Trade effects of ASEAN-plus-China and -Japan free trade agreements by production stage and industry

This article examines the trade creation and diversion effects of ASEAN-Plus-China (ACFTA) and -Japan (AJFTA) free trade agreements with focuses on production stage and machinery industry by estimating the gravity trade model for the recent two decades between 1993 and 2015. The purpose for focusing on the trade flows by production stages (final goods and intermediate goods) and by industries (machinery and non-machinery) is to uncover the effects of ACFTA and AJFTA on the expanding international production networks in East Asia. The main findings are summarized as follows. First, regarding industry total, the trade creation effects of ACFTA and AJFTA are identified not in intermediate goods but in final goods. It might come from the larger tariff gaps between the Most Favored Nation (MFN) rates and the preferential rate for ASEAN in final goods than in intermediate goods, reflecting the structure of “tariff escalation”. Comparing the effects of ACFTA and AJFTA, the larger trade creation effects are found in ACFTA than in AJFTA, probably due to the larger tariff gaps with the higher MFN rates in China. As for machinery industry, the trade creation effects are verified on ACFTA probably due to the large tariff gaps with the still-existing high MFN in China, while no trade creation effects are found because of no tariff gaps with almost zero MFN rates in Japan

Trade effects of ASEAN-plus-China and -Japan free trade agreements by production stage and industry

This article examines the trade creation and diversion effects of ASEAN-Plus-China (ACFTA) and -Japan (AJFTA) free trade agreements with focuses on production stage and machinery industry by estimating the gravity trade model for the recent two decades between 1993 and 2015. The purpose for focusing on the trade flows by production stages (final goods and intermediate goods) and by industries (machinery and non-machinery) is to uncover the effects of ACFTA and AJFTA on the expanding international production networks in East Asia. The main findings are summarized as follows. First, regarding industry total, the trade creation effects of ACFTA and AJFTA are identified not in intermediate goods but in final goods. It might come from the larger tariff gaps between the Most Favored Nation (MFN) rates and the preferential rate for ASEAN in final goods than in intermediate goods, reflecting the structure of “tariff escalation”. Comparing the effects of ACFTA and AJFTA, the larger trade creation effects are found in ACFTA than in AJFTA, probably due to the larger tariff gaps with the higher MFN rates in China. As for machinery industry, the trade creation effects are verified on ACFTA probably due to the large tariff gaps with the still-existing high MFN in China, while no trade creation effects are found because of no tariff gaps with almost zero MFN rates in Japan

Phylogeography of Juniperus Species (Cupressaceae) with a Disjunct Distribution in the Island Areas of Japan

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A study of transileocolic vein obliteration (TIO) for gastric varices

Seven cases of giant gastric varices were treated using TIO combined with balloon occlusion of the gastro-renal shunt, for the purpose of reviewing the significance of TIO in the treatment of gastric varices. In 6 of the 7 cases, giant varices were cured completely. In the unsuccessful case, it was a giant varix (the minimum diameter was 25 mm or more) which had been failed to be treated by the TIO. In 3 of the 7 cases, the varices on the gastric fornix had ruptured ; therefore, emergency TIO was undertaken and resulted in successful hemostasis and disappearance of the varices. After treatment using this technique, one case developed esophageal varices, and two patients showed a reduction in esophageal varices. In case where gastric varices had been accompanied by RC sign-positive esophageal varices, favorable results were obtained with obliteration of the gastro-renal shunt was combined with compression of the esophagus which had served as another shunt in these cases. After TIO, hepatic function remained unchanged or improved slightly. No case showed exacerbation of hepatic function. For massive gastric varices with an inside diameter of up to 2 cm, transileocolic vein obliteration (TIO) combined with balloon occlusion of the gastro-renal shunt, which occludes the shunt in an anterograde manner, secures the occlusion of the shunt with no complications. This technique seems to be an effective therapy for gastric varices

Safety confirmation of induced pluripotent stem cell-derived cardiomyocyte patch transplantation for ischemic cardiomyopathy: first three case reports

IntroductionWith the expected increase in patients with heart failure and ischemic 15 cardiomyopathy, the development of myocardial regenerative medicine using cell transplantation as a novel treatment method is progressing. This first-in-human clinical trial aimed to confirm the safety of cardiomyocyte patch transplantation derived from allogeneic induced pluripotent stem (iPS) cells based on the results of several preclinical studies.Study designThe inclusion criteria were left ventricular ejection fraction of 35% or less; heart failure symptoms of New York Heart Association class III or higher despite existing therapies such as revascularization; and a 1-year observation period that included a 3-month immunosuppressive drug administration period after transplantation of iPS cell-derived cardiomyocyte patches to evaluate adverse events, cardiac function, myocardial blood flow, heart failure symptoms, and immune response.ResultsIn the first three cases of this trial, no transplanted cell-related adverse events were observed during the 1-year observation period, and improvement in heart failure symptoms was observed. In addition, improvements in left ventricular contractility and myocardial blood flow were observed in two of the three patients. Regarding immune response, an increase in transplant cell-specific antibody titer was observed in all three patients after immunosuppressive drug administration. In one patient with poor improvement in cardiac function and myocardial blood flow, an increase in antibody titer against HLA-DQ was observed even before cell transplantation.ConclusionsOur case findings demonstrate that the transplantation of iPS cell-derived cardiomyocyte patches for ischemic cardiomyopathy can be safely performed; however, further investigation of the therapeutic effect and its relationship with an immune response is needed by accumulating the number of patients through continued clinical trials

Different Contacted Cell Types Contribute to Acquiring Different Properties in Brain Microglial Cells upon Intercellular Interaction

Microglial cells (MGs), originally derived from progenitor cells in a yolk sac during early development, are glial cells located in a physiological and pathological brain. Since the brain contains various cell types, MGs could frequently interact with different cells, such as astrocytes (ACs), pericytes (PCs), and endothelial cells (ECs). However, how microglial traits are regulated via cell–cell interactions by ACs, PCs, or ECs and how they are different depending on the contacted cell types is unclear. This study aimed to clarify these questions by coculturing MGs with ACs, PCs, or ECs using mouse brain-derived cells, and microglial phenotypic changes were investigated under culture conditions that enabled direct cell–cell contact. Our results showed that ACs or PCs dose-dependently increased the number of MG, while ECs decreased it. Microarray and gene ontology analysis showed that cell fate-related genes (e.g., cell cycle, proliferation, growth, death, and apoptosis) of MGs were altered after a cell–cell contact with ACs, PCs, and ECs. Notably, microarray analysis showed that several genes, such as gap junction protein alpha 1 (Gja1), were prominently upregulated in MGs after coincubation with ACs, PCs, or ECs, regardless of cell types. Similarly, immunohistochemistry showed that an increased Gja1 expression was observed in MGs after coincubation with ACs, PCs, or ECs. Immunofluorescent and fluorescence-activated cell sorting analysis also showed that calcein-AM was transferred into MGs after coincubation with ACs, PCs, or ECs, confirming that intercellular interactions occurred between these cells. However, while Gja1 inhibition reduced the number of MGs after coincubation with ACs and PCs, this was increased after coincubation with ECs; this indicates that ACs and PCs positively regulate microglial numbers via Gja1, while ECs decrease it. Results show that ACs, PCs, or ECs exert both common and specific cell type-dependent effects on MGs through intercellular interactions. These findings also suggest that brain microglial phenotypes are different depending on their surrounding cell types, such as ACs, PCs, or ECs

Clinical Evaluation of Complex Decongestive Physiotherapy for Acute Malignant Lymphedema of the Leg

癌終末期における下肢浮腫は難治性であり,浮腫増悪により歩行困難となる場合が少なくない.今回,入院中に下肢リンパ浮腫を発症した症例に対し複合的理学療法を施行しその効果を検討した.対象は,当院緩和ケアチームで担当した急性下肢リンパ浮腫症例のうち,浮腫発症前Performance Status(以下PS)2以上の症例10例を対象とした.下肢リンパ浮腫の診断は,理学所見とともに超音波検査を行い静脈血栓が併存していないことを確認した.複合的理学療法としてスキンケア,リンパドレナージ,圧迫療法,運動療法を組み合わせて治療.浮腫軽減の目的での利尿剤の投与は併用しなかった.治療効果の検討のため,下肢計測(足背,足関節,下腿,大腿周径),PS変化で有効性を検討した.治療による副作用・事故はなく安全に治療を行えた.下肢計測では4回の治療で有意に大腿,下腿周径の改善を認めた.PSは治療前平均3.8で歩行困難であったが,治療開始7日で平均PS1.9と有意に改善し,さらに21日後では,治療により歩行可能となり平均PS0.9に改善された.以上より,下肢リンパ浮腫の治療は困難であるが,PS2以上で合併症のない急性期では複合的理学療法によりPSが改善され有効な治療法と考えられる.Malignant lymphedema of the leg is intractable : although not fatal, the patients\u27 quality of life and daily life activity can be decreased. This study reports the usefulness of complex decongestive physiotherapy (CDP) as a treatment for acute malignant lymphedema. Ten cases of acute malignant lymphedema with pre-critical Performance Status greater than 2 were treated with CDP by the palliative care team in Nakadori General Hospital. Diagnosis of acute malignant lymphedema was determined from clinical history and physical examination. Furthermore, ultra-sonography examination was performed to rule out the possibility of deep venous thrombosis. CDP was structured by Dr Michael Foeldi as multiple treatments of skin care, manual lymph drainage (MLD), compression bandage and ergotherapy. The effectiveness of CDP was evaluated through changes in body weight, leg diameter, serum albumin value and performance status (PS). No side effects were observed during CDP. There were no changes in body weight and serum albumin value. Significant improvement of leg diameter was observed at the fourth treatment. PS was significantly improved seven days after CDP from 3.8 to 1.9, and with continuous treatment, by the 21st day PS improved to 0.9 and the patients could walk around the bedside. Although treatment of acute malignant leg lymphedema is problematic, CDP is an effective treatment when applied as soon as possible

Image4_Safety confirmation of induced pluripotent stem cell-derived cardiomyocyte patch transplantation for ischemic cardiomyopathy: first three case reports.jpeg

IntroductionWith the expected increase in patients with heart failure and ischemic 15 cardiomyopathy, the development of myocardial regenerative medicine using cell transplantation as a novel treatment method is progressing. This first-in-human clinical trial aimed to confirm the safety of cardiomyocyte patch transplantation derived from allogeneic induced pluripotent stem (iPS) cells based on the results of several preclinical studies.Study designThe inclusion criteria were left ventricular ejection fraction of 35% or less; heart failure symptoms of New York Heart Association class III or higher despite existing therapies such as revascularization; and a 1-year observation period that included a 3-month immunosuppressive drug administration period after transplantation of iPS cell-derived cardiomyocyte patches to evaluate adverse events, cardiac function, myocardial blood flow, heart failure symptoms, and immune response.ResultsIn the first three cases of this trial, no transplanted cell-related adverse events were observed during the 1-year observation period, and improvement in heart failure symptoms was observed. In addition, improvements in left ventricular contractility and myocardial blood flow were observed in two of the three patients. Regarding immune response, an increase in transplant cell-specific antibody titer was observed in all three patients after immunosuppressive drug administration. In one patient with poor improvement in cardiac function and myocardial blood flow, an increase in antibody titer against HLA-DQ was observed even before cell transplantation.ConclusionsOur case findings demonstrate that the transplantation of iPS cell-derived cardiomyocyte patches for ischemic cardiomyopathy can be safely performed; however, further investigation of the therapeutic effect and its relationship with an immune response is needed by accumulating the number of patients through continued clinical trials.</p