DRUG-ADMINISTERING PERSONS' EXPOSURE TO ORAL ANTICANCER DRUGS TO BE ADMINISTERED THROUGH A TUBE

Objective: The objective of this study was to quantitatively evaluate anticancer drug exposure of non-health care professionals who administer drugs through a tube employing a method devised by us. Methods: The subjects were 30 general volunteers aged 22-84 years. They wore gloves and administered Indian ink, simulating an anticancer drug, to a multipurpose adult human-type patient care simulator through a tube using 5 types of syringe, and the area stained with Indian ink was measured. Results: When comparing the number of pixels among the syringes regardless of age, Syringe B showed the lowest number (11.8±3.1 cm2), and there was a significant difference between Syringes B and E. Furthermore, we compared the total number of pixels in each age group regardless of the type of syringe. In the 20-year-old group, it was the lowest (10.9±2.3 cm2) showing significant differences in comparison with the other groups. When Syringe B was used, the number of pixels was markedly lower than on adopting the other syringes. Conclusion: It was clarified that the level of exposure to anticancer drugs markedly varies depending on the type of syringe and age. It was also clarified that the method to evaluate exposure to anticancer drugs using Indian ink devised by us is simple and useful

DRUG-ADMINISTERING PERSONS' EXPOSURE TO ORAL ANTICANCER DRUGS TO BE ADMINISTERED THROUGH A TUBE

ABSTRACTObjective: The objective of this study was to quantitatively evaluate anticancer drug exposure of non-health care professionals who administer drugsthrough a tube employing a method devised by us.Methods: The subjects were 30 general volunteers aged 22-84 years. They wore gloves and administered Indian ink, simulating an anticancer drug, toa multipurpose adult human-type patient care simulator through a tube using 5 types of syringe, and the area stained with Indian ink was measured.Results: When comparing the number of pixels among the syringes regardless of age, Syringe B showed the lowest number (11.8±3.1 cm2), and therewas a significant difference between Syringes B and E. Furthermore, we compared the total number of pixels in each age group regardless of the typeof syringe. In the 20-year-old group, it was the lowest (10.9±2.3 cm2) showing significant differences in comparison with the other groups. WhenSyringe B was used, the number of pixels was markedly lower than on adopting the other syringes.Conclusion: It was clarified that the level of exposure to anticancer drugs markedly varies depending on the type of syringe and age. It was alsoclarified that the method to evaluate exposure to anticancer drugs using Indian ink devised by us is simple and useful.Keywords: Oral anticancer drugs, Simple suspension method, Drug-administering persons' exposure

ゲンパツ フメイ ガン ニオケル PET/CT ケンサ ノ ユウヨウセイ ニツイテ

We reported the utility of１８F-FDG-PET/CT examination for patients with cancer of unknownprimary origin. Twenty six patients（13 men, 13 women, aged 27-91 years, mean 71）were examined.The indication for PET/CT examination was tumor maker elevation（14 patients）, suspectedmetastatic tumor（14）and metastasis diagnosed histopathologically（3）. Patients weretold not to eat for at least four hours and a PET/CT image was obtained one hour after theadministration of 3.7MBq/kg FDG. From April to August 2006, 33 patients diagnosed with a cancerof unknown primary origin were referred to our hospital for PET/CT examination from anoutside institution. Twenty six patients could be investigated for outcomes. Seventeen patientsshowed an abnormal accumulation, with 14 of the 17 having their primary regions detected histopathologicallyor clinically. For one patient, the abnormal accumulation could not be determined toshow the origin. For 2 patients, it was difficult to diagnose if these abnormal accumulationsshowed the primary region or not, but CT examinations were helpful for a diagnosis. Seven of the9 patients who showed no abnormal accumulation were treated conservatively and the primaryregion for their cancer could not be detected during the follow up study. In 21 of 26 patients, theseresults were useful to select an appropriate therapy to be applied or a relevant examination. Weconsidered PET/CT examination, where it is possible to scan the whole body at one time, was veryuseful to get both morphologic and metabolic information. PET/CT examination showed a highersensitivity for detecting abnormal lesions than other imaging modalities

創造性を育成するための看護教育方法の開発(その1) : 創造性看護教育に関する海外研修レポート

報告Report2006年9月、共同研究「創造性を育成するための看護教育方法の開発」の一環としての韓国研修の機会を得た。今回の研修の目的は、研究を進めるにあたって、研究対象の1つである韓国における研究計画の実現可能性の確認と具体的な打ち合わせを行うことであった。病院見学をはじめ、嶺南(ヨンナム)理工大学看護学科教員との交流セッション、嶺南大学の大学院生とのラベルワークの実施を通して、両国の看護教育に対する理解を深めるとともに、われわれの研究に対する理解と協力を得ることができた。さらに研究の具体的計画の実現可能性の確認できた。また、共同研究者である朴教授と綿密な打ち合わせもでき、研究を発展させるための方向性と課題を明確にすることができた。その成果を報告する

危険への感受性を育むディベート学習

医療事故防止には危険を察知し、認識するという個人の危険に対する感受性が大きく影響すると考えた。今回、学生が実際に体験したインシデント事例を提示し、危険性を判断させた。その結果、学年差はみられず、講義や臨床実習などの量的体験よりも個人の資質が大きく影響すると考えられた。調査から学生たちが危険ではないと判断した理由を分析し、判断を誤らせる5つの要因を明らかにした。再度の調査でも危険への感受性が変化しない学生には感受性の鋭い学生とのディベートが有効であった。ディベートでは自分の思考の根拠を示して、他の学生と意見を闘わせる能動的学習によって、学生自らが判断の誤りに気づくことができた。学習の早い段階から安全教育を取り入れることで、危険な状況を察知し、対処できる感受性や直感力を養う必要性が確認できた

看護基礎教育における「ヒヤリハット」防止の教育方法の検討 : トランスファー場面の分析を通して

基礎看護学実習における学生の「ヒヤリハット」体験を分析した結果、トランスファ一時の「ヒヤリハット」が53.3%を占めていた。そこでこれに焦点を絞って分析し、5つの具体的な危険因子を抽出した。その結果、「ヒヤリハット」はこれら5つの危険因子が複雑に絡み合って、複雑な状況で起きていることがわかった。それを解決するために看護基礎教育でできる医療事故防止のための、具体的な教育方法を工夫して試みたところ以下の事が明らかになった。(1)体験学習から、学生は人の身体の重さ、身体バランスの悪さを実感することができた。またトランスファー時、安定した姿勢で行うにはボディメカニクス活用の必要性が認識でき、知識と体験とが合致し、理解が深まった。(2)学生が実習で体験した「ヒヤリハット」を実例教材として提示し、グループ討議をすることで、「ヒヤリハット」は「自分にも起こり得ること」と捉え、思い込みや不注意などの危険性が認識できた。以上のことから体験学習や実例教材を使ったグループ討議を行うことが、学生の「ヒヤリハット」を防止する上で有効であるとわかった

The whole blood transcriptional regulation landscape in 465 COVID-19 infected samples from Japan COVID-19 Task Force

「コロナ制圧タスクフォース」COVID-19患者由来の血液細胞における遺伝子発現の網羅的解析 --重症度に応じた遺伝子発現の変化には、ヒトゲノム配列の個人差が影響する--. 京都大学プレスリリース. 2022-08-23.Coronavirus disease 2019 (COVID-19) is a recently-emerged infectious disease that has caused millions of deaths, where comprehensive understanding of disease mechanisms is still unestablished. In particular, studies of gene expression dynamics and regulation landscape in COVID-19 infected individuals are limited. Here, we report on a thorough analysis of whole blood RNA-seq data from 465 genotyped samples from the Japan COVID-19 Task Force, including 359 severe and 106 non-severe COVID-19 cases. We discover 1169 putative causal expression quantitative trait loci (eQTLs) including 34 possible colocalizations with biobank fine-mapping results of hematopoietic traits in a Japanese population, 1549 putative causal splice QTLs (sQTLs; e.g. two independent sQTLs at TOR1AIP1), as well as biologically interpretable trans-eQTL examples (e.g., REST and STING1), all fine-mapped at single variant resolution. We perform differential gene expression analysis to elucidate 198 genes with increased expression in severe COVID-19 cases and enriched for innate immune-related functions. Finally, we evaluate the limited but non-zero effect of COVID-19 phenotype on eQTL discovery, and highlight the presence of COVID-19 severity-interaction eQTLs (ieQTLs; e.g., CLEC4C and MYBL2). Our study provides a comprehensive catalog of whole blood regulatory variants in Japanese, as well as a reference for transcriptional landscapes in response to COVID-19 infection

DOCK2 is involved in the host genetics and biology of severe COVID-19

「コロナ制圧タスクフォース」COVID-19疾患感受性遺伝子DOCK2の重症化機序を解明 --アジア最大のバイオレポジトリーでCOVID-19の治療標的を発見--. 京都大学プレスリリース. 2022-08-10.Identifying the host genetic factors underlying severe COVID-19 is an emerging challenge. Here we conducted a genome-wide association study (GWAS) involving 2, 393 cases of COVID-19 in a cohort of Japanese individuals collected during the initial waves of the pandemic, with 3, 289 unaffected controls. We identified a variant on chromosome 5 at 5q35 (rs60200309-A), close to the dedicator of cytokinesis 2 gene (DOCK2), which was associated with severe COVID-19 in patients less than 65 years of age. This risk allele was prevalent in East Asian individuals but rare in Europeans, highlighting the value of genome-wide association studies in non-European populations. RNA-sequencing analysis of 473 bulk peripheral blood samples identified decreased expression of DOCK2 associated with the risk allele in these younger patients. DOCK2 expression was suppressed in patients with severe cases of COVID-19. Single-cell RNA-sequencing analysis (n = 61 individuals) identified cell-type-specific downregulation of DOCK2 and a COVID-19-specific decreasing effect of the risk allele on DOCK2 expression in non-classical monocytes. Immunohistochemistry of lung specimens from patients with severe COVID-19 pneumonia showed suppressed DOCK2 expression. Moreover, inhibition of DOCK2 function with CPYPP increased the severity of pneumonia in a Syrian hamster model of SARS-CoV-2 infection, characterized by weight loss, lung oedema, enhanced viral loads, impaired macrophage recruitment and dysregulated type I interferon responses. We conclude that DOCK2 has an important role in the host immune response to SARS-CoV-2 infection and the development of severe COVID-19, and could be further explored as a potential biomarker and/or therapeutic target