The turning on of downlights during nighttime treatment in neonatal intensive care units (NICU) rapidly increases light intensity. Therefore, at Hospital A, we investigated how a change in light intensity from low to high affected 30 premature/low birth weight infants, by turning on downlights in the NICU for 10 s and using a stress scale to compare stress levels before and after the change in light intensity. High-intensity lighting induced tachypnea and brief pauses in breathing, and significantly decreased SpO2 by 0.6% in 58% of the infants. Autonomic stress responses observed in this study were apnea, tachypnea, hiccup, distress, twitching, yawning, and sighing. Motor stress responses were stretching the arms and legs, making a fist, and opening the palm. CNS stress responses were vocalization, scowling, and eye-opening (rapid change from sleep to arousal state). These findings suggest that the change to high-intensity lighting can induce stress symptoms and temporarily suppress breathing, which shortens inspiration as well as the entire respiratory cycle, thereby decreasing SpO2, in many infants in the NICU. Our findings also suggest that a change in light intensity causes stress not only in the autonomic nervous systems but also in other body systems.

BACKGROUND: Programmed cell death ligand 1 (PD-L1) is an immune checkpoint molecule that attenuates the immune response. PD-L1 contributes to failed antitumor immunity; thereby, blockade of PD-L1 with monoclonal antibody enhances the immune response. Recently, it was reported that PD-L1 was regulated by protein 53 (p53). Besides, cytokeratin 17 (CK17) is thought to be a diagnostic marker of oral squamous cell carcinoma (OSCC). Our aim was to evaluate the correlation between the immunohistochemical expression of PD-L1, p53 and CK17 with clinicopathological characteristics and disease-specific survival in patients with OSCC. METHODS: A total of 48 patients with OSCC were included in this study. Immunohistochemical staining was performed to evaluate the correlation among the expressions of PD-L1, p53 and CK17, and furthermore the correlation among various clinicopathological factors, PD-L1, p53 and CK17. RESULTS: The positive rate of p53, CK17, PD-L1 (tumor cells) and PD-L1 (tumor-infiltrating lymphocytes) was 63.2%, 91.7%, 48.9% and 57.1%. A statistically significant correlation between p53 expression and T stage and TNM stage (p = 0.049, p = 0.03, respectively) was observed. Also, a statistically significant correlation between p53 and PD-L1 (TCs) expression (p = 0.0009) was observed. Five-year disease-specific survival rate was not significantly correlated with gender, TNM stage, p53 expression, PD-L1 expression and CK17 expression. CONCLUSION The expression of p53 and PD-L1 shows significantly positive correlation in oral squamous cell carcinoma in tumor cells. Also, a significant correlation between p53 expression and T stage and TNM stage was observed. No other significant correlation between PD-L1 staining or CK17 and clinical or pathologic characteristics was identified.

Introduction: several clinical training hospitals have their own resident mentor systems in Japan. However, the details and effects of the system still remain unclear.　Objective: The aim of this study is to introduce Okayama University Hospital’s resident mentor system and to investigate its effectiveness based on mentees’ evaluations.　Method: A questionnaire survey was conducted on residents using the system.　Results: 32 (78.0%) of 41 residents used the system. 28 (87.5%) of them completed the survey, indicating most residents were satisfied with the currently-used system.　Discussion: We will conduct a more detailed questionnaire survey for mentors and mentees to further improve the resident mentor system.