Objectives: To clarify the preferences for survival time (ST) or quality of life (QOL) in the treatments for advanced cancer. Method: Patients with breast cancer, oncologists, and healthcare-providers including nurses, pharmacists and medical clerks were asked to anonymously complete a survey: The survey included questions regarding 1) priority among treatment options for a fictitious cancer patient, 2) preference of treatment aggressiveness for fictitious cancer patients by age group, 3) preference of treatment among options, with different weight on ST and QOL. Results: 1) Cancer patients' priority regarding ST and QOL was clearer than healthcare providers. 2) Oncologists tended to prioritize ST than cancer patients and other medical staffs in elderly patients. 3) Patients and oncologists tended to prioritize ST, whereas and other medical staffs prioritized QOL. Conclusion: Cancer patients and healthcare providers may have different perception regarding a treatment goal, which should be recognized in the practice of oncology.

End-of-life discussion with patients with advanced cancer is one of the important factors to determine the patient quality of life and their families' grief. The primary aim of this study is to collect Japanese medical oncologists' views toward end-of-life discussion. A context analysis of free comments of the questionnaire survey was conducted. Questionnaires were mailed to 864 medical oncologists, and 490 responses were obtained. A content analysis identified 420 free comments. As barriers of end-of-life discussion for oncologists, three types of barriers were emerged: 1) issues relating to patient and family (e.g., [individuality of the patient and family], [difficulty of acceptance of illness progression]), 2) issues relating to medical professionals (e.g., [a lack of psychological support], [difference in beliefs about end-of-life discussion among medical professionals]), and 3) health care systems (e.g., [a lack of time and human resources], [a lack of education and research]). The findings of this study may be useful to improve mutual understanding of oncologists and palliative care physicians when performing the end-of-life discussion in collaboration.

Introduction: The purpose of this study was to identify the current status, issues, and training needs of nurses in terms of the appearance care for patients who undergo cancer therapy. Methods: Self-administered anonymous surveys were mailed to a total of 2,025 nurses. Potential respondents included five nurses who work at various departments in all the 400 Designated Regional Cancer Centers and Hospitals in Japan, or who accessed the Appearance Care Research Network website voluntarily and registered for study participation. Survey items included demographics and the 94 items concerning appearance care for changes associated with cancer therapy. The data analysis included descriptive statistics and logistic regression analysis to identify correlates of the provision of appearance care. Textual responses were qualitatively and descriptively analyzed. Results: Seven hundred and twenty six (35.9%) usable responses were returned. The respondents had a mean age of 42.5 (a range of 24 through 62) years. As a result of the survey, 93 out of 94 care items were carried out by respondents. Correlates of healthcare professionals’ appearance care provision included “collecting information from various sources” and “having confidence in providing care.” Seventeen categories of issues related to appearance care were created, including various items such as “appearance care is not standardized, and recognition level is different between healthcare professionals.” Discussion: Based upon the identified issues and needs of this study, an effective training program will be developed for healthcare professionals who provide appearance care for patients undergoing cancer therapy.

LR11, also known as SorLA or SORL1, is a type-I membrane protein from which a large extracellular part, soluble LR11 (sLR11), is released by proteolytic shedding on cleavage with a disintegrin and metalloproteinase 17 (ADAM17). A shedding mechanism is presumed to have a key role in the functions of LR11, but the evidence for this has not yet been demonstrated. Tetraspanin CD9 has been recently shown to regulate the ADAM17-mediated shedding of tumor necrosis factor-alpha and intercellular adhesion molecule-1 on the cell surface. Here, we investigated the role of CD9 on the shedding of LR11 in leukocytes. LR11 was not expressed in THP-1 monocytes, but it was expressed and released in phorbol 12-myristate 13-acetate (PMA)-induced THP-1 macrophages (PMA/THP-1). Confocal microscopy showed colocalization of LR11 and CD9 proteins on the cell surface of PMA/THP-1. Ectopic neo-expression of CD9 in CCRF-SB cells, which are LR11-positive and CD9-negative, reduced the amount of sLR11 released from the cells. In contrast, incubation of LR11-transfected THP-1 cells with neutralizing anti-CD9 monoclonal antibodies increased the amount of sLR11 released from the cells. Likewise, the PMA-stimulated release of sLR11 increased in THP-1 cells transfected with CD9-targeted shRNAs, which was negated by treatment with the metalloproteinase inhibitor GM6001. These results suggest that the tetraspanin CD9 modulates the ADAM17-mediated shedding of LR11 in various leukemia cell lines and that the association between LR11 and CD9 on the cell surface has an important role in the ADAM17-mediated shedding mechanism.
ADAM Proteins/*metabolism ; Antigens, CD9/genetics/*metabolism ; Cell Line, Tumor ; Humans ; LDL-Receptor Related Proteins/genetics/*metabolism ; Leukocytes/*metabolism ; Macrophages/metabolism ; Membrane Transport Proteins/genetics/*metabolism ; Proteolysis

BACKGROUND/AIMS: Although studies using conventional animal models have shown that specific stressors cause irritable bowel syndrome (IBS), it is unclear whether depression itself causes IBS. Our aim was to establish a rat model to determine if depression itself promotes the onset of IBS and to elucidate the role of gut microbiota in brain-gut axis pathogenesis during coincident depression and IBS. METHODS: Rat models of depression were induced using our shuttle box method of learned helplessness. Visceral hypersensitivity was evaluated by colorectal distension (CRD) to diagnose IBS. Gut microbiota compositions were analyzed using high-throughput sequencing. In the subanalysis of rats without depression-like symptoms, rats with posttraumatic stress disorder (PTSD) were also examined. RESULTS: The threshold value of CRD in depressed rats was significantly lower than that in control rats. Microbial community analysis of cecal microbiota showed that the relative abundance of Clostridiales incertae sedis, the most prevalent microbe, was significantly lower in depressed rats than in control rats. The distribution pattern of the microbiota clearly differed between depressed rats and control rats. Neither visceral hypersensitivity nor the composition of gut microbiota was altered in rats with PTSD-like phenotypes. CONCLUSIONS: Our rat model of depression is useful for clarifying the effect of depression on IBS and suggests that depression itself, rather than specific stressors, promotes the onset of IBS. Further, we provided evidence that various psychiatric diseases, viz., depression and PTSD, are associated with unique gut microbiota profiles, which could differentially affect the onset and progression of coincident IBS.
Animals ; Clostridiales ; Depression ; Dysbiosis ; Gastrointestinal Microbiome ; Helplessness, Learned ; Hypersensitivity ; Irritable Bowel Syndrome ; Methods ; Microbiota ; Models, Animal ; Phenotype ; Rats ; Stress Disorders, Post-Traumatic

Objective: Eye drops may contain certain preservatives, and there is concern in patients who use them on a daily basis for the treatment of diseases, including corneal epithelial disorder and glaucoma. PF eye drops (Rohto Nitten Co., Ltd.) are used widely; however, their usability may be difficult in patients prescribed these medications for the first time. Therefore, fact-finding was performed on the usability of PF eye drops, particularly the difficulty in squeezing out these eye drops. Methods: The squeezing forces for various eye drops in 11 different shapes were determined. A sensuality evaluation examination on “the easiness of pushing out the eye drops” was performed in addition to a questionnaire survey targeting patients who used eye drops at a community pharmacy. Results: The squeezing forces ranged from 2.0 to 17.1 N. This study showed that the squeezing force tended to increase as the drop got closer to the opening of the container. Significant differences in the sensuality examination scores were found: 3.09 points for Santen Pharmaceutical Co., Ltd.; 3.07 points for Senju Pharmaceutical Co., Ltd.; 2.47 points for Sawai Pharmaceutical Co., Ltd.; and 1.37 points for PF eye drops for any place other than Santen and Senju (p<0.001). Conclusion: When eye drops were prescribed for an elderly individual, the pharmacist considered it necessary to suggest an alternative agent to the doctor depending on body function. In addition, it is important to explain to the patient that an additional squeezing force is required to push out the drop as it gets closer to the opening of the container.