乳房切断術患者の術後遠隔期におけるQOLに関する研究

根治的乳房切断術を受けた乳癌患者137例について，術後遠隔時のQOLをアンケート調査票を送付して行った．QOLの構成因子を患側上肢の機能障害，Activity　of　Daily　Life（以下ADL），State of　Daily　Life（以下SDL），就労状況，身体的活動意欲，精神的活動意欲，手術満足度，癌再発不安度，ボディ・イメージの変容とした．患側上肢の自覚症状として，腫脹32％，筋力低下25％，疼痛14％，可動域制限14％，知覚異常7％が認められた．ADLを各項目別に検討すると，過半数の例に何らかの支障を認めた．これら機能障害の高度な例では，身体的・精神的活動意欲などの他のQOL因子も有意に不良であった．SDLが術前と不変と回答した例は108例中79％であった．手術不満例は16％であり，上肢の高度機能障害例に多かった．癌再発不安は，65歳以上の高齢者群に比し，65歳未満の若年者群に有意に高く，長期経過例であっても不安は解消されていなかった．乳房喪失というボディ・イメージの変容に対して，大多数の症例がブラジャー，衣服の工夫を行っていた．　以上により種々の程度の上肢の機能障害に対し，各人に適合した補整具の開発やアフタケアを含めた指導や，癌再発不安などに対する継続的な看護が重要であると考えられた．We conducted a questionnaire survey to evaluate the long-term quality of life (QOL) in 137 patients with breast cancer who underwent radical mastectomy. QOL factors consist functional impairment in the upper limb on the affected side, activity of daily life (ADL), state of daily life (SDL), the status of postoperative rehabilitation, mental activities, physical activities, satisfaction of the surgery, anxiety for recurrence of cancer, cosmetic factor (changes in the body image). In the upper limb on the affected side, swelling was observed in 32％, decreased muscle strength in 25％, pain in 14％, limitation in the range of motion in 14％, and sensory impairment in 7％. However, evaluation of the items of the ADL questionnaire revealed specific disturbance in daily life in more than 50％ of respondents. Patients who showed marked functional impairment in this limb had other QOL factors, such as the desire to do mental and physical activiies which were also significantly poor. Of these patients, 108 (79％) replied that state of daily living (SDL) did not change after the survey. Sixteen percent of the patients were not satisfied with the results of their surgery, and they often noted marked functional impairment in the upper limb. Anxiety about recurrence of cancer was more in the middle aged group (65 years or more) than in the aged group (less than 65 old). Anxiety persisted even in patients showing a long survival without regard to aging. Against changes in the body image, ie., loss of the breast, most patients used prosthetic devices in a brassiere and clothes. These results suggested the need to develop prosthetic consultation for each patient, and instruction in post operative care to help prevent functional impairment in the upper limb, continuous nursing intervention to the anxiety about recurrence of cancer might be needed. to various level of the functional impairment in the upper limb

Electron Microscopy Observation of Biomineralization within Wood Tissues of Kurogaki

Interactions between minerals and microorganisms play a crucial role in living wood tissues. However, living wood tissues have never been studied in the field. Fortunately, we found several kurogaki (black persimmon; Diospyros kaki) trees at Tawara in Kanazawa, Ishikawa, Japan. Here, we report the characterization of kurogaki based on scanning electron microscopy equipped with energy-dispersive spectroscopy (SEM-EDS) and transmission electron microscopy (TEM), associated with inductively coupled plasma-mass spectrometry (ICP-MS) analyses, X-ray fluorescence analyses (XRF) and X-ray powder diffraction (XRD) analyses. This study aims to illustrate the ability of various microorganisms associated with biominerals within wood tissues of kurogaki, as shown by SEM-EDS elemental content maps and TEM images. Kurogaki grows very slowly and has extremely hard wood, known for its striking black and beige coloration, referred to as a “peacock pattern”. However, the scientific data for kurogaki are very limited. The black “peacock pattern” of the wood mainly comprises cellulose and high levels of crystal cristobalite. As per the XRD results, the black taproot contains mineralized 7 Å clays (kaolinite), cellulose, apatite and cristobalite associated with many microorganisms. The chemical compositions of the black and beige portions of the black persimmon tree were obtained by ICP-MS analyses. Particular elements such as abundant Ca, Mg, K, P, Mn, Ba, S, Cl, Fe, Na, and Al were concentrated in the black region, associated with Pb and Sr elements. SEM-EDS semi-qualitative analyses of kurogaki indicated an abundance of P and Ca in microorganisms in the black region, associated with Pb, Sr, S, Mn, and Mg elements. On the other hand, XRF and XRD mineralogical data showed that fresh andesite, weathered andesite, and the soils around the roots of kurogaki correlate with biomineralization of the black region in kurogaki roots, showing clay minerals (kaolinite) and cristobalite formation. In conclusion, we describe how the biominerals in the black region in the cellulose within wood tissues grow chemically and biologically in the sap under the conditions associated with the beige portions of the taproot. This can explain why the crystals produce the “peacock pattern” in the kurogaki formed during the year. We conclude that kurogaki microbiota are from bacteria in the andesitic weathered soil environment, which produce silicification. In other words, the patterned portions of kurogaki consist of silicified wood

看護基礎教育における心肺蘇生法の習得状況-一次救命処置を中心として-

長崎大学医療技術短期大学部看護学科学生70名を対象に，救急蘇生訓練用人形を用いて，一次救命処置を中心とした心肺蘇生法の学内演習を行った．実技テスト，演習前後の客観テスト，学生の自己評価などをもとに学習効果および今後の課題を検討した．　実技テストでは，チェックリストにそって，各項目ごとに教官が評価した結果，ほとんどの項目で9割以上の学生が合格できた．客観テストでは演習後の平均点は高かったが，知識と技術の統合がされていない項目もあり，指導上の課題と考えられた．また，学生の自己評価では，人工呼吸法が「できなかった」とする学生が多く，気道の確保および維持，また吹き込みもかなり難しい技術であった．一次救命処置は緊急の現場で実践できなければ意昧のない技術であり，反復訓練による習得が必要であると考えられた．Nursing skill training for cardiopulmonary resuscitation as part of the basic life support was conducted in the school using dummies for training emergency resuscitation. This training was participated by 70 students of the Department of Nursing, the School of Allied Medical Sciences, Nagasaki University. The effectiveness of learning and practicing by the students and the problems were analyzed on the basis of their nursing practical test and objective tests before and after the skill exercise. In nursing practical skill test, the instructors evaluated each item on the check list, and more than 90% of the students passed the test for most of the items. In objective test, the average marks after the nursing skill exercise was high. However, knowledge and skill were not integrated in some items, leaving problems for the teaching procedure. In self-evaluation, many students "could not" perform artificial respiration, indicating that keeping airway and mouth-to-mouth ventilation were quite difficult. Basic life support is meaningless if one is unable to perform at an emergency circumstance. Acquisition of the skill by repeated training is considered essential

Very Low Nucleation Rates of Glucose Isomerase Crystals under Microgravity in the International Space Station

In situ observation of the nucleation and growth of glucose isomerase (GI) crystals under microgravity was conducted using an optical microscope during the first flight of the Advanced Nano Step project undertaken in the International Space Station (ISS). Very low apparent nucleation rates (J’) of GI crystals in the solution and on the substrate of the growth container were confirmed compared with those on the ground. In particular, J’ of GI crystals in the solution were a few times lower than that on the substrate. The growth rates (R) of the {101} faces of GI crystals on the substrate and the apparent growth rates (R’) in the solution were measured. The very low nucleation rates allowed us to successfully measure R at a very high supersaturation region (up to ln(C/Ce) = 6), at which R cannot be measured on the ground

Peak Oxygen Uptake and Respiratory Function in Persons with Spinal Cord Injury

This study investigated the association between peak oxygen uptake (peak Vo_2) during arm cranking exercise and respiratory function in paraplegics. Fourteen male paraplegics were recruited for the present study. The subjects were grouped according to the level of injury into the HL (Th3-Th8) and LL (Th11-L3) group. Prior to the maximal test, pulmonary function, including vital capacity (VC) and residual volume (RV), was measured in the sitting position. Mean peak Vo_2 in the LL group (1662 mlロin^-1) was significantly greater than that in the IIL group (1357 mlロin^-1), corresponding to 82% of that in the LL group (P ≦0.05). Inrespiratory function, the HL group showed marked restrictive impairment of ventilatory function. That is, VC and RV were significantly lower in the HL group than in the LL group (P≦0.05). The reduction in VC and RV is related to the degree of loss of control in respiratory functioning muscle mass. However, there was no clear-cut correlation between respiratory function and peak V02 expressed as a function of body mass (mlkg^-1 min^-1). In addition, a multiple linear regression analysis revealed that RV and VC were not associated with peak V0_2 (mlロin^-1) in contrast to the importance of body mass. It seems reasonable to conclude from these results that respiratory function is not an important factor in determining peak Vo_2 in the paraplegi

Sex Differences in Interrelationships between Percent Body Fat (%Fat) and Waist-to-Hip Ratio (WHR) in Healthy Male and Female Adults

The purpose of the present study was to investigate sexual differences in relationships among percent body fat (%Fat), waist-to-hip ratio (WHR), waist-to-stature ratio (WSR), abdominal circumference to stature ratio (ASR), body mass Index (BMI) and skinfold thicknesses in healthy male and female adults. Subjects were 64 males and 65 females, aged 22-60. Body density was measured by under \vater weighing and by skinfold anthropometry. Mean %Fat was 15.6% in males and 23.9% in females. Mean WHR was 0.83 in males and 0.72 in females. The correlation between %Fat and WHR was not significant in females (r= -0.l04) but was significant in males (r= 0.631, p 0.001). Highly significant correlations were obtained among %Fat, WSR, ASR, BMI, and sum of eight skinfolds in both sexes