リハビリテーション医療系学生の抑うつ状況について : 学習性無気力の観点から

リハビリテーション医療系学生は、授業の多さとそれに伴う課題の多さ、長期にわたる実習、国家試験などストレッサーとなる出来事が数多く長期に継続する特徴がある. 長期にわたるストレッサーの中、学生は「学習性無気力」の状況にあるのではないかと考え、学生の抑うつ傾向をはじめ自尊感情・ストレス反応など心理的状況を調査した. 結果として、抑うつ傾向・ストレス反応が高くまた自尊感情は低い状況が明らかになった. また家庭内に相談できる人物が多いこと、また睡眠・休養・食事のいわゆる生活リズムが確立していることが、抑うつ傾向を抑えることが示された. 学生生活や精神状態について家族と情報を共有すること、また生活リズムの確立に向けた援助が、教員として必要であると考えられた.Rehabilitation Medical student, there is a feature event to be a large number of stressors and challenges of multi-class, training for a long period of time, such as the national examination to continue in the long-term number. Under the influence of the stressor long-lasting, and is in a situation of "learned helplessness"to students, I guess. And I investigated the psychological conditions such as stress response and self-esteem and depression of students. That as a result, stress response and depression is high, self-esteem is low have been revealed. Which of the following influence to suppress the tendency of depression, it was that there is more than one person you can talk to family. Further, it may life including diet and rest and sleep is stable affects the suppression of depression was shown. I was considered the assistance for the establishment of life rhythm, is necessary as a teacher and that, to share information with the family about the mental state and student life

Intestinal reversed rotation in neonates: A case report and review of the literature

Introduction: Reversed rotation is an extremely rare congenital anomaly that is often associated with intestinal obstruction or midgut volvulus. Although reverse rotation is classified into four types embryologically, there has been no comprehensive review of the mechanisms of the symptoms, imaging findings, or surgical management. Case presentation: A newborn with repeated non-bilious vomiting was admitted to our hospital because of a change to bilious vomiting. Abdominal ultrasonography revealed that the duodenum was in front of the superior mesenteric vessels. An upper gastrointestinal series demonstrated bowel obstruction. Intestinal malrotation was suspected, and surgery was emergently performed. The operative findings revealed reversed intestinal rotation (retroarterial-type). Adhesiolysis and relocation of the small intestine and colon were performed using the Ladd procedure. No recurrence was observed during 2 years of follow-up. Conclusion: A review of the relevant literature on reversed rotation revealed that the retroarterial type was the most common type and that the Ladd procedure was appropriate. Due to the rarity of the condition, the characteristic imaging findings based on the embryological background should be kept in mind to facilitate an adequate diagnosis and treatment in cases of intestinal reversed rotation

Effect of Alkyl Chain Length on Adsorption and Release of Hydrophobic Drug to/from Hydrophobically-modified Gelatin Hydrogel

Hydrogels have become popular as drug carriers. Controlled release of the drugs from hydrogels can reduce dosage, inducing prevention of side effects. However, the hydrophilicity of hydrogels interferes with controlled release of hydrophobic drugs such as anticancer agents or antibiotics. In this study, we developed hydrophobically-modified gelatin (HMG) hydrogel, which was cross-linked only by hydrophobic interaction. HMG does not require toxic chemical cross-linkers to form hydrogel. In addition, the HMG hydrogel has hydrophobic chambers in its structure which hydrophobic drugs can adsorb to and desorb from. In order to control the amount of hydrophobic drugs adsorbed into the hydrogel, hydrophobic alkyl chains with different lengths (C4-C12) were incorporated into gelatin molecules. Uranine was used as a model for hydrophobic drugs. The adsorption test exhibited that the amount of uranine adsorbed in HMG hydrogels could be controlled by varying hydrophobic alkyl chain length and that the drug could be released in a controlled manner. These results show that HMG hydrogels are promising carriers of hydrophobic drugs

Intermittent infusions of carperitide or inotoropes in out-patients with advanced heart failure.

[Background]: The ambulatory treatment of advanced heart failure (HF) with intermittent infusions of inotropes or natriuretic peptide chosen immediately before each infusion has not been described. [Methods]: Between May 2005 and July 2009, we treated 11 patients presenting with advanced HF, who received a total of 369 infusions of carperitide, olprinone, dopamine, or dobutamine, once or twice weekly. The pharmaceutical was selected before each infusion based on the systolic blood pressure (BP). [Results]: Carperitide, olprinone, and catecholamines were administered to 8 (73 infusions of 0.030 ± 0.004 μg/kg/min for 3.3 ± 0.8 h), 4 (18 infusions of 0.070 ± 0.017 μg/kg/min for 3.3 ± 0.5 h), and 6 patients (278 infusions of 3.6 ± 1.9 μg/kg/min for 2.8 ± 1.0 h), respectively. No adverse effect requiring cessation of infusion was observed. Over a mean follow-up of 29.3 ± 28.8 months (range 2–104), 4 patients died, all from cardiac causes. The Kaplan–Meier cumulative survival rate was 69.3% at 20 months (median follow-up). Compared with the pre-infusion period, the duration and number of hospitalizations for management of HF were decreased by 73.9% (p = 0.017), and 51.9% (p = 0.007), respectively, during the treatment period, and the overall medical costs by 56.9% (p = 0.021). [Conclusions]: In this study population, intermittent drug infusions selected from inotropes or natriuretic peptide based on the baseline systolic BP significantly decreased the length and number of hospitalizations and costs, without increasing mortality. These results indicate that intermittent infusions might be one of the therapeutic options in advanced HF

Effectiveness of combined thoracoscopic-laparoscopic esophagectomy: comparison of postoperative complications and midterm oncological outcomes in patients with esophageal cancer.

[Background ] : During esophagectomy, laparoscopy can be used together with thoracoscopy, but it is not known whether a combined thoracoscopic–laparoscopic procedure is associated with fewer postoperative complications than open esophagectomy, and without compromising oncological outcome. [Methods ] : This was a longitudinal cohort study that included 185 esophageal cancer patients, including 72 who underwent combined thoracoscopic–laparoscopic esophagectomy (TLE), 34 who underwent thoracoscopic esophagectomy (TE), and 79 who underwent open esophagectomy (OE) between January 2002 and May 2010. The main outcome measures were postoperative respiratory and overall complications. The secondary outcome was 2-year relapse-free survival (RFS). [Results ] : Respiratory complications occurred in 9 patients who underwent TLE, 13 who underwent TE, and 31 who underwent OE. TLE was associated with fewer respiratory complications (TLE vs. OE: odds ratio [OR], 0.22; 95% confidence interval [CI], 0.09–0.53 and TE vs. OE: OR, 0.71; 95% CI 0.29–1.76). Overall complications occurred in 34 patients who underwent TLE, 20 who underwent TE, and 54 who underwent OE. TLE was associated with fewer overall complications (TLE vs. OE: OR, 0.47; 95% CI 0.23–0.94 and TE vs. OE: OR, 0.51; 95% CI 0.21–1.25). The 2-year RFS rates were similar among the three groups: 71.6% for TLE, 57.7% for TE, and 58.3% for OE (TLE vs. OE: hazard ratio, 0.65; 95% CI 0.35–1.20 and TE vs. OE: hazard ratio, 0.91; 95% CI 0.45–1.82). [Conclusion ] : Unlike TE, TLE was associated with fewer postoperative complications than was OE, with no compromise of 2-year RFS. A randomized controlled trial with longer follow-up is needed

Japanese version of the Dermatology Life Quality Index: validity and reliability in patients with acne.

[Background]Patient-reported quality of life is strongly affected by some dermatologic conditions. We developed a Japanese version of the Dermatology Life Quality Index (DLQI-J) and used psychometric methods to examine its validity and reliability. [Methods]The Japanese version of the DLQI was created from the original (English) version, using a standard method. The DLQI-J was then completed by 197 people, to examine its validity and reliability. Some participants completed the DLQI-J a second time, 3 days later, to examine the reproducibility of their responses. In addition to the DLQI-J, the participants completed parts of the SF-36 and gave data on their demographic and clinical characteristics. Their physicians provided information on the location and clinical severity of the skin disease. [Results]The participants reported no difficulties in answering the DLQI-J items. Their mean age was 24.8 years, 77.2% were female, and 78.7% had acne vulgaris. The mean score of DLQI was 3.99(SD: 3.99). The responses were found to be reproducible and stable. Results of principal-component and factor analysis suggested that this scale measured one construct. The correlations of DLQI-J scores with sex or age were very poor, but those with SF-36 scores and with clinical severity were high. [Conclusion]The DLQI-J provides valid and reliable data despite having only a small number of items

Cycle and rate properties of mesoporous tin anode for lithium ion secondary batteries

A mesoporous Sn anode was electrodeposited in the presence of lyotropic liquid crystals made of nonionic surfactants. The introduction of mesoporous structure was effective for the accommodation of volume change of Sn during charge and discharge cycling of Li ions. The discharge capacity of the mesoporous Sn anode at 1 C rate was as high as 425 mA h g(-1) at the 100th cycle, and that was as high as 320 mA It g(-1) at the 100th cycle even though at 5 degrees C rate

Maternal Renal Dysfunction in Late Pregnancy in Twin and Singleton Pregnancies: Retrospective Study

This study aimed to evaluate the differences in the impact on maternal renal function between singleton and twin pregnancies in the second half of pregnancy. It retrospectively enrolled 1711 pregnant women consisting of 1547 singleton pregnancies and 164 twin pregnancies from Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital from January 2019 to June 2021. Patients underwent renal function tests (serum blood urea nitrogen, creatinine, and estimated glomerular filtration rate (eGFR)) at least one month before delivery. The main outcome measure was maternal renal dysfunction, defined as a serum creatinine level above 0.8 mg/dL. The serum creatinine level was significantly higher and the eGFR was significantly lower in twin than in singleton pregnancies (p p < 0.01). Multivariate analysis revealed that twin pregnancy (odds ratio (OR) 3.38), nulliparity (OR 2.31), and preeclampsia (OR 3.64) were significant risk factors for maternal renal dysfunction. Maternal renal dysfunction was observed in 13 twin pregnancies, all of which recovered to within normal limits during the early months of the postpartum period. Twin pregnancy is a significant risk factor for maternal renal dysfunction; renal function should be carefully monitored in twin pregnancies