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ケイ酸/亜鉛置換ストロンチウムアパタイトコーティングによるβ-リン酸カルシウムの骨誘導能促進効果
Get PDFBackground: β-Tricalcium phosphate (β-TCP) is a popular synthetic bone graft substitute with excellent osteoconductive properties and bioabsorbability. However, its osteoinductive properties are inferior to those of autologous or allogeneic bone. Trace elements such as strontium (Sr), silica (Si), and zinc (Zn) have been reported to promote osteogenesis in materials. In this study, we aimed to determine whether a Si/Zn-substituted Sr apatite coating of β-TCP could enhance osteoinductive properties. Methods: The apatite-coated β-TCP disks were prepared using nanoparticle suspensions of silicate-substituted Sr apatite (SrSiP) or silicate- and Zn-co-substituted Sr apatite (SrZnSiP). Bone marrow mesenchymal cells (BMSCs) from rat femur were cultured and subsequently seeded at a density of 1.0 × 106/cm2 onto apatite-coated and non-coated β-TCP disks. In vitro, the β-TCP disks were then placed in osteogenic medium, and lactate dehydrogenase (LDH) activity was measured from supernatants after culture for 2 days. Additionally, after culture for 14 days, the mRNA expression of genes encoding osteocalcin (OC), alkaline phosphatase (ALP), bone morphogenetic protein-2 (BMP-2), and vascular endothelial growth factor (VEGF) was evaluated by qRT-PCR. In vivo, the β-TCP disks were transplanted subcutaneously into rats that were sacrificed after 4 weeks. Then, the harvested disks were evaluated biochemically (ALP activity, OC content, mRNA expression of OC, ALP, BMP-2, and VEGF measured by qRT-PCR), radiologically, and histologically. Results: Significantly higher mRNA expression of almost all evaluated osteogenic and angiogenic genes was observed in the SrZnSiP and SrSiP groups than in the non-coated group, with no significant cytotoxicity elicited by the apatite coating in vitro. Moreover, in vivo, the SrZnSiP and SrSiP groups showed significantly higher osteogenic and angiogenic gene expression and higher ALP activity and OC content than the non-coated group (P < 0.05). Radiological and histopathological findings revealed abundant bone formation in the apatite-coated group. Conclusions: Our findings indicate that apatite coating of β-TCP improves osteoinductive properties without inducing significant cytotoxicity.博士（医学）・甲第805号・令和3年12月21日© 2021. The Author(s).Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data
Current Status of Kodoku-Shi in Nara Prefectureia.
Get PDFThe situation where people living in single-person households are discovered dead at home is called kodoku-shi in Japan. However, the actual status of kodoku-shi has not been investigated fully. The object of this study was to investigate the actual status of kodoku-Shi in Nara prefecture. The data were obtained from autopsy records kept at the Department of Legal Medicine, Nara Medical University during the Period between January 2008 and December 2017. We investigated 552 autopsy cases judged to be kodoku-shi. In the last decade, the number of cases of kodoku-shi has nearly doubled, with about twice as many men as women. It peaked at 60-69 years old, followed by 70-79 years old and 80-89 years old. The rate of discovery tended to be slightly higher in the summer months. The triggers for discovery were visits by children, brothers / sisters, acquaintances, etc.; checking on safety due to recent disappearance / lack of communication; and awareness of offensive odors and numerous flies. The time to discovery was most often 7 days to 1 month, followed by 1 to 3 days. About half of the causes of death were natural death, followed by death by fire and suicide. Head injuries were common in traumatic death. Hanging and death by poisoning were common in cases of suicide. Women aged 80-90 were more likely to die of hypothermia. The cause of death was unknown in 16.7% of cases, and these involved highly decomposed cadavers. Most of the corpses in cases of kodoku-shi were taken over by brothers and sisters and children, but 13.9% of them were taken over by a government office. Analyzing kodoku-shi through postmortem examination contributes to the formulation of preventive measures and, above all, early discovery of the corpse is important
Supporting Parents of "Children of Concern" at Nursery Schools.
Get PDFEarly childhood educators struggle to provide support for the parents of "children of concern". To improve the knowledge of nursery teachers and nurses in this area of specialization, consultations, training, and case meetings were conducted by professionals, including clinical psychologists. However, supporting parents may be difficult in some situations due to misunderstandings between these stakeholders regarding child development, problems with parental care, lack of parental ability, and improper parental care⁹⁾. In addition, nursery teachers and nurses working in nursery schools may not be confident at supporting "children of concern" because they do not know how to interact with these children and have not learned how to teach them. The aim of this study was to clarify the type of support available to parents with children deemed "of concern" by teachers and nurses in nursery schools; the effects of these types of support were also examined. A questionnaire-based survey was performed. The data were analyzed using a simple tabulation method; the free description method was used for qualitative analysis. Early childhood educators remain in a difficult situation when dealing with parents of "children of concern", in particular, when conveying concern to parents and when dealing with parents not accepting or not aware of these concerns. Referrals to experts and talking and listening to parents can help build trust and support parents. Nurses have a duty to support parents of "children of concern" who are suspected of having developmental disabilities. In addition, it is necessary to incorporate education on practicing childcare support in basic nursing training
Literature review of mothers' feelings about breastfeeding support while their child is in the neonatal intensive care unit.
Get PDF目的: 児がNICUに入院中の母乳育児支援やNICU環境に対する母親の思いを、関連する文献から整理し、母乳育児が継続できる支援の方策を検討する。方法: 医中誌Web、PubMed、CINAHLを用いて、キーワードから質的研究の文献検索を行った。対象12文献から、児がNICUに入院中の母親への支援に関する母親の思いを分析した。結果: 【母親役割を認めてもらいたい】【周囲に支えられる】【励ましや気遣いによる苦しみ】【家族の母乳育児への関心が必要】【孤独を感じる】【専門的な支援が必要】【周囲からの情報が役に立つ】【情報が交錯し、不安になる】【リラックスして搾乳したい】の9のカテゴリが抽出された。結論: 1.児がNICUに入院中の母親の母親役割肯定に、周囲の母乳育児支援や関わりが影響していた。2.母親の家庭状況や価値観、文化的背景によって、母乳育児支援や授乳環境の受け取り方が異なっていた。3.医療者からの母乳育児必要性の情報に混乱する思いが抽出され、情報提供方法の改善と母親自身の情報リテラシーの重要性が示唆された。Objective: This study aimed to examine support measures for continuing breastfeeding by analyzing excerpts from the literature on mothers' feelings about breastfeeding support while their child is in the neonatal intensive care unit (NICU) and about the NICU environment. Methods: Ichushi Web, PubMed, and CINAHL were used to conduct a literature search of qualitative research based on key words. The 12 papers found were analyzed for mothers' feelings about support for breastfeeding while their child is in the NICU. Results: Nine categories were identified: "Mothers want others to recognize maternal role" ; "Mothers are supported from others" ; "Mothers suffer due to encouragement and concern from others" ; "Mothers need their family members' interest in the breastfeeding" ; "Mothers feel lonely" ; "Mothers feel they need professional support" ; "Information obtained from other people is useful to mothers" ; "Mothers become anxious when information is mixed" ; and "Mothers want to breast pump in relaxed." Conclusions: 1) Support and care from other people has a large influence on the continuation of breastfeeding by mothers whose child is in the NICU. 2) Mothers perceived the same breastfeeding support and breastfeeding environment differently depending on their home situation, values, and cultural background. 3) Examples of mothers feeling confused by information about the need for breastfeeding from medical professionals were extracted from the literature, which suggests the importance of improving how information is provided and the importance of mothers' own information literacy
Enhancing subjective well-being of elderly people in healthcare or special elderly nursing facilities : Review of literature.
Get PDF【目的】介護老人保健施設および特別養護老人ホームに入所する高齢者（以下、入所高齢者）の主観的幸福感について、その程度、高めるケアの可能性、高めるケアの方法を示す。【方法】医中誌Webを用いて、入所高齢者の主観的幸福感に関して検討された内容を含む原著論文22を分析した。【結果】入所高齢者の改訂PGCモラール・スケールの得点範囲は、9.09±4.12～11.8±3.93であった。また、自宅で生活する高齢者（以下、在宅高齢者）との比較があった研究3件中、1件では、在宅高齢者が有意に高かった。【考察】入所高齢者の主観的幸福感は、在宅高齢者と比べ、低い傾向にある。しかし、安心感や充実した時間の創出により、自宅での生活時と同等に保つことが可能であると考えられる。健康状態や障害、孤独感、心理的変化、役割・自由さを感じられる環境、活動での楽しみの継続、に対するケアが、入所高齢者の主観的幸福感を高めると考えられる。Purpose: This study examines the degree, the potential for enhanced care, and the methods, for the subjective well-being of the elderly living in healthcare and special elderly nursing facilities. Method: The web version of the Japanese Society for Medical Abstracts was used to search the literature. The selection criteria were original papers that include research on the subjective well-being of the elderly living in such facilities. Overall, 22 articles met the selection criteria. Results: The score range of the revised PGC moral scale for the elderly in these facilities was 9.09 ± 4.12 to 11.8 ± 3.93. In addition, compared to the revised Philadelphia Geriatric Center Morale Scale (PGC morale scale) scores for the elderly in these facilities, the ones for those at home were significantly higher in one of the three studies. Discussion: The subjective well being of the elderly living in such facilities tends to be lower than those at home. However, it is thought that this could be maintained at the same level as home by creating a sense of security and a fulfilling time. Care for health conditions and disabilities, loneliness, psychological changes, an environment in which one can experience roles and freedom, and continued enjoyment of activities is thought to enhance the subjective well-being of the elderly living in these facilities
川崎病急性期におけるa disintegrin and metalloproteinase with thrombospondin type 1 motif, member 13 (ADAMTS13) の動態
No full textINTRODUCTION: ADAMTS13 modulates shear-dependent platelet thrombus formation (PTF) by limited proteolysis of von Willebrand factor (VWF). A high-plasma-ratio of VWF antigen to ADAMTS13 activity (VWF:Ag/ADAMTS13:AC) promotes PTF and aggravates shear-induced inflammation mediated by VWF. A role of ADAMTS13 in Kawasaki disease (KD) remains unknown, however. We investigated the involvement of ADAMTS13-VWF axis in the acute-phase of KD (acute-KD). METHODS: VWF:Ag and ADAMTS13:AC in 77 KD infants were measured at three time-points; immediately before (Pre), one-week (1 W) and one-month (1 M) after intravenous-immunoglobulin (IVIG) treatment. VWF multimer (VWFM) distribution and ADAMTS13-isoelectrofocusing (IEF) patterns were compared between the responders and non-responders to IVIG. RESULTS: A high VWF:Ag (195.7 ± 85.6%, p < 0.05), low ADAMTS13:AC (60.3 ± 23.8%, p < 0.05) and high VWF:Ag/ADAMTS13:AC ratio (3.70 ± 2.12, p < 0.05) at Pre were seen compared to control plasmas. These parameters returned to normal levels time-dependently after IVIG treatment. Non-responders to IVIG demonstrated high VWF:Ag and low ADAMTS13:AC at Pre, and high VWF:Ag/ADAMTS13:AC ratio at 1 W compared to responders, but there were no significant differences in VWFM distribution between both groups. IEF analyses revealed the decreased free form of ADAMTS13 and increased complex form with ADAMTS13 and high-molecular-weight-VWFM at Pre in non-responders. A high VWF:Ag/ADAMTS13:AC ratio was associated with increased white blood cell counts, together with decreased serum albumin and sodium at Pre and 1 W. CONCLUSIONS: A high VWF:Ag/ADAMTS13:AC ratio in acute-KD persisted after primary treatment in non-responders, and unbalanced substrate-to-enzyme ratio appeared to associate with vascular endothelial damage. Analysis of existing mode of ADAMTS13 may help to clarify pathogenesis of IVIG resistance in acute-KD.博士（医学）・甲第720号・令和元年9月27日Copyright © 2019 Elsevier Ltd. All rights reserved