半月体性腎炎におけるbeta2 integrin 関与の病型間の相違について

An immunohistochemical study was performed to investigate the involvement of beta2 integrins in the glomerular infiltration of leukocytes in different types of human crescentic glomerulonephritis (CrGN). On 51 ethanol-fixed paraffin embedded renal biopsy specimens (34 cases of pauci-immune type and 17 cases of immune-mediated type), the following antigens were evaluated by immunoperoxidase method ; the glomerular (intra-capillary and extra-capillary) expression of ICAM-1, deposition of FRA and infiltration of leukocytes bearing beta2 integrins (LFA-1, CR3 and CR4). ICAM-1 was expressed both in extra-capillary and intra-capillary areas in very early stage of crescent formation and was rapidly decreased with the progression of the stage of crescent. Similarly, infiltration of leukocytes bearing beta2 integrins were observed both in extra-capillary and intra-capillary areas in early stage of crescent formation and were rapidly decreased with the progression of the stage of crescent. In pauci-immune type, the extra-capillary expression of ICAM-1 was significantly correlated with extra-capillary infiltration of LFA-1+cells (γ=0.800, p<0.0001) and CR3+cells (γ=0.791, p<0.0001). The extra-capillary deposition of FRA was also significantly correlated with extra-capillary infiltration of CR3+cells (γ=0.685, p<0.001) and CR4+cells (γ=0. 741, p<0.0001). In both types, the intra-capillary expression of ICAM-1 was significantly correlated with intra-capillary infiltration of LFA-1+cells (γ=0.618, p<0.01 and γ=0.754, p<0.05 respectively). These results suggested that ICAM-1/LFA-1 and ICAM-1/CR3 interaction might be involved in both the extra- and intra-capillary infiltration of leukocytes in pauci-immune CrGN. CR3 and CR4 might also function as fibrin/fibrinogen receptors in extra-capillary lesions in this type. On the other hand, only ICAM-1/LFA-1 interaction might be involved only in the intra-capillary infiltration of leukocytes in immune mediated CrGN

[研究報告] 双生児の乳児期早期における睡眠覚醒リズムの同調性と関連する要因

本研究は乳児期早期の双生児ペアの睡眠覚醒リズムの同調性を腕時計型加速度センサー、アクチグラフ（Micro Mini，Ambulatory Monitoring Inc. USA）を用いて定量的に評価し、同調性の高低に双生児ペアのどのような要因が影響しているのかを明らかにすることを目的とし実施した。双生児の睡眠変数と睡眠覚醒リズムの同調性は、睡眠覚醒同調率と夜間同時睡眠率を算出した結果，それぞれ68.8％（SD；7.0％）と58.6％（標準偏差8.1％）であった。両者の相関は、有意水準には達しなかった（Rs＝0.383，p＝0.481）。また、睡眠覚醒同調率、夜間同時睡眠率と双生児のプロフィール、育児要因、睡眠環境との関連する要因を検討した結果、睡眠覚醒同調率では、自律授乳の励行、母親の添い寝、睡眠覚醒リズムを整える工夫を行うとの関係が示唆された。夜間同時睡眠率に関しては、関連が推測できる要因は特定できなかった。The present study was conducted to determine twin pair‒specifi c factors that may influence synchrony between sleep-wake cycles, using a wrist accelerometer Actigraph （Micro Mini, Ambulatory Monitoring Inc., USA） for quantitatively measuring the synchrony in twin pairs in early infancy. The rates of sleep-wake synchrony and nighttime synchronic sleep in twin pairs were 68.8 % （with a SD of 7.0 %） and 58.6 % （with a SD of 8.1 %），respectively. These two parameters did not significantly correlate with each other （Rs＝0.383, p＝0.481）．In addition, we investigated the relationship between the rates of sleep-wake synchrony and nighttime synchronic sleep, and various factors relating to the twin pairs’ characteristics, child-rearing, and sleep environment. We found that the rate of sleep-wake synchrony was related to strict self-demand feeding, mother-twins co-sleeping, and attempts to regulate twins’ sleep-wake cycles. We could not identify any factors that were presumably related to the rate of nighttime synchronic sleep

Regulation of human renal adenocarcinoma cell growth by retinoic acid and its interactions with epidermal growth factor

Regulation of human renal adenocarcinoma cell growth by retinoic acid and its interactions with epidermal growth factor. Retinoic acid (RA) is a natural derivative of vitamin A which regulates the growth and differentiation of epithelia. We have previously proposed that RA participates in compensatory kidney growth and reported that RA inhibits rat mesangial cell growth. This paper describes the effects of RA on a human renal adenocarcinoma cell line (PAD) under different growth conditions, and its interactions with epidermal growth factor (EGF). PAD cells were shown to express RA receptors α and β by Northern blot analysis. In serum free cultures, addition of RA (10-7 M) markedly increased thymidine incorporation by PAD cells (155 ± 7% mean ± se vs. control in 6 separate experiments; P < 0.0001). RA also caused a significant increase in thymidine incorporation by PAD cells under conditions of rapid growth in serum supplemented medium (115 ± 2% vs. control; P < 0.001). RA by itself was unable to reverse contact inhibition of PAD cell growth (NS vs. control), but it synergistically enhanced the mitogenic effect of EGF on confluent monolayers (110 ± 0.6% vs. EGF alone; P < 0.05). Northern blot analysis demonstrated that PAD cells express EGF receptor mRNA, and this was not significantly modified by the addition of RA. Growth arrested (serum starved) PAD cells expressed RAR-α mRNA which was up-regulated eightfold at three hours following the addition of 10% FCS. Thus, our data show that RA is directly mitogenic for serum starved human renal adenocarcinoma cells and that it exerts complex modulation of cell growth in the presence of EGF and serum components

Stress-Reducing Effects of Watching a Bonfire Video

departmental bulletin pape

[資料] 小児看護に携わる看護師が新人看護師にのぞむ臨床実践能力 －入職時に修得していることをのぞむ小児看護技術－

小児看護領域で求められる小児看護技術は、新人看護職員研修で修得する臨床実践能力を基盤として、小児の特性に応じたさらに専門性・難易度が高い技術の修得が必要となる。本研究では、小児看護に携わる看護師が新人看護師の入職時までに修得していることをのぞむ小児看護技術について、総合病院の小児病棟に勤務し新人看護師教育に携わる看護師を対象とした調査を実施した。結果、新人看護師にのぞむ看護技術の多くは「知識としてわかる」レベルであった。しかし「バイタルサイン測定」「日常生活行動の援助」「成長発達の理解と発達段階に応じた関わり」「検査・処置の援助」「基本的な育児行動」「コミュニケーション能力」が入職時までにこれだけは修得してきてほしい看護技術としてあげられた。また小児看護を実践していく上で新人看護師にのぞむ姿勢として「責任感」が最も多く求められていた。The skills required in the field of pediatric nursing are based on the clinical practice abilities developed during training of new nursing staff and require the acquisition of more specialized and challenging skills appropriate to the characteristics of children. This study conducted a survey among nurses who worked in pediatric wards within general hospitals and were involved in the education of new nurses, to investigate the specific skills that nurses involved in pediatric nursing believe new nurses should acquire before the time of accession. The results showed that most of the nursing skills desired to be developed in new nurses were related to learning to a “level wherein the content could be understood as knowledge.” However, “measurement of vital signs,” “support for daily living activities,” “understanding of growth and development, and involvement appropriate to developmental stages,” “support for examinations and treatments,” “basic childcare behaviors,” and “communication ability” were listed as the minimum nursing skills needed to be learned by new nurses before the time of accession. In addition, “a sense of responsibility” was most frequently cited as the attitude to be acquired by new nurses for pediatric nursing practice

療養型医療施設における臨地実習指導の現状と課題 : 初めて実習指導を行った臨地実習指導者と病棟管理者の面接調査より

本研究は療養型医療施設において初めて実習指導を行った臨地実習指導者の指導上の困難および病棟管理者や病棟スタッフ(看護職スタッフ・介護職スタッフ)の連携を明らかにすることを目的とし指導者8名と病棟管理者2名に面接調査を実施した。その結果、(1)指導者の指導上の困難は「指導内容や方法」「指導に対する不安」など指導者自身の問題が多かった。(2)指導者は自己の指導を振りかえり、指導方法を工夫し、学生の事故防止や緊張緩和に重点をおき実習指導を行っていた。(3)指導者と看護職スタッフとの連携では「指導への無関心」で、指導者と介護職スタッフとの連携では「情報伝達の不足」があげられており、指導者同士の連携では「連携の不足」、「指導の違い」であった。(4)病棟管理者は指導者と病棟スタッフ(看護職スタッフ・介護職スタッフ)の調整において「スタッフは協力的」「問題はなかった」と認識しており、指導者の病棟スタッフ(看護職スタッフ・介護職スタッフ)の連携に対する認識と差異があることが明らかになった。This research is aimed at indentifing difficulties experienced by clinical training staff who conducted training for the first time at medical care centers; and to make clear the cooperation between hospital ward administrators and the ward staff (nursing and care staff). To achieve this a survey was carried out by means of interviewing 8 instructors and 2 ward administrators. The results from the interviews show that, 1). Many of the difficulties in training instruction faced by the instructors were self-induced created by \u27the content and the methods of training\u27 and with the instructors feelings of \u27anxiety toward training instruction; 2). It was made clear that the instructors reflected on their own instructing skils for improvement and to carry out training instructions which focus on preventing accidents happening to the trainees while also putting them at ease; 3). There was a discrepancy in the understanding of cooperation between the staff, as ward administrators felt that in coordinating the instructors and the ward staff (nursing and care staff) \u27the staff was cooperative\u27 and \u27there were no problems\u27; 4). The main problem concerning cooperation between the instructors and the nursing staff was duetoa \u27lack of interest toward the training\u27, for the instructors and the care staff the problem was \u27a lack of information conveyance\u27, and as for the problem of cooperation between the instructors themselves it was dueto \u27insufficient cooperation\u27 and \u27differences in training methods

子どもとの関わりが困難な学生の実習指導のあり方

臨床実習を効果的に進めるための指導のあり方を探るために,入院2日目で症状が強く,学生を受け入れられない状況にある3歳女児と,学生との関わりを学生の実習記録と教師の指導記録から分析した。学生は患児の拒否する態度に困惑し,状況を客観的に捉えることができずに実習意欲を低下させていた。教師は,混乱している学生が客観的に現象を捉え,行動を評価できるよう心理的余裕を持たせることが必要であった。また,関わりの具体的方法を助言し,学生が実施してゆく過程をサポートし続けることで,学生が患児と関わることができた。How the association went on between a three-year-old girl who still showed strong symptoms on the second day after she was admitted to a hospital and the student nurse who was having practical training of nursing was analyzed from the student nurse\u27s records of practice and the teacher\u27s records of instruction. The student nurse was embarrassed by the sick child who refused her, and could not have an objective understanding of the situation, thus losing motivation to have practical training. The teacher had to make the confused student nurse feel relaxed enough to understand what was taking place and evaluate the behaviors objectively. The teacher also advised the student nurse about specific approaches to the child and gave support to the student nurse throughout the processes of training. As a result, the student nurse was able to associate with the sick child