脳血管疾患を発症し，緊急入院となった成人期患者の家族の体験―緊急入院時，一般病棟転棟時，急性期病院退院時の三時期に焦点をあてて―

目的：脳血管疾患を発症し，緊急入院となった成人期患者家族の体験を明らかにし，その特徴を踏まえた看護実践への示唆を得る． 方法：脳血管疾患を発症し，緊急入院となった成人期患者家族6名に研究同意を得て面接調査を行った．面接内容を対象者が述べた言葉のみでなく，観察された反応，表情，態度等のメッセージも文字化して，Krippendorff, Kの内容分析法を用いて分析した． 結果・考察：三時期の家族の体験を表す27のカテゴリを形成した．緊急入院時には【配偶者の生命の危機に対する衝撃】，一般病棟転棟時には【配偶者の病状変化に対する継続的懸念】，急性期病院退院時には【退院・転院に向けた心身の準備状態の確立の実感】など，三時期で特有の体験をしていた． 結論：家族の体験の特徴を踏まえ，緊急入院時は家族が過酷な状況を乗り越えられるような支援，一般病棟転棟時には感情の揺れに配慮した支援，急性期病院退院時には発達段階を考慮した具体的支援の必要性が示唆された．Purpose: To elucidate the experiences of family members of adults who were urgently hospitalized due to cerebrovascular disease and to obtain insights into nursing practice based on the characteristics of such experiences. Methods: An interview survey was conducted with six family members who agreed to participate in the research. The data were analyzed using Krippendorff’s method of content analysis. Not only words, but also the observed reactions, expressions and manners expressed by family members during the interviews were analyzed. Results: A total of 27 categories were generated for the following three periods: 1) when patients were urgently hospitalized, 2) when patients were transferred to a general ward, and 3) when patients were discharged after urgent hospitalization. The participants had experiences specific to each period, such as‘ feeling shocked and relieved by the spouse being alive’ upon urgent hospitalization,‘ expectations for recovery and worries for disease progression’ upon transfer to a general ward, and‘ being ready to provide support again’ upon discharge after urgent hospitalization. Conclusions: The characteristics of experiences faced by the participants suggest the necessity of the following support strategies: support for family members to overcome critical situations upon immediate hospitalization, support that considers emotional changes upon transfer to a general ward, and support specific to disease progression level upon discharge after immediate hospitalization.原

Argonaute2 is a potential target for siRNA-based cancer therapy for HT1080 human fibrosarcoma.

Small interfering RNAs (siRNAs) are small RNA molecules that have a potent, sequence-specific gene silencing effect and therefore show promise for therapeutic use as molecular-targeted drugs for the treatment of various genetic diseases, including cancer. The aim of the present study was to evaluate whether Argonaute2 (Ago2) is a therapeutically effective target for siRNA-based cancer therapy. Ago2 is the key protein in mammalian RNAi and is also known as the only member of the Ago family that mediates the microRNA (miRNA)-dependent cleavage of targeted mRNAs. It is assumed that these unique properties of the Ago2 protein can play a central role in the regulation of the miRNA pathway and subsequent translational inhibition of miRNA-targeted mRNAs, including cell survival and cancer progression. To assess its therapeutic effect, siRNA against Ago2 (Ago2-siRNA) was transfected into HT1080 human fibrosarcoma cells, which are malignant cancer cells. Ago2 gene silencing resulted in the inhibition of cell growth and the induction of apoptosis and G0/G1 arrest in the cell cycle. In addition, Ago2 knockdown induced morphological changes and actin stress fiber formation in the cells. The results of a microarray study showed that Ago2 suppression stimulated several crucial genes related to apoptosis, the cell cycle, immune response, cell adhesion, metabolism, etc. Repeated intratumoral injection of Ago2-siRNA/cationic liposome complex induced tumor growth suppression in an HT1080 xenograft model. These results suggest that the suppression of the Ago2 gene may be useful for the inhibition of cancer progression and that Ago2 may be a desirable target for siRNA-based cancer therapy

喉頭摘出術後の食道発声における練習中断のプロセス

[目 的]喉頭摘出者が,喉頭摘出術の告知後,食道発声の練習を継続できず中断するプロセスを明らかに し,看護支援のあり方を検討する.[対象と方法]術後3年以上経過した喉頭摘出者で,食道発声の練習を 中断した患者8名を対象とした.倫理審査委員会の承認を得て,2005年1月～8月に半構成面接を実施し,修 正版グラウンデッド・セオリー・アプローチを用いて分析した.[結 果]食道発声における練習中断のプ ロセスは,[喉頭摘出術の意思決定に対する葛藤][失声に伴うコミュニケーションの回避][患者会参加と食 道発声練習継続を阻害する否定的感情の白覚]の3つのカテゴリ,11概念から構成された.患者会に適応でき ない孤独感の増大が,食道発声に対する否定的感情を引き起こし,練習の中断に至った.[結 語]食道発 声の練習継続を促すには,患者会と看護師の連携強化や実現可能な目標を設定し,練習の成果を白覚できる よう支援する必要がある