Potential Respiratory Pathogens in the Trachea and Nasal Mucosa of Intubated ICU Inpatients : Longitudinal Change and Relationship with Consciousness Level

本研究では，気管内挿管により人工呼吸管理を受けている患者のICU 入室後の鼻腔および気管内細菌の臨床検査データを解析し，その実態を把握するとともに，その経時的変化や意識レベルとの関連性を明らかにすることを目的とした．香川大学医学部附属病院ICU において，院内肺炎や市中肺炎の起炎菌として監視培養の対象としている『要注意菌』8 菌種について，気管内採痰および鼻腔スワブ中の検出状況を経時的に調べた．その結果，挿管初日の検査において32.7%の患者の気管内採痰に要注意菌が検出された．さらに，初日の検査で気管内に要注意菌が検出されなかった患者においても経時的に要注意菌の検出率が上昇することが明らかとなった．気管内で要注意菌が検出されるケースのほとんどで鼻腔内でも要注意菌が検出されることがわかった．また，患者の意識レベルと要注意菌の検出率の関連性を調べたところ，昏睡状態にある患者はそうでない患者に比べて，鼻腔内での要注意菌検出率が有意に高いことが明らかとなった（χ 2 検定；p<0.05）．気管内での肺炎原因菌の定着・増殖を阻止するには，口腔，咽頭，鼻腔に生息する細菌数を減らすことが重要と考えられる．これらのことから，意識障害が遷延化し挿管期間が長くなると見込まれる患者に対しては，より一層の徹底した鼻咽腔や口腔の衛生管理が必要であることが示唆された．また，挿管初日にある程度の細菌が気管内で検出されたことからも，挿管前の可能な限りの口腔ケアが肺炎リスクを減らすために重要であると考えられた．The aim of this study was to elucidate the longitudinal change of potential respiratory pathogens in the trachea and nasal mucosa of intubated intensive care unit (ICU) inpatients with neurological disorders. We focused on eight bacterial species designated “Bacteria requiring special attention” (SA), which are routinely under surveillance in the ICU of Kagawa University Hospital. Clinical data from bacterial testing of specimens from tracheal sputum or nasal mucosa swabs were analyzed. SA were detected in the trachea of 32.7% of patients on the first day of intubation. Furthermore, the detection rate of SA in the trachea increased over several days among patients in whom they were not detected on the first day. Most patients who were SA-positive in the trachea were also positive in the nasal mucosa. The rate of SA in the nasal mucosa of comatose patients was significantly higher than that in patients at other consciousness levels. It was suggested that thorough oral and/or nasal hygiene management is very important for comatose patients to reduce the risk of pneumonia

ガーナ ト ニホン ノ キソ レベル ニオケル エネルギー キョウイク ノ ヒカク ケンキュウ

本研究はガーナと日本のエネルギー事情の違いを採り入れた研究授業を小学校と高校で実施し,エネルギー教育を国際的な視点から見直すことの重要性を実践的に明らかにしたものである。同時にガーナと日本の指導要領の比較をエネルギー教育の観点から行い,両国の今後のエネルギー教育への提案を模索した。This study is concerned with: Comparison on Energy Education between Ghana and Japan and study lessons on energy from international view point. Energy Education and issues in the two countries quite differ in several ways. Findings of this research are as follows: i. In Ghana all the energy topics are taught under natural science but in Japan they are integrated with other subjects ii. In Ghana and in Japan it is part of the school curriculum furthermore in Japan some schools are sponsored by private companies in the energy sector as a project. iii. In Ghana energy lessons are started at grade 4 but in Japan, Tsunomine elementary, grades 1 iv. In Ghana the lessons are more theoretical but in Japan they are practically oriented国立情報学研究所『研究紀要公開支援事業』により電子化

Status of 48Ca double beta decay search in CANDLES

We study a strategy to reduce veto-time in the search for neutrino-less double-beta decay (0υββ) with CANDLES-III system. We develop a new likelihood analysis and apply it to our new Run010 data. We show that we can increase the un-vetoed live-time by 11.8%. Thanks to this improvements, We expect to increase a limit on the life-time of 0υββ by a factor of three by analyzing both Run009 and Run010 data

骨形成因子シグナル伝達経路の阻害はT細胞活性化及び分化に特異的な効果をもたらす

京都大学0048新制・課程博士博士(医学)甲第16725号医博第3673号新制||医||992(附属図書館)29400京都大学大学院医学研究科医学専攻(主査)教授 生田 宏一, 教授 成宮 周, 教授 開 祐司学位規則第4条第1項該当Doctor of Medical ScienceKyoto UniversityDA

The comprehensive assessment of local immune status of ovarian cancer by the clustering of multiple immune factors.

The aim of this study was to evaluate the local immune status of human ovarian cancers by the comprehensive analysis of tumor-infiltrating immune cells and immunosuppressive factors, and to elucidate the local immunity in clinical course. The numbers of CD1α+, CD4+, CD8+, CD57+, forkhead box P3+ and programmed cell death-1+ cells were counted, and the intensity of immunosuppressive factors, such as programmed cell death-1 ligand (PD-L)1, PD-L2, cyclooxygenase (COX)-1, COX-2 and transforming growth factor β1, were evaluated in 70 ovarian cancer specimens stained by immunohistochemistry. Then hierarchical clustering of these parameters showed the four clusters into ovarian cancer cases. Cluster 1, which had significantly better prognosis than the others, was characterized by high infiltration of CD4+ and CD8+ cells. In conclusion the comprehensive analysis of local immune status led to subdivide ovarian cancers into groups with better or worse prognoses and may guide precise understanding of the local immunity

Metabolic alterations caused by HNF1ß expression in ovarian clear cell carcinoma contribute to cell survival

HNF1ß is expressed exclusively in ovarian clear cell carcinoma (OCCC) and not in other ovarian cancers, regarded as a hallmark of this tumor. This implies its central role in the unique character of OCCC, including resistance to chemotherapy, but its exact role and influence in cancer biology or the molecular bases of its function are largely unknown. Using comprehensive metabolome analysis of HNF1ß_shRNAstable cell lines, we show here that HNF1ß drastically alters intracellular metabolism, especially in direction to enhance aerobic glycolysis, so called the "Warburg effect". The consequence of the metabolic change contributed cell survival under stresses such as hypoxia and chemo-reagent, only when sufficient glucose supply was available. Augmented cell survival was based on the reduced ROS activity derived from metabolic alteration such as shift from oxidative phosphorylation to glycolysis and increased intracellular anti-oxidant, glutathione (GSH). One of the cystine transporters, rBAT is likely to play a major role in this GSH increase. These data suggest that HNF1ß, possibly induced by stressful microenvironment in the endometriotic cyst, confers survival advantage to the epithelial cells, which leads to the occurrence of OCCC, a chemo-resistant phenotype of ovarian cancer