根治的前立腺全摘標本における神経線維周囲浸潤の生化学的再発予知因子としての意義

著者らは, 臨床的限局性前立腺癌に対して術前内分泌療法を施行せずに根治的前立腺全摘除術を施行した202症例を対象に, 全摘標本における神経線維周囲浸潤の臨床病理学的意義を検討した.その結果, 1)神経線維周囲浸潤は131例(64.9%)に陽性であった.また, 神経線維周囲浸潤の存在は, 臨床病期, 病理学的病期, Gleasonスコア, 精嚢浸潤, リンパ節転移および腫瘍体積と有意に相関したが, 術前PSA値との相関は認めなかった. 2)経過観察期間(中央値34ヵ月)中, 20例に生化学的再発を認めたが神経線維周囲浸潤はこの内17例に陽性であった. 3)神経線維周囲浸潤陽性131例および陰性71例の5年生化学的非再発率は, それぞれ84.4%および94.3%であり統計学的有意差を認めた.神経線維周囲浸潤の他, 病理学的病期, 精嚢浸潤, リンパ節転移および腫瘍体積が生化学的非再発率と有意な相関を示した.しかし, 多変量解析の結果, これら5因子の内, 精嚢浸潤のみが生化学的再発の独立した予知因子であった.以上, これらのことからも, 根治的前立腺全摘標本における神経線維周囲浸潤の存在は, 種々の予後規定因子と有意な相関を示すが, 生化学的再発の独立した予知因子とは成りえない可能性が示唆されたThe objective of this study was to determine whether the presence of perineural invasion (PNI) in radical prostatectomy specimens could be a useful prognostic parameter in Japanese men with prostate cancer. Between January 1995 and September 2003, 202 Japanese men underwent radical retropubic prostatectomy for prostate cancer without any neoadjuvant therapies prior to surgery. We retrospectively analyzed the relationship between PNI in radical prostatectomy specimens and other prognostic factors, and also assessed the significance of PNI in biochemical recurrence after radical prostatectomy. The presence of PNI was significantly related to clinical stage, pathological stage, Gleason score, seminal vesicle invasion, lymph node metastasis and tumor volume, but not pretreatment serum prostate specific antigen value. During the observation period, biochemical recurrence occurred in 20 patients (3 in patients without PNI and 17 in those with PNI), and the biochemical recurrence-free survival rate in patients with PNI was significantly lower than that in patients without PNI. In addition to-PNI, pathological stage, seminal vesicle invasion, lymph node metastasis and tumor volume were significantly associated with the biochemical recurrence-free survival rate; however, among these five factors, only seminal vesicle invasion was an independent predictor of biochemical recurrence on multivariate analysis. Despite a significant association between several prognostic parameters, PNI was not an independent predictor of biochemical recurrence; therefore, it may not provide an additive effect to consider the presence of PNI in predicting the prognosis of Japanese men who underwent radical prostatectomy if there are other conventional parameters available

Chiral Magnetic Effect from Q-balls

We apply a generic framework of linear sigma models for revealing a mechanism of the mysterious phenomenon, the chiral magnetic effect, in quark-gluon plasma. An electric current arises along a background magnetic field, which is given rise to by Q-balls (non-topological solitons) of the linear sigma model with axial anomaly. We find additional alternating current due to quark mass terms. The hadronic Q-balls, baby boson stars, may be created in heavy-ion collisions.Comment: 4 pages, 3 figures, revtex; v2: minor revisio

Anomaly-induced charges in baryons

We show that quantum chiral anomaly of QCD in magnetic backgrounds induces a novel structure of electric charge inside baryons. To illustrate the anomaly effect, we employ the Skyrme model for baryons, with the anomaly-induced gauged Wess-Zumino term (\pi_0 + (multi-pion)) E_i B_i. Due to this term, the Skyrmions giving a local pion condensation ((\pi_0 + (multi-pion)) \neq 0) necessarily become a local charge source, in the background magnetic field B_i. We present detailed evaluation of the anomaly effects, and calculate the total induced charge, for various baryons in the magnetic field.Comment: 18 pages, 12 figure

The impact of rotating work schedules, chronotype, and restless legs syndrome/Willis-Ekbom disease on sleep quality among female hospital nurses and midwives: A cross-sectional survey

Background: Decreases in subjective sleep quality are prevalent among nurses and midwives engaged in rotating shift work. Objectives: The present study aimed to examine the relationship between differences in work schedules and subjective sleep quality among female nursing staff. Design: A cross-sectional survey design was used for descriptive and logistic regression analyses. Data collection was conducted from December 2016 to September 2017. Settings: Participants were recruited from five regional core hospitals in Japan. Participants: A total of 1253 nurses and midwives were included in the final analysis. Methods: Subjective sleep quality was assessed using the Japanese version of the Pittsburgh Sleep Quality Index. Chronotype and social jet lag were calculated for both work day and work-free day. Symptoms related to restless legs syndrome/Willis-Ekbom disease were assessed using the Japanese version of the Cambridge-Hopkins questionnaire short form 13. Participants with the urge to move their legs, though not fulfilling the restless legs syndrome/Willis-Ekbom disease criteria, were classified as having leg motor restlessness. Logistic regression analyses for poor sleep were adjusted for age, body mass index, smoking, drinking, menstruation status, the presence of premenstrual syndrome, and the presence of a spouse. Results: Rates of poor sleep (Pittsburgh Sleep Quality Index score ?6) among those working, day shifts, rotating 12.5 hour night shifts, rotating 16 hour night shifts, and three-shift rotations were 41.2%, 51.1%, 44.5%, and 60.4%, respectively. Approximately 40% of three-shift rotation workers experienced difficulty initiating sleep. Shift workers tended to exhibit evening chronotype, delayed sleep phase, and high social jet lag. The prevalence of restless legs syndrome/Willis-Ekbom disease was 2.5%. Leg motor restlessness was observed in. 15.5% of participants. The adjusted odds ratios (95% confidence interval) of three-shift work (vs. day shift), evening chronotype (vs. morning chronotype), and the presence of leg motor restlessness (vs. no leg motor restlessness) for those with poor sleep were 2.20 (1.47?3.30), 1.95 (1.29?2.94),and 1.66 (1.15?2.39), respectively. Conclusions: Regardless of the working schedules, rates of poor sleep were high among female hospital nurses and midwives. Our findings suggest that poor sleep quality is influenced by three-shift rotation, the evening chronotype, and leg motor restlessness

The impact of sleep–wake problems on health-related quality of life among Japanese nursing college students: a cross sectional survey

Aim: This study was conducted to examine the impact of sleep–wake problems on health-related quality of life of Japanese nursing college students.Methods: This cross-sectional study was conducted in 2019 on 150 third and fourth-year nursing college students from two locations in Japan. Insomnia severity was assessed using the Insomnia Severity Index (ISI) and health-related quality of life using the SF-8 questionnaire. The total sleep time (TST) was divided into 3 groups: < 6 h, 6–7 h (reference), and ≥ 7 h. The total ISI score was divided into 2 groups: ≥ 8 points and < 8 points (reference). Logistic regression analysis was performed to evaluate sleep–wake problems related to decline in mental health.Results: The median mental health indicated in the SF-8 questionnaire was divided into two groups, and the factors causing decline in mental health were investigated. The odds ratios (95% confidence interval) for adjusted ISI ≥ 8 and TST on weekdays < 6 h was 6.51 (2.96–14.30) and 3.38 (1.40–8.17), respectively. Mental health status was significantly lower when ISI ≥ 8 and even lower when TST < 6 h.Conclusion: Insomnia and short sleep duration are associated with decreased mental health status in nursing college students. Many tended to lack sleep on weekdays. Sleep–wake problems identified while in university should be comprehensively dealt with

Malignant Mesodermal Mixed Tumor of the Bladder : A Case Report

We report an autopsy case of malignant mesodermal mixed tumor of the urinary bladder of a 67 year old male. He had been admitted to Kita Hospital under the diagnosis of Alzheimer\u27s disease since 1979. His dementia aggravated and he was confined to bed in 1985. While in the hospital, he developed hematuria and calculi and necrotic materials were sometimes noticed in his urine. Although the CT scan and intravenous urography revealed left hydronephrosis and vesical lithiasis, urinary cytological studies showed no remarkable changes. At the beginning of September 1992, he was found to have a child\u27s fist-sized tumor in his left lower abdominal cavity, which was diagnosed as a bladder tumor and left renal pelvic tumor. The tumor grew rapidly and reached a child\u27s head-size within 3 months. Several cytological examinations of his urine were performed, but all showed negative for malignancy. There was no tumor response against anti-cancer chemotherapy and he died on November 22, 1992. Autopsy revealed a bulky tumor mass which occupied the whole lower abdominal cavity. Histologically, the tumor was composed of an epithelial element of well differentiated squamous cell carcinoma and a non-epithelial element of rhabdomyosarcoma. The cross striations in rhabdomyosarcoma cells were clearly stained by PTAH. Immunohistochemically, rhabdomyosarcoma cells were positively stained by Desmin and partially by Vimentin. Therefore we diagnosed this tumor as malignant mesodermal mixed tumor of the urinary bladder

The Pattern of Pediatric Solid Malignant Tumors in Western Kenya, East Africa, 1979?1994: An Analysis Based on Histopathologic Study

This study analyzed histopathologic specimens of 600 pediatric solid malignant tumors seen during the period 1979?1994 at the histopathology laboratories of the Rift Valley Provincial General Hospital in Nakuru, the Nyanza Provincial General Hospital in Kisumu, and the Uasin Gishu Hospital in Eldoret in western Kenya. The crude incidence rate of each malignancy per 100,000 children per year was calculated. The patterns of malignancies were examined with a focus on tumor incidence, age, sex, geographic, and ethnic distribution to relate the tumors to putative environmental and genetic causative factors. The six common tumors were Burkitt\u27s lymphoma (33.5%), non-Hodgkin\u27s lymphoma (21.8%), retinoblastoma (11.5%), Kaposi\u27s sarcoma (6.1%), nephroblastoma (4.5%), and Hodgkin\u27s disease (4.1%). Significantly high crude incidence rates for lymphomas and Kaposi\u27s sarcoma showed a characteristic ethnogeographic distribution. The majority of the tumors were found concentrated around Lake Victoria and showed decreasing occurrence as one moved towards the semi-arid and highland areas. We concluded that environmental factors seem to play a major role in childhood tumors in western Kenya

Short Report: Herpes-Like DNA Sequences in African-Endemic and Acquired Immunodeficiency Syndrome-Associated Kaposi\u27s Sarcoma

Recently, the unique nucleic acid closely related to the herpes-like sequences has been found in acquired immunodeficiency syndrome (AIDS)-associated Kaposi\u27s sarcoma (KS). We have confirmed the presence of herpes-like DNA sequences in six cases of AIDS-associated KS and three of the nine cases of African-endemic KS in adults, but not in eight cases of KS in children from the same area. These sequences were seen in a histologically early stage of KS. Our results suggest that herpes-like DNA sequences may play an important role in the pathogenesis of AIDS-associated KS