Severe Renal Hemorrhage in a Pregnant Woman Complicated with Antiphospholipid Syndrome: A Case Report

Antiphospholipid syndrome is a systemic autoimmune disease with thrombotic tendency. Consensus guidelines for pregnancy with antiphospholipid syndrome recommend low-dose aspirin combined with unfractionated or low-molecular-weight heparin because antiphospholipid syndrome causes habitual abortion. We report a 36-year-old pregnant woman diagnosed with antiphospholipid syndrome receiving anticoagulation treatment. The patient developed left abdominal pain and gross hematuria at week 20 of pregnancy. An initial diagnosis of left ureteral calculus was made. Subsequently abdominal-pelvic computed tomography was required for diagnosis because of the appearance of severe contralateral pain. Computed tomography revealed serious renal hemorrhage, and ureteral stent placement and pain control by patient-controlled analgesia were required. After treatment, continuance of pregnancy was possible and vaginal delivery was performed safely. This is the first case report of serious renal hemorrhage in a pregnant woman with antiphospholipid syndrome receiving anticoagulation treatment and is an instructive case for urological and obstetrical practitioners

Severe renal hemorrhage in a pregnant woman complicated with antiphospholipid syndrome: A case report

金沢大学医薬保健研究域医学系Antiphospholipid syndrome is a systemic autoimmune disease with thrombotic tendency. Consensus guidelines for pregnancy with antiphospholipid syndrome recommend low-dose aspirin combined with unfractionated or low-molecular-weight heparin because antiphospholipid syndrome causes habitual abortion. We report a 36-year-old pregnant woman diagnosed with antiphospholipid syndrome receiving anticoagulation treatment. The patient developed left abdominal pain and gross hematuria at week 20 of pregnancy. An initial diagnosis of left ureteral calculus was made. Subsequently abdominal-pelvic computed tomography was required for diagnosis because of the appearance of severe contralateral pain. Computed tomography revealed serious renal hemorrhage, and ureteral stent placement and pain control by patient-controlled analgesia were required. After treatment, continuance of pregnancy was possible and vaginal delivery was performed safely. This is the first case report of serious renal hemorrhage in a pregnant woman with antiphospholipid syndrome receiving anticoagulation treatment and is an instructive case for urological and obstetrical practitioners. Copyright © 2011 Shohei Kawaguchi et al

骨盤から姿勢を考える授業 : 首はね跳びへのアプローチ <第2部 教科研究>

体育授業における生徒の動きを観察すると，骨盤が後傾したまま動かすことができなかったり，肩甲骨周りも固まってきていたりするような状況が多々見受けられる。そこで，まず，骨盤の活性化を中心にした体つくりを取り入れて， 日頃の姿勢の見直しを図り，身体の使い方を考えさせることから始めた。これらの学習を基盤とし，その後の跳び箱運動（首はね跳び）にチャレンジする過程においても，準備運動などで骨盤から脊柱に連動する動きづくりから身体のしなやかさの向上を図り，自身の身体とじっくりと向き合い，その変化を感じながら取り組めるようにした。また，お互いの関わり合いを感じながら活動できるように，仲間同士の補助やアドバイス場面を多く設定した。このような場面設定や段階的な指導を丁寧に仕組み，「もう少しでできる」と思えるような体験を繰り返し味わわせることを大切にしながら技の習得に取り組ませ，中学1年生女子生徒にとっては難易度が高いと思われる「首はね跳び」に，みんなが安心してチャレンジできるような授業展開を工夫した。その結果，生徒は日常における自己の姿勢の状態について意識を高め，その改善を図りながら，授業中の運動場面へのつながりも考えるようになり，難易度の高い技に仲間とともに積極的にチャレンジすることができた

体のしくみと薬について考える保健の授業 : 探究活動を通して <第2部 教科研究>

薬と正しく付き合うための思考力や実践力を育成するとともに，運動や食事などの生活習慣と健康に関する知識や理解を深めることを目指し保健の授業を実践した。その際，学習する知識や理解の内容や単元のつながりを整理し，「体のしくみ」に重点をおいた学習計画を作成した。また，思考力を高め実生活に生きる実践力を育むために，探究活動として4つの実験を取り入れ， 「体のしくみ」と「薬」について考察する時間を設けた。 その結果，各自がこれまでの生活を振り返り，改善点をみつけ，今後の薬との関わり方や生活の在り方について考える事ができるようになった。特に，探究活動は，学習した知識や理解を深めるだけでなく，多面的・複眼的な視点で考察することができ，思考力を高め実践力を育むのに大変効果的であることを確認できた

細菌の培養実験を取り入れた保健の授業実践 : 感染症と人間 <第2部 教科研究>

感染症の原因となる病原体の多くは， 目に見えず存在が実感できないものである。しかし，それらは人間とともに生物界の一員として生態系の中で共存しているという視点を持つことで，耐性菌の間題や新興感染症• 再興感染症の間題の根本がより理解できると考える。そうした共存関係を理解させるために，私たちの周りに存在する細菌を採集して培養する実験をおこなって，その結果から「感染症と人間の関係」についてお互いに意見を出し合いながら考えを深めていく授業を構成し実施した。生徒は，積極的に実験に取り組み，「感染症と人間の関係」について考えを深め，「細菌との共生」「免疫力の向上」「生活習慣の重要性」といったキーワードをつかってそれぞれの考えを述べており，感染症を防ぐための行動選択や意思決定につながる授業であったと考える

Role of surgical resection in adult urological soft tissue sarcoma: 25-Year experience

金沢大学附属病院泌尿器科The effect of chelating ligands on iron (Fe) uptake and growth of radish (Raphanus sativus L.) was investigated. The ethylenediaminetetraacetic acid (EDTA) increased 55Fe uptake in roots of radish though its subsequent translocation from roots to shoots and leaves did not increase. About 70%-80% of the total 55Fe was distributed in the roots while about 5%-15% and 11%-17% were in shoots and leaves, respectively. The EDTA increased iron uptake into the roots of radish, but not in the above ground parts of the plant. The growth of radish (Raphanus sativus L.) decreased drastically in alkaline condition (pH > 9), even though the concentration of iron was sufficient in the growth medium. The growth of radish was enhanced successfully by the addition of hydroxyiminodisuccinic acid (HIDS) and EDTA. This might be because HIDS and EDTA solubilize iron from its precipitation with hydroxides at higher pH, and increase iron bioavailability. The influence of EDTA and HIDS on radish growth was comparable. Increase of radish growth by ethylenediaminedisuccinic acid (EDDS) and methylglicinediacetic acid (MGDA) was less than those by EDTA and HIDS. Considering the reproducibility of the radish growth (biomass production) at pH 10, HIDS is supposed to be more effective compared to EDTA. © Taylor & Francis Group, LLC

Urodynamic evaluation before and immediately after robot-assisted radical prostatectomy

Objective To evaluate continence status and mechanism of urinary incontinence immediately after robot-assisted radical prostatectomy (RARP) by performing urodynamic evaluation. Methods A total of 87 patients with localized prostate cancer who underwent RARP were included. Filling cystometry, urethral pressure profilometry, and abdominal leak point pressure (ALPP) tests were performed before and immediately after RARP. Results The mean urine loss ratio (ULR), calculated by dividing the total urine volume by the weight of urine loss after RARP, was 17.8%. Nerve-sparing (NS) surgery significantly affected ULR compared with non-NS surgery. In the comparison between preoperative and postoperative results, the mean maximal cystometric capacity (MCC) and maximal closure urethral pressure (MUCP) decreased from 341 mL and 84.6 cm H 2O to 250 mL and 35.6 cm H2O, respectively. No urine leakage was observed in ALPP test preoperatively; however, urine leakage was observed postoperatively in 75 patients (86%), with a mean ALPP of 47.7 cm H2O. Multivariate analysis revealed that MCC, MUCP, and ALPP after RARP were predictive factors for ULR. Linear correlations were found between ULR and MUCP and between ULR and ALPP after RARP. NS status and MUCP after RARP (r = 0.247; P =.021) and the ALPP (r = 0.254; P =.018) were significantly correlated. Conclusion In urodynamic evaluation immediately after RARP, MCC, MUCP, and ALPP were found to predictive factors for urinary incontinence. The NS procedure contributed to continence status after RARP. © 2014 Elsevier Inc

Sports Competence in Softball : How to Improve Control

本研究の目的は，ソフトボール初心者の中学２年生を対象に技術認識の向上によるパフォーマンスの向上と戦術学習により，自分で結果をコントロールできる自信である「統制感」を高めることであった。宣言的知識と手続き的知識の学習及び，スモールステップによるペッパーゲームとステップアンドスローのドリルによって学び方を考えながらプレイする授業プログラムを構成した。単元前統制感の高低によって反復測定分散分析を行った。結果，統制感下位群において，身体的有能さの認知，統制感，学習方略が有意に高まった。このことより，統制感下位群の生徒が実際のゲームで使える技術認識を向上させ，自分の上達を実感することによって運動学習に見通しを持って挑戦する意欲が高まったことが明らかになった。学習ノートの記述分析をしたところ，授業の進行とともに「手続き的知識」の記述とともに，「状況判断」や「運営」の記述数が増加した。技術認識と統制感を高めることによって状況判断のあるゲームを楽しんでいることが示唆された。The purpose of this study was to improve the control of sports competence. It was studied in softball novices among junior high school students (N=61). Learning about declarative knowledge and the procedural knowledge were programmed in physical education classes. Learning from a challenge, the ‘correction pepper game drill’ and the ‘step and throw drill’ by a small step were programed. As for the results of analysis of variance, the learning strategies and physical competence for control were improved in the lower group after the program. It was suggested that this program made the readiness to enjoy softball with making a prediction and judgment