Immunotherapy has been developed as a novel medical intervention for advanced cancer refractory to conventional therapies. In recent years, there are significant advances in basic knowledge of tumor immunology and ample experience of clinical application of novel cancer immunotherapies. Accordingly, molecular and cellular mechanisms of the interaction between cancer cells and immune system have been elucidated. At the initial stage of cancer occurrence, immune system constantly surveys an emergence of cancerous cells to eliminate them. For cancers which have evaded immune surveillance, immune system generates anti-tumor responses by recognition of tumor-associated antigens. In response to such immunological pressure, cancer cells edit their immunogenicity and develop immune-suppressive conditions in tumor microenvironment, resulting in cancer immune evasion. Therefore, simple approach attempting activation or transfer of anti-tumor immune cells does not necessarily lead to measurable effects in clinical settings. In order to achieve further effective immunotherapy, it is imperative to inactivate cancer immune evasion mechanisms. Based on this notion, novel immunotherapies have been developed, some of which were approved by the US Food and Drug Administration. In this review, among newer generation of immunotherapy, two most promising approaches, i.e. antibodies targeting immune checkpoint blockade and adoptive transfer of T cells with genetic modification, will be introduced.

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The mixed methods, which comprises both quantitative and qualitative research, has developed as a third method which enhances the validity and reliability of research, and offers a reconcilable view of the paradigm dichotomy between quantitative and qualitative research. Mixed methods researchers, using both quantitative and qualitative methods with their two different paradigms, that is, positivism and constructivism, cannot disregard their philosophical premises. The paradigm supported by most of mixed methods researchers is pragmatism, but dialectic is also convincing. Mixed methods researchers have developed a common visual notation, but not a common typology of mixed methods. The author suggested that the studies classified as mixed methods must have complete study designs for both quantitative and qualitative research. The author looked up various types of mixed methods for the last 10 years in the Journal of the Japan Academy of Nursing Science. The number of mixed methods for the last 10 years has not changed, compared with the previous 23 years. It would be expected that the interaction between the quantitative and qualitative approaches would occur not only within one study design, but also between different studies.

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The bone marrow microenvironment plays a critical role in regulating the proliferation and differentiation of hematopoietic stem cells. Granulocyte colony-stimulating factor(G-CSF)-mobilized peripheral blood stem cells(PBSCs)are widely used to reconstitute hematopoiesis ; however, preclinical and clinical studies show that improvements to this mobilization can be achieved. To investigate the mechanisms involved in the stem cell mobilization, we examined several marker levels of bone metabolism, adipose tissue, and sympathetic nervous system in the blood samples from G-CSF-treated healthy human donors. Furthermore, in order to develop a simple, rapid, and reliable method of assessing the harvest quality of PBSCs, we conducted a prospective study comparing the use of CD34+ cell count with some surrogate decision markers for patients requiring autologous PBSC mobilization. Further studies will be required to fully develop a safe and efficient mobilization and harvesting of PBSCs.

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Purpose:We examined the visual acuity after phototherapeutic keratectomy(PTK)for the treatment of corneal dystrophies and assessed its implications for cataract surgery.Patients and methods:50 eyes in 32 patients with corneal dystrophies were treated with PTK . Cataract surgeries were performed after PTK in case of 32 eyes of 21 patients. The primary outcome measures were best-corrected visual acuity.Results:18 eyes of 14 patients were performed only PTK. The mean visual acuity of 18 eyes improved from 0.31 to 0.67(p<0.01).Visual acuity improved in 14 eyes out of 18 eyes(77.8%).32 eyes of 21 patients were performed cataract surgery after PTK. The mean visual acuity of 32 eyes improved from 0.26 to 0.58(p<0.01).Visual acuity improved in 26 eyes out of 32 eyes(81.3%).Mean time between PTK and cataract surgery was 4.4±2.6 months.Conclusion:PTK is effective for improving vision in patients with corneal dystrophies, as evaluated at more than 1-year follow-up examination. Cataract surgeries after PTK in those patients were further benefical for improvement of vision and may be useful to perform cataract surgery safely.

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This study is the current analysis with the secondary use of Sanyo Onoda city health plan baseline survey to show associations between social capital, lifestyles and health. The sampling is snowball sampling. Starting from members of health plan steering committee, 1000 sheets were distributed and 961 were collected, 1.43% of the population of Sanyo Onoda city. Data with answers were used by each analysis. The result of multiple regression analysis show life satisfaction level was affected by, in descending order, mental health, neighborhood, working environment, physical health, city health policy, and all of them are significant. In almost all questions about social capital, satisfaction level of life, physical health, and mental health of good answers are high. About lifestyle, the rate of 20s underweight women, 20-30s non breakfast men, non exercise women, and stressful people are higher than baseline of“Healthy Japan 21st".In personal level, life, physical health, and mental health are affected to the same degree by social capital and lifestyle. In regional level, the relationships between social capital and life and mental health are significant. In municipal health plan, both social capital promotion and lifestyle improvement are important.

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We studied 18 patients with ameloblastoma who visited and were treated in our department from September 2002 to August 2010. The patients were 11 males and 7 females, aged 14 to 74 years(median, 34.7 years).The percentage of the patients under 40 years of age was 72.2%. Tumor occurred in mandible on 16 cases and in maxilla on 2 cases. Histopathologically, solid / multicystic type was observed in 15 cases, unicystic type in 2 cases, desmoplastic type in 1 case. We performed extirpation on 14 cases and dissection of the jaw on 4 cases. When we performed extirpation, we added the procedure of peripheral osteotomy and cryotherapy. Two of 14 patients(14.3%)who underwent extirpation had a recurrence, but we performed re-extirpation and the lesions can be controlled. These results suggested that the treatment policy in our department for ameloblastoma is appropriate.

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We described a patient with carcinomatous peritonitis and rectal stenosis that developed 5 years after surgery for breast cancer. The 60-year-old patient had undergone a radical mastectomy for breast cancer 5 years before. She visited to our hospital because of difficulty with defecation, and underwent extensive examinations. She was diagnosed as having rectal stenosis and bilateral hydoronephrosis. Carcinomatous peritonitis or retroperitoneal fibrosis was suspected but differential diagnosis was difficult. We performed laparotomy and a large number of granules were evident macroscopically in the greater omentum and mesenterium. Some pieces of these granuler tissues were biopsied and a double-barrelled ileostomy was created. The patient was diagnosed histologically as having carcinomatous peritonitis. She was discharged from the hospital 12 days after surgery, and has been followed up for continuation of EC therapy in the outpatient department. We report the case with a review of the literature.

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We report a case of a rare gastrointestinal stromal tumor(GIST)of the transverse colon with multiple liver metastases. A 74 years old man was hospitalized in emergency because of revealing melena. 9cm diameter mass in the transverse colon was found in colonoscopy and also multiple liver metastasis in CT. The patient underwent right hemicolectomy under the diagnosis of submucosal tumor. Histopathological findings showed the fascicular growth of spindle cells, and tumor cells presented palisading formation. Even though immunohistochemical examination showed tumor cell to be only a few positive for S-100, negative for c-Kit, nor Desmin, nor SMA, we diagnosed the case as GIST due to presenting histological palisading. We administered imatinib therapy after the surgery and the patient is doing well at this time.

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A man in his 40's was transferred to our hospital by ambulance because of high fever and immobility. The patient has been well until two weeks earlier, when he began to have epigastralgia and back pain, followed by fever, diarrhea and general fatigue. Laboratory tests showed marked inflammatory reactions and mild elevation of hepatobilliary enzymes. A computed tomography of the abdomen revealed a 70mm-diameter, well-defined and lobulated low density area in the left hepatic lobe, which was consistent with hepatic abscess. We performed percutaneous abscess drainage and aspirated red-brown fluid. Although cefmetazole was given intravenously, the patient's temperature rose to 38.0 or higher during the first 3days of hospitalization. So we added oral metronidazole on the third day. His temperature reduced on the fourth day, and didn't rise after that. Although microbiologic evaluation of stool and aspirated specimen from liver abscess was negative, test for antibodies to Entamoeba was positive. He was discharged on the 33rd hospital day. The patient was confirmed as being HIV-positive by serological tests. We referred him to a specialist for treatment of HIV.

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