福沢諭吉,F.ウェーランド,阿部泰蔵

1868年の初夏,彰義隊討伐戦の当日,砲声の響くなかで福沢諭吉がF・ウェーランドの 『経済学』を講義していたことは,『自伝』に語られている有名なエピソードである。ところが翌年になると彼は『経済学』の講義を小幡篤次郎に譲り,自分は(小幡の見つけてきた)同じ著者の『道徳科学』の講義担当に代わっている。福沢はそこに,在来からの仁義五常の道徳諭とはまったく異る,新しい「修身諭」を見出したのである。ウェーランドはバプティスト派のブラウン大学の学長を務める聖職者であったから,その経済学は牧師派経済学の典型であったし,ましてや倫理学原理はキリスト教々義にもとづくものであったけれども,実践倫理は独立の個人と社会を成り立たせているreciprocity (相互いの精神)を軸とした所説であった。福沢は『学問のすゝめ』2,6～8編では,自由や,国法の尊重,国民の義務など,宗教色を排したトピックスをウェーランドによって教え説している。慶応義塾のカリキュラムを見ると,1870年代の終わり頃まで『道徳科学』のみならず『経済学』の親版ならびに縮約版が中級,初級のテキストとして使われているが,その間に上級生は先生とともにギゾーやミルを読み始めていたことが推察できる

Successful management of hyperammonemia with hemodialysis on day 2 during 5-fluorouracil treatment in a patient with gastric cancer: a case report with 5-fluorouracil metabolite analyses

Ozaki, Y., Imamaki, H., Ikeda, A. et al. Correction to: Successful management of hyperammonemia with hemodialysis on day 2 during 5‑fluorouracil treatment in a patient with gastric cancer: a case report with 5‑fluorouracil metabolite analyses. Cancer Chemotherapy and Pharmacology (2020) 86:693-699.Purpose: Hyperammonemia is an important adverse event associated with 5-fluorouracil (5FU) from 5FU metabolite accumulation. We present a case of an advanced gastric cancer patient with chronic renal failure, who was treated with 5FU/leucovorin (LV) infusion chemotherapy (2-h infusion of LV and 5FU bolus followed by 46-h 5FU continuous infusion on day 1; repeated every 2 weeks) and developed hyperammonemia, with the aim of exploring an appropriate hemodialysis (HD) schedule to resolve its symptoms. Methods: The blood concentrations of 5FU and its metabolites, α-fluoro-β-alanine (FBAL), and monofluoroacetate (FA) of a patient who had hyperammonemia from seven courses of palliative 5FU/LV therapy for gastric cancer were measured by liquid chromatography–mass spectrometry. Results: On the third day of the first cycle, the patient presented with symptomatic hyperammonemia relieved by emergency HD. Thereafter, the 5FU dose was reduced; however, in cycles 2–4, the patient developed symptomatic hyperammonemia and underwent HD on day 3 for hyperammonemia management. In cycles 5–7, the timing of scheduled HD administration was changed from day 3 to day 2, preventing symptomatic hyperammonemia. The maximum ammonia and 5FU metabolite levels were significantly lower in cycles 5–7 than in cycles 2–4 (NH3 75 ± 38 vs 303 ± 119 μg/dL, FBAL 13.7 ± 2.5 vs 19.7 ± 2.0 μg/mL, FA 204.0 ± 91.6 vs 395.9 ± 12.6 ng/mL, mean ± standard deviation, all p < 0.05). After seven cycles, partial response was confirmed. Conclusion: HD on day 2 instead of 3 may prevent hyperammonemia in 5FU/LV therapy