看護職者の個人の内的属性の対人不安への影響

看護職者の個人の内的属性の対人不安への影響について調べた.調査対象は, 2つの公立総合病院に勤務する看護職者332名である.測定用具には, 対人不安意識尺度・多次元自我同一性尺度・自己没入尺度・共感的配慮尺度・孤独感の類型判別尺度・自己評価式抑うつ性尺度を使用した.対人不安を従属変数とし, 自我同一性・自己没入・共感的配慮・孤独感・抑うつ性を独立変数としてこれらの関係をみた.さらに, 調査対象の属性である性・年齢・看護経験年数・職階・看護教育背景・兄弟姉妹数・友人数等の違いによりこれらの関係がどのように異なるかを調べた.その結果, 自我同一性と対人不安との間に負の相関がみられ, 自己没入や抑うつ性は対人不安との間で正の相関を示した.また, 女性群に有意な相関がみられたが, 男性群には相関がみられなかった.年齢, 経験年数, 職階, 看護教育背景, 兄弟姉妹数, 友人数等の違いにより, 対人不安への影響の程度は異なっていた.一方, 共感的配慮や孤独感との間には有意な相関は認められなかった.The purpose of this study was to examine relationships between nurses\u27 negative self-awareness in interpersonal relationships and their internal attributions. A sample consisted of 332 nurses was examined. The instruments used were Negative self-awareness in Interpersonal relationships scale by Hayashi and Ogawa, Multidimensional ego identity scale by Tani, Self-preoccupation scale by Sakamoto, Japanese version of Empathy consideration scale of the sub-concepts of Interpersonal Reactivity Index by Davis, Loneliness Scale by Ochiai and Japanese version of Depression Scale by Zung. The scores of ego identity showed partial correlation coefficient with significant level of 0.1% to those of negative self-awareness in interpersonal relationships. The scores of self-preoccupation showed positively correlation with those of negative self-awareness in interpersonal relation-ships. The scores of depression showed partial correlation coefficient with significant level of 0.1% to those of negative self-awareness in interpersonal relationships. Also, the relation-ships between nurses\u27 negative self-awareness in interpersonal relationships and internal attribution is different by their gender, age, experience, career ladder, brother numbers and friends\u27 numbers etc

Functional relationships between cyclodextrin glucanotransferase from an alkalophilic Bacillus and α-amylases Site-directed mutagenesis of the conserved two Asp and one Glu residues

AbstractComparison of the amino acid sequences of cyclodextrin glucanotransferases (CGTases) with those of α-amylases revealed that two Asp and one Glu residues, which are considered to be the catalytic residues in α-amylases, were also conserved in CGTases. To analyze the function of the three conserved amino acid residues in CGTases, site-directed mutagenesis was carried out. The three mutant CGTases, in which Asp229, Glu257 and Asp328 were individually replaced by Asn or Gln, completely lost both their starch-degrading and β-cyclodextrin-forming activities, whereas another mutant CGTase, in which Glu264 replaced by Gln, retained these activities. The three inactive enzymes retained the ability to be bound to starch. These results suggest that Asp229, Glu257 and Asp328 play an important role in the enzymatic reaction catalyzed by CGTase and that a similar catalytic mechanism is present in both CGTases and α-amylases

妊娠・産褥期における描画によるリラクセーション効果の検討 － POMS・筋硬度・口頭データを用いた心理・生理的評価－

　本研究の目的は，生理的指標と心理的指標を用いて，妊娠・産褥期における描画によるリラクセーション効果を検討することである．妊婦および褥婦5名を対象に，パステルによる描画前後に, POMS (Profile of Mood States) および肩部の筋硬度の測定を実施し，描画後に感想を求めた．描画前後のPOMSの6尺度の各得点および筋硬度比較を行った．また，描画した内容についてのテーマ毎の説明・感想，および全テーマの描画終了後の感想を記録し，質的に分析を実施した．描画前後のPOMSは，全員が緊張- 不安などのネガティブな気分の5尺度（T-A･D･A-H･F･C）の得点が下がり，活気得点（V）は上昇した．筋硬度は描画途中で授乳をした褥婦1名を除き描画後に低下した．テーマ毎の描画内容に関する説明・感想として，「自分」のテーマでは，「風に色がついている感じ」で「やわらかく柔軟になりたい」，「ピンクとかオレンジ」よりも「緑が欲しい」気分などが聞かれた．描画後の感想では，「力が抜ける」，「リラックスできる」，「あったかい」，「発汗」などがあった．今回の調査対象者は，描画後に，生理的指標である筋硬度及び心理的指標であるPOMSの測定でリラクセーション傾向を示した．全体終了後の感想でもリラックス感が表出された．また，描画の説明・感想より，色のイメージと気持ちの一致や色で自分を表現させていることが認められ，気持ちの表現に色などのパステル素材の効果があり，妊婦と褥婦にとっては描画が自己表出の機会となっていることが考えられた．パステルによる描画は心身両面に変化を与え，出産前後の女性の心身のリラクセーションに効果があることが示唆された．The purpose of this study was to examine the effects of relaxation evoked by drawing during pregnancy and the puerperal period by using a physiological index and a psychological index. Muscular tension of the shoulder and the Profile of Mood States (POMS) were assessed before and after drawing with pastels in 5 pregnant or puerperal women. After drawing, subjects gave their impressions of the experience, and POMS scores and muscular hardness measurements before and after drawing were compared. The impressions of drawing were qualitatively analyzed. After drawing, scores on 5 POMS scales for negative feelings had decreased, while the vigor score had increased. Muscular hardness also decreased after drawing, except in one puerperal participant who had suckled while drawing. The impressions of drawing with the theme of“ Myself” included feelings of“ I used the color of the wind”,“ I want to become flexible gently”, and“ I want to use green from pink and the orange”. Impressions of the entire drawing experience included “The tension in my body was relieved”, “I became relaxed”, “It became warm”, and “I started sweating”. After drawing, muscular hardness measurements and POMS scores indicated a tendency toward relaxation. The participants then matched the colors in images to feelings and expressed this connection with colors from their impressions of the drawing experience. The pastel material was effective for the expression of feelings. Drawing provided an opportunity for self-expression in the pregnant and puerperal women. The results suggest that drawing with pastels elicits a change in mind and body that can effectively help women to relax before and after birth

Cystoid Macular Edema following Treatment with Nanoparticle Albumin-Bound Paclitaxel and Atezolizumab for Metastatic Breast Cancer

Cystoid macular edema (CME) is a rare side effect associated with chemotherapy. Although the development of CME has been reported to occur following treatment with taxane drugs, such as nanoparticle albumin-bound paclitaxel (Nab-PTX), the occurrence of CME with treatment with atezolizumab has not yet been reported. Here, we report the case of a 49-year-old woman who developed CME 19 months into chemotherapy with Nab-PTX and atezolizumab. Improvement was not achieved with steroid injections into the Tenon’s sac, and Nab-PTX and atezolizumab treatments were ceased. One month later, there was subjective improvement in her symptoms. Although many reports have indicated that cessation of chemotherapy has successfully improved CME, a specific treatment for CME has not yet been established. Clinicians should be aware of the ophthalmologic side effects and offer immediate treatment if symptoms develop

Re-biopsy status among non-small cell lung cancer patients in Japan: A retrospective study

AbstractObjectiveDisease progression because of acquired resistance is common in advanced or metastatic epidermal growth factor receptor (EGFR)-mutation positive non-small cell lung cancer (NSCLC), despite initial response to EGFR-tyrosine kinase inhibitors (TKIs). In Japan, transbronchial tissue biopsy is the most common sampling method used for re-biopsy to identify patients eligible for treatment. We aimed to investigate the success rate of re-biopsy and re-biopsy status of patients with advanced or metastatic NSCLC completing first-line EGFR-TKI therapy.Patients and methodsThis was a retrospective, multi-center, Japanese study. The target patients in the study were EGFR mutation-positive NSCLC patients. The primary endpoint was the success rate (number of cases in which tumor cells were detected/total number of re-biopsies performed×100). Secondary endpoints included differences between the status of the first biopsy and that of the re-biopsy in the same patient population, and the details of cases in which re-biopsy could not be carried out. Re-biopsy-associated complications were also assessed.ResultsOverall, 395 patients were evaluated (median age 63 years), with adenocarcinoma being the most common tumor type. Re-biopsy was successful in 314 patients (79.5%). Compared with the sampling method at first biopsy, at re-biopsy, the surgical resection rate increased from 1.8% to 7.8%, and percutaneous tissue biopsy increased from 7.6% to 29.1%, suggesting the difficulty of performing re-biopsy. Approximately half of the patients had T790M mutations, which involved a Del19 mutation in 55.6% of patients and an L858R mutation in 43.0%. Twenty-three patients (5.8%) had re-biopsy- associated complications, most commonly pneumothorax.ConclusionsSuccess rate for re-biopsy in this study was approximately 80%. Our study sheds light on the re-biopsy status after disease progression in patients with advanced or metastatic NSCLC. This information is important to improve the selection of patients who may benefit from third-generation TKIs

Role of Phe283 in enzymatic reaction of cyclodextrin glycosyltransferase from alkalophilic Bacillus sp.1011: Substrate binding and arrangement of the catalytic site

Cyclodextrin glycosyltransferase (CGTase) belonging to the α-amylase family mainly catalyzes transglycosylation and produces cyclodextrins from starch and related α-1,4-glucans. The catalytic site of CGTase specifically conserves four aromatic residues, Phe183, Tyr195, Phe259, and Phe283, which are not found in α-amylase. To elucidate the structural role of Phe283, we determined the crystal structures of native and acarbose-complexed mutant CGTases in which Phe283 was replaced with leucine (F283L) or tyrosine (F283Y). The temperature factors of the region 259–269 in native F283L increased >10 Å2 compared with the wild type. The complex formation with acarbose not only increased the temperature factors (>10 Å2) but also changed the structure of the region 257–267. This region is stabilized by interactions of Phe283 with Phe259 and Leu260 and plays an important role in the cyclodextrin binding. The conformation of the side-chains of Glu257, Phe259, His327, and Asp328 in the catalytic site was altered by the mutation of Phe283 with leucine, and this indicates that Phe283 partly arranges the structure of the catalytic site through contacts with Glu257 and Phe259. The replacement of Phe283 with tyrosine decreased the enzymatic activity in the basic pH range. The hydroxyl group of Tyr283 forms hydrogen bonds with the carboxyl group of Glu257, and the pKa of Glu257 in F283Y may be lower than that in the wild type