Shiga University of Medical Science Repository BI WAKO / 滋賀医科大学機関リポジトリ
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Association of Sleep Reactivity and Anxiety Sensitivity with Insomnia-Related Depression and Anxiety among City Government Employees in Japan
Get PDFIt has recently been noted that a reduction in sleep reactivity, characterized as the trait-like degree to which exposure to stress interferes with sleep, and anxiety sensitivity are associated with reduced insomnia severity. This study aimed to examine whether sleep reactivity and anxiety sensitivity are associated with insomnia-related depression and anxiety among city government employees in Japan. This cross-sectional study included 1810 city government employees of Koka City, Japan (mean age (standard deviation): 45.33 (12.20) years) who completely answered the scales for sleep reactivity, anxiety sensitivity, anxiety, and depression. Stepwise multiple regression analysis adjusted for demographic data showed that anxiety sensitivity (β = 0.39) was significantly linked to anxiety, and sleep reactivity (β = 0.36) was significantly linked to depression in individuals with insomnia. Additionally, the results of a logistic regression analysis adjusted for demographic data showed that anxiety sensitivity and sleep reactivity were relevant factors for anxious insomnia (OR = 12.69) and depressive insomnia (OR = 8.73), respectively. Whereas both sleep reactivity (OR = 14.67) and anxiety sensitivity (OR = 6.14) were associated with combined insomnia. These findings indicate that sleep reactivity is strongly associated with depressive symptoms, and anxiety sensitivity is strongly associated with anxiety symptoms in individuals with insomnia.journal articl
Non-occlusive Mesenteric Ischemia with Significant Hyperphosphatemia
Get PDFapplication/pdfAn 86-year-old Japanese woman was referred to our hospital due to the sudden onset of abdominal pain. Abdominal contrast-enhanced computed tomography (CT) revealed no signs of ischemic bowel; however, laboratory investigations revealed metabolic lactic acidosis, elevation of inflammatory markers, and a remarkable elevation in the serum phosphate level. A prompt surgical evaluation revealed non-occlusive mesenteric ischemia (NOMI). Elevated serum phosphate levels may suggest extensive bowel ischemia or infarction, which can lead to a prompt surgical evaluation, even in the absence of specific radiological findings.Journal Articlejournal articl
Unilateral rete mirabile in multiple intracranial arteries with ipsilateral agenesis of the internal carotid artery : a case report
Get PDFBackground:
Rete mirabile of the cerebral artery is a rare anomaly, with most previous cases occurring in the middle cerebral artery or internal carotid artery. Here, we present the first report of unilateral rete mirabile in multiple intracranial arteries with ipsilateral internal carotid artery agenesis.
Case presentation:
A 64-year-old Japanese woman was brought to the emergency department of our hospital in a deep coma. Computed tomography of the head showed severe intraventricular hemorrhage with subarachnoid hemorrhage. Computed tomography angiography showed not only congenital left internal carotid artery agenesis, but also rete mirabile of the left posterior communicating artery, the left posterior cerebral artery, and the left anterior cerebral artery. This unilateral vessel anomaly complex may have contributed to the formation of a peripheral aneurysm arising from a perforating branch of the pericallosal artery, which ruptured. The patient underwent urgent bilateral external ventricular drainage, but deteriorated and was declared brain dead.
Conclusions:
We report the first case of unilateral rete mirabile in multiple intracranial arteries. Because the cerebral arteries in patients with rete mirabile may be vulnerable, close attention should be paid to the development of cerebral aneurysms.journal articl
Association of Arterial Stiffness and Atherosclerotic Burden With Brain Structural Changes Among Japanese Men
Get PDFBackground
Little is known regarding whether arterial stiffness and atherosclerotic burden are each independently associated with brain structural changes. Simultaneous assessments of both arterial stiffness and atherosclerotic burden in associations with brain could provide insights into the mechanisms of brain structural changes.
Methods and Results
Using data from the SESSA (Shiga Epidemiological Study of Subclinical Atherosclerosis), we analyzed data among 686 Japanese men (mean [SD] age, 67.9 [8.4] years; range, 46–83 years) free from history of stroke and myocardial infarction. Brachial‐ankle pulse wave velocity and coronary artery calcification on computed tomography scans were measured between March 2010 and August 2014. Brain volumes (total brain volume, gray matter, Alzheimer disease signature and prefrontal) and brain vascular damage (white matter hyperintensities) were quantified using brain magnetic resonance imaging from January 2012 through February 2015. In multivariable adjustment models including mean arterial pressure, when brachial‐ankle pulse wave velocity and coronary artery calcification were entered into the same models, the β (95% CI) for Alzheimer disease signature volume for each 1‐SD increase in brachial‐ankle pulse wave velocity was −0.33 (−0.64 to −0.02), and the unstandardized β (95% CI) for white matter hyperintensities for each 1‐unit increase in coronary artery calcification was 0.68 (0.05–1.32). Brachial‐ankle pulse wave velocity and coronary artery calcification were not statistically significantly associated with total brain and gray matter volumes.
Conclusions
Among Japanese men, higher arterial stiffness was associated with lower Alzheimer disease signature volumes, whereas higher atherosclerotic burden was associated with brain vascular damage. Arterial stiffness and atherosclerotic burden may be independently associated with brain structural changes via different pathways.journal articl
Effects of different bed heights on the physical burden of physiotherapists during manual therapy: an experimental study
Get PDFThis study aimed to determine the effect of physiotherapists' physical burden caused by different bed heights during manual therapy. Thirty-three male physiotherapists performed tasks simulating lumbar massage and passive hip abduction range-of-motion exercise (ROM) on the beds with low height (LH) and adjusted height (AH), with each task performed three times. The anterior inclination angle of the physiotherapist's trunk was measured, the surface electromyograms of the erector spinae and trapezius muscles were recorded, and perceived stress was assessed. The indexes obtained were statistically compared for different bed heights. Additionally, the lumbar disc compression force and flexion torque were estimated. The lumbar burden caused by the excessive bending and the biomechanical burden and perceived stress were stronger at LH than AH. In ROM tasks using the right hand, the muscle activity was lower at the left lumbar region at LH than at AH. At LH, the anterior inclination angle increased and the lumbar muscle activity declined as the number of tasks increased. The burden on the shoulders was not significantly different by bed heights. Our results showed that, when physiotherapists perform manual therapy, it is necessary to adjust the bed height to reduce physical burden and ensure higher quality of service.journal articl
エンシュウ カラ ジッシュウ エ カンゴ ジッセンリョク ノ コウジョウ オ メザス キョウイク ジッセン : レイワ3ネンド カンゴガク OSCE ジッシ ニ ムケタ トリクミ
Get PDF本論文の目的は、看護学科のカリキュラム上新たな試みである看護学OSCEの実施に関して、前年度のリハーサルから令和3年度の看護学OSCEの実施について報告することであり、この報告を踏まえ、次年度以降の実施に向けての検討資料とすることである。令和2年度は看護学OSCEリハーサルを実施した。受験学生は領域別実習の半分からすべて終了した3回生からボランティアを募り12名が受験した。このリハーサル及び看護学OSCEには看護学科教員全員、医学・看護学教育センター教員が参画し、さらに模擬患者役として大学院生や学生等の協力を得た。リハーサルにおいては、運営方法全般、評価方法、課題の難易度の確認について、各教員が確認し、さらには領域が作成する学生に提示する課題の確認や検討をし、ボランティア学生からも感想を得た。この結果を踏まえて、令和3年度の看護学OSCEを実施した。学生の受験の評価としておおむね、目的であった自己の課題に気づくことについて述べられており、目的は達成していると考えられる。今後より円滑で効果的な実習に向け改善や評価方法を検討する必要がある。departmental bulletin pape
ニホン ニ オケル ニュウボウ シタギ ノ レキシテキ ヘンセン : ニュウボウ ケア ノ イミ オ フクム ブラジャー
Get PDF【背景と目的】
乳房ケアの担い手である助産師は、ケア用品としての乳房下着に関する研究に取り組んでこなかった。ブラジャーとしての定着とケア用品としての歴史的変遷を明らかとし、ブラジャーの意味について再考することを目的に文献研究に取り組んだ。
【方法】
2019年5月～9月、国立国会図書館デジタルコレクションにて関連書物を検索し、研究目的に該当する35文献を調査対象とした。
【結果】
乳房下着は、乳房を隠すことを目的に女性は着用していたが、社会進出によるライフスタイルの変化や洋装の定着により、乳房を美しく見せるための役割として変化していった。1800年頃(寛政12年頃)は、ブラジャーに乳房を支持する機能はなかったが、授乳期女性にとって、乳房の締め付けは乳汁産生と分泌を妨げることが理解されていた。1880年頃(明治13年頃)には、妊娠期女性のために、乳房を支えることは良いとされていたが、マタニティブラジャーが誕生したのは、70年後の1950年代(昭和25年)であった。
【考察】
女性が着用する乳房下着は、女性性の象徴として乳房を美しくみせるといった印象が時代とともに先行し、母乳栄養を行う女性のケア用品としての意味は、欠如していたことが示唆された。助産師として、授乳する女性のためのケア用品として、乳房変化に合わせた望ましいブラジャーの機能特性の見解を世に出すべく、研究に取り組んでいく必要性がある。departmental bulletin pape
Pseudoangiomatous Stromal Hyperplasia of the Breast : A Case Report
Get PDFpdf乳腺偽血管腫様過形成（pseudoangiomatous stromal hyperplasia、PASH）は、血管様の間隙を伴う間質の増殖を主体とする良性疾患である。今回われわれは46歳女性に発症したPASHの1例を経験したので報告する。症例は4カ月前より徐々に増大する左乳房腫瘤を自覚し、精査加療目的に当科紹介となった。局所所見では左乳房C領域に約9cmの弾性軟の腫瘤を触知した。マンモグラフィおよび超音波所見では境界明瞭な充実性腫瘍を認めた。乳房MRIで腫瘍は脂肪抑制 T2強調像にて低信号を呈し、内部にスリット状の高信号域が認められた。針生検では細胞成分の乏しい膠原線維の増生巣を認め、増生巣内には細血管様の間隙構造が目立った。診断と治療をかねて腫瘍摘出術および広背筋皮弁による一期的乳房再建術を施行した。病理組織学的には細胞成分の乏しい膠原線維の増生からなり、線維組織間に細血管様の裂隙形成が広範囲に生じていた。免疫染色では筋線維芽細胞マーカーが陽性であり、PASHと診断された。Pseudoangiomatous stromal hyperplasia (PASH) is a benign disease characterized by proliferation of the stroma with vascular-like spaces. We report a case of PASH in a 46-year-old woman. The patient was aware of a left breast mass that had gradually increased in size over the previous 4 months, and was referred to our department for further investigation and treatment. On local examination, an elastic soft mass of about 9 cm in size was palpable in the C region of the left breast. Mammographic and ultrasonographic findings showed a well-defined solid tumor. Breast MRI showed low signal in the fat-suppressed T2-weighted image and a slit-like high signal area inside the tumor. The needle biopsy showed foci of collagenous fibers with poor cellular component, and microvascular-like pore structures were prominent in the foci. For diagnostic and therapeutic purposes, the patient underwent tumor resection and breast reconstruction with a latissimus dorsi muscle flap. Histopathologically, the tumor was composed of collagenous fibers with poor cellularity, and there were extensive microvascular-like fissures between the fibrous tissues. Immunostaining revealed positive myofibroblast markers, and the diagnosis of PASH was made.Departmental Bulletin Paperdepartmental bulletin pape
Difficult removal of totally implantable venous access devices in adult patients : Incidence, risk factors, and management.
Get PDFpdfBackground:
Totally implantable venous access devices (TIVADs) have played an important role of medical oncology practice. However, operators sometimes encounter considerable difficulty when removing TIVADs. This study aimed to investigate the incidence of difficult TIVAD removal, determine associated risk factors, and investigate interventional radiology (IR) approaches to difficult removal.Methods:
A total of 514 TIVAD removal procedures performed in a single-center between January 2014 and May 2021 were retrospectively analyzed to determine incidence of difficult removal and associated risk factors. IR approaches applied in difficult removal cases were also reviewed.Results:
The incidence of difficult removal was 7.4% (38/514). In univariable analysis, indwelling duration, silicone catheter, and subcutaneous leakage of fluid were identified as significant risk factors for difficult removal. Multivariable analysis showed that indwelling duration per year (odds ratio (OR), 1.46; 95% confidence interval (CI), 1.28-1.67; p < 0.01) and subcutaneous leakage of fluid (OR, 6.04; 95% CI, 2.45-14.91; p < 0.01) were significantly associated with difficult removal. In the 38 difficult removal cases, 32 TIVADs could be removed using more dissection and traction than the standard removal method. In the other 6, TIVADs were successfully removed by using several IR techniques, including insertion of a guide wire (n = 1), dissection using an introducer sheath (n = 2), pushing with a dilator (n = 1), and pulling with a snare (n = 2).Conclusion:
Difficult TIVAD removal is uncommon. However, operators should expect it when removing long indwelling TIVADs and those with subcutaneous leakage. IR approaches to difficult removal are minimally invasive and can be useful.Journal Articlejournal articl