Non-financial social determinants of diabetes among public assistance recipients in Japan: A cohort study

Aims/Introduction: Poverty is an important social determinant of diabetes. Poverty is a multidimensional concept including non-financial difficulties, such as social isolation and exclusion from communities. Many countries provide financial social assistance programs for those in need. This study aimed to explore non-financial social determinants of diabetes among public assistance recipients in Japan, by using linkage data of two municipal public assistance databases and medical assistance claim data. Materials and Methods: We carried out a retrospective cohort study. Public assistance is provided to households below the poverty line to ensure their income security. We extracted recipients’ sociodemographic factors of January 2016 (household number and employment status as non-financial social determinants of diabetes) and identified the incidence of diabetes diagnosis until December 2016 as the outcome. Results: We included the data of 2, 698 younger individuals (aged 65 years). A multivariable Poisson regression, with a robust standard error estimator, showed that among 2, 144 younger recipients at risk, unemployment and living alone were slightly associated with 1-year cumulative incidence of diabetes diagnosis (adjusted incidence ratio 1.20, 95% confidence interval 0.93–1.54 and adjusted incidence ratio 1.15, 95% confidence interval 0.89–1.48, respectively). Among 2, 181 older recipients at risk, there was no strong association between their sociodemographic factors and incidence of diabetes diagnosis. Conclusions: Unemployment and living alone might be additional risk factors for diabetes among younger public assistance recipients. Multidimensional supports assuring financial and non-financial securities are required to prevent diabetes among people living in poverty

Somaclonal Variation in Plants Regenerated from Callus and Protoplasts of Taro cv. 'Yatsugashira'

Characters of plants regenerated from callus and protoplasts of taro (Colocasia esculenta Schott cv. Yatsugashira) were studied. Many green compact cell masses (calloid) and small number of yellow friable calli were formed by culturing segments of etiolated stem on Murashige and Skoog's (MS) medium supplemented with 30 g･liter-1 sucrose, 1 mg･liter-1 2,4-D and 2ip. Friable calli were proliferated by subculturing on the same fresh medium, and then they were suspension-cultured in a liquid medium. Protoplasts were isolated from these suspension cells. Shoots were regenerated from calloids, friable calli and protoplast derived-calli by transferring them to MS medium supplemented with 30 g･liter-1 sucrose, 0~2 mg ･liter-1 NAA and 2 mg･liter-1 BA or 2 ip. These shoots formed roots after being transferred to basal MS media. Plantlets were acclimatized and grown in the field. Original 'Yatsugashira' formed many shoots from the main corm, whereas 2 of 4 plants regenerated from calloid formed a single shoot from the main corm. Plants regenerated from friable calli were dwarf type and grew slowly. plants regenerated from both friable calli and protoplasts formed larger number of shoots than original 'Yatsugashira'.サトイモの品種'八頭'供試、カルスおよびプロトプラストから再生した植物の形成を調査した。無菌植物を暗黒下で培養した伸長させた黄化茎の切片を、30g･liter-1ショ糖、1mg･liter-1 2,4-D+ 1mg･liter-1 2ipおよび2g･liter-1ジェランガムを添加したMS培地で培養し、カルスを誘導した。黄化茎切片から形成した組織は、ほとんどが緑色の塊状であったが、一部黄白色の柔らかいカルスも形成された。この黄白色の柔らかいカルスを同組成の培地で継代培養して増殖させた。このカルスを振とう培養として懸濁細胞を形成し、それから、プロトプラストを単離した。緑色塊状組織、カルスおよびプロトプラストを、種々の濃度のNAAとBAを添加した培地で培養し、植物体の再生させた。'八頭'は、親芋から多くの菌条が伸長する性質を持っているが、緑色塊状組織から再生した植物4個体のうち2個体は、親芋から1本しか苗条が伸長しなかった。カルス由来の再生植物や、カルスから単離したプロトプラスト由来の再生植物は、元の'八頭'植物に比べて草丈が著しく低く、苗条数、葉数が多かった

Selective drug delivery to bone using acidic oligopeptides

金沢大学附属病院薬剤

Dysregulated Aire expression and autoimmunity

Deficiency for AIRE/Aire in both humans and mice results in the development of organ-specific autoimmune disease. We tested whether augmented and/or dysregulated AIRE/Aire expression might be also prone to the breakdown of self-tolerance. To define the effect of augmented Aire expression on the development of autoimmunity, antigen-specific clonal deletion and production of clonotypic regulatory T cells (Tregs) in the thymus were examined using mice expressing two additional copies of Aire in a heterozygous state (3xAire-knockin mice: 3xAire-KI). We found that both clonal deletion of autoreactive T cells and production of clonotypic Tregs in the thymus from 3xAire-KI were impaired in a T-cell receptor-transgenic system. Furthermore, 3xAire-KI females showed higher scores of experimental autoimmune encephalomyelitis induced by myelin oligodendrocyte glycoprotein than wild-type littermates, suggesting that augmented Aire expression exacerbates organ-specific autoimmunity under disease-prone conditions. In humans, we found that one patient with amyopathic dermatomyositis showed CD3–CD19– cells expressing AIRE in the peripheral blood before the treatment but not during the remission phase treated with immunosuppressive drugs. Thus, not only loss of function of AIRE/Aire but also augmented and/or dysregulated expression of AIRE/Aire should be considered for the pathogenesis of organ-specific autoimmunity. We suggest that further analyses should be pursued to establish a novel link between organ-specific autoimmune disease and dysregulated AIRE expression in clinical settings

Squamous Cell Carcinoma of the Descending Colon: Report of a Case and Literature Review

It is very rare that squamous cell carcinoma (SCC) arises from colorectal epithelium. An 89-year-old man was treated in 2001 with chief complaints of anorexia, abdominal pain, and low grade fever. The histological diagnosis as SCC was determined by biopsy during a colonoscopy. We diagnosed primary SCC of the colon because except in the colon no malignant lesions were found by systemic CT. Surgical complete resection was performed. However, he died three months after surgical resection because of hepatic metastasis and cachexia. The prognosis of this disease seems to be worse than that of adenocarcinoma

Immunohistochemistry or Molecular Analysis : Which Method Is Better for Subtyping Craniopharyngioma?

Craniopharyngioma (CP) is mainly classified into two pathological subtypes: adamantinomatous (ACP) and papillary (PCP). CTNNB1 (β-catenin) mutations are detected in ACPs, and the BRAF V600E mutation is detected in PCPs. However, genetic analysis is not always possible in general medical practice. In this study, we investigated whether immunohistochemistry could replace genetic analysis as an aid in subtype diagnosis. Here, 38 CP patients who had undergone their first tumor resection were included. Among the 38 cases, 22 were morphologically diagnosed as ACP, 10 cases were diagnosed as PCP, and six cases were diagnosed as undetermined CP that were morphologically difficult to classify as either ACP or PCP. Results of immunohistochemistry and genetic analysis and clinical features were compared. Based on the immunohistochemistry, 26 (22 ACPs and four undetermined CPs) showed nuclear β-catenin expression, 11 (nine PCPs and two undetermined CPs) exhibited positive BRAF V600E immunostaining and one PCP showed membranous β-catenin expression and negative for BRAF V600E immunostaining. Among the 26 nuclear β-catenin expression cases, 11 had CTNNB1 mutations; however, 15 cases had mutations of neither CTNNB1 nor BRAF V600E. All 11 BRAF V600E immunopositive cases had BRAF V600E mutations. When comparing clinical features between, pediatric patients and those with tumor calcification and less solid components on MRI more commonly had nuclear β-catenin expression tumors than BRAF V600E immunopositive tumors, reflecting the differences in clinical features between ACP and PCP. Accordingly, immunohistochemistry can replace genetic analysis as an aid to determine the subtype diagnosis of CP in general medical practice

GSRS ガ リックンシトウ ニヨル ショウカキ ショウジョウ ノ QOL カイゼン ノ ヒョウカ ニ ユウヨウ デアッタ 1レイ

We report here an effective case of Rikkunshi-to（TJ-43）for who had gastrointestinal symptoms,nausea and diarrhea, and a usefulness of GSRS for evaluation of quality of life（QOL）ingastrointestinal symptoms. A 78 year-old male developed nausea and vomitting, and was foundwith a well to moderately differentiated adenocarcinoma of the rectum（Ra, type2, cT2, cN0, cM0,cStageⅡ）. He would be done with neoadjuvant chemoradiotherapy following transverse colostomy.However, he had heart burn and diarrhea after colostomy. Rikkunshi-to improved thesesymptoms. In GSRS, pre-and post-treatment of the total score decreased 3.9 to 2.0. The GSRS isa good relationship to QOL in gastrointestinal symptoms

A case of esophageal cancer with mesojejunal lymph node metastasis after total gastrectomy

A 56-year-old man was diagnosed with esophageal cancer by upper gastrointestinal endoscopy for examination of dysphagia. The patient had undergone total gastrectomy and jejunal interposition 4 years previously for a gastric cancer at the pT1N0M0 stage according to the UICC-TNM classification. Enhanced CT findings revealed a 3-cm-diameter mass located near the superior mesenteric artery. We conducted subtotal esophagectomy associated with partial jejunectomy including mesojejunectomy. The mass was histologically diagnosed to be mesojejunal lymph node metastasis from esophageal cancer. Mesojejunal lymph node metastasis from esophageal cancer developing after total gastrectomy has been reported in only three cases including ours. The present lymph node metastases may have occurred via the newly developed lymphatic drainage route through the esophagojejunostomy, and this metastatic lymph node can be considered the regional lymph node. Therefore, resection of the interposed jejunal limb with mesojejunectomy may be rational in surgery on esophageal cancer developing after total gastrectomy