ミャンマー人低分化型肝細胞がんに於ける核内Pygo2のc-Myc, PCNA, Bcl9との相関的発現上昇

長崎大学学位論文 [学位記番号]博（医歯薬）甲第1417号 [学位授与年月日]令和4年3月18

Seismic Performance Comparison of Fixed Base and Isolated Base Steel Multi-Storey Building

This study presents the comparative study on seismic performance of with and without isolation in eight-storeyed hypothetic steel building located in Mandalay. The base isolation system that is utilized lead rubber bearing which made with Japan rubber and Myanmar rubbers (RSS-1 and RSS-3). In this study, base isolation devices are installed under each column between the building and the supporting foundation to support the building and to minimize the damage due to earthquake. In this study, comparative advantages for using lead rubber bearing isolation systems with various types of rubber are mainly investigated by performing response spectrum and nonlinear time history analyses. The comparison process has been carried out on performance of the structure with storey displacement, storey acceleration, and storey drift. In the analysis phase, nonlinear time history analyses at DBE and MCE levels are conducted in ETABS to obtain the related floor accelerations, interstorey drifts and storey displacement. In performance assessment phase, probable damage cost, repair time and rate of injuries are computed using fragility curves and FEMA P-58 methodology in Performance Assessment Calculation Tool (PACT). Damage cost, repair time and rate of injuries are computed for each building at seismic demand level and the results are compared. According to investigation conducted, it can be inferred that RSS-3 is more effective than RSS-1 at DBE while RSS-1 is better than RSS-3 at MCE levels

Participatory Visioning and Future Planning. Backcasting with Myanmar Farmers for a more Sustainable Future. Methodological Report

This report describes the methodology of participatory visioning and future planning, including a technique called backcasting. Based on literature and experience, we developed and applied this methodology to support smallholder farmers in southern Myanmar. In a highly participatory bottom-up approach, we co-created and documented the vision of these farmers – in direct collaboration with them – including their desirable futures, and we jointly explored possible pathways and action plans to reach these futures. We also co-implemented needs-based actions including concrete trainings, study trips, and a community-led micro-loan system to strengthen their agriculture – their main source of livelihood. Unfortunately, beginning in 2020, Myanmar experienced two overlapping waves of crisis: the health crisis as a result of the COVID-19 pandemic; and the political crisis following the coup d’etat in 2021. The final two years of the project were implemented under these extremely challenging conditions. We frequently had to adapt our operationalization to the very dynamic, changing circum-stances. Fortunately, our methodology allowed for this kind of adaptive management. Despite the challenging circumstances, the farmers were positive in their assessment of the project outcomes. This suggests that the methodology of participatory visioning and future planning can be effective even under difficult circumstances. We conclude the report by presenting lessons learnt and recommendations. Firstly, we reflect on how useful this methodology was and how it can be applied in similar or different projects (research, development, etc.). Secondly, we share our practical insights and recommendations regarding the application of the methodology in the given or similar contexts. Finally, we provide practical recommendations for project planning for those who want to include participatory visioning and future planning in their projects

Nuclear Expression of Pygo2 Correlates with Poorly Differentiated State Involving c-Myc, PCNA and Bcl9 in Myanmar Hepatocellular Carcinoma

In Myanmar, hepatocellular carcinoma (HCC) is commonly seen in young adult and associated with poor prognosis, while the molecular mechanisms that characterize HCC in Myanmar are unknown. As co-activation of Wnt/β-catenin signaling and c-Myc (Myc) are reported to associate with malignancy of HCC, we immunohistochemically investigated the expression of Pygo2 and Bcl9, the co-activators of the Wnt/β-catenin signaling, Myc and PCNA in 60 cases of Myanmar HCC. Pygo2 expression was confirmed by in situ hybridization. The signal intensity was measured by image analyzer and then statistically analyzed. As a result, the expression of Pygo2 was significantly higher in HCC compared to normal liver tissue and the nuclear signal was the most intense in poorly differentiated HCC. Cytoplasmic Bcl9 was expressed in the normal liver tissue but decreased in HCC with the progression of histopathological grade. Myc was significantly higher in poorly differentiated HCC, whereas PCNA labeling index increased with the progression of histopathological grade. Nuclear Pygo2 showed strong correlation with nuclear Myc (P < 0.01) and PCNA (P < 0.001), and inversely correlated with cytoplasmic Bcl9 (P < 0.01). Our results suggested Wnt/β-catenin and Myc signaling is commonly activated in Myanmar HCC and that the correlative upregulation of nuclear Pygo2 and Myc characterizes the malignant features of HCC in Myanmar

Les pratiques funéraires de la fin du Néolithique à l’âge du Bronze de la partie centrale du Myanmar (c. 1300-500 cal BC) : définitions et évolutions

En Asie du Sud-est continentale, la fin de la préhistoire est surtout définie à travers l’étude des sites funéraires. Les données disponibles jusqu’à présent concernent presque essentiellement la partie sud et est de la péninsule indochinoise, représentée par le Viet Nam et la Thaïlande. Le Myanmar pâtit d’un état de la recherche beaucoup moins favorable. Pourtant son emplacement est crucial. Il est le seul territoire d’Asie du Sud-est à partager des frontières terrestres avec l’Inde et la Ch..

Comparative Study on Atmospheric Corrosivity of Under Shelter Exposure in Yangon and Mandalay (Myanmar)

Corrosion is a degrading process and it is the main degradation problem in building industry around the world. This study emphasises on the corrosivity classification of studied areas and discusses long term prediction for thickness loss of carbon steel and weathering steel under shelter condition. Two locations, Yangon and Mandalay, are selected as study areas in Myanmar. Corrosion rates are measured after one year exposure. The pollutant data of sulphur dioxide and chloride deposition rates are measured according to JIS Z 2382 and the meteorological data are collected by Easy USB data logger. The corrosion rate is classified based on ISO 9223 by evaluating the important atmospheric variables, such as time of wetness, CL- and SO2. The classes of sulphur dioxide and chloride deposition rate can be seen low level for both areas and Time of Wetness (TOW) can be seen τ4 for Yangon and τ3 for Mandalay.So, according to ISO 9223, the corrosivity category for Yangon area is C3 and that for Mandalay area is C2-C3. The actual mass loss for weathering steel is a little more than that of carbon steel in Yangon and adverse condition can be seen in Mandalay after one year period. Then the future corrosion rates of studied areas are discussed based on long time test results from JFE Steel Corporation, Japan. From this, weathering steel is suitable when chloride deposition rate is less than or equal to 0.05 mdd because of its protective properties

National scale-up of tuberculosis-human immunodeficiency virus collaborative activities in Myanmar from 2005 to 2016 and tuberculosis treatment outcomes for patients with human immunodeficiency virus-positive tuberculosis in the Mandalay Region in 2015.

Background: HIV-associated TB is a serious public health problem in Myanmar. Study objectives were to describe national scale-up of collaborative activities to reduce the double burden of TB and HIV from 2005 to 2016 and to describe TB treatment outcomes of individuals registered with HIV-associated TB in 2015 in the Mandalay Region. Methods: Secondary analysis of national aggregate data and, for treatment outcomes, a cohort study of patients with HIV-associated TB in the Mandalay Region. Results: The number of townships implementing collaborative activities increased from 7 to 330 by 2016. The number of registered TB patients increased from 1577 to 139 625 in 2016, with the number of individuals tested for HIV increasing from 432 to 114 180 (82%) in 2016: 10 971 (10%) were diagnosed as HIV positive. Uptake of co-trimoxazole preventive therapy (CPT) and antiretroviral therapy (ART) nationally in 2016 was 77% and 52%, respectively. In the Mandalay Region, treatment success was 77% and mortality was 18% in 815 HIV-associated TB patients. Risk factors for unfavourable outcomes and death were older age (≥45 years) and not taking CPT and/or ART. Conclusion: Myanmar is making good progress with reducing the HIV burden in TB patients, but better implementation is needed to reach 100% HIV testing and 100% CPT and ART uptake in TB-HIV co-infected patients

Bcl9の異なるエピトープを認識する二つの抗体を用いた免疫組織化学的マッピングによるミャンマー国若年性発症肝細胞がんの特徴付け

B-cell lymphoma 9 (Bcl9) is the core component of Wnt/β-catenin signaling and overexpressed in nuclei of various tumors, including hepatocellular carcinoma (HCC). However, the extent of Bcl9 expression relative to HCC differentiation stage and its functional aspects are poorly understood. In this study, we examined the expression pattern of Bcl9 immunohistochemically, using two anti-Bcl9 antibodies; one was a conventional polyclonal-antibody (anti-Bcl9ABC) against amino acid no.800?900 of human-Bcl9, while the other (anti-Bcl9BIO) was against amino acid no.50?200, covering Pygopus-binding sites of Bcl9. Immunohistochemistry using anti-Bcl9BIO demonstrated distinctive staining in the cytoplasm, while the anti-Bcl9ABC signal was detected in both cytoplasm and nuclei of HCC cells, reflecting different states of Bcl9 function because Pygopus-binding to Bcl9 is essential to exert its function together with β-catenin in nucleus. Quantitative analysis revealed a significantly higher immunohistochemical-score by anti-Bcl9BIO in normal liver comparing various differentiation grades of HCC (P < 0.004), whereas no significant difference was noted with anti-Bcl9ABC. Interestingly, immunohistochemical-score of anti-Bcl9BIO in patients aged < 40 years was significantly lower than that of ? 40 years group (P < 0.01). The results indicated that anti-Bcl9BIO detected cytoplasmic Bcl9, which does not bind to Pygopus suggesting it could be a useful indicator for development of HCC in young Myanmar patients.長崎大学学位論文 学位記番号:博(医歯薬)甲第1129号 学位授与年月日:平成31年3月20日Author: Myat Thu Soe, Yasuaki Shibata, Myo Win Htun, Kuniko Abe, Kyaw Soe, Nay Win Than, Thann Lwin, Myat Phone Kyaw and Takehiko KojiCitation: Acta Histochemica et Cytochemica, 52(1), pp.9-17; 2019Nagasaki University (長崎大学)課程博

High rate of virological failure and low rate of switching to second-line treatment among adolescents and adults living with HIV on first-line ART in Myanmar, 2005-2015.

BACKGROUND: The number of people living with HIV on antiretroviral treatment (ART) in Myanmar has been increasing rapidly in recent years. This study aimed to estimate rates of virological failure on first-line ART and switching to second-line ART due to treatment failure at the Integrated HIV Care program (IHC). METHODS: Routinely collected data of all adolescent and adult patients living with HIV who were initiated on first-line ART at IHC between 2005 and 2015 were retrospectively analyzed. The cumulative hazard of virological failure on first-line ART and switching to second-line ART were estimated. Crude and adjusted hazard ratios were calculated using the Cox regression model to identify risk factors associated with the two outcomes. RESULTS: Of 23,248 adults and adolescents, 7,888 (34%) were tested for HIV viral load. The incidence rate of virological failure among those tested was 3.2 per 100 person-years follow-up and the rate of switching to second-line ART among all patients was 1.4 per 100 person-years follow-up. Factors associated with virological failure included: being adolescent; being lost to follow-up at least once; having WHO stage 3 and 4 at ART initiation; and having taken first-line ART elsewhere before coming to IHC. Of the 1032 patients who met virological failure criteria, 762 (74%) switched to second-line ART. CONCLUSIONS: We found high rates of virological failure among one third of patients in the cohort who were tested for viral load. Of those failing virologically on first-line ART, about one quarter were not switched to second-line ART. Routine viral load monitoring, especially for those identified as having a higher risk of treatment failure, should be considered in this setting to detect all patients failing on first-line ART. Strategies also need to be put in place to prevent treatment failure and to treat more of those patients who are actually failing

Long-term outcomes of second-line antiretroviral treatment in an adult and adolescent cohort in Myanmar.

BACKGROUND: Myanmar has a high burden of Human Immunodeficiency Virus (HIV) and second-line antiretroviral treatment (ART) has been available since 2008 in the public health sector. However, there have been no published data about the outcomes of such patients until now. OBJECTIVE: To assess the treatment and programmatic outcomes and factors associated with unfavorable outcomes (treatment failure, death and loss to follow-up from care) among people living with HIV (aged ≥ 10 years) receiving protease inhibitor-based second-line ART under the Integrated HIV Care Program in Myanmar between October 2008 and June 2015. DESIGN: Retrospective cohort study using routinely collected program data. RESULTS: Of 824 adults and adolescents on second-line ART, 52 patients received viral load testing and 19 patients were diagnosed with virological failure. However, their treatment was not modified. At the end of a total follow-up duration of 7 years, 88 (11%) patients died, 35 (4%) were lost to follow-up, 21 (2%) were transferred out to other health facilities and 680 (83%) were still under care. The incidence rate of unfavorable outcomes was 7.9 patients per 100 person years follow-up. Patients with a history of injecting drug use, with a history of lost to follow-up, with a higher baseline viral load and who had received didanosine and abacavir had a higher risk of unfavorable outcomes. Patients with higher baseline C4 counts, those having taken first-line ART at a private clinic, receiving ART at decentralized sites and taking zidovudine and lamivudine had a lower risk of unfavorable outcomes. CONCLUSIONS: Long-term outcomes of patients on second-line ART were relatively good in this cohort. Virological failure was relatively low, possibly because of lack of viral load testing. No patient who failed on second-line ART was switched to third-line treatment. The National HIV/AIDS Program should consider making routine viral load monitoring and third-line ART drugs available after a careful cost-benefit analysis