Sapporo Medical University Hospital

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    6459 research outputs found

    Investigation into achievement levels and experience frequencies of employing nursing skills among students in the final year of nursing study

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    目的は,A大学の卒業年次学生の看護技術の到達度「Ⅰ」単独で実施できる,「Ⅱ」指導のもとで実施できる各レベルの到達状況と経験状況を明らかにすることである.A大学2016年度卒業年次学生48名を対象に,「看護技術学習ノート」から,厚生労働省(2007)が示した看護師教育の技術項目,小項目141項目と大項目13項目の到達状況に関する自己評価と実習経験を調査した.到達度「Ⅰ」のうち,到達したのが最も少ない項目は「経管栄養を受けている患者の観察の視点がわかる」であった.到達度「Ⅱ」のうち,到達したのが最も少ない項目は「経鼻胃カテーテルからの流動食の注入ができる」であった.到達度「Ⅰ」「Ⅱ」において,到達状況が低い項目は経験状況も低い傾向にあることがわかった.これらより臨地実習側は経験可能な看護技術を再考し,教育機関側は実習で経験の少ない看護技術を抽出して,学内演習で行うよう検討する必要がある

    Research activities on neurological disorders up to the present

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    To offer the best quality of life for patients suffering from various kinds of neurological disorders, I have been conducting numerous matters of clinical and basic research. My main interests include neurobiology and treatment of neurodegenerative diseases such as Alzheimer’s disease (AD), Parkinson’s disease (PD) and amyotrophic lateral sclerosis. I also conduct research on demyelinating diseases and autoimmune disorders such as myasthenia gravis with our colleagues. We study the molecular mechanisms of AD, and are trying to develop a novel therapy for it. Accumulation of activated microglia in and around senile plaques has been demonstrated in autopsied brains from AD patients, and is believed to modulate amyloid-beta clearance, inflammation and oxidative stress. Findings from our recent research suggest that microglial activation changes with progression of AD expressing several marker molecules. To explore a novel therapy against PD, we evaluated the therapeutic effects of an alpha-7 nicotinic acetylcholine receptor agonist and human bone marrow-derived mesenchymal stem cells. Excitation?contraction (E?C) coupling of skeletal muscles has been a somewhat under-explored field in clinical neurophysiology. We have explored the impaired post-tetanic potentiation of muscle twitch and the effect of local cooling on E-C coupling in myasthenia gravis

    Is the number of covered intercostal arteries a predictor of postoperative spinal cord ischemia after thoracic endovascular aortic repair?

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    Objective: The purpose of this study was to investigate the impact of the number of covered intercostal arteries (ICAs) on postoperative spinal cord ischemia (SCI) after Thoracic endovascular aortic repair (TEVAR).Methods: A retrospective review of a collected database was performed for all patients who underwent TEVAR at the Sapporo Medical University between January 2006 and February 2016. The pre- and post-operative thin slice contrast-enhanced computed tomography was performed, and ICAs were evaluated. Preoperative demographics, procedure-related variables, and clinical details related to SCI were examined. Logistic regression analysis was performed to identify risk factors for the development of SCI.Results: Of the 263 patients who underwent TEVAR during the study period, 11 patients (4.1%) developed SCI. The number of patent preoperative ICAs was 10.1 ± 4.4. There was no significant difference in the number of patent ICAs between the SCI and No SCI groups. On the other hand, the number of postoperative covered ICAs was 4.8 ± 3.3. The number of covered ICAs was higher in the SCI than No SCI group (8.3 ± 2.9 vs 4.7 ± 3.2, p = 0.001). The cut-off value was set at 6 ICAs by ROC curve analysis. Multivariate analysis demonstrated that in TEVAR, the covering of 6 or more ICAs by stent grafts became a significant risk factor for SCI (odds ratio, 10.9; p = 0.029).Conclusions: The number of covered ICAs becomes a predictor of postoperative SCI after TEVAR. The patient with 6 or more ICAs covered by stent grafts is deemed to require a more careful perioperative management

    周手術期看護における手術室見学実習での学生の学び

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    本研究の目的は,周手術期看護実習における手術室見学実習を通して振り返った実習レポートから,学生の学びを明らかにし教授活動への示唆を得ることである.対象はA大学で手術室見学実習を行った47名のうち同意が得られた44名の学生の実習レポートである.実習レポートに記載された学びを理解,気づき,実施ごとに質的帰納的に分析を行った.学生の学びは,理解が【手術室看護師に必要な合併症予防の実践】【患者の不安緩和を目的とした手術室看護師が行う心理的援助】など5カテゴリー,気づきが】【手術を受ける患者の心理的状態】【手術室看護師に求められる役割と能力】など10カテゴリー,実施は【受け持ち患者の緊張緩和を目的とした看護援助】の1カテゴリーとして抽出された.学生は術中看護を術前から術後の継続看護の一環として捉えることができていた.今後は,臨床指導者と協力し学生が手術室で体験できる援助内容を検討していく

    The role of nurses for hospital discharge support : A literature review

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    【目的】退院支援に関する国内文献で述べられている看護師の役割を理解し,看護師間の連携・協働に向けた課題と方向性について示唆を得るための基礎資料とする.【方法】医中誌Web版を用いて「退院支援OR退院調整」AND「看護」AND「役割」をキーワードとして検索した.検索された554文献のうち,本研究の目的に合致した15文献を分析対象とした.15文献から看護師の役割として述べられている内容を抽出し,意味内容の類似しているものを質的帰納的に分析した.【結果】分析対象文献より抽出された看護師の役割は【患者・家族の意思や希望の尊重と実現に向けた関わり】【患者の療養生活を支える家族に焦点を当てた支援】【看護師の退院支援の実践能力を向上させるための教育支援】を含む7カテゴリーに分類された.【参考】退院支援を担う看護師の役割として,家族に焦点を当てた支援を行うことや退院支援に関する教育支援があると考えられた.また,退院支援においては異なる役割を担う看護師同士がそれぞれの専門性を明らかにし,相互理解を深めた上で連携・協働を進めていく必要性が示唆された

    Antagonists to TRPV1, ASICs and P2X have a potential role to prevent the triggering of regional bone metabolic disorder and pain-like behavior in tail-suspended mice

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    尾部懸垂マウスにおける局所性骨代謝障害においてTRPV1・ASICs・P2X拮抗薬は疼痛行動の抑制と骨代謝マーカー発現増強の抑制を示した.これらの拮抗薬は疼痛の誘発と骨粗鬆化に対する予防効果を有する可能性がある

    Prognostic factors for progression of visual field deterioration in patients with primary open-angle glaucoma

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    Regulatory T cells (Tregs) play an important role in the maintenance of self-tolerance and immune homeostasis. Interleukin-2 (IL-2) is critical for Treg expansion, activity and survival. Previous studies have demonstrated that low-dose IL-2 resulted in the selective expansion of Tregs and the clinical improvement of auto-immune disease. To examine the mechanisms whereby IL-2 affects Treg apoptosis through the intrinsic pathway, we used BH3 profiling, and quantitated mitochondrial apoptotic priming. This pattern suggests that Tregs were more primed than conventional CD4 T cells (Tcons) in a BCL2-dependent manner. Tregs expressed lower levels of BCL2 than Tcons. To examine the functional effects of IL-2, sorted Tregs and Tcons were cultured with different concentrations of IL-2. Low-dose IL-2 (10 IU/mL) lowered priming and increased BCL2 expression in Tregs. However, higher concentrations of IL-2 (>100 IU/mL) were required to increase BCL2 expression and decrease priming in Tcons. Apoptosis assays also revealed that low-dose IL-2 reduced susceptibility to apoptosis only in Tregs. ABT-199, a selective BCL2 inhibitor, enhanced the priming and apoptosis of both Tcells. IL-2 reversed the effects of ABT-199 for Tregs only. This provides further evidence that the inhibition of intrinsic pathway apoptosis mediated by IL-2 in Tregs is dependent on BCL2

    Parental rearing attitudes in childhood is associated with adult sleep disturbances independently from depression and life events: a cross-sectional survey in Japan

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    Sleep disturbance associated with depression and suicide is a serious public health concern. Previous studies have suggested that sleep disturbances increase the risk of suicide without going through depression. Adverse childhood experience, which has a long-term effect on mental health, is also a serious problem. We conducted a study to investigate the association between parental rearing attitudes in childhood and sleep disturbances in adulthood by performing a questionnaire survey. A cross-sectional survey performed with the residents of a provincial city in Japan. A total of 1,500 male (aged ≧ 30 years) subjects were randomly selected by a computer from the basic resident register after stratifying them by age. The subjects were assessed by personal characteristics, the Center for Epidemiologic Studies Depression Scale (CES-D), the Social Readjustment Rating Scale (SRRS), and the Parent Bonding Instrument (PBI). We obtained an answer from 400 people (26.7%) among 1,500 subjects. Their average age and standard deviation were 48.3±8.6 years at the time of the survey. According to performing a logistic regression analysis that assessed each parental bonding type compared with optimal bonding adjusted for CES-D and SRRS, “affectionless control” and “awaking during sleep,” and “affectionate constraint” and “a sense of insufficiency of the sleep” were significantly associated, even after controlling for age (OR 2.93, 95% CI: 1.46-5.87; OR 0.24, 95% CI: 0.07-0.79, respectively). Our study raises the possibility that the parental care of a child affects sleep disturbances in adulthood

    Advancing the integrity of medical research : Fundamentals of research ethics and resent trends

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    今日,医学系研究をめぐっては,研究不正や利益相反疑いの問題が報道で大きく取り上げられるようになってきた。ひとたび,研究不正や利益相反疑いを投げかけられた研究者や研究機関の被るダメージは甚大である。他方,近年,研究公正という概念が注目を集めている。研究公正とは,単に研究不正がないだけでなく,今日において研究に要請される倫理的要求を満たした研究を意味する。そこで本稿では,研究に要請される倫理的要素として有名なFINER CRITERIAやALCOA-CCEA原則,また,Emanuelの臨床倫理7原則について紹介する。また,公正な研究を進める上で必要な研修や倫理審査といったプロセスについても,今日の新しい状況についてレビューする。そして最後に,公正な医学系研究を進めるにあたっては,研究倫理に関する研修等研究者サイドの取組のみではなく,研究支援部門の設置・運営等研究機関全体として組織的に取り組む必要性を論ずる

    The roles of metformin and pravastatin on placental endoplasmic reticulum stress and placental growth factor in human villous-Like trophoblastic BeWo cells

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    Preeclampsia (PE) is related to an imbalance of angiogenic factors. Placental growth factor (PlGF) is reduced in early onset PE. Recent evidence indicates that metformin and statins may suppress endoplasmic reticulum (ER) stress. We previously reported that the unfolded protein response activated by ER stress down-regulated PlGF protein expression and predicted these drugs could prevent placental ER stress and up-regulate PlGF protein expression in trophoblast-like cells. In this study, we aimed to establish the effects of these drugs on PlGF and activating transcription factor 4 (ATF4) protein expression. We confirmed that PlGF messenger RNA (mRNA) levels were decreased under ER stress induced by thapsigargin and that ATF4 mRNA was increased under the same conditions and then administered metformin to it. Transcript analysis showed increased PlGF mRNA compared with thapsigargin only treatment and that this was dependent on metformin levels. Under ER stress, western blot showed high levels of ATF4 and phosphorylated-eukaryotic initiation factor 2 subunit α (p-eIF2α) but low levels of PlGF protein. By contrast, compared with thapsigargin alone, ATF4 and p-eIF2α levels were low and PlGF levels were high when metformin and thapsigargin were given, but these were again dependent on metformin concentrations. Western blot also confirmed that pravastatin attenuated ER stress and increased PlGF protein expression. In conclusion, metformin and pravastatin suppressed ER stress and restored PlGF levels in trophoblast-like cells. However, although these results indicate that these drugs have a potential for preventing or treating PE, the lack of clarity on the mechanism requires further study

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