Effects of Prolonged High Phosphorus Diet on Phosphorus and Calcium Balance in Rats

The amount of phosphorus contained in food as food additives is currently increasing and a high intake of phosphorus can cause various diseases. To determine the effects of a prolonged high phosphorus diet, here we investigated the phosphorus and calcium balance and expression of type IIa sodium-dependent phosphate transporter (Npt IIa) in mature rats. Wistar male rats (8-weeks old) were divided into five groups and fed diets containing 0.6% calcium plus 0.3, 0.6, 0.9, 1.2 or 1.5% phosphorus for 4 weeks. Urinary and fecal phosphorus excretions were significantly increased by the high phosphorus diets (from 0.6 to 1.5%), dependent on the amount of dietary phosphorus. The net absorption of intestinal phosphorus was also significantly increased by high phosphorus diets. As a result, a negative phosphorus balance was observed in rats given the 1.2% or 1.5% phosphorus diets. Serum parathyroid hormone and 1,25-dihydroxyvitamin D3 concentrations were increased by high phosphorus diets. In addition, high phosphorus diets decreased the expression of Npt IIa mRNA and protein in the renal brush border membrane. Taken together, these results suggest that diets containing 1.2 or 1.5% phosphorus plus 0.6% calcium have potentially adverse effects on phosphorus homeostasis in mature rat

Placenta Accreta in a Woman with Childhood Uterine Irradiation: A Case Report and Literature Review

The pregnancies of childhood cancer survivors who have received uterine irradiation are associated with a high risk of several obstetrical complications, including placenta accreta. The present case was a 26-year-old pregnant woman with a history of myelodysplastic syndrome treated with umbilical cord blood transplantation following chemotherapy and total body irradiation at the age of 10. Despite every possible measure to prevent preterm labor, uterine contractions became uncontrollable and a female infant weighing 892 g was vaginally delivered at 27⁺⁴ weeks of gestation. Under the postpartum ultrasonographic diagnosis of placenta accreta, we selected to leave the placenta in situ. Although emergency bilateral uterine artery embolization was required, complete resorption of the residual placenta was accomplished on the 115th day postpartum. Our experience highlighted the following points. (1) The expectant management of placenta accreta arising in an irradiated uterus may not only fulfill fertility preservation, but may also reduce possible risks associated with cesarean hysterectomy. (2) Due to extreme thinning of and a poor blood supply to the myometrium, reaching an antepartum diagnosis of placenta accreta in an irradiated uterus is difficult. (3) The recurrence of placenta accreta in subsequent pregnancies needs to be considered after successful preservation of the uterus

The significance of clinical symptoms of subchorionic hematomas, “bleeding first”, to stratify the high-risk subgroup of very early preterm delivery

OBJECTIVE: To investigate the factors that stratify high-risk cases among subchorionic hematomas (SCHs) patients with persistent vaginal bleeding in early pregnancy. MATERIALS AND METHODS: A total of 56 patients who required hospitalization for SCH with vaginal bleeding in early pregnancy were classified into two groups: 1) no hematoma by ultrasonography when vaginal bleeding occurred, and then hematoma was observed by ultrasonography "bleeding to hematoma (BH group, n = 15)" and 2) no vaginal bleeding when hematoma was observed by routine ultrasonography, and then vaginal bleeding occurred later "hematoma to bleeding (HB group, n = 41)". Retrospective cohort study was performed and maternal and neonatal outcomes were evaluated. RESULTS: The duration of SCHs and/or vaginal bleeding was significantly longer in the BH group than in the HB group (mean: 60.8 days [BH group] vs. 33.3 days [HB group], p = 0.015). BH group patients delivered earlier than HB group patients significantly (mean: 27.3 weeks [BH group] vs. 35.6 weeks [HB group], p = 0.0028). The frequency of chronic abruption and oligohydramnios sequence (CAOS) was significantly higher in the BH group than in the HB group (3/15; 20.0% [BH group] vs. 0/41; 0.0% [HB group], p = 0.016). The frequency of sever fetal distress (Apgar score <4 points) was significantly higher in the BH group than in the HB group (4/15; 26.7% [BH group] vs. 0/41; 0.0% [HB group], p = 0.0037). The levels of factor XIII were relatively lower in the BH group than in the HB group (mean: 54.8% (n = 4) [BH group] vs. 76.1% (n = 7) [HB group], p = 0.077). CONCLUSION: The order of the symptoms, bleeding first, is an important feature that reflects the subsequent prolonged duration of SCHs/vaginal bleeding, resulting in very early preterm delivery. Continuous hemorrhage consumes coagulation factor XIII, which further worsen the hemostasis

Oncofertility care in young women and the outcomes of pregnancy over the last 5 years

Aim: To ascertain the actual outcomes of oncofertility care in young women to provide more appropriate care. Materials & methods: We analyzed the data of 67 female patients under 43 years of age who underwent oncofertility care between January 2015 and September 2019. Results: There were 28 patients with breast cancer, 19 patients with hematologic cancer and 20 patients with other cancer diagnoses. Breast cancer patients tended to take longer than hematologic cancer patients to initiate oncofertility treatment. Despite undergoing oncofertility care, seven of nine pregnant patients did not choose assisted reproductive technology (ART). Conclusion: As spontaneous pregnancies were more common than ART pregnancies in our study, pregnancy by not only ART but also non-ART method is a viable option for young cancer survivors

Study of Training Programs Designed for Teachers Providing Education in a Globalizing Society : The Development and Delivery of Lessons Based on Principles of Inclusive Teaching of Special Support Class Teachers and Normal Curriculum Teachers

本研究では，教育のグローバル化や共生社会の実現に向け，児童の個別教育ニーズに対応するための教員研修に着目し，教員間の共生関係や教師の力量形成につながる研修を実施した。研究の２年目にあたり，インクルーシブ教育研修を校内研修に位置づけ，その第１段階として異学級編成の集団における授業を実施した。その結果，特別支援学級と通常学級の教員の連携によって互いの専門性を生かし合いながら授業を行い，それぞれの児童実態の把握の仕方・捉え方の違いを検討すること，教科の指導については，学習したことを次の学習に生かしたり，生活に反映させたりするための視点について検討することを通して，成果と課題を得ることができた。This study investigated training programs designed to correspond to the demands of individual tutoring needs and the delivery of training programs. We aimed to enable teachers to develop stronger teaching skills as well as socializing ability with other teachers. In the second year, we set an inclusive educating training program as a staff training. At the first stage, teachers taught a class in a group of the different class organization. By teaching a class in which special support class teachers and normal curriculum teachers cooperated, emphasizing their ability and skills in their field, strong results and future tasks were clarified. The study examined how children are observed and recognized by each of the teaching parties, how children apply the method of learning obtained from one subject of study to another, and how children adapted the learned matter into real life situations

Review of global teacher lecture development training for the realization of symbiotic society: Taking into consideration the development of lessons in special support class and normal curriculum class can collaborate

本研究では，教育のグローバル化や共生社会の実現に向け，児童の個別教育ニーズに対応するための教員研修に着目し，教員間の共生関係や教師の力量形成につながる研修を実施した。研究の３年目にあたり，第２段階である複数学級編成の児童に対して，特別支援学級と通常学級の教員が協力して授業開発し，実践・協議を行った。その協議会では，授業における児童の学び合いやかかわりについての議論が中心となり，その代案ついても話し合いが行われた。また，授業者においても協議における多面的な見方・考え方から，新たな課題に気づくことができたことからも，研修の有効性を明らかにすることができた。今後の課題においては，児童の学び合いやかかわりについて，質を高めていく授業デザインを検討していく必要がある。This study focused on globalization and inclusive society by focusing on training programs designed to correspond towards demands of individual tutoring needs and conducting of training programs for teachers to develop stronger teaching skills as well as socializing ability between other teachers. In the third year of the research, special support classes and regular class faculty members cooperated with the second stage, multi-class organization children, to develop lessons, practice and consultation. Discussions on learning and engagement of students in classes focused mainly on discussions at the council, and discussions on alternatives were also held. In addition, it was possible for the lesson to clarify the effectiveness of the training also from being able to notice the new task from the multifaceted viewpoint and way of thinking in consultation. In the future tasks, we need to consider class design to improve the quality of learning and engagement of children

The Development of the Japanese Lesson to Foster Independent Reader

本研究は，グローバル化社会において自立した読書人となるために必要な資質・能力を育てるための小学校国語科における読書カリキュラムの開発を行うことを目的としている。 本年度は，自立した読書人に必要な資質・能力を「読書に関する知識・技能」「読書を通した思考力・判断力・表現力」「主体的・積極的に読書に取り組み，読書を通して情緒を育て，様々な人の中に参入する態度」とし，カリキュラムの内容も同じ３領域で編成した。国語科の指導内容は，系統的・段階的につながるとともに，螺旋的・反復的に学習することで能力の定着を図ることが大切であると考える。そこで，「読書に関する知識・技能」「読書を通した思考力・判断力・表現力」は，それぞれの学年で焦点化したり重点化したりしながら指導していくが，指導対象学年を明確に分けることはしない。「主体的・積極的に読書に取り組み，読書を通して情緒を育て，様々な人の中に参入する態度」は，読書に向かう態度と本によって培う人間性とに分け，２学年ずつで段階的に指導していくこととした。これに基づいて実践を４本行い，その成果と課題からカリキュラムの妥当性を検証した。In this research, we aimed to develop the reading curriculum in elementary school in order to foster independent reader in the global society. We examined and configured the reading curriculum based three competences:（1）reading skills, （2）the competency of thinking, judging and expressing through reading, （3）the positive attitude to reading, the affect through reading and the positive attitude to participate in the community. We think it is important to teach in the gradual and repeated approach. Then, we planned and practiced the four lessons based these three competences, examined the achievement and problems of these lessons and validity checked our reading curriculum

Intestinal epithelial cell-derived IL-15 determines local maintenance and maturation of intraepithelial lymphocytes in the intestine

Interleukin-15 (IL-15) is a cytokine critical for maintenance of intestinal intraepithelial lymphocytes (IELs), especially CD8αα+ IELs (CD8αα IELs). In the intestine, IL-15 is produced by intestinal epithelial cells (IECs), blood vascular endothelial cells (BECs) and hematopoietic cells. However, the precise role of intestinal IL-15 on IELs is still unknown. To address the question, we generated two kinds of IL-15 conditional knockout (IL-15cKO) mice: villin-Cre (Vil-Cre) and Tie2-Cre IL-15cKO mice. IEC-derived IL-15 was specifically deleted in Vil-Cre IL-15cKO mice, whereas IL-15 produced by BECs and hematopoietic cells is deleted in Tie2-Cre IL-15cKO mice. The cell number and frequency of CD8αα IELs and NK IELs were significantly reduced in Vil-Cre IL-15cKO mice. By contrast, CD8αα IELs were unchanged in Tie2-Cre IL-15cKO mice, indicating that IL-15 produced by BECs and hematopoietic cells is dispensable for CD8αα IELs. Expression of an anti-apoptotic factor, Bcl-2, was decreased, whereas Fas expression was increased in CD8αα IELs of Vil-Cre IL-15cKO mice. Forced expression of Bcl-2 by a Bcl-2 transgene partially restored CD8αα IELs in Vil-Cre IL-15cKO mice, suggesting that some IL-15 signal other than Bcl-2 is required for maintenance of CD8αα IELs. Furthermore, granzyme B production was reduced, whereas PD-1 expression was increased in CD8αα IELs of Vil-Cre IL-15cKO mice. These results collectively suggested that IEC-derived IL-15 is essential for homeostasis of IELs by promoting their survival and functional maturation

JOA Back Pain Evaluation Questionnaire: initial report

AbstractBackgroundThere is no widely accepted objective evaluation for lumbar spine disorders. New outcome measures should be patient-oriented and should measure symptoms and self-reported functional status in multiple dimensions. The aim of this study was to identify items to be included in the disease-specific quality of life (QOL) questionnaire for the assessments of patients with lumbar spine disorders.MethodsThe draft of the QOL questionnaire that consisted of a total of 60 items, including 24 items derived from the Japanese version of the Roland Morris Disability Questionnaire (RDQ) and 36 items derived from the Japanese version of Short Form 36 (SF-36), were administered to patients and controls. After obtaining written informed consent, the following data were collected from the patient group (n = 328) and the control group (n = 213): (1) background characteristics, including age, diagnosis, Japanese Orthopaedic Association (JOA) score, and finger to floor distance; (2) responses to the questionnaire; (3) the identification rate by discrimination analysis to select the candidates for adoption and by adopting explanatory variables. The items to be excluded were determined by examining the explanatory variables, which were selected after the discrimination analysis, by setting the candidate to-be-excluded items as an objective variable.ResultsBased on the distribution of the responses, two items, RDQ-15 and RDQ-19, were excluded. From the results of the correlation coefficient calculation for each question in the patient group, 33 items were excluded and 27 candidate items were adopted. Based on the adoption explanatory variable used in the discrimination analysis, 25 of the 27 candidate items for adoption were accepted.ConclusionsThis study identified the 25 specific questionnaire items that should be included in the questionnaire to evaluate QOL of patients with various lumbar spine disorders