自我機能の発達と病態化の研究(その1) : 自我機能の測定尺度の開発

　力動精神医学において，「自我」は人格の重要な構成基準であってさまざまな精神機能をつかさどる機関として考えられている．その自我機能の評価は，病態を把握し，治療の見通しを立てる上で，重要な手がかりとなるものである．よって，これまでにも多くの研究者たちがU一ルシャッハ・テストなどの投影法，質問紙，面接などを用いて，自我機能を評価・測定する方法をさまざまに提案してきた．その中でも特に中心的な研究は，Bellak，L．（1969，1973）のものである。Bellakは自我機能を12に分類し，臨床的面接，実験的手続き，既成の心理研究という3つの手続きによって詳細な自我機能の評価を試み，精神分裂病患者，神経症患者，正常者の比較研究を行った．このBellakの臨床的面接の質問項目を質問紙形式で取り入れ，正常から境界例に至る一般の中・高生の自我機能の評定と再適応の能力の評価を行い，指導や治療の指針を得ることを目的にして作成されたのが，中西・古市（1981）のEF1－2である．EF1－2は信頼性・妥当性について検討がなされ，標準化が行われているにもかかわらず，臨床の現場では未だ普及に至っていないのが現状である．そこで，自我機能の測定尺度について，われわれはまず以下のような問題点と今後の課題を検討した．　一つには，EF1－2はBellakの自我機能の枠組みに沿って作成されているが，そもそもBellakの枠組みをそのまま日本に適用することには無理があるのではなかろうか．むしろ，日本での臨床的な経験を踏まえて，自我機能の測定尺度を作成する必要があるのではないか．すなわち，Bellakの分類にこだわらず，例えば，「同一性」のような病態の把握にとって重要と考えられる下位尺度を盛り込む方が有用である．　また，Bellak，中西・古市，いずれの研究においても，自我機能の1下位分類である防衛機制についてはその全般的な機能水準を問題としており，個々の防衛機制の種類は捉えられていない．個々の防衛機制を測定する質問紙も別に考案されているが（DSQ：Bond，Gardner，Christian＆Sigal　1983，Bond　1986，申西　1998），他の自我機能と共には検討されていない．個々の防衛機制のあり方と自我機能との関連を同時に調べることがきわめて重要であると考えられるので，「防衛機制」についてはその種類も取り上げ，より詳細な項目で構成されるべきであろう．　以上の点を踏まえて，本研究は，新たな自我機能の測定尺度を作成することを試みるものである，また，今後，測定された自我機能を対象にして，その発達過程（その2）と病態化（その3）についても研究を展開していく予定であるが，本研究は，その一連の研究の第一段階に該当する

Survey of Period Variations of Superhumps in SU UMa-Type Dwarf Novae

We systematically surveyed period variations of superhumps in SU UMa-type dwarf novae based on newly obtained data and past publications. In many systems, the evolution of superhump period are found to be composed of three distinct stages: early evolutionary stage with a longer superhump period, middle stage with systematically varying periods, final stage with a shorter, stable superhump period. During the middle stage, many systems with superhump periods less than 0.08 d show positive period derivatives. Contrary to the earlier claim, we found no clear evidence for variation of period derivatives between superoutburst of the same object. We present an interpretation that the lengthening of the superhump period is a result of outward propagation of the eccentricity wave and is limited by the radius near the tidal truncation. We interpret that late stage superhumps are rejuvenized excitation of 3:1 resonance when the superhumps in the outer disk is effectively quenched. Many of WZ Sge-type dwarf novae showed long-enduring superhumps during the post-superoutburst stage having periods longer than those during the main superoutburst. The period derivatives in WZ Sge-type dwarf novae are found to be strongly correlated with the fractional superhump excess, or consequently, mass ratio. WZ Sge-type dwarf novae with a long-lasting rebrightening or with multiple rebrightenings tend to have smaller period derivatives and are excellent candidate for the systems around or after the period minimum of evolution of cataclysmic variables (abridged).Comment: 239 pages, 225 figures, PASJ accepte

チイキ ノウギョウ シンコウ モデル コウチク ノ タメ ノ チョウサチ ノ センテイ ─ インドネシア・ボゴール ノウソン ニ オケル トクサンヒン カイハツ ジレイ ─

インドネシアでは近年,急激な工業化によって経済成長が著しいが,農村部門では相変わらず貧困率が高止まりしており,農村部の所得向上が緊急の課題となっている。地域農業が発展していくには,営農における経営の維持安定とともに生物生産の基盤となる農生態系の安定が課題となる。本研究は,地域農業の持続的発展を究極の目的として,小規模農家の経営を向上させることで貧困の解消が可能になるよう,地域特産品の作出を軸とした多様な農業の展開を目指している。そのために,持続可能な地域農業の形成のための実学的アプローチとして,社会経済的分野と農生態学(アグロエコロジー)分野を統合させるような地域レベルでの研究を遂行するための調査対象地を選定することを目的とした。 まず,西ジャワ州ボゴール郊外の14村を決定し,社会経済状況を整理し,さらに主成分分析によって村々の特徴を把握した。そこで,貧困率が高く,特産品のプログラムの取り組みが始まっている4村に絞り込みを行った。ここで現地に赴き,それぞれの村の自然環境および村落の状況について村役場でのインタビューや住民への聞き取り調査を実施し,農生態系の構成と農村開発の可能性を検討し,最終的に 1村に決定した。最後に,対象1村について,農業上の課題を明確化し,今後の研究の方向性を示した。Economic development has been accelerated by rapid industrialization, however poverty still remains as a major issue and improving income level is a significant agenda in the rural areas in Indonesia. In order to develop regional agriculture, the stability of both farm economy and agroecosystem as the bases of bioproduction are the main challenges. To pursue the sustainable development of regional agriculture, we set out to evolve a more diversified agriculture with special regional products for the elimination of poverty through the improvement of the household economy of small scale farms. This study aims to select a research site to integrate socio-economic as well as agroecological approaches as a practical science to find a new direction toward sustainable regional agriculture. Firstly, we chose 14 candidate villages in the rural area of Bogor, West Java, and sorted out the socio-economic factors by conducting principal component analysis to break down the characteristics of the villages. Four predominantly agricultural villages with the highest rate of poverty were selected. Then we conducted a field survey to clarify the natural environment and the actual situation of these rural communities by interviewing village officers and farmers. The potential for rural development based on diversified agroecosystems was considered and finally one village was selected. Agricultural issues in the intended village were overviewed and the direction of further research clarified

Clinical responses to EGFR-tyrosine kinase inhibitor retreatment in non-small cell lung cancer patients who benefited from prior effective gefitinib therapy: a retrospective analysis

<p>Abstract</p> <p>Background</p> <p>Gefitinib was the first epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) approved for the treatment of advanced non-small cell lung cancer (NSCLC). Few treatment options are available for NSCLC patients who have responded to gefitinib treatment and demonstrated tumor progression. The present study was conducted to evaluate the efficacy and toxicity of the 2^ndEGFR-TKI administration.</p> <p>Methods</p> <p>We retrospectively analyzed 11 patients who had obtained a partial response (PR) or stable disease (SD) with gefitinib treatment and were re-treated with EGFR-TKI after failure of the initial gefitinib treatment.</p> <p>Results</p> <p>Three patients (27%) were treated with gefitinib as the 2^ndEGFR-TKI, and 8 patients (73%) received erlotinib. Only one patient (9%) showed PR, 7 (64%) achieved SD, and 3 (27%) had progressive disease. The disease control rate was 73% (95% CI, 43% - 91%) and the median progression-free survival was 3.4 months (95% CI, 2 - 5.2). The median overall survival from the beginning of the 2^ndEGFR-TKI and from diagnosis were 7.3 months (95% CI, 2.7 - 13) and 36.7 months (95% CI, 23.6 - 43.9), respectively. No statistical differences in PFS or OS were observed between gefitinib and erlotinib as the 2^ndEGFR-TKI (PFS, P = 0.23 and OS, P = 0.052). The toxicities associated with the 2^ndEGFR-TKI were generally acceptable and comparable to those observed for the initial gefitinib therapy.</p> <p>Conclusions</p> <p>Our results indicate that a 2^ndEGFR-TKI treatment can be an effective treatment option for gefitinib responders.</p

Clinical responses to EGFR-tyrosine kinase inhibitor retreatment in non-small cell lung cancer patients who benefited from prior effective gefitinib therapy: a retrospective analysis

<p>Abstract</p> <p>Background</p> <p>Gefitinib was the first epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) approved for the treatment of advanced non-small cell lung cancer (NSCLC). Few treatment options are available for NSCLC patients who have responded to gefitinib treatment and demonstrated tumor progression. The present study was conducted to evaluate the efficacy and toxicity of the 2^ndEGFR-TKI administration.</p> <p>Methods</p> <p>We retrospectively analyzed 11 patients who had obtained a partial response (PR) or stable disease (SD) with gefitinib treatment and were re-treated with EGFR-TKI after failure of the initial gefitinib treatment.</p> <p>Results</p> <p>Three patients (27%) were treated with gefitinib as the 2^ndEGFR-TKI, and 8 patients (73%) received erlotinib. Only one patient (9%) showed PR, 7 (64%) achieved SD, and 3 (27%) had progressive disease. The disease control rate was 73% (95% CI, 43% - 91%) and the median progression-free survival was 3.4 months (95% CI, 2 - 5.2). The median overall survival from the beginning of the 2^ndEGFR-TKI and from diagnosis were 7.3 months (95% CI, 2.7 - 13) and 36.7 months (95% CI, 23.6 - 43.9), respectively. No statistical differences in PFS or OS were observed between gefitinib and erlotinib as the 2^ndEGFR-TKI (PFS, P = 0.23 and OS, P = 0.052). The toxicities associated with the 2^ndEGFR-TKI were generally acceptable and comparable to those observed for the initial gefitinib therapy.</p> <p>Conclusions</p> <p>Our results indicate that a 2^ndEGFR-TKI treatment can be an effective treatment option for gefitinib responders.</p