Reactions of pulmonary emphysema patients before and after VRS - Forcusing on the rehabilitation, activity, surgery -

今まで内科的治療が主体であった肺気腫に対して,近年外科的治療(Volume Reduction Surgery 以後VRSと略す)が行われるようになった｡VRSを受ける患者の看護では,手術前後において, リハビリテーション(以後リハビリと略す)や機能回復に向けてのケアが必要不可欠とされる。そこで,本研究は肺気腫患者の適切な看護援助を検討するために,手術前後に示す肺気腫患者のリハビリや活動に対する反応を明らかにすることを目的とした｡対象者は当病棟に入院している肺気腫患者8名(VRS手術前8名,手術後はそのうちの6名である)で, リハビリ, 日常生活活動,呼吸,手術などについて,面接ならびに観察による調査を行った｡分析の結果,手術前においてリハビリでは≪義務感≫,頑張って行えば呼吸が楽になるという≪期待感≫,≪サポート≫,≪不安≫が,活動では≪活動の制限≫,手術では呼吸が楽になるのではという≪期待感≫,≪おまかせ≫,≪いちかばちかの賭け≫,≪不安≫,≪回復に向けての欲求の高まり≫が明らかになった｡手術後においてリハビリでは≪呼吸が楽になるための手段≫が, 日常生活活動では≪今の状態よりは良くなると いう期待感≫が,手術では≪達成感≫ と≪身体的苦痛≫が,将来については≪ささやかな欲求≫が明らかになった｡Pulmonary emphysema has been mainly treated with medicine, but recently VRS(volume reduction surgery) has been receiving much attention. In nursing care for VRS patients, it is important to help the patient improve his/her daily activities and recover physical function smoothly after surgery. The purpose of this study is to clarify the reactions of pulmonary emphysema patients before and after VRS for appropriate nursing. The subjects were eight pulmonary emphysema patients at a ward in Okayama University Hospital, but six of them completed both before and after VRS data collection. The data were collected by interview and observation, and from medical and nursing records. Contents of the interview included rehabilitation, daily activities, respiratory symptoms, operative stress, and so on. The results were as follows : , , , and on rehabilitation, on activity, , , , , and on surgery were extracted as pre-operative patients's reactions. on rehabilitation, on activity, and on surgery, on future were extracted as post-operative patients's reactions

Links between ecotoxicology, biomonitoring and water chemistry in the integration of water quality into environmental flow assessments.

Aquatic organisms have physico-chemical as well as flow habitat requirements. There are three main kinds of data which are useful in quantifying these requirements: chemical data which describe in-stream chemical conditions; ecotoxicity data which describe the tolerances of organisms and their in-stream responses to changing chemical concentrations; and biomonitoring data which describe the distribution and composition of communities. However, it is only by linking these data that organism requirements can be adequately elucidated and translated into resource quality objectives. This paper describes the methods for linking these data and their application in the integration of water quality into environmental flow assessments and the assessment of the water quality Reserve. A case study is presented to demonstrate the methodology

The development of water qualtiy methods within ecological Reserve assessments, and links to environmental flows

n the South African National Water Act (NWA, No 36 of 1998), the ecological Reserve is defined as the quality and quantity of water required to ensure appropriate protection of water resources, so as to secure ecologically sustainable development and use. Aquatic ecosystems are recognised as the core location of water resources, and although considerable progress has been made in developing methods for quantifying environmental flow requirements, this paper describes and discusses the first agreed method for quantifying environmental water quality requirements in an ecological Reserve assessment. Integration of flow and water quality is emphasised, and is based on the philosophy that environmental flows should be motivated to provide ecologically important flow-related habitat, or geomorphological function, but should not be motivated to solve water quality problems by dilution. Water quality is multivariate, and not all variables can be considered in an ecological Reserve assessment, but core water quality variables include: system variables (salts, dissolved oxygen, turbidity, temperature), nutrients (phosphate, nitrite, nitrate) and toxic substances (those listed in the South African Water Quality Guidelines for Aquatic Ecosystems, including toxic metal ions, toxic organic substances, and/or substances from a chemical inventory of an effluent or discharge). In addition, biological indicator data (e.g. SASS data), chlorophyll-a (e.g. phytoplankton and periphyton data) and toxicity test data may be used. For each variable, a concentration range or response is linked to a class within a water resource classification system, where classes range from minimally to severely modified. There are five main stages in the environmental water quality method: Initiate study and determine scope of assessment. Delineate water quality sub-units. Select sites and collect data and information

Mapping of bionic array electric field focusing in plasmid DNA-based gene electrotransfer

Molecular medicine through gene therapy is challenged to achieve targeted action. This is now possible utilizing bionic electrode arrays for focal delivery of naked (plasmid) DNA via gene electrotransfer. Here, we establish the properties of array-based electroporation affecting targeted gene delivery. An array with eight 300 μm platinum ring electrodes configured as a cochlear implant bionic interface was used to transduce HEK293 cell monolayers with a plasmid-DNA green fluorescent protein (GFP) reporter gene construct. Electroporation parameters were pulse intensity, number, duration, separation and electrode configuration. The latter determined the shape of the electric fields, which were mapped using a voltage probe. Electrode array-based electroporation was found to require ~100 × lower applied voltages for cell transduction than conventional electroporation. This was found to be due to compression of the field lines orthogonal to the array. A circular area of GFP-positive cells was created when the electrodes were ganged together as four adjacent anodes and four cathodes, whereas alternating electrode polarity created a linear area of GFP-positive cells. The refinement of gene delivery parameters was validated in vivo in the guinea pig cochlea. These findings have significant clinical ramifications, where spatiotemporal control of gene expression can be predicted by manipulation of the electric field via current steering at a cellular level