Since 2005, one of our clinical technologists has been involved in providing assisted reproductive technology (ART) services ranging from egg retrieval to embryo transfer, which were previously performed only by doctors at our hospital. In 2011, the clinical technologist was certified as a clinical embryologist by the Japanese Society of Clinical Embryologists. Around 2020, insurance coverage for ART related to infertility treatment began to be considered. Consequently, the training and development of ART-supporting clinical technologists became an urgent issue. In response, we developed a training program for ART-supporting clinical technologists that covers egg retrieval assistance, fertilization, culture, embryo freezing/thawing, and embryo transfer. By the end of fiscal year 2022, we had successfully trained two new ARTsupporting clinical technologists, bringing the total to three.

BACKGROUND: Asbestos fibers possess tumorigenicity and are thought to cause mesothelioma. We have previously reported that exposure to asbestos fibers causes a reduction in antitumor immunity. Asbestos exposure in the mixed lymphocyte reaction (MLR) showed suppressed induction of cytotoxic T lymphocytes (CTLs), accompanied by a decrease in proliferation of CD8 METHODS: For MLR, human peripheral blood mononuclear cells (PBMCs) were cultured with irradiated allogenic PBMCs upon exposure to chrysotile B asbestos at 5 μg/ml for 7 days. After 2 days of culture, IL-15 was added at 1 ng/ml. After 7 days of MLR, PBMCs were collected and analyzed for phenotypic and functional markers of CD8 RESULTS: IL-15 addition partially reversed the decrease in CD3 CONCLUSION These findings indicate that CTLs induced upon exposure to asbestos possess dysfunctional machinery that can be partly compensated by IL-15 supplementation, and that IL-15 is more effective in the recovery of proliferation and granzyme B levels from asbestos-induced suppression of CTL induction compared with IL-2.
Asbestos/adverse effects* ; CD8-Positive T-Lymphocytes/metabolism* ; Humans ; Interleukin-15/pharmacology* ; Lymphocyte Activation/immunology* ; T-Lymphocytes, Cytotoxic/metabolism*

Asbestos exposure is known to cause malignant mesothelioma, which is associated with poor prognosis. We focused on and examined the effect of asbestos exposure on the differentiation and function of cytotoxic T lymphocytes (CTLs). CTLs have the ability to specifically attack tumor cells after being differentiated from naïve CD8 T cells following antigen stimulation. Exposure to chrysotile B asbestos suppressed the differentiation of CTLs during the mixed lymphocyte reaction (MLR) and was associated with a decrease in proliferation of CD8 T cells. Additionally, in an effort to investigate the mechanism associated with suppressed CTL differentiation upon exposure to asbestos, we focused on IL-2, a cytokine involved in T cell proliferation. Our findings indicated that insufficient levels of IL-2 are not the main cause for the suppressed induction of CTLs by asbestos exposure, although they suggest potential improvement in the suppressed CTL function. Furthermore, the functional properties of peripheral blood CD8 lymphocytes from asbestos-exposed individuals with pleural plaque (PP) and patients with malignant mesothelioma (MM) were examined. MM patients showed lower perforin levels in CD8 lymphocytes following stimulation compared with PP-positive individuals. The production capacity of IFN-γ in the MM group tended to be lower compared with healthy volunteers or PP-positive individuals. In an effort to determine whether chronic and direct asbestos exposure affected the function of CD8 T cells, cultured human CD8 T cells were employed as an in vitro model and subjected to long-term exposure to chrysotile (CH) asbestos. This resulted in decreased levels of intracellular perforin and secreted IFN-γ. Those findings underlie the possibility that impaired CD8 lymphocyte function is caused by asbestos exposure, which fail to suppress the development of MM. Our studies therefore reveal novel effects of asbestos exposure on CTLs, which might contribute towards the development and implementation of an effective strategy for the prevention and cure of malignant mesothelioma.

OBJECTIVEThe changes in serum adipokines and cytokines related to oxidative stress were examined during 3 months 'Off to On' and 'On to Off' periods using negatively charged particle-dominant indoor air conditions (NCPDIAC).

METHODSSeven volunteers participated in the study, which included 'OFF to 3 months ON' periods (ON trials) for a total of 16 times, and 'ON to 3 months OFF' (OFF trials) periods for a total of 13 times.

RESULTSWith the exception of one case, serum amyloid A (SAA) levels decreased significantly during the ON trials.

CONCLUSIONConsidering that SAA is an acute phase reactive protein such as C reactive protein (CRP), this observed decrease might indicate the prevention of cardiovascular and atherosclerotic changes, since an increase in high-sensitive CRP is associated with the subsequent detection of these events.

Adult ; Air ; analysis ; Air Pollution, Indoor ; Environmental Monitoring ; Female ; Housing ; Humans ; Male ; Serum Amyloid A Protein ; metabolism

RibotestMycoplasma (Ribotest™), a rapid antigen detection assay for ribosomal protein L7/L12 for the diagnosis of Mycoplasma pneumoniae infection, has become available in Japan. However, the clinical utility of Ribotest remains controversial. We enrolled 1,140 children admitted to our hospital between January 2014 and March 2016 due to community-acquired pneumonia. We prospectively obtained two throat swabs during the acute phase; DNA detection using a loop-mediated isothermal amplification (LAMP) assay and antigen detection using Ribotest were performed for each sample. We also collected paired serum samples during the acute and convalescent phases for determining M. pneumoniae antibody titers using the particle agglutination test. M. pneumoniae pneumonia was diagnosed through either a positive LAMP assay or a 4-fold increase in antibody titers. Overall, 237 children (21%) were diagnosed with M. pneumoniae pneumonia. We evaluated the utility of Ribotest both in the non-epidemic period (January 2014–July 2015) and the epidemic period (August 2015–March 2016). Sensitivity of Ribotest for M. pneumoniae pneumonia was 23% in the non-epidemic period and 22% in the epidemic period, respectively. When serology was used as the standard, sensitivity of Ribotest was 25% in the non-epidemic period and 22% in the epidemic period, significantly lower than those of the LAMP assay (80% and 91%, respectively). Ribotest yielded false-positive results in 16 cases in the non-epidemic period and in 6 cases in the epidemic period. Thus, positive predictive values of Ribotest were significantly lower in the non-epidemic period (50%) than in the epidemic period (86%). Multivariate analysis showed that a shorter duration of fever before sampling (OR = 1.7) and a higher incidence of co-infection with other pathogens (OR = 29.4) were observed in children showing false-positive results of Ribotest. Thus, we conclude that Ribotest is unsuitable for rapid diagnosis of pediatric M. pneumoniae pneumonia.

　　There is a need for measures to prevent accidental ingestion at hospitals that provide food for children with food allergies. The dietetics department of our hospital attempts to prevent accidental ingestion by providing meal tags that clearly indicate the dishes prepared without allergens (“allergen-free meal”), which are attached in the designated area by a licensed cook in charge of food preparation. During the 1-year period between January and December 2014, 258 children with food allergy were treated in our hospital and received allergen-free meals. There were 3 cases in which dishes containing allergens were served by mistake, and accidental ingestion by the patient occurred in 2 cases. Regarding the cause of these serving errors, it is likely that they occurred because allergen-free dishes were served using tableware with the same color as that used for allergen-containing dishes. Accordingly, we have revised our preventive measures against accidental ingestion so that all of the tableware and trays used for allergen-free dishes are yellow in color, in order to distinguish them from other dishes. Furthermore, we have provided a dedicated shelf for allergen-free dishes, and have also made it a requirement for final confirmation to be performed by 2 responsible cooks who double-check the food before serving. We will continue to monitor and improve our measures to prevent accidental ingestion as necessary.

OBJECTIVEThe custom-homebuilding company, Cosmic Garden Co. Ltd., located in Okayama City, Japan was established in 1997 and uses specific natural ore powder (SNOP) in wall materials and surveys customers in order to improve allergic symptoms.

METHODSTo investigate the biological effects of SNOP, patients with a pollen allergy were recruited to stay in a room surrounded by cloth containing SNOP (CCSNOP), and their symptoms and various biological parameters were compared with those of individuals staying in a room surrounded by control non-woven cloth (NWC). Each stay lasted 60 min. Before and immediately after the stay, a questionnaire regarding allergic symptoms, as well as POMS (Profile of Mood Status) and blood sampling, was performed. Post-stay minus pre-stay values were calculated and compared between CCSNOP and NWC groups.

RESULTSResults indicated that some symptoms, such as nasal obstruction and lacrimation, improved, and POMS evaluation showed that patients were calmer following a stay in CCSNOP. Relative eosinophils, non-specific Ig E, epidermal growth factor, monocyte chemotactic protein-1, and tumor necrosis factor-α increased following a stay in CCSNOP.

CONCLUSIONThis ore powder improved allergic symptoms, and long-term monitoring involving 1 to 2 months may be necessary to fully explore the biological and physical effects of SNOP on allergic patients.

Adult ; Chemokine CCL2 ; immunology ; Clothing ; Female ; Geologic Sediments ; chemistry ; Humans ; Immunoglobulin E ; immunology ; Japan ; Male ; Pollen ; immunology ; Rhinitis, Allergic, Seasonal ; immunology ; therapy ; Tumor Necrosis Factor-alpha ; immunology

  The incidence of fever in children admitted to general hospitals is very high. Provision of adequate nutrition and fluid supplements to febrile children is very important, but with some children it is difficult to maintain an adequate intake. To address this problem, we devised a new ‘febrile children's menu’, utilizing preparation methods and foods to produce a palatable menu for patients with fever.
  We introduced this ‘febrile children's menu‘ on January 6, 2011, providing it to 109 patients (age range: 1 to 8 years, average age: 3.3±1.9 years) over the ensuing 3-month period. We provided a mean 4.0±2.9 meals per day to each patient during their febrile stage (≥37.5°C). To evaluate the usefulness of the ‘febrile children's menu’, we investigated eating rates during the febrile period in all patients who had been provided with the menu, and performed a questiomaire survey on their parents/guardians. The mean eating rates during the febrile period were 39±30% for main meals, and 28±22% for side dishes. No significant difference was seen in the eating rates during the febrile period recorded over the 2-month period prior to introduction of the new menu to 112 febrile children (age range: 1 to 8 years, average age: 3.3±2.1 years), 39±30% for main meals, and 29±22% for side dishes. The questionnaire survey was responded by 43 parents/guardians (a recovery rate of 39%). The ‘febrile children's menu’ was assessed as ‘good’ by 67% of respondents, representing an overall favourable impression from the parents/guardians. With reference to the survey results, we will attempt to further improve the ‘febrile children's menu’ with the aim of increasing eating rates during the febrile period.

  In recent years, changes in Japanese dietary habits have been associated with the increased incidence of obesity and lifestyle diseases even among children. Dietary education is considered essential for stemming this trend. In this study, we introduced the following initiative in dietary education for children admitted to hospital and their parents from the standpoint of health care workers providing meals to inpatients. We added a ‘Children's Lunch’ to the menu. Designed for the fussy children, it was a nutritionally balanced meal. On traditional seasonal festival days, we wrote an introduction to Japanese seasonal cuisine and showed it to the children. To the parents, we distributed a regular weekly pamphlet outlining the importance of dietary education, with an explanation of the ingredients used in the meals, and recipes.  To assess the results of this initiative, we conducted a questionnaire survey of parents on a weekly basis. The results of the surveys (n=215, recovery rate 87%) taken during the first three months showed that the majority of parents rated all four aspects of the ‘Children's Lunch’ high menu content, presentation, child's response, and the pamphlet contents. The parents displayed a deep interest in our activity, because 93% of those parents said that they were impressed with dietary education. On the other hand, some dietary problems were identified, with tendencies to use only ingredients preferred by the children, and eat out often.  This was a short term initiative, limited to hospitalization, but we were cwetain that we had been able to provide an opportunity for parents to think about their children's diets. We plan to continue this initiative, thereby making a contribution to dietary education for children.

This review is partly composed of the presentation "Cytokine alteration and speculated immunological pathophysiology in silicosis and asbestos-related diseases" delivered during the symposium "Biological effects of fibrous and particulate substances and related areas" organized by the Study Group of Fibrous and Particulate Studies of the Japanese Society of Hygiene and held at the 78th Annual Meeting in Kumamoto, Japan. In this review, we briefly introduce the results of recent immunological analysis using the plasma of silica and asbestos-exposed patients diagnosed with silicosis, pleural plaque, or malignant mesothelioma. Thereafter, experimental background and speculation concerning the immunological pathophysiology of silica and asbestos-exposed patients are discussed.