The purpose of this study was to compare demographic trends in the aging of the Japanese and Brazilian populations on the basis of health indicator data collected by the statistics bureaus of the Japanese and Brazilian governments. The demographic and health indicator data from surveys by the Statistics Bureaus of the Japanese and Brazilian governments and other sources were obtained from websites. The data showed that Japan has an aging population, that the number of elderly persons in Japan is increasing and that the Government of Japan has a plan to address future demands for health resources by this aging population, whereas Brazil has a rapidly population aging but no plan for its future health services. Brazil may need to increase the number of hospitals and hospital beds and develop a medical care plan for the elderly within its Unified Health System.

Histopathological and immunohistochemical studies were conducted to investigate the local existence and distribution of mast cells, fibroblasts or dendritic cells, and myofibroblasts in scleroderma, while paying particular attention to the interstices around the adnexa. The skin tissues in 15 cases of systemic scleroderma were classified histopathologically into three stages: early, fully developed, and late stage. Mesenchymal cells were distinguished immunohistochemically by 6 markers: tryptase, CD34, factor XIIIa, alpha smooth muscle actin (αSMA), vimentin, and desmin. In scleroderma, there was an increase in the number of tryptase-positive mast cells in the interstices around the adnexa. With no relation to the interstitial sites, there was a significant decrease in the number of CD34-positive cells in the late stage, and a significant increase in αSMA-positive cells in the fully developed stage, but a decrease in the late stage. Results of the present study brought about the following new findings: it was only in the mast cells that there was a significant difference in the cell distribution between the interstices around the adnexa and the interstices in non-adnexal sites. Secondly, it was suggested that mast cells, CD34-positive dendritic cells, and αSMA-positive myofibroblasts were involved in the fibrosis and shrinkage or disappearance of the adnexa when scleroderma developed.

Hepatocellular carcinoma (HCC) has a poor prognosis even after curative surgery, due to the high frequency of early intrahepatic recurrence (IHR). Conventional staging systems are almost completely inadequate, and need to be complemented by novel tools. To this end, many investigators have performed DNA microarray analysis on the basis of genome-wide information. However, so far, few studies have been able to truly account for the clinical efficacy of DNA microarray analysis in HCC. To address this dilemma, we used a supervised learning method with information of 7070 genes from 33 HCC samples, to construct a 12-gene predictor for early IHR, and then evaluated its predictive performance in 27 independent HCC samples. Our 12-gene predictor correctly predicted early IHR or non-recurrence in 25 (93%) of the 27 independent samples. This predictive value is higher than that of any other system currently available, suggesting that our system can serve as a robust tool for accurate prediction of early IHR of HCC. I emphasize in this mini-review that, although there are some technical issues to resolve prior to clinical use, DNA microarray technology can provide molecular basis to initiate “bench to bedside” translation, which cannot be easily reached with other methods.

Application of cell therapy using stem cell into intractable diseases has been noted as the medicine in the next generation taking the place of organ transplantation. Bone marrow cells have been focused as a candidate of the source of this therapy. Liver failure is a terminal state of all advanced liver diseases and thousands of patients are dying of decompensated liver cirrhosis in every year in Japan. Liver transplantation must be the strongest weapon to relieve those patients. However, particularly in Japan, liver transplantation has not been popularized. In this sense, we thought of autologous bone marrow cells transplantation for decompensated liver cirrhosis. Basic studies using animal model revealed that transplanted bone marrow cells into syngenic mouse suffering from liver cirrhosis migrated into the damaged liver and transdifferentiated to the hepatocytes. Based upon the animal studies, clinical trial of this new cell therapy supported by the Ministry of Health, Labor and Welfare is ongoing. It is early to estimate this therapy. However, free from liver failure has been observed in some cases.

高校生を対象に,医師になるモチベーションを高め,山口大学医学部への入学を勧めることを目的にした医療体験セミナーを実施した.セミナーは,平成23年から平成26年の間,県内の6地区の病院で開催し,病院の施設見学,医師講演,医療体験,医師や医学生への質疑などから構成した.医療体験では,研修医や指導医とともに,医学生が高校生への指導を行った.4年間計11回のセミナーに,のべ210名の高校生が参加した.参加者へのアンケートでは,参加高校生の89.8%がセミナーを｢大変良かった｣,91.4%がセミナーで｢医師を目指す意欲がわいた｣と回答した.高校への進路調査の結果,参加者のうち高校を卒業した者(浪人中除く)69名から20名が山口大学医学部医学科に入学した.また,医学部入学者のうち山口大学の割合は,セミナー参加者69.0%(20名/29名),非参加者45.5%(46名/101名)であった.これらの結果は,本セミナーが,高校生の医師を目指すモチベーションや山口大学への親和性を高め,地元から医学部,特に,山口大学への入学者を増加させることに有効であることを示唆する.