コウチュウキュウ ニ オケル プレセプシン ノ サンセイ メカニズム ニ カンスル ケントウ

プレセプシンは敗血症マーカーの一つで、単球において貪食により産生されることが知られているが、単球以外からの産生の報告はない。本研究では好中球からのプレセプシン産生の可能性、及びその産生機所を探索するため、好中球を用いたプレセプシン産生実験及び、貪食、プロテアーゼ阻害実験を行った。好中球を大腸菌で刺激することによりプレセプシン産生が認められた。次にアクチン重合阻害薬による貪食阻害を行ったが、プレセプシン濃度の有意な減少は認められなかった。また、セリンプロテアーゼ阻害薬添加によりプレセプシン濃度は有意に減少したが、一方で好中球エラスターゼ阻害剤の添加ではプレセプシン産生に有意な減少は認められなかった。以上からプレセプシンは単球と同様に好中球からも産生されるが、その産生経路は貪食以外のものであることが示唆された。さらに、エラスターゼ以外のセリンプロテアーゼも産生に関与する可能性が推測された。Presepsin, which is produced in monocytes via its phagocytosis, is one of the biomarker proteins for sepsis, but it is unknown whether other cells secrete presepsin besides monocytes. To clarify the mechanism of presepsin production, we studied presepsin production from neutrophils and effects of inhibitors of phagocytosis and serine protease. We confirmed that prsepsin levels increased significantly when neutrophils were stimulated by Escherichia coli (E. coli). In phagocytosis blocking assay, no presepsin changes were observed nevertheless phagocytosis were weakened in the cells treated cytochalasin D for blocking actin polymerization. In addition, presepsin production of the cells treated with serine protease inhibitor were significantly decreased, on the other hand in cells treated neutrophil elastase inhibitor, presepsin production were a little suppressed. These results indicate that neutrophils as well as monocytes produce presepsin but different pathways from the phagocytosis, and furthermore serine proteases other than elastase may be involved in presepsin production

ヒト ハッケツビョウ サイボウ HL-60 ニ オケル p21^waf1 ノ ハツゲン コウシン 12-o-tetradecanoylphorbol 13-acetate ニ ヨル ブンカ オヨビ アポトーシス ユウドウ トノ カンレン

TPA (12-o-tetradecanoylphorbol 13-acetate) induces monocyte/macrophage differentiation and adhesion in the human leukemic HL-60 cell line, and cyclin D1 and p21^waf1 (cell cycle control genes) are overexpressed in TPA-treated adherent HL-60. It is also known that TPA induces apoptosis of the cell line. In this study, to investigate the relationship between differentiation and/or apoptosis induction and cell cycle control genes, we analyzed the expressions of p21^waf1 and cyclin D1 mRNA in adherent and floating cells separately. Using flow cytometry, there was an increase in the apoptosis of floating cells when TPA treatment was applied. Quantitative analysis using real-time polymerase chain reaction revealed that p21^waf1 and cyclin D1 expression was increased in both the floating and adherent cells. There was an increase in apoptosis of floating cells 3 h post-TPA treatment, and by this time the expression of p21^waf1 had already significantly increased. Adherent cells were observed 12 h after TPA treatment, and by this time the expression of p21^waf1 had already increased. These observations suggest that the increased expression of p21^waf1 may play a role in the induction of apoptosis by TPA in HL-60 cells

シンガタ インフルエンザ ニ タイスル コウベトキワダイガク ノ トリクミ

Novel influenza A (H1N1) outbreak in Mexico was reported on April 25, 2009, and soon spread worldwide. In Japan, the first case of domestic infection was reported from Kobe City on May 16. The health control committee of Kobe Tokiwa University took several actions to prevent infection outbreak. The University was closed from May 18 to May 23. During this period, protective equipments such as gargles, alcoholic hand wash sprays and face masks were installed, and health conditions of all students were individually surveyed by faculty staffs. All the students were requested to check body temperature before going to school, and if febrile, report to the health control committee. The first case of influenza A infection in Kobe Tokiwa University was reported on August 31. The number of infection cases gradually increased and amounted, in total, from August 31 to December 12, to 104. As seasonal influenza infection may overlap the novel influenza A (H1N1) in winter, a further increase could be expected. Further preventive measure seems to be necessary

Analysis of the Nutrient Intake and the Nutritional and Health State of the people in a Nepalese Mountainous Village:Dithal VDC

【目的】世界辺境地区の一つであるネパール山間地方の住民の摂取栄養と健康状態について解析した。【方法】神戸常盤大学を中心に共同調査プロジェクト(JICA 草の根事業)を編成し、ネパールデタール村でのフィールドワークを行った。住民208名(年齢5～82歳、男女比82:126)の健康調査を施行し、身体計測とBIA法を用いた体構成成分測定、および血液検査(TP、Albumin、GPT、BUN、Ca)を行った。また住民の内科診療を行い、下痢などの消化管疾患の有無を調査した。さらに、一般家庭における日々の食事内容をデジタルカメラに撮影し、摂取熱量、摂取栄養素を計測すると同時に、村の採水所30ヵ所での飲水を含めた生活用水の細菌学的検査を行った。【結果】身体計測上、BMI<18.5の比率が50%を超え、12歳以下の子供では80%近くに及んだ。体構成成分測定では、特に子供で体内脂肪、筋肉量の減少と、体内水分量の増加が見られた。また一見肥満体系であっても、栄養障害による浮腫や、筋肉量の減少による下腹部の突出(クワシオルコル)を示す症例も、12歳以下の子供で見られた。血液検査は、血清総タンパク、アルブミンの低下以外は、ほぼ正常値内であった。食事は、ネパール特有のダル・バート・タルカリという炭水化物が中心の料理で、摂取栄養素の80%を占めた。1日2食が標準である現地人の平均摂取熱量は800～1000kcal程度と推計された。飲料水の細菌学的検査では、大腸菌、及び大腸菌群が80～100%の頻度で検出された。【結論】未だカースト制度の現存するネパールの山間地方における栄養状態と衛生環境は劣悪であったが、これは過去に先進国が経た道であり、自らの事として手を差しのべる必要があると考えられた。The research team jointed with Kobe Tokiwa University, Kobe University, and Nepal Medical College has been organized to implement the fieldwork at Dithal Village in Nepalese mountainous area for JICA Kusanone Project. In the fieldwork, the nutritional and health state of 208 village inhabitants (5 to 82 years old : 82 of male and 126 of female) were investigated, and their daily dietary foods were analyzed intake of calories and nutrients. The state of hygiene was also studied including of checking the contamination of drinking water microbiologically. The results showed that the high presence of over 50% of thinness, which is defined as less than 18.5 of BMI, was estimated in all age-groups, however among the age group under 12 years, the rate was much higher up to 75~80%. In body component analysis, the decreased fat and muscle volume and increased body water volume were manifested in children. Some of the children showed the distended abdomen, which is the typical sign of Kwashiorkor type malnutrition. The average calorie intake of daily diet was estimated about 800～1000kcal, and the content of it was 80% of carbohydrate, 10% each of fat and protein. The contaminations of Coliform bacilli and E. coli could be detected 80 to 100% of drinking water at 30 water places. The internal medical check revealed the prevalence of water-borne digestive diseases with abdominal pain, vomiting, and diarrhea. The deteriorated nutritional and public health state in Nepalese mountainous area could be disclosed in this study, but these are the similar paths on which the advanced countries have gone through in their past. We are entrusted to give our hands to them

ジャクネン ジョセイ ノ タイナイ シボウリョウ ヒョウカ ニ オケルフクマクマエ シボウアツ ソクテイ ノ イギ

The indicators relating to the amounts of visceral fats including preperitoneal fat thickness were measured from 51 students attending our university, and the significance of the measurement of preperitoneal fat thickness was considered. (Method) The maximum preperitoneal fat thickness (hereafter referred as to "Pmax"), the minimum subcutaneous fat thickness, and the existence or nonexistence of hepato-renal contrasts were measured via ultrasonography. Body fat ratio, visceral fat area and VSR (visceral fat area/subcutaneous fat area ratio) were measured by the impedance method. (Result) Significant positive correlations were found between Pmax and other measurement items in both the all-subject group and the normal weight groups. Regarding the comparison between the group of Pmax 10 mm or more and that of Pmax of less than 10mm, the group of Pmax 10 mm or more was significantly higher in body fat ratio and VSR. The average value of the Pmax plus/minus standard deviation was 7.10 ±2.23mm. From the above, Pmax can be used as an indicator of the visceral fat amount for young women, and it is suggested that attention should be paid to the accumulation of visceral fat of more than 10 mm

ヒト ジュウモウセイ ゴナドロビン ノ リンショウテキ イギ ト ソクテイ ニ オケル モンダイテン

Human chorionic gonadotropin is a glycoprotein hormone composed of α and β subunits, and shows a seat-belt structure three-dimensionally. The α subunit is identical to those of pituitary glycoprotein hormones, FSH, LH, and TSH. The biochemical characteristics of hCG, the amino acid sequences,carbohydrate structures, and biosynthetic pathways, were clarified in the 1970\u27s. Recent genomic studies demonstrated that hCG is coded by multiple copies of genes that form a cluster at 19q13.33 on chromosome 19. A novel hCG molecule with a different immunoreactivity has been identified. It has the same amino acid sequences as regular hCG (R-hCG), but has a higher carbohydrate content than regular hCG, and has therefore been named hyperglycosylated hCG (H-hCG). Although R-hCG is secreted by the syncytiotrophoblast, H-hCG is produced in the cytotrophoblast, and promotes the invasion of the fertilized ovum into the endometrium during the first two weeks of gestation. H-hCG is also secreted in choriocarcinoma and is related to malignancies. By the 1980\u27s, hCG was being measured immunologically using polyclonal antibodies. Sandwichimmunoassays with monoclonal antibodies and improved detection systems have now replaced the old immunoassay systems. The new systems have enabled the detection and discrimination of not only R-hCG and H-hCG but also various previously identified hCG-related peptides that result from degradation. However, false negative and false positive results, which are caused by increased levels of the hCG-related peptides and heterophilic antibodies, respectively, have been reported in some cases. To increase the accuracy of these analyses, specific protocols using both serum and urine as test samples should be applied to the measurement hCG levels, especially for diagnosis and treatment of choriocarcinoma

ケツエキ シッカン カンジャ ノ テツカジョウショウ ニ タイスル ヒョウカ ホウホウ ノ ケントウ MRI ニヨル ヒ シンシュウテキ テツリョウ テイリョウ ソクテイ

【背景】血液疾患では長期輸血等で鉄過剰となる。肝鉄量は鉄過剰の重要な指標であり、欧米では MRI によ る非侵襲的定量法が普及しつつあるが、日本では殆ど行われていない。【方法】Gandon らの論文に基づき、腹部 MRI をグラディエントエコー法(GRE)で撮影、肝臓(L)と脊筋(M)の信号強度比(LBackground: Iron overload is a major problem for patients with hematological diseases. Liver iron concentration (LIC) is an important marker of iron overload. LIC has been measured by MRI (Magnetic Resonance Imaging) instead of invasive hepatic biopsy in European countries, but not yet in Japan. Methods: LIC was measured by MRI according to Gandon\u27s method (Lancet 2004;363:357-362) using gradient echo sequence (GRE). Signal intensity ratio of the liver and muscle (L/M) was measured. LIC was estimated from the linear correlation curve of L/M and LIC shown in Gandon\u27s paper. LIC estimated from MRI (LIC-MRI) was compared with serological markers such as serum ferritin level. Patients:Three patients with hematological diseases (post-transfusion iron overload, chronic hemolytic anemia, secondary myelofibrosis) and three healthy persons as normal controls. Results: LIC-MRI and serological markers were normal among the three normal controls. Two patients showed ten times higher LIC-MRI and ferritin levels than normal ranges. Conclusion: LIC-MRI showed an excellent correlation with serum ferritin level. Because of low examination numbers for the present cases, further study is necessary

ジョクソウ チリョウ ニ オケル エイヨウ カンリ ノ ヤクワリ ニ ツイテ コウレイシャ ジョクソウ カンジャ ノ カイセキ オ ツウジテ

近年の社会の高齢化に伴い、寝たきり患者数は200万人を超え、その10%以上に褥瘡の発生を見る。褥瘡の発生・増悪は直達力の他に、二次的なリスク因子が存在し、加齢に加え、栄養障害が強く相関している。この論文は、高齢者褥瘡患者についての臨床症例を通して、栄養と褥瘡治療の関連性について検討することである。今回、18名の高齢者褥瘡患者を対象に、栄養評価による栄養障害の程度、栄養管理法、および栄養療法を施行した後の褥瘡の治療反応性について検討した。その結果、対象患者は全例中等度～高度の栄養障害を有し、その半数以上に高度の褥瘡を認めた。チーム医療による栄養管理を行った結果、18例中12例に治療効果を認め、この治療反応性は、経口摂取群、経腸栄養投与群に多く見られた。以上より、褥瘡患者では栄養障害が存在するため、局所の創管理に加えて、チーム医療による全身的な栄養管理をより生理的な栄養投与ルートを介して行うことが必要であると考えられた。With the recent advance of aging society in Japan, the number of the patients with pressure ulcers has been increasing over 10% of two million elderly who are bedridden.The primary cause of pressure ulcer is the disintegration of skin and subcutaneous tissue for pressure due to voluntary immobility of the patients. Moreover there are other risk factors for development of pressure ulcers, which are the old age and malnutrition. The purpose of this study is to survey the relevance of hospitalized aged patients with pressure ulcers and the role of nutrition therapy in the treatment.Eighteen elderly patients with pressure ulcer(s) were entered in this study, and their nutritional assessment, nutritional management, and the healing of the wound were investigated. All patients had moderate to severe malnutrition, and over the half of them had suffered from severe pressure ulcers. In our study, there was strong correlation between the healing of pressure ulcer and nutritional management.The patients with pressure ulcers have mostly been malnourished and needed not only the local wound treatment but the systemic nutritional care via physiological enteral route under the management by the interprofessional team

タンキ ダイガク ツウシンセイ カテイ ２ネンセイ ノ ガクセイ ガ シュウギョウ スル シセツ ニ オケル ヒヤリ ハット タイケン ノ ジッタイ チョウサ

目的:本学通信制課程の学生が就業する施設で体験するヒヤリ・ハット事例を全国300床以上の病院と比較し特徴を明らかにし、事故報告のしくみや意識についての実態を知る。方法:対象は1年次生188名。2013年質問紙調査を実施。調査内容は背景、事故報告のしくみ、意識、ヒヤリ・ハット体験で、印象的な体験や気持ちは自由記載とした。結果:回収率52%。就業する施設は200床以下の病院、施設が約7割を占めた。ヒヤリ・ハット体験は「療養上の世話」で、熱傷・暴力・誤嚥・入浴・離院、「観察情報」が高率で、自由記載からは注射・与薬・転倒転落が上位を占めた。事故報告の仕組みは約90%が保有し、意識では約30%が報告に消極的であった。結論:学生が就業する施設でのヒヤリ・ハット体験の特徴は、療養上の世話と医師、患者・家族に関する項目が全国調査より高い比率を占めた。事故報告のしくみは有るものの運用実態や事故報告の意識の解明は今後の課題である。Objective: To reveal characteristics and perception of near-miss errors and its reporting system of hospitals where the students are employed, comparing with a national data of larger scale hospitals over 300 beds.Methods: A questionnaire survey was conducted in 2013 on 188 first-year working students in a correspondence course. Main question items were consisted of the background information, experience, perception, and the system of reporting near-miss errors. Significant events were asked in the form of an open question. Results: The response rate was 52%. Around 70% of the hospitals had less than 200 beds. There was an increase of the near-miss errors of burns, violence, aspirations, bathing, leaving hospitals, and observation on patient care. Also, increased cases at injection, medication, and falls were observed in open questions. Ninety percent of the facilities had a system of reporting near-miss cases but 30% of nurses were passive about the reporting. Conclusion:Features of near-miss errors at targeted hospitals were revealed as there were increased cases at patient care, and items related to doctors, patients or their families. Although most facilities have the system of incident report, analysis of the perception on near-miss errors and actual implementation of the system is further needed

コツソショウショウ チリョウヤク ビスホスネート ノ アラタナ ヤクワリ コウシュヨウ コウカ ノ カノウセイ

Bisphosphonates (BP) are widely used for the prevention and treatment of osteoporosis, and are also implicated for treatment of skeletal related events associated with malignancy. There is increasing evidence of anti-tumor effects of BP from pre-clinical and clinical studies. Several investigators have reported reduction of breast cancer and colon cancer by long term BP administration, indicating cancer preventive effect of BP. Recent pre-clinical and clinical studies about anti-cancer effects of BP are reviewed