function management in our hospital was 1,377, an increase of about 1.6 times compared to 2015, and the implementation rate also increased to 34.5%. The educational activities in the hospital increased the awareness of the oral health of people in many professions, and led to an increase in the number and rate of perioperative oral function management. On the other hand, issues such as the lack of manpower and the number of chairs became apparent. Based on the results of this survey, we plan to continue our efforts to develop the system

カンセツ シッカン ニ モチイラレル セイタイ ザイリョウ ノ キカイテキ オヨビ セイブツガクテキ ヒョウカ

京都大学0048新制・課程博士博士(工学)甲第14834号工博第3131号新制||工||1468(附属図書館)27240UT51-2009-F476京都大学大学院工学研究科機械工学専攻(主査)教授 富田 直秀, 教授 北條 正樹, 准教授 玄 丞烋学位規則第4条第1項該当Doctor of Philosophy (Engineering)Kyoto UniversityDA

Poly(ethylene glycol)-Lipid-Conjugated Antibodies Enhance Dendritic Cell Phagocytosis of Apoptotic Cancer Cells

A simple method for attaching immunoglobulin G (IgG) on the cell surface was successfully developed for enhancing phagocytosis of apoptotic tumor cells (ATCs) by dendritic cells (DCs) <em>ex vivo</em>. By conjugating with a poly(ethylene glycol) (PEG)-lipid, named the biocompatible anchor for the membrane (BAM), arbitrary IgG could be incorporated into the cell membrane. In particular, when IgG-BAM conjugates were prepared at the optimal molar ratio of IgG to BAM (1 to 20), almost all cells were efficiently modified with IgG by treatment with IgG-BAM. This simple method was successfully applied to four types of mammalian cells. Furthermore, treatment of ATCs with the IgG-BAM conjugate increased the phagocytosis ratio of ATCs by DCs two-fold when compared to no treatment. This phagocytosis-enhancing effect was nearly identical to treatment with a tumor-specific IgG. Thus, without employing the tumor-specific IgG, which is difficult to obtain for any tumor cells and is expensive, the present method could opsonize ATC with the use of arbitrary IgG. The results strongly indicate that IgG-BAM treatment represents a promising method for opsonizing ATC with human serum IgG, and that this approach will lead to objective clinical responses in DC vaccines

Leukoaraiosis significantly worsens driving performance of ordinary older drivers.

BACKGROUND: Leukoaraiosis is defined as extracellular space caused mainly by atherosclerotic or demyelinated changes in the brain tissue and is commonly found in the brains of healthy older people. A significant association between leukoaraiosis and traffic crashes was reported in our previous study; however, the reason for this is still unclear. METHOD: This paper presents a comprehensive evaluation of driving performance in ordinary older drivers with leukoaraiosis. First, the degree of leukoaraiosis was examined in 33 participants, who underwent an actual-vehicle driving examination on a standard driving course, and a driver skill rating was also collected while the driver carried out a paced auditory serial addition test, which is a calculating task given verbally. At the same time, a steering entropy method was used to estimate steering operation performance. RESULTS: The experimental results indicated that a normal older driver with leukoaraiosis was readily affected by external disturbances and made more operation errors and steered less smoothly than one without leukoaraiosis during driving; at the same time, their steering skill significantly deteriorated. CONCLUSIONS: Leukoaraiosis worsens the driving performance of older drivers because of their increased vulnerability to distraction