A profile of pro-inflammatory cytokine expression in human Delta-1-induced monocyte-derived Langerhans cell-like dendritic cells after stimulation with Toll-like receptor ligands

Monocyte-derived Langerhans cell-like dendritic cells （Mo-LCs） are involved in epidermal disorders such as psoriasis in murine models. However, the roles of Mo-LCs in the pathogenesis of psoriasis in humans remain unclear. Also, the contribution of notch ligand delta-like 1 （DLL-1）, expressed on keratinocytes, to Mo-LC functions requires clarification. Here, we established a new method of stimulating Mo-LCs derived from CD14＋ monocytes with immobilized human DLL-1 to generate induced Mo-LCs （DI（＋）Mo-LCs）. The DI（＋）Mo-LCs were compared to the dendritic cells derived from monocytes （Mo-DCs） cultured with interleukin-4 （IL-4） and granulocyte-macrophage colony-stimulating factor （GM-CSF）, and M1 macrophages （Mφ） derived from monocytes cultured with GM-CSF. The DI（＋）Mo-LCs were found to produce significant amounts of IL15, IL23A, and interferon-β （IFNB1） in response to the Toll-like receptor （TLR）3 agonist Polyinosinic-polycytidylic acid （Poly（I:C）） or TLR4 agonist lipopolysaccharide （LPS） despite their low expression of tumor necrosis factor （TNF）. In conclusion, we have established a new method to generate DI（＋）Mo-LCs. We have also discovered that DI（＋）Mo-LCs have a unique capacity for producing IL15 and IL23A, which are related to the pathogenesis of psoriasis. Our data contribute to a better understanding of the roles of Mo-LCs in epidermal defense and pathogenesis

精神科看護の魅力

本研究の目的は，長期入院の精神障害者の退院支援のための精神科看護の魅力について文献検討により明らかにすることである．日本においては長期入院の精神障害者に対する積極的な退院支援が行われている．しかし，退院後の継続的な支援環境が整わないために，退院できない状況もあり，看護師は仕事への無力感を感じる場合も多い．それでもなお，精神障害者の退院支援に魅力を抱いている看護師がいる．したがって看護師らが退院支援に対して抱く魅力は何かを明らかにすることが長期入院の解決に対して重要である．文献検討の結果，長期入院の精神障害者の退院支援の魅力として（１）患者との相互作用のなかでの自己洞察と自らの人間的成長，（２）患者と看護師の関係発展過程から得られる患者の本質的な理解，（３）看護師が主体性を持って患者と関わることができるという特徴が示唆された．The purpose of this literature study is to clarify the fascination of positive programmed discharge support （PPDS）and psychiatric nursing for long-term inpatient with mental disorders. Long-term psychiatric hospitalization remains as a major problem in Japan. PPDS is performed to such inpatient with social hospitalization. Despite nurses’ efforts with the best intentions, some nurse feel powerless to work because patient cannot discharge from a hospital by reason that living environment after patient leaves hospital was not ready. Therefore, it is important to clarify nurses’ fascination for PPDS and their achievement motive to work to solve prolonged hospitalization. The result of literature review, it was suggested that fascination of psychiatric nursing have the following features : （１）nurse’s self-insight and personal growth in the interaction between patient and nurse, （２）intrinsically understanding of patient obtain from developmental process in the interaction between patient and nurse, and （３）psychiatric nurse is able to intervene to the patient independently

アルコール依存症と感情障害への支援

アルコール依存症と感情障害の関係性は以前から指摘されている．アルコール依存症とうつ病は，自殺企図者の精神障害の内訳の半数を占め，それらが合併した場合には自殺の危険性を一層高める．また，アルコール依存症治療において，患者がうつ症状を呈している場合，再飲酒のリスクが高くなり治療の継続を妨げる原因となりうる．そのため，うつ病の治療にも注意を払うことが求められる．さらに，家族からの支援はアルコール依存症患者の断酒を継続するなどの治療において重要な役割を果たしている．しかし，患者の断酒の継続に注意を払いすぎるあまり，それがストレスとなり患者の問題飲酒を助長することになったり，家族自身がさまざまな悩みを抱え苦しんだりすることが考えられ，家族への支援もとても重要となる．加えて，親がアルコール依存症である場合，子どもも将来アルコール依存症となる危険性が高くなるなど，子どもに与える影響も大きい．そこで医師，看護師，ソーシャルワーカーが支援に関わることや自助グループを活用することが重要となる．本総説ではアルコール依存症と感情障害の関係と治療方法，アルコール依存症と感情障害を抱える患者とその家族への支援に焦点を当て，包括的な支援のありかたを検討した．The relationship between alcohol dependency and affective disorder has been noted. Alcohol dependence and depression account for approximately half of psychiatric disorders which suicidal persons have, and in case of the combination of them, the risk for suicide would be much higher. Also, in case of patient suffering from alcohol dependence and depression as a complicated disease, it becomes an obstructive factor to provide appropriate alcoholism treatment. Therefore, it is desired to pay attentions to care of depression. In addition, the support from self-help group and patient’s family plays a great role in the alcoholism and depression treatment. However, too much attention of patient’s family to continuation of abstinence becomes a cause of stress for patient. That stress fosters problem drinking. Furthermore, it is conceivable that family has many worries and is plagued with anxiety, so family support is also very important. In this review, we focus on comprehensive support for people with both alcohol dependency and affective disorder, and their families

断酒に至る過程に関する実態調査

断酒に至るまでには，どのような問題があり，その問題に断酒会会員がどのように対処しながら，断酒に至ったかを明らかにすることが目的である．断酒会会員２９４人を調査対象として質問紙および留め置き調査を行った．回収率は５６．８％（１６７名：男性１５０名，女性１７名）であった．調査対象者の平均年齢は５８．６±１１．１（mean±SD）（男性５９．７±１０．５，女性４８±１１．７）歳であった．初回飲酒年齢は平均１８．４±６．３歳であり，１５歳未満の初回飲酒は男性２８名，女性５名であった．飲酒歴は平均２５．４±１１．３年（男性２６．４，女性１６．５年）で，平均断酒期間は１０年１ヵ月±９年６ヵ月（男性１０年７ヵ月，女性４年６ヵ月）であった．調査対象者は飲酒によって家庭や仕事における深刻な問題を引き起こしたため，酒量の調節を試みたが，逆に飲酒量が増し連続飲酒状態に陥り医療機関を受診していた．断酒例会への継続参加により，断酒が可能となり，信用と健康を取り戻し，自信となっていることがあきらかになった．アルコール依存症者が再び社会で正常な日常生活が送れるようになる為には断酒が唯一の方法であることがあらためて確認された．Aim : The purpose of this survey is to clarify alcohol-related problems, the coping methods and how to reach total abstinence in the self-help group members for total abstinence. Method : A mail survey and/or a placement method survey of alcohol dependency were conducted in two prefectures. Subjects were ２９４ recovering alcoholic and they were members of regular meeting for total abstinence. The response rate was５６．８％（１５０males,１７females）. Results : Subjects average age was ５８．６±１１．１ （mean±SD） years （male, ５９．７±１０．５； female, ４８±１１．７ years）. The average of first alcoholic experience of them was at the age of １８．４±６．３. Twenty eight men （１８．６％） and five women （２９．４％） started drinking at the age of less than １５years old. Average duration of drinking was ２５．４±１１．３ years （male, ２６．４； female, １６．５years）, and average abstinence periods were １０．１±９．５years （male, １０．６； female, ４．５years）. They tried to regulate the amount of alcohol because of serious social problems at a home and/or workplace by drinking. However, they could not visit hospitals or clinics until they lapsed into the continuous excessive drinking state. They could quit drinking with continuous participation to regular meeting for total abstinence （Dansyu Reikai） and regained trust, health, and self-confidence. Conclusion : These results suggest that the method to quit drinking is not a self-regulation of amount of alcohol but an attendance of Dansyu Reikai （self-help group participation）

婚姻状況と飲酒による問題行動

背景：アルコール依存症では，支えとなる婚姻の有無が，問題行動に大きな影響を与え，それが治療方針や予後を決定する因子となることが多い． 目的：本研究では，婚姻の有無がアルコール依存に関連する問題と断酒継続にどのような影響を与えるかについて検討した． 方法：調査対象者は断酒会会員２９４人を調査対象とした．回収率は５６．８％（１６７名：男性１５０名，女性１７名）であった．調査内容は，婚姻の有無に加え，①飲酒による問題行動（飲酒で喧嘩・警察沙汰になった）の有無，②飲酒による対人関係の崩壊の有無，③アルコール依存症の認知の有無，④現在の節酒の可能性の有無，⑤機会飲酒（冠婚葬祭・会合等）の経験の有無，⑥断酒会に入会する前の断酒の経験の有無，⑦断酒後の生活の変化，⑧スリップ（再飲酒）の経験の有無，⑨飲酒欲求の有無，⑩問題飲酒の経験の有無，⑪断酒会以外への所属状況であった． 結果：飲酒による問題行動（飲酒で喧嘩・警察沙汰になった）（▯２＝３．９８，P＜０．０５），断酒会以外への所属状況（▯２＝４．００，P＜０．０５）では，未婚者が有意に多かった． 結論：既婚者の場合には，配偶者が飲酒による問題行動を警察沙汰にまでしないように制止もしくは緩衝する役割を果たしていると推察された．また未婚者は断酒を日々継続していく生活の工夫として断酒外以外の他の組織にも所属していると推察された．AIM : Alcoholism is a relevant problem in public health. Family intervention is a necessary condition for the complete recovery of the alcoholic and their partners. The family system is a more powerful force than the addiction itself and has great potential for overcoming or sustaining the alcoholism. The purpose of this study was to investigate the relationship between the marriage status and the problem associated with alcohol dependence and abstinence. METHOD : A mail survey and/or a placement method survey of alcohol dependency were conducted in two prefectures. Subjects were ２９４ recovering alcoholic and they were members of “Danshu-kai” （Japan Sobriety Association）for total abstinence. The response rate was ５６．８％ （１５０males，１７females）. Survey contents were a marriage status, problem associated with alcohol dependence, and items related to continue abstinence. RESULTS : In the item of problem behavior（fight or a problems with police）by drinking（▯２＝３．９８，P＜ ０．０５） and belonging to the Danshu-kai and the other group（▯２＝４．００，P＜０．０５），there were many replies of unmarried people significantly compared with married people. CONCLUSION : The findings suggest that alcohol-dependent clients’ partner was repressing or adjusting the alcohol problems in the case of the married person, the unmarried person belonged also to the Danshukai and the other group as a device to continue abstinence

アルコール依存症者の婚姻状況と飲酒関連行動・断酒に関する認識

本研究は，断酒会に入会するまでの飲酒をしていた時のアルコール依存者の行動と現在の状況を調査し，更に婚姻と飲酒による問題に関連した各調査項目および断酒に関する認識との関係を明らかにすることが目的である．調査項目は，①対象者の婚姻の有無別平均年齢・飲酒期間・断酒期間に加えて，②婚姻別断酒会に入会するまでの飲酒をしていた時の状況の９項目，および③断酒会入会後の現在の状況についての４項目の計１３項目である．調査の結果，既婚者で酒の影響による疾患があると回答した人が有意に多かった．断酒歴は既婚者が１１．６±１０．４年，未婚者４．８±６．０年で，既婚者が有意に長かった．要因として考えられることは，①既婚者の平均年齢が高く，飲酒歴が長いことから身体的疾患を抱えている割合が高いこと，②イネイブラーの存在が飲酒行動を助長している可能性があること，③配偶者の存在が治療継続意欲に結びついたことで医療機関への受診に繋がり，④身体合併症の発見率が高くなること，そして，⑤既婚者，未婚者ともに常時再飲酒行動への不安を抱いていることから，断酒継続の動機要因になっていると考えられた．The aim of this paper is to examine the associations between marital status, drinking problems, awareness of alcohol addiction. The questionnaire is composed of １３ items that （１）marital status, average age, average length of alcohol drinking and average length of abstinence（ALA），（２）drinking problems before admission into the group of alcoholics “Danshu-kai” （Japan Sobriety Association, JSA）for total abstinence, and （３）the present situation after admission into the JSA. Statistically significant difference was obtained in alcohol-related health problems in the married group. ALA of the married group （１１．６±１０．４ yrs）shows significantly longer than unmarried group （４．８±６．０ yrs）. These results suggest that： （１）average age of the married group was high, also length of alcohol drinking is long, therefore this group have a high prevalence of physical illness； （２）enabler may be promoting problem drinking； （３） possibility health problems would be discovered by the spouse； （４）the existence of a spouse is related to the motive for abstinence continuation and this has contributed to the successful abstinence； （５）both group have a profound understanding of alcohol dependence, because they worry about alcohol slip

Absence of germline mono-allelic promoter hypermethylation of the CDH1 gene in gastric cancer patients

<p>Abstract</p> <p>Background</p> <p>Germline mono-allelic promoter hypermethylation of the <it>MLH1 </it>or <it>MSH2 </it>gene in families with hereditary nonpolyposis colorectal cancer has recently been reported. The purpose of this study was to evaluate if germline promoter hypermethylation of the tumor suppressor gene <it>CDH1 </it>(<it>E-cadherin</it>) might cause predisposition to gastric cancer.</p> <p>Methods</p> <p>We prepared two groups of samples, a group of blood samples from 22 patients with familial gastric cancer or early-onset gastric cancer selected from among 39 patients, and a group of non-cancerous gastric tissue samples from 18 patients with sporadic gastric cancer showing loss of CDH1 expression selected from among 159 patients. We then investigated the allele-specific methylation status of the <it>CDH1 </it>promoter by bisulfite sequencing of multiple clones.</p> <p>Results</p> <p>Although there was a difference between the methylation level of the two alleles in some samples, there was no mono-allelic promoter hypermethylation in any of the samples.</p> <p>Conclusion</p> <p>These results suggest that germline mono-allelic hypermethylation of the <it>CDH1 </it>promoter is not a major predisposing factor for gastric cancer.</p

退院支援施設入所後の神障害者の生活能力

研究目的は，退院促進支援により退院し，退院支援施設で生活した精神障害者の生活能力を明らかにし，看護のあり方を検討することである．調査対象者は，施設入所後１年が経過した長期入院であった精神障害者１７名（男性１２名，女性５名）で，平均年齢は，５２．５歳，平均入院期間は１１．３年であった．データ収集は，調査対象者一人ずつに約２０分程度の半構成的面接を行った．その結果，逐語録から２５５のラベルが得られ，１１のサブカテゴリーに分類された．これらから「自分自身のペースに合わせた生活リズムの獲得」，「病気を悪化させないための自己管理」，「施設退所後の生活のための心の準備」，「良好な対人関係の構築」という４つのカテゴリーが抽出された．これらの結果から，施設利用者は自分なりのペースで社会復帰に向けての準備をしながら，着実に生活能力を身につけていることが示唆された．The aim of this survey is to describe the life ability of people with mental disorders who entered the Discharge Support Center for People with Mental Disorders（DSC）, also to examine how best to help them. Participants were １７ people who had been long-term patients（１２ men and ５ females）living in the DSC for about a year. Their average ages were ５２．５ years old, and the average length of hospital stay was １１．３ years. Semi-structured interviews were conducted approximately１２months after discharged from the psychiatric hospital, transcribed verbatim and analyzed according to qualitative content analysis. Sentences of ２５５ were obtained, and they were classified into １１ subcategories. Finally, ４ categories were identified from these subcategories : “Acquisition of life rhythm matched to self-pace”, “Self-care to prevent aggravation of disease”, “Mental preparedness for social life after discharge from the DSC”, and “Creation of good interpersonal relationship”. From these results, it was suggested that people with mental disorders had social ability for social living by preparing with their own pace

Regulatory Effect of IL-4 on Early Th17 Differentiation from Naive T Cells into Stem Cell Memory Th17 Precursors via Modulation of CD31 and CCR6 Expression

Although antigen-specific T helper （Th） cells are developed from naive T cells, human Th17 cells are not derived from naive CD4+ T cells unlike murine cells. Therefore, the source of human Th17 cells has remained unresolved. In this study, we assessed the early differentiation pathway of human Th17 cells from CD31+ thymic naive T cells into stem cell memory CCR6+ Th17 precursors and the regulation of this process by cytokines. Peripheral blood mononuclear cells were isolated from healthy volunteers. We found that only CD31- CCR6+ naive type CD4+ T cells had the ability to produce IL-17A in response to Th17-inducing stimuli. A cell tracking assay using CD31+ CCR6- cells labeled with carboxyfluorescein diacetate succinimidyl ester revealed that CD31- CCR6+ Th17 precursors were derived from CD31+ CCR6- thymic naive T cells. CD31 is known to suppress IL-17 production by interfering with downstream T cell receptor （TCR） signaling molecules including Lck, which is essential for IL-17 production. The inactive form of Lck was much higher in CD31+ T cells than CD31- T cells after TCR stimulation. In experiments of cytokine-mediated modulation of Th17 cell differentiation, IL-4 suppressed the conversion of CD31+ CCR6- naive T cells into CD31- CCR6+ Th17 precursors by upregulating CD31 expression and suppressing CCR6 expression. In conclusion, CD31- CCR6+ Th17 precursors could be sourced from CD31+ CCR6- naive T cells, and IL-4 regulated the early Th17 differentiation. Our findings provide novel insights into the regulation of differentiation of naive CD4+ T cells into Th17 cells in humans. Furthermore, our results may provide hints for further elucidation of the differentiation process of Th17 cells and of the pathology of Th17 cell-related diseases

iNOS Promotes Proteasome-Dependent Degradation of IRS-2 and Suppresses PDX-1 Expression by Activating GSK-3β in Pancreatic β-Cells

info:eu-repo/semantics/nonPublishe