A successful rechallenge with cetuximab for a case with metastatic rectal cancer

　A 55-year-old man who had been diagnosed with rectal cancer with multiple liver metastases and lymph node metastases on colonoscopy and computed tomography (CT) was referred to Okayama University Hospital for treatment. Based on the diagnosis of non-curative rectal cancer, we planned to perform systematic chemotherapy after surgical resection. We performed a low anterior resection of a 36×35 mm upper rectal moderately differentiated adenocarcinoma with wil-type KRAS. After the resection, a FOLFIRI regimen with cetuximab was given as the first-line chemotherapy. Although metastatic lesions in the liver showed shrinkage, we decided to switch regimens because of intolerable adverse events. A modified FOLFOX6 regimen with bevacizumab was administered as the second-line treatment. There were no signs of disease progression until eight months later, when positron emission tomography (PET)/CT scans revealed that the new metastatic lesions appeared. As the third-line treatment, an irinotecan with cetuximab regimen was administered, leading to a good response for over 12 months. 　We experienced a successful rechallenge with cetuximab for a case with metastatic rectal cancer. For patients with wild-type KRAS colorectal cancer, rechallenge with cetuximab-based chemotherapy can be an effective therapeutic option

Accuracy of an Artificial Intelligence–Based Model for Estimating Leftover Liquid Food in Hospitals : Validation Study

Background: An accurate evaluation of the nutritional status of malnourished hospitalized patients at a higher risk of complications, such as frailty or disability, is crucial. Visual methods of estimating food intake are popular for evaluating the nutritional status in clinical environments. However, from the perspective of accurate measurement, such methods are unreliable. Objective: The accuracy of estimating leftover liquid food in hospitals using an artificial intelligence (AI)–based model was compared to that of visual estimation. Methods: The accuracy of the AI-based model (AI estimation) was compared to that of the visual estimation method for thin rice gruel as staple food and fermented milk and peach juice as side dishes. A total of 576 images of liquid food (432 images of thin rice gruel, 72 of fermented milk, and 72 of peach juice) were used. The mean absolute error, root mean squared error, and coefficient of determination (R2) were used as metrics for determining the accuracy of the evaluation process. Welch t test and the confusion matrix were used to examine the difference of mean absolute error between AI and visual estimation. Results: The mean absolute errors obtained through the AI estimation approach were 0.63 for fermented milk, 0.25 for peach juice, and 0.85 for the total. These were significantly smaller than those obtained using the visual estimation approach, which were 1.40 (P<.001) for fermented milk, 0.90 (P<.001) for peach juice, and 1.03 (P=.009) for the total. By contrast, the mean absolute error for thin rice gruel obtained using the AI estimation method (0.99) did not differ significantly from that obtained using visual estimation (0.99). The confusion matrix for thin rice gruel showed variation in the distribution of errors, indicating that the errors in the AI estimation were biased toward the case of many leftovers. The mean squared error for all liquid foods tended to be smaller for the AI estimation than for the visual estimation. Additionally, the coefficient of determination (R2) for fermented milk and peach juice tended to be larger for the AI estimation than for the visual estimation, and the R2 value for the total was equal in terms of accuracy between the AI and visual estimations. Conclusions: The AI estimation approach achieved a smaller mean absolute error and root mean squared error and a larger coefficient of determination (R2) than the visual estimation approach for the side dishes. Additionally, the AI estimation approach achieved a smaller mean absolute error and root mean squared error compared to the visual estimation method, and the coefficient of determination (R2) was similar to that of the visual estimation method for the total. AI estimation measures liquid food intake in hospitals more precisely than visual estimation, but its accuracy in estimating staple food leftovers requires improvement

A case of metastatic cecal cancer with mutation in the BRAF oncogene and poor survival

　A 79-year-old woman visited a previous hospital with a complaint of general fatigue. The patient was diagnosed with cecal cancer with multiple liver metastases and lymph node metastases on colonoscopy, abdominal ultrasonography and CT scan, and was referred to our division for treatment. Based on the diagnosis of non-curative colonic cancer, we planned to perform systematic chemotherapy after local surgical treatment. We performed an ileocecal resection, and the specimen showed poorly differentiated adenocarcinoma with mutation in the BRAF oncogene. After the surgical treatment, the tumor grew rapidly and the patient died from cancer on the 19th postoperative day without having the opportunity to undergo chemotherapy. 　Multiple genetic and epigenetic alterations in oncogenes and tumor suppressor genes are involved in the process of colorectal carcinogenesis. Some of the alterations have been identified as predictive and prognostic biomarkers. A mutation in the BRAF oncogene was reported to be associated with a very unfavorable prognosis in colorectal cancers. Some of the cases with rapid progression are suggested to have the BRAF oncogene mutation. According to our experience, chemotherapy before surgical treatment might improve the prognosis of cases with the BRAF mutation

カイガイ ムケ ビデオ キョウザイ 『ニホンゴ キョウイク ヨウ テレビ コマーシャル シュウ』 -キョウザイ セイサク ト ソノ ヒョウカ-

本論文では、海外向けビデオ教材『日本語教育用TVコマーシャル集』(2002年版・2005年版)制作のねらいとその特徴について報告するとともに、本教材の海外における使用実態と使用者に対するアンケート調査の結果を基に、本教材の評価について述べるものである。本教材は、テレビコマーシャルという生教材を通して、言語的知識や日本事情的知識だけでなく、その文化・社会的背景をも理解することを目的として作成された。使用実態とアンケート調査結果から、本教材の使用地域に偏りがあること、高等教育、一般成人対象の機関、初級レベルでの使用が多いこと、文化・社会的特徴を利用した使用や、楽しむための利用が多いこと、作品に「わかりやすさ・面白さ」を求める傾向が強いことがわかった。本教材はアンケート調査の結果からおおむね高い評価を得ているが、本稿では、「使いやすさ」「受容」「有効性」の各観点から再考し、それぞれ評価すべき点と問題点があることを指摘した。This paper attempts to clarify the aim and features of the new video materials named “TV Commercials for Japanese Classrooms, 2003 & 2005 ”produced by The Japan Foundation for Japanese-language learners overseas. It also aims to evaluate the materials based on the results of the questionnaires as answered by users in 61 countries; as well as some practical reports. The aim of these authentic materials is to introduce not only the Japanese spoken language and the latest trends in Japanese society, but also the cultural backgrounds of the TV commercials. The results of the analysis are as follows: 1) Regarding the frequency of practical use, it seems there is variety among the users in different countries. 2) There is a variety in the educational institutions and Japanese language levels in which the materials are used. Especially, they are frequently used at the beginning levels. 3) The materials are mainly used for the introduction of Japanese culture and society. 4) The materials are also used for fun. 5) There is a tendency to demand the easiness of understanding. It is also observed that the aspect of entertainment toward Japanese TV commercials is also becoming important. These findings may lead to the conclusion that the new materials are overall properly evaluated, but the difficulty of understanding TV commercials is left as a problem that suggests the need of proper selection of TV commercials and the need of teachers’support system

CCN3 (NOV) Drives Degradative Changes in Aging Articular Cartilage

Aging is a major risk factor of osteoarthritis, which is characterized by the degeneration of articular cartilage. CCN3, a member of the CCN family, is expressed in cartilage and has various physiological functions during chondrocyte development, differentiation, and regeneration. Here, we examine the role of CCN3 in cartilage maintenance. During aging, the expression of Ccn3 mRNA in mouse primary chondrocytes from knee cartilage increased and showed a positive correlation with p21 and p53 mRNA. Increased accumulation of CCN3 protein was confirmed. To analyze the effects of CCN3 in vitro, either primary cultured human articular chondrocytes or rat chondrosarcoma cell line (RCS) were used. Artificial senescence induced by H2O2 caused a dose-dependent increase in Ccn3 gene and CCN3 protein expression, along with enhanced expression of p21 and p53 mRNA and proteins, as well as SA-beta gal activity. Overexpression of CCN3 also enhanced p21 promoter activity via p53. Accordingly, the addition of recombinant CCN3 protein to the culture increased the expression of p21 and p53 mRNAs. We have produced cartilage-specific CCN3-overexpressing transgenic mice, and found degradative changes in knee joints within two months. Inflammatory gene expression was found even in the rib chondrocytes of three-month-old transgenic mice. Similar results were observed in human knee articular chondrocytes from patients at both mRNA and protein levels. These results indicate that CCN3 is a new senescence marker of chondrocytes, and the overexpression of CCN3 in cartilage may in part promote chondrocyte senescence, leading to the degeneration of articular cartilage through the induction of p53 and p21

ニホンゴ キョウシ ノ タメ ノ CSCL カンキョウ ミンナ ノ キョウザイ サイト ノ カイハツ ト ヒョウカ リヨウシャ ノ シテン オ ジュウシ シタ サイト カイハツ ト ウンヨウ ノ ジッセキ

「みんなの教材サイト」は、教材用素材の提供と、日本語教師がそれぞれの教育現場で教材作成や授業設計に役立て、また他の教師との相互交流を通じて各自の専門性を高めていくことを支援するために開発されたウェブサイトである。本サイトは、内容・機能面においては、学習科学の一分野であるコンピュータによる協調学習支援(CSCL)研究を理論的枠組みとしている。また、サイトの開発・評価の方法論として、教育工学におけるシステム的な教材設計・開発の手順、教授設計論(Instructional Design)を参照した。本サイトの開発及び運用面での特徴として、各局面ごとに評価を組み入れ、「形成的評価」を重視している点が挙げられる。 本稿では、教授設計論という観点から、サイトの開発及び運用方法についての評価と課題について述べる。また、CSCL環境の構築という観点から、サイトの内容・機能面の評価と課題について分析し、今後の方策について述べる。 まず、これまでの開発及び運用について、Flagg(1990)の言う形成的評価の三つの観点に基づいて見直した。Flaggは、形成的評価の観点として「使いやすさの問題」「受容の問題」「有効性の問題」の三つを挙げている。第一次開発では、ユーザーテストに代表されるように、主に「使いやすさの問題」に評価の焦点を当てた。第二次開発では、「使いやすさの問題」に着目すると同時に、教師研修で本サイトを利用し、利用者の反応を見るなど「受容の問題」にも注意を払ったといえる。現在進行中の第三次開発では、これら二つの問題に注意を払いつつ、「有効性の問題」について評価を行うことが重要であると考えている。「有効性の問題」の評価の準備段階として、CSCL環境の構築という観点から現時点でのサイトの評価を行い、利用者ニーズを把握するためのログ解析ツールの導入、利用者ニーズにあったコンテンツ開発を行うための利用者の類型化(ポジショニングマップの作成)、センター内外の教師研修との連携、の三つの方策が有効であるという認識に至り、第三次開発に反映した

Analysis of DOC and Ram for NSCLC

Background: Current clinical trials demonstrated that combination regimens comprising chemotherapy and immunotherapy lead to better patient outcomes compared to chemotherapy alone as the first line of treatment for non-small cell lung cancer (NSCLC). In addition, the combination therapy of docetaxel (Doc) and ramucirumab (Ram) was considered one of the standard treatments for advanced or relapsed NSCLC patients. However, little is known about the therapeutic responders of this combination therapy among previously treated NSCLC patients. In the present study, we aimed to identify predictive factors for therapeutic response, including programmed death-ligand 1 (PD-L1) expression in tumors, for Doc treatment in combination with Ram. Methods: We retrospectively analyzed a total of 135 advanced or relapsed NSCLC patients who were refractory to platinum-based chemotherapy at eleven institutions in Japan between July 2016 and November 2018. Results: Our observations showed that PD-L1 expression in tumors is not associated with the efficacy of combined therapy of Doc and Ram in previously treated NSCLC patients. Analysis of the patient clinical profiles indicated that prior treatment with immune checkpoint inhibitors (ICIs) is a reliable predictor for the good progression-free survival (PFS) to this combination therapy (P=0.041). Conclusions: Our retrospective study indicated that combination regimens comprising chemotherapy and ICIs followed by Doc and Ram could be an optimal therapeutic option for NSCLC patients regardless of the PD-L1 status of tumors. Further investigations are required to strengthen clinical evidence demonstrating the effectiveness of the combination therapy of Doc plus Ram in previously treated NSCLC patients

Transdisciplinary Joint Seminar Studies: Conflits et Interprétations

This report details the research activity carried out from 2009 to date under the Transdisciplinary Joint Seminar Studies of the universities of Aoyama Gakuin, Franche-Comté and Tsukuba. Through study sessions and conferences as well as individual research papers, the issue of conflict and interpretation is addressed across the specific fields of study from the three distinct considerations of circulation, representation and language. 要旨本報告は2009年から現在まで「青山学院大学・フランシュコンテ大学・筑波大学異分野共同セミナー」において行われた研究活動をまとめたものである。分科会、講演、ならびに個々の論文において論じられた「循環」「表象」「言語」の考察を通じて、「衝突」と「解釈」をめぐる諸問題が検証される