The self-esteem and the activities of daily living in inpatients after an ischemic stroke

急性期の脳梗塞患者の自尊感情と日常生活動作の関連を明らかにするために,入院中の脳梗塞患者150人に調査協力を依頼した.調査協力の同意が得られなかった患者25人と調査前に退院された患者17人を除き,108人(72.0%)(男性74人,女性34人,平均年齢64.5(SD 12.5)才)にアンケート調査を実施した.自尊感情(Rosenberg のSelf-Esteem,以下RSE と記載)は平均29.9(SD 6.1)点,日常生活動作(Barthel index,以下BI と記載)は平均89.4(SD 16.0)点であり,RSE とBI の間にはBI が低いとRSE が低いという正の相関がみられた(Spearman のρ= 0.461,p < 0.001).また,BI が低いことと「女性である」「高齢である」「入院時の機能障害が重い」の関連が示唆された.急性期には,脳梗塞患者の日常生活動作の自立に向けた援助と,自尊感情を高める介入が必要であると考えられた.The purpose of this study was to investigate the relationship between self-esteem and the activities of daily living in inpatients after an ischemic stroke. The level of Rosenberg's Self-esteem and the Barthel index were examined. There were 108 respondents (74 males and 34 females). Based on these results, selfesteem was significantly correlated to the Barthel Index (Spearman's ρ=0.461, p<0.001). Findings indicated that low self-esteem related to dependence, and the level of dependence showed a negative association with women, the elderly and severe disability. These results suggested the necessity of rehabilitation for re-acquiring the skills of daily living and enhancement of self-esteem in patients who are dependent.広島保健学学会 特別講

ナマズ卵レクチンのクラスター形成と細胞内輸送

Rhamnose-binding lectins are widely found in fush eggs,and Silurus asotus lectin (SAL) isolated from catfish eggs having three carbohydrate recognition domains preferentially recognizes non-reducing end Galα-linked sugar chain.In the previous study,we revealed that SRL binds to globotriaosylceramide (Gb3) by the surface plasmon resonance analysis.However,its biological effect on cultured cells is still unclear.To investigate localization and trafficking of SAL in the renel adenocarcinoma ACHN cells,which express Gb3 on the cell surface,we prepared HiLyte Fluor 555-labeled SAL (HL-SAL).When ACHN cells were treated with HL-SAL at 4℃ for 5min, and at 37℃ for 24h,HL-SAL was distributed on the cell membrane and in the intracellular compartment,respectively.To trace the trafficking route of HL-SAL from cell surface to the intracellular compartment,the images of HL-SAL-treated live cells were obtained using confocal scanning microscopy.HL-SAL was clustered on ACHN cell surface,and furthermore,partially co-localised with transferrin in intracellular compartment.These results suggest that SAL induces alteration of Gb3 distribution on the membrane and migrates from the cell surface to the intracellular vesicles

Glycosphingolipid-enriched microdomain中でGb3と会合する分子の探索

Silurus asotus (catfish) egg lectin (SAL) is a member of rhamnose-binding lectin family, and binds to globotriaosylceramide (Gb3) localized in a glycosphingolipid-enriched microdomain (GEM) on several tumor cell lines. It is known that GEM is involved in cell adhesion and has the capability of sending signals. We report here about proteins involved in GEM associating with Gb3 and mediating signal transduction system in Burkitt\u27s lymphoma Raji cells via SAL binding to Gb3. Although Gb3 molecule was sprinkled over the surface of Raji cells, SAL uniformly bound to the Raji cell surface. Sucrose density-gradient centrifugation method and fluorescence microscopic analysis revealed that not only CD20 and CD81 but also Lyn and Csk were distributed in GEM of Raji cells. The distribution of these molecules was not altered by the treatment with SAL at 4℃ for 30 ruin. Because CD20 was not co-precipitated with the anti-Gb3 antibody, CD20 was not associated with Gb3 on Raji cells. However, there was a 47kDa protein, which was specifically co-precipitated with anti-Gb3 antibody. These results suggest that the 47kDa protein is a candidate for Gb3-associating protein in Raji cells

[その他] 統合実習研修会「教員と指導者の連携強化をめざして －実習指導の実態と課題から－」の報告

本学における統合実習指導の実態や課題を解決に導くために研修会を企画・運営したので報告する。研修会では統合実習開始当初からこれまでの指導体制に関する課題と各実習施設の工夫や取り組みについてグループワークをし、情報共有することができた。研修会を終えて、グループ毎のまとめをもとに、研修会担当者らで検討した結果、統合実習の指導体制、臨地実習PBL展開、夜間実習計画・指導、の３点が課題として集約できた。また大学と実習施設の連携強化のために必要な内容として、初めての実習施設で学生が力を発揮できるための学習環境の整備、臨地実習指導者と教員間の実習目標・指導方法・評価方法の共有、学生の心身両面のサポートも含めて教員と指導者の役割の明確化など、指導体制の連携強化の重要点が示唆された。Abstract：Planning workshops to guide in solving challenges and the realities of practice teaching methods at a university were conducted. Since leadership is challenging and the sharing of initiatives and information is important, there was a need to devise a training and work method for each practice of the integration exercise.The results of each group, based on consultation, training of personnel, training, integrated training in the education system, along with clinical practice PBL deployment, night-time practice planning and guidance, were summarized into three points. These key points were: strengthening leadership, such as clarification of the role of teachers and leaders; including support for shared training goals which can aid students at practice facilities for the fi rst time at a university for practical training necessary to foster a cohesive learning environment; and aiding clinical instructors and teachers, including teaching methods for evaluation of the student’s mental condition

イイダコ(Octopus ocellatus)卵由来の赤血球凝集素について

Hemagglutinating activity was found in extract from Octopus ocellatus eggs. The hemagglutinin was partially purified by ammonium sulfate precipitation and DEAE anion exchange chromatography. DT300, a 300 mM NaCl-eluted fraction from DEAE column, possessed Ca^-dependent hemagglutinating activity on rabbit erythrocytes at concentrations from 0.47 to 30 μg/mL. Protein bands over 200 kDa were observed in DT300 on sodium dodecyl sulfate polyacrylamide gel electrophoresis. On the other hand, ruthenium red staining gave an obvious single band on a cellulose acetate membrane. The protein and carbohydrate contents of DT300 were 24% and 2%, respectively. DT300-induced hemagglutination was inhibited by fetuin, asialofetuin, heparin, and DNA but not by heparan sulfate and mono- or oligosaccharides tested. This activity was resistant to heat and protease digestion. These results indicate that the active component having C-type lectin-like activity from octopus eggs may not be composed of protein

A Case of Vaginal Stillbirth in the Presence of Placenta Previa at 33 Weeks of Gestation

It was demonstrated that second- and third-trimester therapeutic termination of pregnancy (TOP) is feasible in cases with placenta previa. We report a 34-year-old woman with complex fetal malformations associated with placenta previa. An ultrasound examination at 21 weeks of gestation revealed fetal growth restriction (FGR) and complex fetal malformations associated with a placenta previa. After extensive information, the parents opted for careful observation. Thereafter, FGR gradually progressed and we observed arrest of end-diastolic velocity of the umbilical artery. Finally, intrauterine fetal death (IUFD) was confirmed at 33 weeks of gestation. Two days after IUFD, the patient experienced labor pain. The placenta and dead fetus weighing 961 g were vaginally delivered, and total bleeding was 270 mL. Although further studies to confirm the dynamic change of the uteroplacental blood flow are necessary to avoid the risk of maternal hemorrhage, vaginal TOP with placenta previa after feticide or IUFD would be feasible

Fetal Congenital Peripheral Bronchial Atresia Diagnosed by Magnetic Resonance Imaging : Two Case Reports

Two types of congenital bronchial atresia (proximal and peripheral) have been classified. We report two cases of peripheral bronchial atresia diagnosed by prenatal ultrasonography (US) and magnetic resonance imaging (MRI). Evaluating an enlarged lung mass that is homogeneously hyperechoic on US and hyperintense on T2-weighted MRI can help in determining whether bronchial atresia is present. Proximal type is suggested when a dilated main bronchus is observed as a tubule structure of an involved lung hilum. In our cases, T2-weighted MRI revealed homogeneously hyperintense lung lesion with decreased signal intensity of adjacent lobe, flattening diaphragm, and mediastinal shift. Dilatation of the main bronchus was not observed and the opposite lung was normal in appearance. These findings were explained by secondary compression due to enlargement of the involved lung. The preservation of vascular structure and the retained normal shape, though enlarged, in the affected lobe were observed, which demonstrated undisrupted pulmonary architecture of the lobe. Thus, congenital cystic adenomatoid malformation was excluded because pulmonary architecture was relatively preserved. Finally, presumed diagnoses of the peripheral bronchial atresia were made and confirmed by postnatal chest computed tomography

Diffuse Venous Malformation of the Uterus in a Pregnant Woman with Klippel-Trénaunay Syndrome Diagnosed by DCE-MRI

Background. We experienced a rare case of a pregnant woman with Klippel-Trénaunay syndrome complicated with diffuse venous malformation of the uterus. This is the first report on the usefulness of dynamic contrast-enhanced-MRI for the diagnosis of diffuse venous malformation of the uterus. Case Presentation. A 23-year-old woman presented with convulsions and talipes equinus position of both lower limbs at 11 weeks of gestation. At 27 weeks, ultrasonography demonstrated tubular echolucent spaces throughout the myometrium. Dynamic MRI at 37 weeks revealed that the myometrial lesion was enhanced slowly and showed homogeneous enhancement even on a 10 min delayed image. Taken together with unilateral foot hypertrophy, varices, and port-wine stain, the patient was diagnosed as having Klippel-Trénaunay syndrome complicated with diffuse venous malformation of the pregnant uterus. The patient underwent elective cesarean section because of severe dystonia. The lower uterine segment was thickened and heavy venous blood flow was observed at the incision. Histological diagnosis of the myometrial biopsy specimen was venous malformation. Conclusions. Both diffuse venous malformation and Klippel-Trénaunay syndrome during pregnancy can involve considerable complications, in particular, massive bleeding during labor. Women who suffer from this syndrome should be advised about the risk of complications of pregnancy