日本におけるBig Fiveパーソナリティの地域差とその背景に関する検討

早大学位記番号:新9157博士(文学)早稲田大

Successful management of placenta percreta by cesarean hysterectomy with transverse uterine fundal incision

Placenta accreta presents one of the highest risks to pregnancy, and its more severe variant, placenta percreta, is particularly risky. The incidence of both conditions is increasing. Placenta percreta requires a cesarean hysterectomy for management, but the challenges associated with this surgery often result in severe obstetric hemorrhaging and high rates of maternal morbidity. Several recent obstetric studies have reported on the usefulness of the transverse uterine fundal incision for the management of placenta accreta and its variants. However, these reports included only a few cases of placenta percreta. Here we present a case of placenta percreta covering the anterior uterine wall that was successfully managed using a transverse fundal incision, which avoided incising the placenta at delivery and thus reduced maternal blood loss. After delivery, the patient underwent a total abdominal hysterectomy without the need for a blood transfusion. We conclude that a transverse uterine fundal incision can be very useful for the management of placenta percreta of the anterior uterine wall

A validation of the Japanese adaptation of the Big Five Inventory-2

The purpose of this study was to adapt a Japanese version of the Big Five Inventory-2 (BFI-2-J) to examine its factor structure, reliability, validity, and measurement invariance. The BFI-2-J assesses five domains and 15 facets of the Big Five personality traits. We analyzed two datasets: 487 Japanese undergraduates and 500 Japanese adults. The results of the principal component analysis and confirmatory factor analysis revealed that the domain-facet structure of the BFI-2-J was similar to that of other language versions. The reliability of the BFI-2-J is sufficient. The correlation coefficients between the BFI-2-J and the other Big Five and self-esteem measures supported convergent and discriminant validity. Moreover, we confirmed measurement invariance across age and sex groups in domain-level and facet-level models. The results suggest that the BFI-2-J is a good instrument for measuring the Big Five personality traits and their facets in Japan. The BFI-2-J is expected to be useful in Japanese personality research and international comparative research

Examination of Gender Differences in Dichotomy Beliefs and Age-related Changes

publisher奈良"　本研究は、二分法的思考尺度の下位尺度である「二分法的信念」「損得思考」「二分法的選好」への年齢と性別の影響を検討することを目的とし、併せてBig5の要素や幸福感、他者信頼度等の変数との関連性を検討することにより先行研究で示された人格障害等との関連性を検証することを目的に行われた。具体的には、75歳以上の高齢者の年代では、その年代未満よりも二分法的思考傾向が高くなること（仮説１）二分法的思考は女性よりも男性の方が高いこと（仮説２）を検証することを目的に行われた。 　その結果、二分法的思考尺度の下位尺度各々とBig5の各要素との有意な関連性が示された。特に神経症傾向との正の相関ならびに幸福感との負の相関が示されたことにより先行研究と一致する結果が得られた。 　性別・年代の影響について、仮説１は年代別比較により75歳以上の年代が65歳未満、65歳以上74歳未満の年代に比べて高くなっていたことから支持され、仮説２については、65歳以上74歳未満でのみ有意な性差が確認されたことから部分的支持となった。

Risk factors related to the reduction of subjective taste ability in middle-to old-aged nursing home residents in Sri Lanka : a cross-sectional study

The purpose of this study is to verify the factors significantly related to the reduction of subjective taste ability of 1,015 middle-aged and elderly (50 - 96 years old) at 25 randomized selected nursing homes in Sri Lanka. Binary logistic regression analyses by gender were performed using IBM SPSS on following variables. A dependent variable is taste ability, and 27 independent variables are age, daily lifestyle, nutritional problems, general status, dental status and physiological thresholds of taste abilities (sweet, salt, sour, bitter, and umami). Smell ability (p < 0.001 - 0.05) and the Self-Report Questionnaire, 20-item version :SRQ 20 (p < 0.01 - 0.05) were significant risk factors of reducing taste ability in both genders. Especially, smell ability was closely linked to taste ability. Existence of comprehensive perception of “flavor” composed of taste and smell ability was illustrated. Significant gender differences factors were observed in long term care needs (p < 0.05), sleeping (p < 0.01 - 0.001), bowel condition (p < 0.05) in males; and height (p < 0.05), weight (p < 0.05), BMI 3 categories (p < 0.05), and brushing (p < 0.05) in females. Other variables such as age and five types of physiological taste ability were not significant in both genders. The results of this investigation also strongly indicated that the perception of subjective sense of taste was different from the objective sense of taste. Epidemiological studies such as cohort or intervention studies focusing on a relationship between subjective taste ability and sense of smell are necessary to identify more accurate and changeable risk factors for dysgeusia in order to improve elderly’s nutritional intake in Sri Lanka

Diagnostic Value of Dual-time-point F-18 FDG PET/CT and Chest CT for the Prediction of Thymic Epithelial Neoplasms

We retrospectively assessed the dual-time-point (DTP) F-18 FDG PET/CT findings of thymic epithelial neoplasms (TENs) and investigated the diagnostic capacity of PET/CT compared to that of CT for predicting carcinoma. We calculated the ratio of the standardized uptake value of the tumor and that of the aortic arch (T/M ratio) for both the 90-min early scan and the 2-h delayed scan in 56 TEN patients. We used a multivariate logistic regression (MLR) analysis to estimate the CT features of carcinoma. We compared the diagnostic capacities of PET/CT and chest CT using receiver operating characteristic (ROC) analyses. The ROC curve revealed that the appropriate cut-off T/M ratio value for the highest accuracy was 2.39 with 75.0% accuracy. The area under the curve (AUC) was 0.855. The statistical analyses for DTP scans of 35 TEN patients demonstrated 74.3% accuracy and 0.838 AUC for the early scan versus 82.9% and 0.825 for the delayed scan. The MLR analysis indicated that mediastinal fat infiltration was a predictor of carcinoma. The ROC curve obtained for the model yielded an AUC of 0.853. Delayed scanning could improve the diagnostic capacity for carcinoma. The T/M ratio and mediastinal fat infiltration are predictive of carcinoma with moderate diagnostic accuracy

Effect of a long-acting somatostatin analogue (SMS 201-995) on a growth hormone and thyroid stimulating hormone-producing pituitary tumor.

A 46-year-old woman with acromegaly and hyperthyroidism due to a pituitary adenoma. She had high serum thyroid-stimulating hormone (TSH) levels and very high serum growth hormone (GH) levels. Transsphenoidal removal of the tumor, post-operative irradiation, frontal craniotomy for removal of residual tumor and large-dose bromocriptine therapy were carried out consecutively. After therapy, serum GH levels gradually decreased, but not to the normal range, and serum TSH levels remained at inappropriately normal levels. Using immunoperoxidase techniques, GH-, TSH- and follicle-stimulating hormone (FSH)-containing cells were demonstrated in the adenoma. A long-acting somatostatin analogue (SMS 201-995, 600 micrograms/day) suppressed the serum GH level to the normal range with a concomitant suppression of TSH. Furthermore, the paradoxical serum GH responses to TRH and LH-RH were slightly improved. No important subjective side-effects were noted. Therefore, SMS 201-995 appeared to be a very effective drug in this patient with a GH- and TSH-producing pituitary tumor.&#60;/P&#62;</p

Transforming somatic mutations of mammalian target of rapamycin kinase in human cancer

Mammalian target of rapamycin (mTOR) is a serine-threonine kinase that acts downstream of the phosphatidylinositol 3-kinase signaling pathway and regulates a wide range of cellular functions including transcription, translation, proliferation, apoptosis, and autophagy. Whereas genetic alterations that result in mTOR activation are frequently present in human cancers, whether the mTOR gene itself becomes an oncogene through somatic mutation has remained unclear. We have now identified a somatic non-synonymous mutation of mTOR that results in a leucine-to-valine substitution at amino acid position 2209 in a specimen of large cell neuroendocrine carcinoma. The mTOR(L2209V) mutant manifested marked transforming potential in a focus formation assay with mouse 3T3 fibroblasts, and it induced the phosphorylation of p70 S6 kinase, S6 ribosomal protein, and eukaryotic translation initiation factor 4E-binding protein 1 in these cells. Examination of additional tumor specimens as well as public and in-house databases of cancer genome mutations identified another 28 independent non-synonymous mutations of mTOR in various cancer types, with 12 of these mutations also showing transforming ability. Most of these oncogenic mutations cluster at the interface between the kinase domain and the FAT (FRAP, ATM, TRRAP) domain in the 3-D structure of mTOR. Transforming mTOR mutants were also found to promote 3T3 cell survival, and their oncogenic activity was sensitive to rapamycin. Our data thus show that mTOR acquires transforming activity through genetic changes in cancer, and they suggest that such tumors may be candidates for molecularly targeted therapy with mTOR inhibitors