DSpace コレクション: 2016年度博士論文

Keratin 19 as a key molecule in progression of human hepatocellular carcinomas through invasion and angiogenesis.

Thu, 17 Nov 2016 15:00:00 GMT

タイトル: Keratin 19 as a key molecule in progression of human hepatocellular carcinomas through invasion and angiogenesis. 著者: Takano, Masato; Shimada, Keiji; Fujii, Tomomi; Morita, Kohei; Takeda, Maiko; Nakajima, Yoshiyuki; Nonomura, Akitaka; Konishi, Noboru; Obayashi, Chiho 抄録: BACKGROUND: Keratin (K) 19-positive hepatocellular carcinoma (HCC) is well known to have a higher malignant potential than K19-negative HCC: However, the molecular mechanisms involved in K19-mediated progression of HCC remain unclear. We attempted to clarify whether K19 directly affects cell survival and invasiveness in association with cellular senescence or epithelial-mesenchymal transition (EMT) in K19-positive HCC. METHODS: K19 expression was analysed in 136 HCC surgical specimens. The relationship of K19 with clinicopathological factors and survival was analysed. Further, the effect of K19 on cell proliferation, invasion, and angiogenesis was examined by silencing K19 in the human HCC cell lines, HepG2, HuH-7, and PLC/PRF/5. Finally, we investigated HCC invasion, proliferation, and angiogenesis using K19-positive HCC specimens. RESULTS: Analysis of HCC surgical specimens revealed that K19-positive HCC exhibited higher invasiveness, metastatic potential, and poorer prognosis. In vitro experiments using the human HCC cell lines revealed that K19 silencing suppressed cell growth by inducting apoptosis or upregulating p16 and p27, resulting in cellular senescence. In addition, transfection with K19 siRNA upregulated E-cadherin gene expression, significantly inhibited the invasive capacity of the cells, downregulated angiogenesis-related molecules such as vasohibin-1 (VASH1) and fibroblast growth factor 1 (FGFR1), and upregulated vasohibin-2 (VASH2). K19-positive HCC specimens exhibited a high MIB-1 labelling index, decreased E-cadherin expression, and high microvessel density around cancer foci. CONCLUSION: K19 directly promotes cancer cell survival, invasion, and angiogenesis, resulting in HCC progression and poor clinical outcome. K19 may therefore be a novel drug target for the treatment of K19-positive HCC. 内容記述: 博士（医学）・乙第1399号・平成29年3月15日; © The Author(s). 2016 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Biomechanical analysis of immediately loaded implants according to the "All-on-Four" concept.

Sun, 04 Sep 2016 15:00:00 GMT

タイトル: Biomechanical analysis of immediately loaded implants according to the "All-on-Four" concept. 著者: Horita, Satoshi; Sugiura, Tsutomu; Yamamoto, Kazuhiko; Murakami, Kazuhiro; Imai, Yuichiro; Kirita, Tadaaki 抄録: PURPOSE: The purpose of this study was to investigate the biomechanical behavior of immediately loaded implants in an edentulous mandible according to the "All-on-Four" concept. METHODS: A 3D-finite element model of an edentulous mandible was constructed. Four implants were placed between the bilateral mental foramen according to "All-on-Four" concept. A framework made of titanium or acrylic resin between the bilateral first molars was modeled. Immediate loading and a delayed loading protocol were simulated. A vertical load of 200N was applied at the cantilever or on the abutments region of the distal implants, simulating the absence of a cantilever. RESULTS: The peak principal compressive strains in the immediate loading models resulted in 24.0-35.8% and 26.4-39.0% increases compared with the delayed loading models under non-cantilever loading and cantilever loading, respectively. The loading position greatly affected the principal compressive and tensile strain values. The peak principal compressive strains in non-cantilever loading resulted in a 45.3-52.6% reduction compared with those in cantilever loading. The framework material did not influence the peak compressive and tensile strain. The maximum micromotion at the bone-implant interface in the immediate loading models was 7.5-14.4μm. CONCLUSIONS: Mandibular fixed full-arch prostheses without cantilevers may result in a favorable reduction of the peri-implant bone strain during the healing period, compared with cantilevers. The maximum micromotion was within the acceptable limits for uneventful implant osseointegration in the immediate loading models. Framework material did not play an important role in reducing the peri-implant bone strain and micromotion at the bone-implant interface. 内容記述: 博士（医学）・乙第1398号・平成29年3月15日; Copyright © 2017 The Authors. Published by Elsevier Ltd on behalf of Japan Prosthodontic Society. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Effects of anesthetics on early postoperative cognitive outcome and intraoperative cerebral oxygen balance in patients undergoing lung surgery: a randomized clinical trial.

Fri, 30 Sep 2016 15:00:00 GMT

タイトル: Effects of anesthetics on early postoperative cognitive outcome and intraoperative cerebral oxygen balance in patients undergoing lung surgery: a randomized clinical trial. 著者: Egawa, Junji; Inoue, Satoki; Nishiwada, Tadashi; Tojo, Takashi; Kimura, Michitaka; Kawaguchi, Takeshi; Taniguchi, Shigeki; Furuya, Hitoshi; Kawaguchi, Masahiko 抄録: PURPOSE: One-lung ventilation (OLV) may impair cerebral oxygen balance and induce postoperative cognitive dysfunction (POCD). It is unclear whether the type of anesthetic influences the incidence of POCD in patients undergoing OLV. This prospective study compared the incidence of POCD and intraoperative cerebral oxygen desaturation in OLV patients anesthetized with propofol vs sevoflurane during lung surgery. METHODS: There were 148 participants enrolled in this study and randomized equally to either the propofol or the sevoflurane group. Anesthesia was maintained with either propofol or sevoflurane combined in both groups with fentanyl and epidural anesthesia. Regional cerebral oxygen saturation (rSO2), jugular bulb venous oxygen saturation (SjO2), and the incidence of cerebral oxygen desaturation (rSO2 or SjO2 < 50% or rSO2 < 80% of baseline) were measured during anesthesia. Cognitive function was assessed using seven neurocognitive tests two days preoperatively, five days postoperatively (primary outcome), and three months postoperatively. Bivariable and multivariable regression analyses were conducted to identify factors associated with POCD. RESULTS: Rates of POCD did not differ statistically between groups five days postoperatively (propofol, 16/72 patients; sevoflurane, 24/72 patients; RR, 0.67; 95% CI, 0.39 to 1.15; P = 0.14) or three months postoperatively (propofol, 9/60 patients; sevoflurane, 12/58 patients; RR, 0.73; 95% CI, 0.33 to 1.59; P = 0.42). Only three subjects per group showed intraoperative cerebral oxygen desaturation. Multivariable regression analysis revealed older age as an independent predictor of POCD. CONCLUSIONS: No statistically significant difference in the incidence of POCD could be detected between the sevoflurane and propofol anesthesia groups. Postoperative cognitive dysfunction was relatively frequent following OLV in both groups. (REGISTRATION NUMBER: UMIN 000002826). 内容記述: 博士（医学）・乙第1397号・平成29年3月15日; © Canadian Anesthesiologists' Society 2016; This is a post-peer-review, pre-copyedit version of an article published in Canadian journal of anaesthesia. The final authenticated version is available online at: http://dx.doi.org/10.1007/s12630-016-0700-4.

Association of Visual Acuity and Cognitive Impairment in Older Individuals: Fujiwara-kyo Eye Study.

Sun, 31 Jul 2016 15:00:00 GMT

タイトル: Association of Visual Acuity and Cognitive Impairment in Older Individuals: Fujiwara-kyo Eye Study. 著者: Mine, Masashi; Miyata, Kimie; Morikawa, Masayuki; Nishi, Tomo; Okamoto, Nozomi; Kawasaki, Ryo; Yamashita, Hidetoshi; Kurumatani, Norio; Ogata, Nahoko 抄録: Both visual impairment and cognitive impairment are essential factors that determine the quality of life in the aged population. The aim of this study was to determine if a correlation existed between visual acuity and cognitive impairment in an elderly Japanese population. The Fujiwara-kyo Eye Study was a cross-sectional study of individuals aged ≥68 years who lived in Nara Prefecture of Japan. Participants underwent ophthalmological examinations and cognitive function test. A mild visual impairment was defined as having a best corrected visual acuity (BCVA) >0.2 logarithm of the minimum angle of resolution (logMAR) units in the better eye. Cognitive impairment was defined as having a Mini-Mental State Examination (MMSE) score of ≤23 points. A total to 2818 individuals completed the examinations. The mean age of the participants was 76.3 ± 4.8 years (mean ± standard deviation). The mean BCVA of the better eye was -0.02 ± 0.13 logMAR units and 6.6% subjects were classified as being mildly visually impaired. The mean MMSE score was 27.3 ± 2.3 and 5.7% subjects were classified as being cognitively impaired. The proportion of subjects with cognitive or moderate visual impairment increased with age, and there was a significant correlation between the visual acuity and MMSE score (r = -0.10, p < 0.0001). Subjects with mild visual impairments had 2.4 times higher odds of having cognitive impairment than those without visual impairment (odds ratio 2.4, 95% confidence interval, 1.5-3.8, p < 0.001) after adjusting for age, sex, and length of education. We conclude that it may be important to maintain good visual acuity to reduce the risk of having cognitive impairment. 内容記述: 博士（医学）・乙第1396号・平成29年3月15日; © Masashi Mine et al. 2016; Published by Mary Ann Liebert, Inc. This Open Access article is distributed under the terms of the Creative Commons License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.