Advances in Hospice and Palliative Care in Japan: A Review Paper

Mori, Masanori,Morita, Tatsuya Korean Society for Hospice and Palliative Care 2016 한국호스피스.완화의료학회지 Vol.19 No.4

Over the past decade, hospice and palliative care in Japan have progressed rapidly under the national policies supported by the Cancer Control Act. The numbers of palliative care units/inpatient hospices, hospital palliative care teams, and clinics with a home hospice function have been steadily increasing. The increasing numbers of physicians, nurses, and pharmacists have been certified as specialists in palliative care by national associations. Collaborative efforts have been made to standardize and disseminate educational programs and training opportunities in undergraduate, postgraduate, and continuing medical education. Research activities in Japan have markedly contributed to the growing body of evidence, especially in the fields of terminal delirium, terminal dehydration, palliative sedation, care for dying patients, prognostication, communication, psycho-oncology, and regional palliative care programs. This review focuses on major palliative care settings, specialty, national associations, education, and research in palliative care in Japan. 지난 10년 동안 암 관리법에 의한 국가 정책에 따라 일본에서는 호스피스 및 완화의료가 급속히 발전해왔다. 완화의료 시설 및 입원 환자의 호스피스, 병원의 완화 의료팀, 가정 호스피스 기능을 갖춘 진료소의 수는 꾸준히 증가하고 있으며 국가 협회로부터 완화의료 전문가로 공인된 의사, 간호사, 약사의 수도 증가하고 있다. 학부, 대학원 및 계속적인 의학 교육을 통해서 교육프로그램 및 교육의 기회를 표준화하고 보급하기 위한 공동 노력이 이루어졌다. 일본의 연구 활동은 말기 섬망, 말기 탈수증, 완화적 진정, 임종 환자의 의료, 예후, 의사 소통, 정신 종양학, 지역적인 완화의료 프로그램의 분야에서 현저하게 기여하였다. 이 보고서에서는 일본에서의 주요 완화의료 환경, 특성, 국가 협회, 교육, 완화의료 연구에 초점을 맞추었다.

Prognostication of the Last Days of Life

Masanori Mori,Tatsuya Morita,Eduardo Bruera,David Hui 대한암학회 2022 Cancer Research and Treatment Vol.54 No.3

Accurate prediction of impending death (i.e., last few days of life) is essential for terminally-ill cancer patients and their families. International guidelines state that clinicians should identify patients with impending death, communicate the prognosis with patients and families, help them with their end-of-life decision-making, and provide sufficient symptom palliation. Over the past decade, several national and international studies have been conducted that systematically investigated signs and symptoms of impending death as well as how to communicate such a prognosis effectively with patients and families. In this article, we summarize the current evidence on prognostication and communication regarding the last days of life of patients with cancer, and future directions of clinical research.

Advances in Hospice and Palliative Care in Japan: A Review Paper

Masanori Mori,Tatsuya Morita 한국호스피스완화의료학회 2016 한국호스피스.완화의료학회지 Vol.19 No.4

Over the past decade, hospice and palliative care in Japan have progressed rapidly under the national policies supported by the Cancer Control Act. The numbers of palliative care units/inpatient hospices, hospital palliative care teams, and clinics with a home hospice function have been steadily increasing. The increasing numbers of physicians, nurses, and pharmacists have been certified as specialists in palliative care by national associations. Collaborative efforts have been made to standardize and disseminate educational programs and training opportunities in undergraduate, postgraduate, and continuing medical education. Research activities in Japan have markedly contributed to the growing body of evidence, especially in the fields of terminal delirium, terminal dehydration, palliative sedation, care for dying patients, prognostication, communication, psycho-oncology, and regional palliative care programs. This review focuses on major palliative care settings, specialty, national associations, education, and research in palliative care in Japan.

Crop improvement : Original Paper ; Expression of an enhancin gene from the Trichoplusia ni granulosis virus confers resistance to Lepidopterous insect pests to rice

( Mari Mori ),( Harushige Kitamura ),( Atsushi Kondo ),( Koji Dohi ),( Masashi Mori ),( Masanori Kaido ),( Kazuyuki Mise ),( Eiichi Shimojyo ),( Yoshifumi Hashimoto ) 한국식물생명공학회 ( 구 한국식물조직배양학회 ) 2006 Plant Biotechnology Vol.23 No.1

Convergence Analysis of a Stereophonic Echo Canceling Algorithm Using Input Signals of All Channels

Masanori Kimoto,Toshihiro Furukawa,Shinsaku Mori 대한전자공학회 2002 ITC-CSCC :International Technical Conference on Ci Vol.2002 No.7

Synthesis of nano-sized Ag metal particles protected by adsorbed 3-mercapto-propionic acid

Hiromi Yamashita,Masanori Tomonari,Hitomi Sadohara,Tetsu Yonezawa,Kohsuke Mori 한양대학교 세라믹연구소 2007 Journal of Ceramic Processing Research Vol.8 No.3

Nano-sized Ag metal particles can be synthesized by the addition of sodium borohydride as a reducing agent into an aqueous solution of AgNO3 mixed with 3-mercapto-propionic acid as a protective agent. Using this method the synthesis of an aqueous Ag colloid system with a high density became possible, because the surfaces of synthesized nano-sized Ag metal particles were covered and protected by the adsorbed 3-mercapto-propionic acid. The strong electrostatic repulsion of the negative charge of the carboxylate anion of the adsorbed 3-mercapto-propionic acid disturbed the aggregation of metal particles in the solution with a high pH value (pH > 5), but the aggregation occurred in a solution of low pH value (pH < 2) because of the neutral surface of particles. Using simple coating and baking processes with this aqueous Ag colloid system, an Ag membrane can be formed on glass plate by the partial welding between the nano-size Ag particles. This Ag membrane exhibited a very low electrical resistivity even after baking at a low temperature such as 423 K. Nano-sized Ag metal particles can be synthesized by the addition of sodium borohydride as a reducing agent into an aqueous solution of AgNO3 mixed with 3-mercapto-propionic acid as a protective agent. Using this method the synthesis of an aqueous Ag colloid system with a high density became possible, because the surfaces of synthesized nano-sized Ag metal particles were covered and protected by the adsorbed 3-mercapto-propionic acid. The strong electrostatic repulsion of the negative charge of the carboxylate anion of the adsorbed 3-mercapto-propionic acid disturbed the aggregation of metal particles in the solution with a high pH value (pH > 5), but the aggregation occurred in a solution of low pH value (pH < 2) because of the neutral surface of particles. Using simple coating and baking processes with this aqueous Ag colloid system, an Ag membrane can be formed on glass plate by the partial welding between the nano-size Ag particles. This Ag membrane exhibited a very low electrical resistivity even after baking at a low temperature such as 423 K.

Weight Gain and Alcohol Drinking Associations with Breast Cancer Risk in Japanese Postmenopausal Women - Results from the Japan Collaborative Cohort (JACC) Study

Nitta, Junichi,Nojima, Masanori,Ohnishi, Hirofumi,Mori, Mitsuru,Wakai, Kenji,Suzuki, Sadao,Fujino, Yoshihisa,Lin, Yingsong,Tamakoshi, Koji,Tamakoshi, Akiko Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.3

Background: We investigated four factors, height, weight gain since age 20, physical activity, and alcohol drinking, for associations with risk of breast cancer (BC) according to menopausal status, using the latest data of the Japan Collaborative Cohort Study (JACC Study). Materials and Methods: We confined the analysis to 24 areas available of cancer incidence information, excluding women with a previous diagnosis of BC. Baseline data were collected from 38,610 (9,367 premenopausal, and 29,243 postmenopausal) women during 1988 and 1990. The study subjects were followed-up at the end of 2009, and 273 (84 premenopausal, and 189 postmenopausal) cases of BC were newly diagnosed in 501,907 person-years. The Cox model was used to estimate a hazards ratio (HR) and its 95% confidence interval (CI) of BC risk. Results: As a result of the multivariate analysis adjusting for age at baseline survey, age at menarche, number of live births, and, age at first delivery, weight gain since age 20 of 6.7 kg-9.9 kg, and ${\geq}10.0kg$ were significantly associated with increased risk for postmenopausal BC (HR=2.48, 95% CI 1.40-4.41, and, HR=2.94, 95% CI 1.84-4.70, respectively). Significantly increased trend of BC risk was also observed in weight gain since age 20 (p for trend, p<0.001). Amount of ethanol intake per day${\geq}15.0g$ was significantly associated with increased risk for postmenopausal BC in the multivariable-adjusted analysis (HR=2.74, 95% CI 1.32-5.70). Conclusions: Higher weight gain in adulthood and larger amounts of ethanol intake were significantly associated with increased risk of BC in Japanese postmenopausal women. None of the investigated factors were significantly associated with BC risk in Japanese premenopausal women.

Prediction of Survival in Patients with Advanced Cancer: A Narrative Review and Future Research Priorities

Yusuke Hiratsuka,Jun Hamano,Masanori Mori,Isseki Maeda,Tatsuya Morita,Sang-Yeon Suh 한국호스피스완화의료학회 2023 한국호스피스.완화의료학회지 Vol.26 No.1

This paper aimed to summarize the current situation of prognostication for patients with an expected survival of weeks or months, and to clarify future research priorities. Prognostic information is essential for patients, their families, and medical professionals to make endof- life decisions. The clinician’s prediction of survival is often used, but this may be inaccurate and optimistic. Many prognostic tools, such as the Palliative Performance Scale, Palliative Prognostic Index, Palliative Prognostic Score, and Prognosis in Palliative Care Study, have been developed and validated to reduce the inaccuracy of the clinician’s prediction of survival. To date, there is no consensus on the most appropriate method of comparing tools that use different formats to predict survival. Therefore, the feasibility of using prognostic scales in clinical practice and the information wanted by the end users can determine the appropriate prognostic tool to use. We propose four major themes for further prognostication research: (1) functional prognosis, (2) outcomes of prognostic communication, (3) artificial intelligence, and (4) education for clinicians.

Regulation of Major Histocompatibility (MHC) Class Ⅱ Human Leukocyte Antigen-DRα Gene Expression in Thyrocytes by Single Strand Binding Protein-1, a Transcription Factor That Also Regulates Thyrotropin Receptor and MHC Class I Gene Expression

BALDUCCI-SILANO, PINA L.,SUZUKI, KOICHI,OHTA, MASANORI,SAITO, JUN,OHMORI, MASAYUKI,MONTANI, VALERIA,NAPOLITANO, GIORGIO,SHONG, MINHO,TANIGUCHI, SHIN-ICHI,PIETRARELLI, MICHELE,LAVARONI, STEFANO,MORI, A 충남대학교 생물공학연구소 1999 생물공학연구지 Vol.7 No.-

The single strand binding protein (SSBP-1) is a positive regulator of TSH receptor gene expression and binds to an element with a GXXXXG motif. The S box of the mouse major histocompatibility classⅡ gene has multiple GXXXXG motifs and can also bind SSBP-1. The S box is one of four highly conserved elements on the 5'-flanking region of classⅡ genes that are necessary for interferon-γ (IFNγ) to overcome the normally suppressed state of the gene and induce aberrant classⅡ expression. In this report we show that SSBP-1, when overexpressed in FRTL-5 thyroid cells, is a positive regulator of human leukocyte antigen (HLA)-DRα classⅡ gene expression, as is IFNγ or the classⅡ trans-activator (CIITA). This is evidenced by increased exogenous promoter activity, increased endogenous RNA levels, and increased endogenous antigen expression after transfecting full-length SSBP-1 complementary DNA together with a HLA-DRα promoter-reporter gene chimera into TSH-treated FRTL-5 thyroid cells whose endogenous SSBP-1 levels are low. IFNγ reverses the ability of TSH to decrease endogenous SSBP-1 RNA levels. Also, whereas SSBP-1 transfection does not cause any increase in IFNγ-induced exogenous promoter activity, transfection of SSBP-1 and CIITA additively increases endogenous classⅡ RNA levels to levels measured in cells treated with IFNγ. Further, competition studies show that SSBP-1 binding is necessary for formation of the double strand protein/DNA complexes that are seen in electrophoretic mobility shift assays when the classⅡ 5'-flanking region is incubated with extracts from IFNγ-treated FRTL-5 cells and that have been previously associated with IFNγ-induced aberrant classⅡ expression. These data suggest that SSBP-1 is involved in the action of IFNγ to overcome the normally suppressed state of the classⅡ gene; it functions together with CIITA, whose expression is independently increased by IFNγ. The effect of SSBP-1 as a positive regulator of classⅡ promoter activity is lost in cells maintained without TSH, in which endogenous SSBP-1 RNA levels are already high in the absence of aberrant classⅡ gene expression. These data suggest that high levels of endogenous SSBP-1 are insufficient to cause aberrant classⅡ expression, but, rather, TSH or IFNγ treatment additionally modulates the cell, albeit differently, such that transfected or endogenous SSBP-1, respectively, can express its positive regulatory activity. The effect of TSH is consistent with reports indicating that TSH enhances the ability of IFNγ to increase classⅡ gene expression despite the fact IFNγ increases endogenous SSBP-1 to only the same levels as in cells untreated with TSH. Finally, the effect of SSBP-1 as a positive regulator is lost when GXXXXG motifs, which exist on both the coding and noncoding strands of the S box, are mutated. Consistent with this, mutation and oligonucleotide competition studies show that GXXXXG motifs are necessary for either strand of the S box to bind protein/DNA complexes containing SSBP-1 in FRTL-5 cell extracts or to bind to recombinant SSBP-1. They also suggest that the SSBP-1-binding sites on either strand of the HLA-DRα S box are functionally distinct. We conclude from these data that the positive regulatory action of SSBP-1 on classⅡ gene expression involves GXXXXG motifs on each strand of the highly conserved S box of the classⅡ 5'-flanking region. As SSBP-1 is modulated by IFNγ and is involved in classⅠ and TSH receptor as well as classⅡ gene expression in FRTL-5 cells, the sum of the data supports the hypotheses that common transcription factors regulate all three genes, and their altered activities may contribute to the development of autoimmunity. (Endocrinology 139: 2300-2313, 1998)

Prediction of a Null Response to Pegylated Interferon α-2b Plus Ribavirin in Patients with High Viral Load Genotype 1b Hepatitis C

( Yuki Wada ),( Hideyuki Tamai ),( Akira Kawashima ),( Naoki Shingaki ),( Yoshiyuki Mori ),( Masanori Kawaguchi ),( Kosaku Moribata ),( Hisanobu Deguchi ),( Kazuki Ueda ),( Izumi Inoue ),( Takao Maeki 대한소화기학회 2014 Gut and Liver Vol.8 No.4

Background/Aims: The present study aimed to clarify whether virological response within 2 weeks after therapy initiation can predict a null response to pegylated interferon α-2b plus ribavirin therapy in patients with high viral load genotype 1b hepatitis C. Methods: The participants consisted of 72 patients with high viral load genotype 1b. The dynamics of viral load within 2 weeks were measured. Results: Significant differences between null responders and nonnull responders were noted for interleukin (IL)-28B genotype, amino acid 70 substitution, α-fetoprotein, low-density lipoprotein cholesterol, hyaluronic acid, and viral response. The area under the curve (AUC) for the receiver operating characteristic curve of the hepatitis C virus (HCV) RNA level decline at 2 weeks (AUC=0.993) was the highest among the factors predicting the null response. When the cutoff value for the HCV RNA level decline at 2 weeks was set at 0.80 log, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in predicting a null response were 82%, 96%, 82%, 96%, and 94%, respectively. In comparison, values for the non-TT and mutant type of amino acid 70 substitution were similar to those for HCV RNA level decline at 2 weeks. Conclusions: Virological response at 2 weeks or the combination of IL-28B and amino acid 70 substitution are accurate predictors of a null response. (Gut Liver 2014;8:421-427)