エイゴノ ジョウタイ ヘンカ ドウシ ノ ジタ コウタイ ニツイテ ツイトウ ヤハギ サンゾウ センセイ トクシュウ

論

健康教育と規律の習得(幼児教育)

As children grow, they must acquire the basic rules of modern society and various social rules in their daily lives, and they must learn to lead a healthy and safe lifestyle. These habits and rules that must be acquired in infancy form the foundation of their future life. The habits and rules must be those that reflect the growth of the child and should be incorporated naturally. In the present study, during exercises and medical checkups, we watched the acquisition of basic rules of modern society and various social rules that became more sophisticated as children at K kindergarten in Tokyo went from three to four to five years old. The behavior of the children became orderly as they moved up in grade, and their behavior was more relaxed and calmer. In terms of relationships with the other children, they gained the ability to associate and cooperate with others, and independence, development of patience and self-control were seen

Case report: Neonatal case of intrauterine gastrointestinal bleeding with suspected cow's milk allergy or neonatal transient eosinophilic colitis

The patient was a female newborn. Ultrasonography performed at 35 weeks and 3 days of gestation revealed honeycomb-like dilatation and peri-intestinal strong echo patterns in the gastrointestinal tract. Nonreassuring fetal status was also diagnosed, leading to an emergency Cesarean section. The baby's birth weight was 2,127 g, whereas the Apgar 1 min and 5 min scores were 8 and 9, respectively. The amniotic fluid showed fecal and hematogenous turbidity. After delivery, there was hematogenous intragastric residue and defecation. Thereafter, the bloody intragastric residue and fecal discharge improved. Aggregations of eosinophils in the stool were observed, and gastrointestinal allergy was suspected. Enteral feeding with the hydrolyzed protein formula was initiated and symptoms did not recur. The allergen-specific lymphocyte stimulation test was positive for lactoferrin, and the patient was suspected with neonatal cow's milk allergy or neonatal transient eosinophilic colitis. After her condition stabilized, an oral challenge test was performed using breast milk without dairy products, and the test was negative. Gastrointestinal allergy is rare even in utero, and when gastrointestinal bleeding is suspected in utero, hemorrhagic or surgical gastrointestinal diseases should be ruled out first; however, the possibility of gastrointestinal allergy should also be kept in mind

Case report: A case of fetal umbilical vein varix presenting disseminated intravascular coagulation, polycythemia, and neonatal hepatitis in an extremely low birth weight infant

Reports on the clinical course of fetal umbilical vein varix in premature infants are limited. We report a case of an extremely low body weight infant with intra-abdominal umbilical vein varix who developed disseminated intravascular coagulation, polycythemia, and hyperbilirubinemia after birth; late-onset neonatal hepatitis; and fetal thrombotic vasculopathy confirmed by placental histopathology. Ultrasonography after birth showed a dilated portion of the umbilical vein at the hepatic hilum with thrombi inside. We speculate that the umbilical vein varix caused the fetal thrombotic vasculopathy, and the presence of umbilical vein varix and fetal thrombotic vasculopathy in combination with prematurity caused coagulopathy, polycythemia, hyperbilirubinemia, and hepatitis. Despite the favorable outcomes reported in the literature, premature infants with umbilical vein varix may require careful observation and management for coagulopathy and late-onset hepatitis. Furthermore, placental histopathology could aid in the understanding of various clinical outcomes in infants with umbilical vein varices

Optimal First Trimester Preeclampsia Prediction: a Comparison of Multimarker Algorithm, Risk Profiles and Their Sequential Application

OBJECTIVE: To compare performance of multimarker algorithm, risk profiles and their sequential application in prediction of preeclampsia and determining potential intervention targets. STUDY DESIGN: Maternal characteristics, ultrasound variables and serum biomarkers were collected prospectively at first trimester. Univariate analysis identified preeclampsia associated variables followed by logistic regression analysis to determine the prediction rule. Combined characteristics of the cardiovascular, metabolic and the personal risk factors were compared to the multimarker algorithm and the sequential application of both methods. RESULTS: Out of 2433 women, 108 developed preeclampsia (4.4%). Probability scores considering nulliparity, prior preeclampsia, body mass index, diastolic blood pressure and placental growth factor had an area under the receiver operating characteristic curve 0.784 (95% CI = 0.721-0.847). While the multimarker algorithm had the lowest false negative rate, sequential application of cardiovascular and metabolic risk profiles in screen positives reduced false positives by 26% and identified blood pressure and metabolic risk in 49/54 (91%) women with subsequent preeclampsia as treatable risk factors. CONCLUSION: Sequential application of a multimarker algorithm followed by determination of treatable risk factors in screen positive women is the optimal approach for first trimester preeclampsia prediction and identification of women that may benefit from targeted metabolic or cardiovascular treatmentinfo:eu-repo/semantics/publishedVersio

幼児教育における健康および日常生活習慣の指導について(幼児教育)

Observation of K Kindergarten revealed that the habit of washing one\u27s hands and gargling, brushing teeth, eating, exercising, and playing were the minimum necessary conditions for young children to achieve mental and physical health and grow and develop while interacting within a group. Such an educational environment is believed to have prevented the prevalence of norovirus infection. Looking at the attitude with which the teachers at K Kindergarten treated their charges, it was apparent that they gave due consideration to the mental, and physical development of the children. In the area of acquisition of daily living habits, the initiative of the children was respected. Absolutely no commands or scoldings were observed. As for washing hands, all of the children carefully washed between their fingers and all the way to the tips of their fingers. The kindergarten was also attentive to games and exercises so as to nurture the initiative of children. Of the basic living habits necessary for young children to remain healthy and grow and develop wholesomely both mentally and physically, washing one\u27s hands and gargling, in particular, are believed to have been instrumental in preventing infectious/contagious diseases including norovirus infection, an epidemic of which occurred this winter

A pooling-based genome-wide analysis identifies new potential candidate genes for atopy in the European Community Respiratory Health Survey (ECRHS)

<p>Abstract</p> <p>Background</p> <p>Asthma and atopy are complex phenotypes with shared genetic component. In this study we attempt to identify genes related to these traits performing a two-stage DNA pooling genome-wide analysis in order to reduce costs. First, we assessed all markers in a subset of subjects using DNA pooling, and in a second stage we evaluated the most promising markers at an individual level.</p> <p>Methods</p> <p>For the genome-wide analysis, we constructed DNA pools from 75 subjects with atopy and asthma, 75 subjects with atopy and without asthma and 75 control subjects without atopy or asthma. In a second stage, the most promising regions surrounding significant markers after correction for false discovery rate were replicated with individual genotyping of samples included in the pools and an additional set of 429 atopic subjects and 222 controls from the same study centres.</p> <p>Results</p> <p><it>Homo sapiens </it>protein kinase-like protein SgK493 (<it>SGK493</it>) was found to be associated with atopy. To lesser extent mitogen-activated protein kinase 5 (<it>MAP3K5</it>), collagen type XVIII alpha 1 (<it>COL18A1</it>) and collagen type XXIX alpha 1 (<it>COL29A1</it>) were also found to be associated with atopy. Functional evidences points out a role for <it>MAP3K5</it>, <it>COL18A1 </it>and <it>COL29A1 </it>but the function of <it>SGK493 </it>is unknown.</p> <p>Conclusion</p> <p>In this analysis we have identified new candidate regions related to atopy and suggest <it>SGK493 </it>as an atopy locus, although these results need further replication.</p

後期高齢女性における血清レプチン濃度

高齢者のアセスメント項目として,体組成と栄養素摂取に影響を与える血清レプチン濃度を明らかにすることは機能調節因子に必要であると考えられる。しかし,高齢者の血清レプチン濃度については,報告が少なく17,18,19)一定の見解が得られていない。そこで高齢者のうち,特に後期高齢女性の血清レプチン濃度を明らかにすることを目的とし検討を加えた結果,以下の結論を得た。1)QOLの高い日本人の後期高齢女性の血清レプチン濃度は,正常排卵性月経周期を有する日本人女性と同程度であった。2)後期高齢女性の血清レプチン濃度は,BMIと強い正相関を認めた。3)独力で生活する基礎活動能力を有する後期高齢女性では,やせ及び正常体重者が多かった。以上より,独力で生活できる基礎活動能力を有する後期高齢女性の血清レプチンは若年女性と同レベルであること,適正体重の維持は高齢女性の身体活動を低下させない要因である可能性が示唆された。Objective: Leptin is a protein that is synthesized and secreted from adipose tissue. This protein regulates fat stores and body weight by affecting appetite and thermogenesis. It is known that serum leptin levels are higher in women than men and change at various life stages such as pregnancy and puberty. Leptin may be an important predictive factor of body condition and nutritional intake. Little is known about serum leptin concentrations in elderly people. Thus, we examined serum leptin in elderly Japanese women. Methods: The subjects were thirty elderly women and comprised all residents age 75 and over, living in K-ku, Tokyo. They were all healthy members of the community at large not receiving any special medical care. We measured serum leptin concentrations and performed a survey of eating habits, habitual exercise and smoking. Results: Serum leptin concentrations in the elderly Japanese women were 7.1±0.7ng/ml. They were almost equal to young Japanese women with regular menstrual cycle. Serum leptin concentrations were highly correlated with body mass index (BMI). Serum leptin concentrations with low BMI were lower than that with normal BMI. The percentage of women with low and normal BMI was greater than that of the National Nutrition Survey 2000. These results indicate that serum leptin concentrations in elderly Japanese women with regular weight were not different from that in young Japanese women with regular menstrual cycle