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The Reasons why Laryngectomized Patients Have not Participated in a Self-Help-Group.
Get PDF目的: 喉頭摘出者（以下、喉摘者）が退院後に患者会に参加していない理由を明らかにする。方法: 関東甲信越地方と九州地方で活動する患者会に会員登録をしているが、調査時点において患者会に参加していない喉摘者522名を対象に、患者会活動に参加していない理由を質問紙郵送法で調査し、質的帰納的に分析した。結果: 喉摘者が患者会に参加していない理由は、【身体的状態が整わない】、【社会役割遂行との折り合いがつかない】、【患者会参加が億劫】、【経済的に余裕がない】、【患者会の活動が自分のニーズに合わない】、【患者会に通わなくても大丈夫】の6テーマに集約された。考察: 喉摘者個々に合わせた退院前からの継続的なセルフケア獲得への支援や患者会や社会資源の活用に関する情報的サポートが重要である。更に、現行の患者会活動と連携を図りながら、退院後の喉摘者が活用可能なサポート体制を構築する必要性が示唆された。PURPOSE: The purpose of this study was to clarify why laryngectomized patients have not participated in a Self-Help-Group(SHG) after discharge. It is not clarified what kind of support they need after discharge. METHODS: Among SHG members in prefectures in the Kanto and Kyushu regions of Japan questionnaires were mailed to 522 SHG members who had not participated in SHG at the start of this study and agreed to participate in this research for analyzing the reasons why they have not participated in SHG qualitatively and inductively. RESULTS: The reasons for non-participation were classified into six items: "insufficient physical fitness" ; "unable to come to terms with social roles" ; "psychological barriers to participation" ; "unableto attend for financial reasons" ; "SHG activities not satisfying their own needs" ; and "no perceived need to participate". DISCUSSION: It is important to provide laryngectomized patients with social resources and continuous personalized support, starting before hospital discharge, to help them acquire self-care ability. Further, it is necessary to establish a system in which discharged laryngectomized patients can utilize support provided by medical welfare specialists, in collaboration with current SHG activities
Cognitive and psychological effects of creating a life history book using reminiscence therapy for elderly individuals living in communities.
Get PDF【目的】地域在住の高齢者に対し、回想去を用いた自分史作成を行い、認知機能や心理的な影響、回想の過程で生じた思いを明らかにすることである。【方法】在宅で自立して暮らす65歳以上の高齢者23名に対して、回想法を用いた自分史作成を週1回1時間、全5回行った。介入前後で認知機能評価と高齢者向け生きがい感スケール（K-Ⅰ式）を調査した。回想記録などの質的データは定性的に分析した。【結果】認知機能評価のうち、即時再生が有意に向上した（p=0.000）。高齢者向け生きがい感スケール（K-Ⅰ式）は、有意ではないが数値は向上した。定性的分析により、回想の過程で生じた思いが明らかとなった。【結論】自分史作成後に、「即時再生」が有意に向上し、生きがい感が向上する傾向がみられた。また、回想の過程で生じた「思い」が明らかとなった。 高齢者に対して回想法を用いた自分史作成を行うことによって、高齢期をよりよく生きていくための一助となり得ることが示唆された。Purpose: For elderly individuals living in communities, we aimed to create life history books via reminiscence therapy and clarify the cognitive function, psychological effects, and feelings experienced in the process of reminiscence. Method: This study included 23 elderly individuals aged 65 years and older who lived independently at home. We instructed them to create life history books using reminiscence therapy once a week for 1 hour, for a total of 5 times. Before and after the intervention, we investigated cognitive function and the K-Ⅰ Scale for the Feeling that Life is Worth Living among the Aged scores. We analyzed qualitative data such as recollection record. Results: Immediate regeneration in cognitive function was significantly improved (p=0.000). The K-Ⅰ Scale for the Feeling that Life is Worth Living among the Aged scores improved but not significantly. Qualitative analysis revealed the feelings that were experienced during reminiscence. Conclusion: Creating a life history book significantly improves immediate memory and the sense of purpose in life. We clarified the feelings that are experienced during reminiscence. We conclude that creating a life history book using reminiscence therapy in elderly individuals may help improve their quality of life in their old age
尿路上皮癌微小環境内におけるDisabled Homolog 2 (DAB2) は腫瘍細胞上皮間葉転換を介して遊走能・浸潤能を高める
Get PDFDisabled homolog-2 (DAB2) has been reported to be a tumor suppressor gene. However, a number of contrary studies suggested that DAB2 promotes tumor invasion in urothelial carcinoma of the bladder (UCB). Here, we investigated the clinical role and biological function of DAB2 in human UCB. Immunohistochemical staining analysis for DAB2 was carried out on UCB tissue specimens. DAB2 expression levels were compared with clinicopathological factors. DAB2 was knocked-down by small interfering RNA (siRNA) transfection, and then its effects on cell proliferation, invasion, and migration, and changes to epithelial-mesenchymal transition (EMT)-related proteins were evaluated. In our in vivo assays, tumor-bearing athymic nude mice subcutaneously inoculated with human UCB cells (MGH-U-3 or UM-UC-3) were treated by DAB2-targeting siRNA. Higher expression of DAB2 was associated with higher clinical T category, high tumor grade, and poor oncological outcome. The knock-down of DAB2 decreased both invasion and migration ability and expression of EMT-related proteins. Significant inhibitory effects on tumor growth and invasion were observed in xenograft tumors of UM-UC-3 treated by DAB2-targeting siRNA. Our findings suggested that DAB2 expression was associated with poor prognosis through increased oncogenic properties including tumor proliferation, migration, invasion, and enhancement of EMT in human UCB.博士（医学）・甲第768号・令和3年3月15日© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/)
DRU classificationに基づく特発性側弯症の適切な観察間隔の設定 多施設研究
Get PDFPurpose: To determine the capability of the distal radius and ulna (DRU) classification for predicting the scoliosis progression risk within 1 year in patients with adolescent idiopathic scoliosis (AIS) and to develop simple recommendations for follow-up durations. Methods: Medical records of patients with AIS at two tertiary scoliosis referral centers were retrospectively reviewed for their DRU classification and major curve Cobb angles. Baseline DRU grades and Cobb angles with subsequent 1-year follow-up curve magnitudes were studied for scoliosis progression, which was defined as exacerbation of the Cobb angle by ≥ 6°. The relationship between DRU classification and scoliosis progression risk within 1 year was investigated. Patients were divided into three groups according to the Cobb angle (10°-19°, 20°-29°, ≥ 30°). Results: Of the 205 patients with 283 follow-up visits, scoliosis progression occurred in 86 patients (90 follow-up visits). Radius and ulna grades were significantly related to scoliosis progression (p 80% of patients within 1 year. Curve progression was less likely for grades R9 and U7. Most patients with more mature DRU grades did not experience progression, even with Cobb angles ≥ 30°. Conclusion: With R6, R7, and U5, scoliosis may progress within a short period; therefore, careful follow-up with short intervals within 6 months is necessary. R9 and U7 may allow longer 1-year follow-up intervals due to the lower progression risk.博士（医学）・甲第771号・令和3年3月15日© Springer-Verlag GmbH Germany, part of Springer Nature 2020This is a post-peer-review, pre-copyedit version of an article published in European spine journal. The final authenticated version is available online at: http://dx.doi.org/10.1007/s00586-020-06441-4
マウスの神経細胞において、Ischemic postconditioningはmitochondrial permeability transition poreとKATPチャネルの開口を介してNMDA受容体電流を低下させる。
Get PDFIschemic postconditioning (PostC) is known to reduce cerebral ischemia/reperfusion (I/R) injury; however, whether the opening of mitochondrial ATP-dependent potassium (mito-KATP) channels and mitochondrial permeability transition pore (mPTP) cause the depolarization of the mitochondrial membrane that remains unknown. We examined the involvement of the mito-KATP channel and the mPTP in the PostC mechanism. Ischemic PostC consisted of three cycles of 15 s reperfusion and 15 s re-ischemia, and was started 30 s after the 7.5 min ischemic load. We recorded N-methyl-D-aspartate receptors (NMDAR)-mediated currents and measured cytosolic Ca²⁺ concentrations, and mitochondrial membrane potentials in mouse hippocampal pyramidal neurons. Both ischemic PostC and the application of a mito-KATP channel opener, diazoxide, reduced NMDAR-mediated currents, and suppressed cytosolic Ca2+ elevations during the early reperfusion period. An mPTP blocker, cyclosporine A, abolished the reducing effect of PostC on NMDAR currents. Furthermore, both ischemic PostC and the application of diazoxide potentiated the depolarization of the mitochondrial membrane potential. These results indicate that ischemic PostC suppresses Ca²⁺ influx into the cytoplasm by reducing NMDAR-mediated currents through mPTP opening. The present study suggests that depolarization of the mitochondrial membrane potential by opening of the mito-KATP channel is essential to the mechanism of PostC in neuroprotection against anoxic injury.博士（医学）・甲第781号・令和3年3月15日© Springer Science+Business Media, LLC, part of Springer Nature 2020This is a post-peer-review, pre-copyedit version of an article published in Cellular and molecular neurobiology. The final authenticated version is available online at: http://dx.doi.org/10.1007/s10571-020-00996-y
ATR阻害は非相同末端結合および相同組換え修復と非依存的に5-FUを増感する
Get PDFThe anticancer agent 5-fluorouracil (5-FU) is cytotoxic and often used to treat various cancers. 5-FU is thought to inhibit the enzyme thymidylate synthase, which plays a role in nucleotide synthesis and has been found to induce single- and double-strand DNA breaks. ATR Ser/Thr kinase (ATR) is a principal kinase in the DNA damage response and is activated in response to UV- and chemotherapeutic drug-induced DNA replication stress, but its role in cellular responses to 5-FU is unclear. In this study, we examined the effect of ATR inhibition on 5-FU sensitivity of mammalian cells. Using immunoblotting, we found that 5-FU treatment dose-dependently induced the phosphorylation of ATR at the autophosphorylation site Thr-1989 and thereby activated its kinase. Administration of 5-FU with a specific ATR inhibitor remarkably decreased cell survival, compared with 5-FU treatment combined with other major DNA repair kinase inhibitors. Of note, the ATR inhibition enhanced induction of DNA double-strand breaks and apoptosis in 5-FU-treated cells. Using gene expression analysis, we found that 5-FU induced the activation of the intra-S cell-cycle checkpoint. Cells lacking BRCA2 were sensitive to 5-FU in the presence of ATR inhibitor. Moreover, ATR inhibition enhanced the efficacy of the 5-FU treatment, independently of the nonhomologous end-joining and homologous recombination repair pathways. These findings suggest that ATR could be a potential therapeutic target in 5-FU-based chemotherapy.博士（医学）・甲第791号・令和3年3月15日© 2020 Ito et al. Published under exclusive license by The American Society for Biochemistry and Molecular Biology, Inc.This is an Open Access article under the CC BY license(https://creativecommons.org/licenses/by/4.0/)
Fact-finding survey of health guidance for pregnant women wanting epidural analgesia and postgraduate education of nursing professionals.
No full text看護職者は、無痛分娩を希望する妊婦へ教育や準備を促す必要があるという思いを持っているということが明らかとなっているが、無痛分娩を希望する妊婦への保健指導の実態や無痛分娩に携わる看護職者の卒後教育について調査されたものは見当たらない。本研究は、無痛分娩を希望している妊婦に対する看護職者による保健指導の実態、看護職者の保健指導に対する意識、看護職者による無痛分娩中のケアと講習会などの卒後教育の実態を明らかにすることを目的とした。無痛分娩取り扱い450施設を対象とし、自記式質問紙を郵送配布し、調査を行った。分析対象とした医療施設において看護職者による無痛分娩中のケアと卒後教育の実態、無痛分娩を希望している妊婦に対し看護職者が行う保健指導は、それぞれ施設によってばらつきがあることが明らかとなった。無痛分娩に関するマニュアルの有無と自施設での講習・勉強会の実施の有無による有意差 (p<0.05) が認められた。無痛分娩を希望する妊婦が無痛分娩に関して正しく理解できるよう、妊娠期から看護職者が保健指導などのケアを行う必要性が示唆された。Nursing professionals have been found to feel a need to promote the education and preparation of pregnant women wanting epidural analgesia. However, no research can be found that investigates the actual state of health guidance for pregnant women wanting epidural analgesia and postgraduate education of nursing professionals involved in epidural analgesia. The aim of this study was to clarify the actual state of health guidance provided by nursing professionals to pregnant women wanting epidural analgesia, awareness of health guidance among nursing professionals, and the situation of nursing professionals' management of epidural analgesia for labor and their postgraduate education, including seminars. A total of 450 institutions handling epidural analgesia were included in the study. Self-administered questionnaires were distributed by post to these institutions ask questions. The situation of nursing professionals' management of epidural analgesia and their postgraduate education, as well as health guidance provided by nursing professionals to pregnant women wanting epidural analgesia, were found to Vary according to the institution. A significant difference was seen in the presence or absence of a manual for epidural analgesia for labor according to the presence or absence of seminars and workshops held at the respective institution (p<0.05). The findings suggest that nursing professionals need to provide care that includes health guidance starting from pregnancy to allow pregnant women wanting epidural analgesia to correctly understand it