フィリピンの看護大学および病院の視察報告

２１世紀のグローバル社会を生きる学生が国際的な視野を持つ事ができるよう，国際交流の場を提供することは看護教育における課題である．本稿の目的は，フィリピンの看護教育制度への関心を高めることにある．なぜならば，アジア地域との交流は今後ますます活発になる事が予測されるからである．そこで、フィリピン大学の看護学教育および隣接するPhilippines General Hospital の看護システムを視察した．また，University of the East Ramon Magsaysay Memorial Medical Center（UERM），College of Nursing（私学）も視察した．看護教育はすべて大学でなされ，大学の卒業生は高い実践能力を有する看護師であると考えていた．Philippines General Hospital は利用者の９０％が無収入か低所得者とのことで，１次医療から３次医療まで対応している国立の大規模な総合病院であった．病室の大半が総室で家族の付き添う姿も見られた．看護職の離職および不足においては日本と類似した問題を抱えていた．短時間の視察であったが，看護教育への示唆を得ることができた．It is an important theme in nursing education to offer an opportunity of an international exchange so that the nursing student living in global society of the 21 st century can have an international field of vision. A purpose of this report is to raise interest to a Philippine nursing education system and care system. Because we thought that the transaction with an Asian region is predicted to become more and more active in future. Therefore we inspected a nursing education of a Philippine university and a care system of Philippines General Hospital. In addition, we visited University of the East Ramon Magsaysay Memorial Medical Center（UERM）, College of Nursing（a private school）. All the nursing education in a Philippine nursing education was made at University/college, and the teacher thought that graduates of their university were nurses having ability for high practice. We had explanation that the Philippines General Hospital was the national major general hospital which provided from medical treatment to the third medical treatment and 90% of the patient who used there were no income or low-income people. Most of patient’s room was the room for the plurality of patients, and we saw that a family attended the patient there. We thought that there was a similar problem in quitting a job and a shortage of nurses. But we were able to have a suggestion to nursing education during short inspection

Designing microarray phantoms for hyperspectral imaging validation

The design and fabrication of custom-tailored microarrays for use as phantoms in the characterization of hyperspectral imaging systems is described. Corresponding analysis methods for biologically relevant samples are also discussed. An image-based phantom design was used to program a microarrayer robot to print prescribed mixtures of dyes onto microscope slides. The resulting arrays were imaged by a hyperspectral imaging microscope. The shape of the spots results in significant scattering signals, which can be used to test image analysis algorithms. Separation of the scattering signals allowed elucidation of individual dye spectra. In addition, spectral fitting of the absorbance spectra of complex dye mixtures was performed in order to determine local dye concentrations. Such microarray phantoms provide a robust testing platform for comparisons of hyperspectral imaging acquisition and analysis methods

Snapshot hyperspectral retinal camera with the Image Mapping Spectrometer (IMS)

We present a snapshot hyperspectral retinal camera with the Image Mapping Spectrometer (IMS) for eye imaging applications. The resulting system is capable of simultaneously acquiring 48 spectral channel images in the range 470 nm–650 nm with frame rate at 5.2 fps. The spatial sampling of each measured spectral scene is 350 × 350 pixels. The advantages of this snapshot device are elimination of the eye motion artifacts and pixel misregistration problems in traditional scanning-based hyperspectral retinal cameras, and real-time imaging of oxygen saturation dynamics with sub-second temporal resolution. The spectral imaging performance is demonstrated in a human retinal imaging experiment in vivo. The absorption spectral signatures of oxy-hemoglobin and macular pigments were successfully acquired by using this device

Phospho-Smad3 signaling is predictive biomarker for hepatocellular carcinoma risk assessment in primary biliary cholangitis patients

Introduction: Patients with primary biliary cholangitis (PBC) are at increased risk for development of hepatocellular carcinoma (HCC), particularly in the presence of comorbidities such as excessive alcohol consumption. Although liver fibrosis is an important risk factor for HCC development, earlier predictors of future HCC development in livers with little fibrosis are needed but not well defined. The transforming growth factor (TGF)-β/Smad signaling pathway participates importantly in hepatic carcinogenesis. Phosphorylated forms (phospho-isoforms) in Smad-related pathways can transmit opposing signals: cytostatic C-terminally-phosphorylated Smad3 (pSmad3C) and carcinogenic linker-phosphorylated Smad3 (pSmad3L) signals. Methods and results: To assess the balance between Smad signals as a biomarker of risk, we immunohistochemically compared Smad domain-specific Smad3 phosphorylation patterns among 52 PBC patients with various stages of fibrosis and 25 non-PBC patients with chronic hepatitis C virus infection. HCC developed in 7 of 11 PBC patients showing high pSmad3L immunoreactivity, but in only 2 of 41 PBC patients with low pSmad3L. In contrast, 9 of 20 PBC patients with minimal Smad3C phosphorylation developed HCC, while HCC did not occur during follow-up in 32 patients who retained hepatic tumor-suppressive pSmad3C. Further, PBC patients whose liver specimens showed high pSmad3L positivity were relatively likely to develop HCC even when little fibrosis was evident. Conclusion: In this study, Smad phospho-isoform status showed promise as a biomarker predicting likelihood of HCC occurrence in PBC. Eventually, therapies to shift favorably Smad phospho-isoforms might decrease likelihood of PBC-related HCC

Surgery for older patients with advanced esophageal cancer involving the adjacent organs.

The treatment for thirty three advanced carcinoma of thoracic esophagus with cancer infiltrations to the adjacent organs were clinically analysed. The most affected organs were the aorta, followed by the trachea and bronchus. Clinical features are that two or three organs are affected at the same time and only one organ involvement is rare in frequency. Furthermore, nodal involvement is commonly accompanied and is spreading to the mediastium and abdomen. Surgical outcome of combined resection with involved organs is now unsatisfactory. In contrast, to relieve severe symptoms and to ensure the quality of life, aggressive combined resection is indispensable. It is assumed that further advances in improvement of potent anticancer drugs and surgical techniques may lead to prolonged survival of advanced esophageal cancer patients

Thymectomy for myasthenia gravis

The effect of thymectomy on elimination of a myasthenic symptom was clinically evaluated. The operative approach was primarily extended thymectmy of choice via midsternotomy in all but one of transcervical approaches. Most of them belonged to Osserman II b and II a of the disease type. Thirteen cases were in combination with thymoma and thirty-five were not in combination. Thymectomy yields a 53.8% effectiveness rate for patients with thymoma and a 65.7% for patients without thymoma. There was no defenitive relationship between the operation effectiveness and the suffering duration of time. However, aggravation and no improvement of a clinical sign after thymectomy were observed in patients with a severe or moderate degree of germinal center formation

Incidence of and risk factors for hepatocellular carcinoma in primary biliary cirrhosis: National data from Japan

Primary biliary cirrhosis (PBC) primarily affects females and is rarely complicated by hepatocellular carcinoma (HCC). Although the HCC incidence in PBC patients is low, several characteristics and risk factors associated with its development have been reported. In this study, national data concerning the current status of carcinogenesis in PBC patients in Japan are reviewed. Using data from two national questionnaire surveys, we investigated the clinicopathological findings associated with HCC in PBC patients. According to the data of all reviewed PBC patients, the HCC incidence was 2.4% (71/2946). The HCC incidence by gender was 5.1% (19/370) in males and 2.0% (52/2576) in females, and the proportion of males was 26.7%. Prognosis was significantly poorer in the PBC patients with HCC than in those without. Multivariate analysis of risk factors associated with HCC by gender revealed histological stage at the time of PBC diagnosis as an independent risk factor associated with the development of HCC in females, but not in males. Furthermore, data from another national survey of 178 PBC patients with HCC (male/female = 49/129; proportion of males 27.5%) revealed that the duration between the diagnosis of PBC and that of HCC was significantly shorter in males than in females. In addition, histological stage at the time of HCC diagnosis was an independent risk factor for HCC in females, whereas no risk factors were identified in males. Conclusion: these data indicate that males are at risk of developing HCC at any histological stage of PBC. Therefore, male PBC patients in particular should be carefully screened for HCC from the early stages of PBC. (HEPATOLOGY 2013) Copyright © 2012 American Association for the Study of Liver Diseases

A study on the living condition and the housing problem in central Gondar, Ethiopia

This paper aims at analysis of the housing conditions of a historical city Gondar in Ethiopia. Although rich in historical relics within a historical core formulated in the course of an imperial period since the 17^ century, the central zone of Gondar is suffering from the deterioration of urban blocks generated by a series of modern master planning since 1930\u27s. Repeated field surveys in situ revealed the typological nature of built environment as well as social characteristics of inhabitants residing there. Dominance of female population, juxtaposition of shady occupation and historical monuments, concentration of the poor depending on the informal sector, are the main points abstracted from the surveys. Coordination within public housing is the key for the amelioration of actual situation

Serum neurofilament dynamics predicts neurodegeneration and clinical progression in presymptomatic Alzheimer's disease

Neurofilament light chain (NfL) is a promising fluid biomarker of disease progression for various cerebral proteopathies. Here we leverage the unique characteristics of the Dominantly Inherited Alzheimer Network and ultrasensitive immunoassay technology to demonstrate that NfL levels in the cerebrospinal fluid (n = 187) and serum (n = 405) are correlated with one another and are elevated at the presymptomatic stages of familial Alzheimer's disease. Longitudinal, within-person analysis of serum NfL dynamics (n = 196) confirmed this elevation and further revealed that the rate of change of serum NfL could discriminate mutation carriers from non-mutation carriers almost a decade earlier than cross-sectional absolute NfL levels (that is, 16.2 versus 6.8 years before the estimated symptom onset). Serum NfL rate of change peaked in participants converting from the presymptomatic to the symptomatic stage and was associated with cortical thinning assessed by magnetic resonance imaging, but less so with amyloid-β deposition or glucose metabolism (assessed by positron emission tomography). Serum NfL was predictive for both the rate of cortical thinning and cognitive changes assessed by the Mini-Mental State Examination and Logical Memory test. Thus, NfL dynamics in serum predict disease progression and brain neurodegeneration at the early presymptomatic stages of familial Alzheimer's disease, which supports its potential utility as a clinically useful biomarker