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Background/aim The prognosis of colorectal cancer is reported to differ depending on the tumor site, and clinical differences depending on the site of occurrence have gained attention. The aim was to compare nutrition index and inflammatory markers according to the site of colon cancer. Patients and methods We retrospectively analyzed 272 cases of stage I-III colon cancer (55% males, 45% females). The clinical characteristics, nutrition index and inflammatory markers were compared between patients with right colon cancer (RCC, n=119) and those with left colon cancer (LCC, n=153), and the relapse-free survival was then compared. Results RCC was associated with older age (p=0.03), female gender (p=0.003), higher T stage (p=0.01), elevated platelet/lymphocyte ratio (PLR) (p=0.009), and elevated CONUT score (p=0.028). The prognostic values differed between RCC and LCC (RCC: CONUT score, p=0.04, LCC: PLR, p=0.02). Conclusion RCC was associated with an elevated CONUT score and PLR. In RCC, the CONUT score was an independent recurrence factor, and in LCC, the PLR was an independent recurrence factor.

The Controlling Nutritional Status (CONUT) score is a marker of nutrition and is associated with poor survival in various kinds of cancers. However, no reports have yet compared risk factors for colorectal cancer recurrence using a nutritional index. We assessed the predictive value of the CONUT score compared with the modified Glasgow Prognostic Score (mGPS) and Prognostic Nutritional Index (PNI) in colorectal cancer (CRC) patients. We performed a retrospective cohort study of the medical records of 336 consecutive patients with stage I-I I I CRC who underwent curative resection at a single institution in 2012–2017. Univariate and multivariate analyses were conducted to identify prognostic factors associated with relapse-free survival (RFS) and overall survival (OS). The low CONUT score group exhibited higher RFS and longer OS compared to the high CONUT score group (82.2% vs. 63.3%, p = 0.002 and 95.5% and 86.2%, p = 0.005, respectively). The Akaike’s information criterion values of each index for RFS and OS were superior in CONUT score (723.71 and 315.46, respectively) compared to those of PNI (726.95 and 316.52) and mGPS (728.15 and 318.07, respectively). The CONUT score was found to be a good predictor of RFS and OS in patients with resectable CRC.

Background: It was reported that in surveillance colonoscopy (SC), targeted and random biopsies detected similar proportions of neoplasias. However, that study was conducted by experienced endoscopists familiar with colitic cancer. We report two cases of disseminated colitic cancer in patients who had undergone SC. Case Presentation: Case-1: A 69-year-old Japanese man first suffered from ulcerative colitis (UC) in 1979. Annual SCs had been performed since 1998. In 2017, colonoscopy confirmed a cancer in the ascending colon. A laparoscopy-assisted anal-preserving total proctocolectomy was performed in 2018. Histological findings showed the cancer reaching serosa and lymph node metastasis. Peritoneal dissemination occurred 1 year after the surgery. Two years after the first surgery, an ileostomy was created due to bowel obstruction caused by peritoneal dissemination. Case-2: A 77-year-old Japanese man was diagnosed with UC at another hospital in 2010. SCs were performed annually since 2011. In April 2019, he developed frequent bowel movements, bleeding, and weight loss. Colonoscopy revealed stenosis at the rectum and sigmoid colon. The biopsy revealed adenocarcinoma. Laparoscopy-assisted surgery was performed in July 2019. The yellow ascites was aspirated and submitted for lavage cytology, which revealed signet-ring cell carcinoma. Many white nodules were found in the peritoneum and were diagnosed as peritoneal dissemination. A colostomy was performed. Chemotherapy was administered. Five months have passed since the operation, and the patient is alive. Conclusion: Chromoendoscopy had not been performed in either patient. It is advisable to use chromoendoscopy when a target biopsy is performed.

We report a case of submucosal(SM)adenocarcinoma of the sigmoid colon which developed distant metastasis 3 months after endoscopic mucosal resection(EMR).54-year-old, male. Colonoscopy, which was performed due to positive fecal occult blood test, revealed 18 mm Isp sigmoid polyp. EMR was performed with en bloc resection. Pathological examination revealed adenocarcinoma(tubporsig), pT1b, Ly1c, V1a, pHM0, and pVM1. Therefore, laparoscopic sigmoidectomy(D2 dissection)was performed. Postoperative pathological examination revealed pT1b, pN2b(10/11), PN1b, pPM0, pDM0, pStage Ⅲb. Distant nodal involvement were found on computed tomography 3 months after EMR, although systemic chemotherapy(mFOLFOX6 plus panitumumab 18 courses and FOLFIRI plus bevacizumab 4 courses)was performed, the patient died of liver failure caused by liver metastasis 21 months after EMR.We present a case of T1 sigmoid adenocarcinoma which developed distant metastasis 3 months after EMR with literature review.

The program education is a required content for the Japanese High School Courses of Study published in 2018,and the importance of programming education is increasing. Therefore, the purpose of this study is to make a proposalfor creating teaching materials for programming education in high school information subjects. The purposeof this study is to make a proposal for creating teaching materials for programming education in high school informationsubjects. Surveys on information subjects at high school and junior high school are conducted, and a studyis conducted on what materials are needed as problems and solutions in programming education. High school andjunior high school focus on learning about Microsoft Office software and information morals. High schools do notprovide much programming education. The acquisition of knowledge and skills in programming education in juniorhigh school can be ensured by conducting programming education at high school. It is desirable to create teachingmaterials to introduce programming thinking and teaching materials that make a smooth transition to learning descriptiveprogramming language.

It has been shown that nutritional status correlates with survival in patients with various kinds of cancers. Besides, cancer causes inflammation which has been suggested to stimulate cancer progression. Therefore, inflammation status also has shown to reflect prognosis of cancers. In this study, we evaluated several kinds of nutritional and inflammation parameters in preoperative blood samples and constructed new risk model predicting a survival in patients with CRC (colorectal cancers). We retrospectively examined 286 patients with stage I-III CRC who had undergone curative resection in Teikyo University Hospital between 2013 to 2017. The association between overall survival (OS) and preoperative body mass index, albumin (Alb), cholesterol (Chol), and lymphocyte count, white blood cell count (WBC), neutrophil count (Neu), platelet count (Plt), C-reactive protein (CRP) were examined using Kaplan-Meier curve and log rank test. and eventually Alb, Chol, Neu, Plt, and CRP were shown to correlate with OS. Alb, Chol, Neu, Plt, and CRP were shown to correlate with OS. We constructed a new risk model (NIS: nutrition inflammation status) using these factors, and compared its usefulness with known models such as CRP-albumin ratio (CAR), Glasgow prognostic score (GPS), prognostic nutritional index (PNI), and neutrophil lymphocyte ratio (NLR). NIS prepared using nutritional indicators and inflammatory findings was useful as a new model for predicting overall survival in patients undergoing curative resection for CRC, compared with known models.

Background/Aim: To evaluate the benefits of the addition of oxaliplatin (OX) to fluoropyrimidine (FP)-based neoadjuvant chemoradiotherapy (CRT) for patients with locally advanced rectal cancers (LARCs). Patients and Methods: We performed retrospective analyses comparing the pathological complete response (pCR) rate, overall survival (OS), recurrence-free survival (RFS), and local recurrence-free survival (LRFS) between FP-based and FP+OX-based CRT groups and for patients who had completed the CRT. Results: One hundred patients were included in the analyses: the pCR rate, OS, RFS, and LRFS were similar between these groups. The FP+OX group showed significantly more frequent incompleteness of the CRT compared to the FP group (p=0.049). Among the patients who had completed the CRT, the FP+OX group demonstrated significantly improved LRFS compared to the FP group (p=0.048). Conclusion: The addition of OX to an FP regimen in neoadjuvant CRT for LARC may reduce local recurrence in patients who have achieved good compliance to CRT.

A multi-language software application of visual type to learn programming education for beginners has been developed.Block-type visual programming language is suited to the teaching material of programming education forelementary or junior high school students as in many cases. However, even if it is suitable for beginners, it is necessary to develop to the learning of descriptive language to obtain high interest.Therefore, the feature of this softwareapplication has tools that can learn both block-type graphic and text based programming language. Other featuresof this software application are as follows: simple input by selection, simultaneous display of text based language,learning by preset task, function to notify that debugging is necessary.

Background The term “mesenteric inflammatory veno-occlusive disease (MIVOD)” is used to describe an ischemic injury resulting from phlebitis or venulitis that affects the bowel or mesentery in the absence of arteritis. MIVOD is difficult to diagnose because of its rarity and frequent confusion with other diseases. The incidence and etiology of MIVOD remain unclear; only a few cases have been reported. We describe a case of the successful surgical management of a patient with MIVOD with characteristic images. Case presentation A 65-year-old Japanese man visited a hospital with the chief complaint of abdominal pain in January 2018. CT showed edema and thickening of the intestinal wall from the descending colon to the rectum. The patient was admitted to the hospital. Suspected diagnoses were enteritis, ulcerative colitis, amyloidosis, vasculitis, malignant lymphoma, and venous thrombus, but no definitive diagnosis was obtained. The patient was transferred to our hospital for the treatment of stenosis (located from the descending colon to the rectum) and bowel obstruction. An emergency transverse colostomy was performed. The sigmoid colon and mesentery were too rigid and edematous to resect. Colonic hemorrhage occurred 2 weeks after the surgery. With radiology intervention, coiling for the arteriovenous fistula in the descending colon was performed, and hemostasis was obtained. A colonoscopy at 6 months post-surgery showed neither ulceration nor stenosis in the rectum, indicating that the rectum could be preserved in the next surgery. However, severe stenosis in the descending and sigmoid colon remained unchanged. Ten months after the transverse colostomy, we performed a subtotal colectomy and ileorectal anastomosis, and an ileostomy was created. The sigmoid colon and mesentery were not so rigid compared to the first surgery’s findings, and we were able to resect intestine and mesentery. Histopathology revealed phlebitis and venulitis, fibrinoid necrosis, and normal arteries, meeting the diagnostic criteria for MIVOD. Postoperatively, the patient showed no recurrence for 8 months. Conclusion Clinicians should consider MIVOD when examining a patient with intestinal ischemia. When MIVOD is suspected, the patient is indicated for surgery based on an accurate diagnosis and good prognosis.

Liquid biomarkers for the early detection of resistance to chemotherapy are important for improving prognosis. This study investigated the usefulness of plasma exosomal microRNA-125b (ex-miRNA-125b) for the early detection of resistance to modified fluorouracil, leucovorin and oxaliplatin (mFOLFOX6)-based first-line chemotherapy in patients with advanced or recurrent (advanced/recurrent) colorectal cancer (CRC). First, ex-miRNAs associated with resistance to mFOLFOX6-based chemotherapy were profiled via miRNA microarray analysis. In this analysis, ex-miR-125b exhibited the greatest upregulation in patients with progressive disease (PD) compared with the findings for patients with stable disease (SD) and healthy controls. Next, another 55 patients with advanced/recurrent CRC who received mFOLFOX6-based first-line chemotherapy underwent a validation study of ex-miR-125b. Blood samples were collected before and during treatment until tumor progression. Ex-miRNA levels were measured via TaqMan microRNA assays. Patients with CRC had significantly higher ex-miR-125b levels than healthy controls. In patients with partial responses, ex-miR-125b levels at the Response Evaluation Criteria in Solid Tumors (RECIST) judgment point were significantly lower than those measured before treatment. In patients with SD, ex-miR-125b levels did not differ before and during treatment. In patients with PD, ex-miR-125b levels at the RECIST judgment point were significantly higher than those measured before treatment. These changes in ex-miR-125b levels were significantly different between groups even 1 month after the initiation of chemotherapy. Progression-free survival (PFS) was significantly worse in patients with high baseline ex-miR-125b levels than in those with low levels. In the Cox analysis, baseline ex-miR-125b levels and KRAS mutation were indicated to be independent prognostic factors for PFS. The present results suggest that plasma ex-miR-125b levels may be useful for the early detection of resistance to mFOLFOX6-based first-line chemotherapy. Furthermore, ex-miR-125b before chemotherapy is a predictive biomarker for PFS in patients with advanced/recurrent CRC.

Background: The number of ulcerative colitis (UC) patients is increasing in Japan and other countries. Selective depletion of myeloid lineage leucocytes by adsorptive granulocyte and monocyte apheresis (GMA) with an Adacolumn (JIMRO, Takasaki, Japan) was introduced as a nonpharmacologic treatment strategy in UC patients in 2000. GMA has been reported to be effective in clinical trials; however, the effect of concomitant prednisolone (PSL) on GMA needs to be clarified. Methods: Thirty-nine patients with active UC were treated with GMA at our institute between June 2009 and September 2018. All patients received GMA therapy once or twice a week with the Adacolumn. Conventional medication was to be continued during the whole GMA treatment course. The clinical response was retrospectively evaluated. Results: According to the partial Mayo score, remission was 33.3%, significant efficacy 25.6%, effective 25.6%, and no response 15.4%. The average partial Mayo score was 6.2 ± 1.4 at entry and significantly declined to 1.8 ± 1.8 after GMA sessions (p < 0.0001). The average number of bowel movements was 9.5 ± 5.6 at entry and significantly declined to 3.0 ± 2.8 after GMA sessions (p < 0.0001). In a comparison between the group treated with concomitant PSL and the group without PSL, the change in partial Mayo score or the number of bowel movements from entry to after GMA sessions was not significantly different. Among 24 patients treated by GMA with concomitant PSL, 75% (18/24) became steroid free. Conclusions: The effect of GMA with concomitant PSL and that of GMA without PSL were not different, and GMA was effective irrespective of PSL administration. The present study showed that GMA had efficacy and led many UC patients treated by PSL to be steroid free with no safety concern in the real world, although there is the possibility of recruitment bias due to the retrospective nature of the study.

Objective: We clarified the predictive and prognostic value of circulating plasma exosomal microRNA-21 (miR-21) in each TNM stage of colorectal cancer (CRC) patients. Methods: The microRNA (miRNA) profiles of the plasma exosomes, primary tumor tissues, and liver metastasis tissues from the same CRC patients were examined using a microarray. For validation analysis, the plasma exosome samples from 326 CRC patients were measured by TaqMan miRNA assays. Results: In the miRNA microarray analyses, miR-21 showed the highest upregulation in exosomes, primary tumor tissues, and liver metastasis tissues. Significant correlations were demonstrated between exosomal miR-21 and tissue miR-21 levels. As for the relationship to the pathological condition, exosomal miR-21 showed a significant association with liver metastasis and TNM stage. The overall survival (OS) rates and disease-free survival (DFS) rates in high-exosomal-miR-21 patients were significantly worse than those in low-miR-21 patients. Exosomal miR-21 levels were an independent prognostic factor for OS and DFS in CRC patients with TNM stage II or III, and for OS in patients with TNM stage IV. Conclusion: Plasma exosomal miR-21 levels are a useful biomarker for the prediction of recurrence and poor prognosis in CRC patients with TNM stage II, III, or IV.

The purpose of this study is to clarify the basic operation skills of tablet PCs for children with the intellectual disabilities. The skills measurement method and the software application for mesurement skills are developed to accomplish this purpose. In addition, it was carried out basic skills investigate the children with the intellectual disabilities and the questionnaire survey. The analysis of measurement and questionnaire survey using this application was carried out in children with intellectual disabilities. As the results, the operation skill of tablet PC can not be evaluated only by the age. It is an indication that even the degree of intellectual disabilities to evaluate the operation skills. Therefore, children with intellectual disabilities in school in case of using a tablet terminal, and it is required to use adapted to the degree of disability., 本研究では、知的障がいのある児童・生徒におけるタブレット端末に関する操作スキルの実態把握を目的とする.

特別支援教育において、タブレット端末の利活用は期待されている。しかしながら学校現場では児童生徒個人の特性に合わせた教材が多いとはいえず、その利活用は浸透していない。この状況を鑑み、タブレット端末画面上の操作対象となるボタンの最適寸法を明らかにすることで、今後子どもの特性を踏まえたタブレット端末用教材を開発する一助になると考えた。そこでタブレット端末におけるボタン操作について定量的に測定する方法とソフトの開発を行った。特別支援を要する児童生徒を対象とし、本ソフトを用いて測定を実施した。その結果、操作対象の位置別のミスの傾向や、ボタンの寸法によるミス数や操作時間の傾向が明らかとなった。特別な支援を要する児童生徒を対象とし、タブレット端末用教材の開発を行うにあたって、10.1インチのタブレット端末画面上でボタンの寸法を100×100px以上すなわち、17×17mm以上で設けることが適切であることがわかった。, The tablet PC is expected to use in the special support education. However the tablet PC is not used very much in school because there is a few teaching materials appropriate to the characteristics of the children withspecial needs. From the viewpoint of the situation, the optimal size of the operational button obtained is usefulfor the development of the educational material in the tablet PC. Thus the measurement method and the software application to obtain the optimal button size in tablet PC are developed for the children with special needs. As the result of measurement, it is clear how the mistakes change by the positions or by the button sizes.The operational button size obtained is over 100x100 pixels on 10.1-inch screen of the tablet PC; over 17×17mm.

本論文では、ある工業高校を取り上げ、教科「工業」の科目「工業技術基礎」、「課題研究」、「実習」での活動において、保健室を利用した生徒がどのような場面で、どのような怪我をしたのかに焦点を当て分析を行った。その結果を基に、今後必要となるであろう安全教育について、考察することを目的としている。考察した結果、①3年次の生徒や2学期など慣れたころに怪我が多く発生するので、1年次のみでなく、その時期に再度安全教育に関する授業を実施すること。②ものづくりでは、両手の共同作業が生じるので、利き手以外の怪我に注意すること。などに焦点を当て、安全教育を行う必要があるとの結論に至った。, In this study it will be analyzed how and where students get injured during the following industry class; Foundation of Industry Technology, Project Research and Training by a school infirmary use information in a technical high school. The principal purpose of our study is to consider deeply and examine what kind of safety-education would be required. The result of our analysis clearly shows that students are more likely to get injured when they become accustomed to the industry class, especially at the second semester or at the third year. Besides it should also be noted that students need to pay enough attention not to hurt their dominant hand when they work with both hands. Therefore, in conclusion, it can be said that it is essential to provide education on the safety of handling hazardous\materials at the second period or at the third year as well as at the first year.

ICT機器は児童生徒の障がいの状態や特性に応じて活用することで学習効果を高めると特別支援教育において注目されている。特に、タブレット端末は重複障がいのある児童生徒の自立活動において活用が期待されている。しかし、タブレット端末用教材は充実しているとは言えない。本研究では、重複障がいのある児童生徒を対象とした自立活動におけるタブレット端末教材の開発を行うとともに、本教材を自立活動で活用する際の指針を示す。その目的達成のため、自立活動において行われている識別学習を取り上げ、識別学習におけるタブレット端末用教材を開発した。その後、特別支援学校の重複学級に所属する児童生徒が本教材を使用し、担当する教員へアンケートおよび聞き取り調査を行った。調査の結果、本教材は重複学級の児童生徒に対して有用であることが認められた。また、本教材を活用する際は教員が児童生徒の興味・関心の対象や能力を把握し、発達の程度に応じて教材内容を改変することで有用性は高まるものと考えられる。, ICT devices have been attracting attentions in special support education. because of enhance the learning effects by utilize depending on the conditions and the characteristics of the children's disabilities. In particular, tablet PCs are expected to utilize for the Independent Activities, which is the activities to do the independent lives, of children with multiple disabilities. However, teaching materials for tablet PCs are not enough. In this study, the tablet PC’s teaching materials in the Independent Activities for children with multiple disabilities are developed. Also, it is show that the ways to use the teaching materials the Independent Activities from thesurvey results. The teaching materials for the tablet PCs in the identification learning being done in independent activities are developed for the purpose achievements. Then, teachers are received interviews and questionnaire surveys, after the children used the teaching materials. As the result of the survey, the teaching materials areuseful for the children. Furthermore, when teachers modified the teaching materials contents in the degree of development according to interests and abilities of children, the teaching materials gives usefulness.

本研究では、適応指導教室等で活用可能な、不登校の児童生徒向けの学習ソフトの開発を行う。開発する学習ソフトは、適応指導教室の指導員の負担にならない形式とすること、そして個々の児童生徒に対応できる内容であることを考慮した上で、適応指導教室の指導員を対象としたニーズ調査に基づいて仕様を策定することにした。, The purpose of this paper is to develop a multimedia presentation software for non-attendant students and to evaluate it by practicing learning activity. Recently, treatment of non-attendant students in school education is one of the serious issues in Japan. Teachers should support them from these aspects: support of learning, support of promoting social skills and support of mental health. As one of these, there is ICT utilization in classroom for non-attendant students. Therefore, multimedia presentation software was developed in order to support them from the above three aspects. This software has three functions, i.e. image presentation section, movie presentation section and text presentation section, based on blackboard system. Usage of this software was designed based on the cognitive characteristics of non-attendant students. As a result of trial practice by using this software, non-attendant students who took part in this activity could use this software without any difficulties. And, they could not only make presentation by this software, but also communicate naturally with their friends and instructors. In addition, the instructors gave affirmative evaluation to the software and proposed new some ideas of utilization of it.

OECD's PISA (Programme for International Student Assessment) was developed by participating countries and administered to 15-year-olds in schools every three years from 2000. Among "reading literacy", "mathematical literacy" and "scientific literacy", the rank of the Japanese students' "reading literacy" is not the top from the beginning, and a big drop of the rank becomes the problem. It is not clear, however, how school teacher feel PISA ability in the school and what kind of performance is needed. In this study, the investigation about it was carried out by using "a questionnaire about the actual situation of the PISA ability of the child / student" to recognize how much the child / student in the elementary or junior high school has PISA ability. The questionnaires were sent to 876 elementary or junior high schools selected from all over Japan, the answers from 286 schools were gotten. As a result, a drop of the reading literacy of the child / student (grade 1-9 student) in the elementary or junior high school is felt in many schools. It is concerned that their opinion / thought cannot be expressed by the decrease of the reading literacy. Many school teachers think that improvement of the reading literacy is necessary in all subjects.

To verify the safety and validity of laparoscopic surgery for the treatment of colorectal cancer in elderly patients.A meta-analysis was performed of a systematic search of studies on an electronic database. Studies that compared laparoscopic colectomy (LAC) in elderly colorectal cancer patients with open colectomy (OC) were retrieved, and their short and long-term outcomes compared. Elderly people were defined as 65 years old or more. Inclusion criteria were set at: Resection of colorectal cancer, comparison between laparoscopic and OC and no significant difference in backgrounds between groups.Fifteen studies were identified for analysis. LAC was performed on 1436 patients, and OC performed on 1810 patients. In analyses of short-term outcomes, operation time for LAC was longer than for OC (mean difference = 34.4162, 95%CI: 17.8473-50.9851, P0.0001). The following clinical parameters were lower in LAC than in OC: Amount of estimated blood loss (mean difference = -93.3738, 95%CI: -132.3437 to -54.4039, P0.0001), overall morbidity (OR = 0.5427, 95%CI: 0.4425-0.6655, P0.0001), incisional surgical site infection (OR = 0.6262, 95%CI: 0.4310-0.9097, P = 0.0140), bowel obstruction and ileus (OR = 0.6248, 95%CI: 0.4519-0.8638, P = 0.0044) and cardiovascular complications (OR = 0.4767, 95%CI: 0.2805-0.8101, P = 0.0062). In analyses of long-term outcomes (median follow-up period: 36.4 mo in LAC, 34.3 mo in OC), there was no significant difference in overall survival (mean difference = 0.8321, 95%CI: 0.5331-1.2990, P = 0.4187) and disease specific survival (mean difference = 1.0254, 95%CI: 0.6707-1.5675, P = 0.9209). There was also no significant difference in the number of dissected lymph nodes (mean difference = -0.1360, 95%CI: -4.0553-3.7833, P = 0.9458).LAC in elderly colorectal cancer patients had benefits in short-term outcomes compared with OC except operation time. The long-term outcomes and oncological clearance of LAC were similar to that of OC. These results support the assertion that LAC is an effective procedure for elderly patients with colorectal cancer.

A questionnaire for junior high schools is carried out to know the actual situation for the learning of the school truant students and necessity of the learning support software of the curriculum, on development of the learning support software. Learning support software was requested from this result in many schools. The ability of comprehension or the expression such as Japanese or English and the ability of the logical thinking such as the mathematics are required. In addition, for the truant students, upbringings of the communicative competence or the social nature are demanded. It is the fact that a lot of truant students have the will to the learning. It is necessary to get ready to be able to cope for such the students quickly. More than 75% teachers feel uneasy about a delay of the learning of the school refusal student. It is clear that support for learning delay / the stagnation is an important problem.

本研究では、現場実習に限らず就業に関わる体験的な学習の指導について取り組みの実態調査を全国の知的障害者を教育する学校に対し実施した。この調査結果に基づき就業に関わる体験的な学習の指導における現状と問題点を明らかにし、解決策について考察する。, Investigation about the working activities and its support system in the schools for mentally handicapped children is carried out. Its questionnaires are distributed to the schools for mentally handicapped children all over Japan ; about 150 schools have answered it.

A 67-year-old man was referred to our hospital with suspicion of rectal tumor, hilar tumor, and urinary tumor. Colonoscopic findings were intermittent nodular lesions with redness which were atypical to primary rectal cancer. Endoscopic retrograde cholangiopancreatography showed narrowing of the bilateral intrahepatic bile duct. However, the findings were improved 1 month later. Blood biochemistry showed high level of serum IgG4 up to 1140 mg/dl. The patient matched to comprehensive diagnostic criteria for IgG4-related disease as a possible diagnostic case. Laparoscopic low anterior resection with creation of ileostomy was performed for rectal cancer. Histological findings revealed cancer cells spread horizontally at submucosal layer and subserosal layer. There was marked infiltration of the plasma cells and lymphocytes at tumor stroma, and more than half of the plasma cells were positive for IgG4. After surgery, the level of serum IgG4 was decreased to 597 mg/dl. Although the association with IgG4-related disease and colorectal disease is unclear, the tumor progression was atypical for rectal cancer. Some report that the disease may rise up the risk of a malignant disease. It is necessary to perform systemic examination keeping in mind for concurrence of malignancy.

Investigation about Internet communication in the interchange education between the schools for mentally handicapped children is carried out. Questionnaires about an intechange education are distributed to the schools for mentally handicapped children all over Japan. It is important, particularly, to know how to utilized Internet interchange education, for example, to use e-mail, chat, WWW, bulletin board, et al. Internet has simultaneous, interactive, memorable properties of communication. Its communication has the wide range from a local area persons to a large number of the general public. It can be done not to depend in distance, time and partners at the same time to make use of these characteristics. It is called "Internet communication" in this study. "Electronic comunicasion", on the other hand, has is a communication from a person to a person through electronic media. This communication also has characteristics not to depend in distance and time. This "electronic comunicasion" developed to "Internet communication" which has simultaneous, interactive, memorable properties. The conventional interchange education goes to only among limited domains. A lot of the schools has a problem of a limit of interchange time and a problem that interchange is not continuation. The basic environmental preparation is most important to the students who communicate to the other at any time.

フッ素系ポリマー中の低分子量成分は超臨界CO2によって抽出され, その抽出量は水をエントレーナーとして用いることで増加することが明らかとなった. 低分子量成分の抽出に影響を及ぼす因子としては, CO2密度, CO2流通量, 初期水分濃度があり, 特に, CO2の臨界密度付近以上で抽出が促進される傾向が見られた. 最適条件下では分子量が約1万以下の低分子量成分が抽出され, 精製したポリマーのMw/Mnを1.86から1.16まで下げることができた. 超臨界フルオロホルム, 超臨界フルオロエタンについても同様な抽出実験を試みたところ, 超臨界CO2が最も抽出効果が高いことがわかった.

The purpose of this study was to investigate which factors (including age, sex, grade of cataract, diabetes mellitus (DM), pseudoexfoliation, glaucoma, and atopy) are correlated with thickening and/or multilamellar appearance of the anterior lens capsule. Seventy-two anterior lens capsules were obtained during cataract surgeries. They were fixed, embedded in paraffin, and stained with Periodic acid-Schiff (PAS) and Masson-Trichrome. We measured thickness of the anterior capsules on microscopic photographs. In addition, multilamellar appearance of the anterior capsules was graded by an experienced ophthalmic pathologist and scored (0-3.0). By multiple regression analysis we evaluated whether the seven factors described above were correlated with thickness and/or multilamellar appearance of the anterior capsules. Thickness of the anterior capsule was correlated with DM and age (p=O.O095 and p= O.O138, respectively) . Multilamellar score was significantly correlated with age (p

The potential value of microRNAs (miRNAs) as prognostic biomarkers are of interest. It is known that microRNA-21 (miR-21) is implicated in the promotion, proliferation and progression of several types of human cancers. However, the prognostic significance of miR-21 in each tumor stage of colorectal cancer (CRC) remains elusive. The objective of this study was to clarify the prognostic value of miR-21 for CRC patients at each tumor stage. The expression levels of miR-21 in the tumor tissues and normal adjacent tumor tissues of 306 CRC patients were determined by TaqMan microRNA assays. In order to clarify the miRNA profile in CRC tissues, miRNA arrays were examined. In this analysis, miR-21, miR-224, miR-96, miR-31 and miR-155 showed marked upregulation, and miR-21 showed the highest level. Upon comparison of clinicopathological factors, miR-21 expression showed significant association with depth of invasion, lymphatic and venous invasion, liver metastasis and Dukes' stage. In the Kaplan-Meier survival curve analysis of all patients, overall survival (OS) and disease-free survival (DFS) rates of the patients with high miR-21 expression were significantly worse than these rates in patients with low miR-21 expression. In the Kaplan-Meier analysis of each tumor stage, the DFS of patients with high miR-21 expression was significantly worse than patients with low miR-21 levels in Dukes' stage A tumors. In Dukes' stage B and C, patients with high miR-21 expression showed a significantly worse OS and DFS than patients with low miR-21 expression. In Dukes' stage D, patients with high miR-21 expression showed a significantly worse OS than patients with low miR-21 expression. In the Cox multivariate analysis, it was shown that miR-21 expressions in CRC tissues is an independent prognostic factor in Dukes' stage B, C and D. In conclusion, miR-21 expression may be a valuable biomarker for prediction of poor prognosis in CRC patients with Dukes' stage B, C and D.