Survey on Jiritsu-Katsudo at Special Needs Classes for Hearing Impaired Children in Elementary Schools

小学校の難聴特別支援学級で指導を担当している教員を対象として、自立活動の実態と課題を明らかにすることを目的として質問紙調査を実施した。回答者のうち、特別支援学校教諭免許状（聴覚障害教育領域）保有者は11.8％にとどまった。先行研究でも報告されたとおり、多くの学級内で使用されている主たるコミュニケーション手段は音声言語であった。在籍児童が抱える学校生活上の困難として多く回答されたのは、「語彙について」「やりとりの確実さ」であった。回答者が在籍児童と関わる際に苦慮することについては、「自身の難聴に関する知識が十分でないと感じる」「手話や指文字を使いたいが十分に使えない」「児童間の人間関係が十分に形成できていない」という回答が多くみられた。回答者が自立活動において指導経験のある内容については、読み書きや発音・発語、人間関係の形成に関するものが多かった。自立活動の指導内容を精選及び指導する際に苦慮することについては、「指導したい内容に関する知識や技量が追い付かない」という回答が最も多く、難聴特別支援学級担当教員の専門性に関する課題が改めて示された。A questionnaire survey was conducted with the aim of clarifying the actual condition and issues of Jiritsu-Katsudo for teachers who are instructing at special needs classes for hearing impaired children in elementary schools. Among the teachers, the number of holders of the special needs school teacher’s license (education for hearing impaired) was only 11.8%. As reported in previous studies, the main means of communication used in many classes was spoken language. What was mostly answered as a difficulty in school living by the enrolled children was “About vocabulary”, “Reliability of interaction”. Regarding the difficulties when teachers are involved with enrolled children, many teachers said that “I feel that my knowledge on deafness is not sufficient”,“ I want to use sign language and finger spelling but I cannot use it enough”,“ Relationships among children are not sufficient”. As for teachers who had experience in instructing in Jiritsu-Katsudo, there were many things concerning reading and writing, pronunciation / utterance, and formation of human relations. Regarding the difficulties in selecting and instructing the contents of Jiritsu-Katsudo, the answer that“ Knowledge and skills on the content to be taught does not catch up” is the most frequent, and the problem relating to the expertise of the teachers in charge of special needs classes for hearing impaired are shown

Autosynchronized systolic unloading during left ventricular assist with a centrifugal pump

AbstractObjectives: The purpose of this study was to investigate how the inflow cannulation site of the left ventricular assist system with a centrifugal pump would influence cardiac function on failing heart models. Methods: In 10 sheep, a left ventricular assist system was instituted by an outflow cannula in the descending aorta, two inflow cannulas in the left atrium and the left ventricle, and connecting those cannulas to a magnetically suspended centrifugal pump. A conductance catheter and a tipped micromanometer for monitoring the pressure-volume loop were also inserted into the left ventricle. Myocardial oxygen consumption was directly measured. Heart failure was induced by injection of microspheres into the left main coronary artery. The assist rate was varied from 0% to 100% at each inflow cannulation site. Results: The pump flow with left ventricular cannulation increased during the systolic phase and decreased during the diastolic phase, whereas it was constant with left atrial cannulation. Ejection fraction with left atrial cannulation decreased as the assist rate increased, whereas that with left ventricular cannulation was maintained up to 75% assist. The external work with left atrial cannulation decreased gradually as the assist rate increased, whereas the external work with left ventricular cannulation did not decrease until the assist rate reached 75%. The myocardial oxygen consumption in both cannulations decreased proportionally as the assist rate increased; they were significantly less with left ventricular cannulation at the 100% assist rate than with left atrial cannulation. Conclusion: Left ventricular cannulation during left ventricular assistance maintains ejection fraction and effectively reduces oxygen consumption.J Thorac Cardiovasc Surg 2003;125:353-6

A simple calculation for the preoperative estimation of transverse rectus abdominis myocutaneous free flap volume in 2-stage breast reconstruction using a tissue expander

Background Flap volume is an important factor for obtaining satisfactory symmetry in breast reconstruction with a transverse rectus abdominis myocutaneous (TRAM) free flap. We aimed to develop an easy and simple method to estimate flap volume. Methods We performed a preoperative estimation of the TRAM flap volume in five patients with breast cancer who underwent 2-stage breast reconstruction following an immediate tissue expander operation after a simple mastectomy. We measured the height and width of each flap zone using a ruler and measured the tissue thickness by ultrasound. The volume of each zone, approximated as a triangular or square prism, was then calculated. The zone volumes were summed to obtain the total calculated volume of the TRAM flap. We then determined the width of zone II, so that the calculated flap volume was equal to the required flap volume (1.2×1.05×the weight of the resected mastectomy tissue). The TRAM flap was transferred vertically so that zone III was located on the upper side, and zone II was trimmed in the sitting position after vascular anastomosis. We compared the estimated flap width of zone II (=X) with the actual flap width of zone II. Results X was similar to the actual measured width. Accurate volume replacement with the TRAM flap resulted in good symmetry in all cases. Conclusions The volume of a free TRAM flap can be straightforwardly estimated preoperatively using the method presented here, with ultrasound, ruler, and simple calculations, and this technique may help reduced the time required for precise flap tailoring

Multifaceted Analyses of Epidermal Serine Protease Activity in Patients with Atopic Dermatitis

The serine proteases kallikrein-related peptidase (KLK) 5 and KLK7 cleave cell adhesion molecules in the epidermis. Aberrant epidermal serine protease activity is thought to play an important role in the pathogenesis of atopic dermatitis (AD). We collected the stratum corneum (SC) from healthy individuals (n = 46) and AD patients (n = 63) by tape stripping and then measuring the trypsin- and chymotrypsin-like serine protease activity. We also analyzed the p.D386N and p.E420K of SPINK5 variants and loss-of-function mutations of FLG in the AD patients. The serine protease activity in the SC was increased not only in AD lesions but also in non-lesions of AD patients. We found, generally, that there was a positive correlation between the serine protease activity in the SC and the total serum immunoglobulin E (IgE) levels, serum thymus and activation-regulated chemokine (TARC) levels, and peripheral blood eosinophil counts. Moreover, the p.D386N or p.E420K in SPINK5 and FLG mutations were not significantly associated with the SC's serine protease activity. Epidermal serine protease activity was increased even in non-lesions of AD patients. Such activity was found to correlate with a number of biomarkers of AD. Further investigations of serine proteases might provide new treatments and prophylaxis for AD

Spatiotemporal Control of Ice Crystallization in Supercooled Water via an Ultrashort Laser Impulse

Takahashi H., Kono T., Sawada K., et al. Spatiotemporal Control of Ice Crystallization in Supercooled Water via an Ultrashort Laser Impulse. Journal of Physical Chemistry Letters, 14(19), 4394-4402, 18 May 2023: © 2023 American Chemical Society. DOI: 10.1021/acs.jpclett.3c00414.Focused irradiation with ultrashort laser pulses realized the fine spatiotemporal control of ice crystallization in supercooled water. An effective multiphoton excitation at the laser focus generated shockwaves and bubbles, which acted as an impulse for inducing ice crystal nucleation. The impulse that was localized close to the laser focus and accompanied by a small temperature elevation allowed the precise position control of ice crystallization and its observation with spatiotemporal resolution of micrometers and microseconds using a microscope. To verify the versatility of this laser method, we also applied it using various aqueous systems (e.g., plant extracts). The systematic study of crystallization probability revealed that laser-induced cavitation bubbles play a crucial role in inducing ice crystal nucleation. This method can be used as a tool for studying ice crystallization dynamics in various natural and biological phenomena