看護技術における洗髪時の体位が対象の心身に及ぼす影響に関する文献検討

To shed light on previous research trends and future challenges regarding the effect of body position during hair washing on the mental and physical state of the subject, we conducted a literature review on “body position during hair washing” and “the effect on the mental and physical state of the subject of hair washing based on the body position during that process.” Using an online repository of major medical journals (Igaku Chuo Zasshi—WEB), we performed a search for “hair washing” and “body position or posture” without specifying a date range. When we excluded conference proceedings, meeting minutes, reviews, and commentaries and focused on papers describing the mental and physical effects on the subject of hair washing, we found 24 relevant papers. The results of our analysis revealed the following: 1) half of the research subjects were in a healthy group and half were in a disease group, with the most common conditions of those in the latter group being heart disease, threatened premature delivery/miscarriage, and anemia; 2) the body position used the most during hair washing was the supine position; 3) measurement variables were related to objective and subjective aspects, with the most common objective variables being pulse, heart rate, blood pressure, and the electromyogram, whereas the most common subjective variables were suffering, exhilaration,and fatigue; and 4) in patient subject groups, subjective factors, objective factors, and adjustments in the hair washing position according to the patientʼs illness or condition were used to investigate the physical and mental effects on the patient.Based on the trends in prior studies, it is hoped that in the future, there will be an increase in the amount of clinical data and further investigations toward generalization.洗髪の体位が対象者の心身に及ぼす影響について、これまでの研究結果と今後の課題を明らかにすることを目的とし、「洗髪の体位」と「その体位で洗髪をした際、洗髪を受ける対象者の心身に及ぼす影響」に関する文献検討を行った。医学中央雑誌WEB 版を用いて発行年の制限は行わず、「洗髪」、「体位or 姿勢」でキーワード検索を行い、会議録、議事録、総説、解説を除き、洗髪を受ける対象者の心身への影響を扱った文献に絞ったところ、24 件が該当した。結果、1）研究対象者は、健康群と疾患群、半数ずつであり、疾患群としては、心疾患、切迫流早産、貧血の割合が多かった、2）洗髪体位として、仰臥位を選択している研究が多かった、3）測定項目は客観的指標と主観的指標があり、客観的指標では脈拍、心拍数、血圧、筋電図が、主観的指標では苦痛、爽快感、疲労感の割合が多かった、4）研究内容では、疾患群において対象の疾患や状態に合わせた洗髪の体位や主観的・客観的指標から、患者の心身への影響を検討していた。今後、これら先行研究における検討結果を踏まえ、さらに、実際に洗髪援助が必要な者を対象として臨床などにおいてデータ数を増やし一般化に向け検討を行うことが必要であると考えられた。論

ヤセイ ドウブツ ホゴク ニ オケル ユウボクミン ト チベットノロバ ノ トチ ソウゴ リヨウ ノ イチレイ

本調査では，国立公園内での家畜遊牧について，野生動物との資源と空間利用における競合，あるいは共有の実態を把握し評価することを目的とした。対象はインド・ジャンムーカシミール州のラダック管区ルプシュ地方を年間遊牧するルプシュ・チャンパ（以下「ルプシュパ」）と，ルプシュ地方のツォ・カル湖周辺域に生息するチベットノロバ（以下「キャン」）（Equus kiang kiang）を対象とした。調査方法は2010～2013年の春期，繁殖期，夏期，秋期，冬期における，チャンパへの聞取り調査，キャンの定点観察及び追跡調査法等により，ルプシュパの遊牧移動方法と，ツォ・カル湖周辺域の繁殖期・非繁殖期における放牧域とキャンの分布域の重複状況を分析した。その結果，ルプシュパとキャンのツォ・カル湖周辺域での利用状況は，冬期～春期のキャンの分布は乾燥域を中心とし，また放牧家畜は植物量の多い湿地部～乾燥域とに棲み分けていた。また繁殖期にキャンはツォ・カル湖周辺平坦域に複数の縄張りを展開するが，放牧家畜は同周辺域を去り，地理的に隔たった他の谷間やより高地を利用しており，繁殖期における互いの空間的侵害は回避されていた。さらに，夏期（8月）のツォ・カル湖周辺平坦域の非放牧期間とキャンの非分布期間の重なりは，湿地を含む越冬放牧地の休閑期を作りだしていた。ルプシュパの遊牧方法には，食草を維持するために集約利用を避ける頻度の高い放牧地間移動のみならず，1．）ルプシュパ内グループ別移動による放牧地利用の時間的地理的なずらし，2．）冬期～春期の，キャンとの重複利用地区での空間的ずらし，さらには3．）キャンの繁殖期と夏期（6月～9月）の不在によるずらし，といった複数のずらし機能が確認できた。このような幾つものずらしが，野生動物や植物への侵害や負荷を軽減させ，ツォ・カル湖周辺域に生息するキャンとの相互的土地利用を可能にする要因であると考えられた。In this survey, the objective was to understand and evaluate the actual situation of competition over or sharing of resources and space between nomads and wild animals with regard to nomadic grazing within a national park. The subjects of the survey were the Rupshu Changpa (hereinafter referred to as Rupshupa), who move in the Rupshu area of the Ladakh region in the Indian state of Jammu and Kashmir, and the Kiang (Equus kiang kiang), which inhabit the area around Tso Kar Lake in Rupshu. The survey method consisted of interviewing the Changpa as well as fixed-point observations and focal animal sampling of the Kiang during the spring, breeding period, summer, fall, and winter seasons between 2010 and 2013. Through this survey, an analysis was conducted concerning the nomadic grazing migration method of the Rupshupa and the situation of overlapping of the grazing areas and distribution areas of the Kiang during the breeding and non-breeding periods in the area around Tso Kar Lake. As a result, it was determined that the situation of usage of the areas around Tso Kar Lake by the Rupshupa and the Kiang was as follows : The Kiang mainly inhabited the dry areas during the winter through spring seasons, while grazing livestock separately inhabited wetlands and dry areas abounding in vegetation. In addition, while the Kiang make their territories in many places around the Tso Kar Lake area during the breeding period, the grazing livestock leave the surrounding areas and use other valleys and highlands that are geographically distant. Therefore, mutual spatial infringement between the Kiang and the grazing livestock during the breeding period was avoided. Moreover, the overlapping of the non-grazing period and the non-distribution period of the Kiang in the areas around Tso Kar Lake during the summer (August) had created a period of fallowing for the wintering rangeland that includes the rich wetlands. It was confirmed that the method of nomadic grazing by the Rupshupa consisted of not only very frequent movements among the rangelands intended to avoid concentrated usage of the rangelands in order to maintain edible grass but also several other shifting functions (resulting in keeping the Kiang and the grazing livestock separated) such as the following : 1) temporal and geographical shifting in the use of rangelands by having groups within the Rupshupa move separately ; 2) spatial shifting in areas that are used at the same time as the Kiang during the winter through spring seasons ; and 3) shifting as a result of absence of the Kiang during the breeding period and the summer season (May through September). It is thought that repeated shifting in these ways reduce impacts on wild animals and plants, and is a factor that makes mutual use of rangelands with the Kiang that inhabit the area around Tso Kar Lake possible

Light-dependent induction of Edn2 expression and attenuation of retinal pathology by endothelin receptor antagonists in Prominin-1- deficient mice

Retinitis pigmentosa (RP) and macular dystrophy (MD) are prevalent retinal degenerative diseases associated with gradual photoreceptor death. These diseases are often caused by genetic mutations that result in degeneration of the retina postnatally after it has fully developed. The Prominin-1 gene (Prom1) is a causative gene for RP and MD, and Prom1- knockout (KO) mice recapitulate key features of these diseases including light-dependent retinal degeneration and stenosis of retinal blood vessels. The mechanisms underlying progression of such degeneration have remained unknown, however. We here analysed early events associated with retinal degeneration in Prom1-KO mice. We found that photoreceptor cell death and glial cell activation occur between 2 and 3 weeks after birth. High-throughput analysis revealed that expression of the endothelin-2 gene (Edn2) was markedly up-regulated in the Prom1-deficient retina during this period. Expression of Edn2 was also induced by light stimulation in Prom1-KO mice that had been reared in the dark. Finally, treatment with endothelin receptor antagonists attenuated photoreceptor cell death, gliosis, and retinal vessel stenosis in Prom1-KO mice. Our findings suggest that inhibitors of endothelin signalling may delay the progression of RP and MD and therefore warrant further study as potential therapeutic agents for these diseases

放射線皮膚炎に対するスキンケアに関する文献レビュー

The aim of this study was to identify future challenges and trends of Japanese nursingrelated research to date regarding skin care for radiotherapy-induced dermatitis.We conducted a literature review on “skin care” performed by nurses for radiation dermatitis. Using an online repository of major medical journals (Igaku Chuo Zasshi ―WEB), we performed a search for “radiation therapy”, “dermatitis” (or “radiation dermatitis”), and “skincare” without specifying a date range. When we excluded conference proceedings and meeting minutes and focused on papers describing nursing, we found 14 relevant papers.The results of our analysis of these papers revealed the following:1) There were six case studies (42.9%), and many papers dealt with head and neck cancer patients.2) In terms of observation and evaluation items, there were eight papers (64.3%) that used the Common Terms for Adverse Events (CTCAE ver.4, Japanese translation JCOG version) as is; 14 (100.0%) that used skin conditions, such as redness, erosion, dryness, and desquamation as evaluative items; and 11 (78.6%) that observed subjective patient symptoms, such as pain and itching.3) Regarding skin care, there were 11 papers (78.6%) relating to washing, with many describing specific washing methods, such as, “Wash using low pH soap,” “Use soap that has been lathered well,” Rinse with warm water,” and “Wash by gently stroking and not rubbing.” There were 12 papers (85.7%) relating to moisturizing and wound management.4) Although there were many papers that stated that carrying out skin care improved dermatitis and prevented worsening, there was scant evidence illustrating such results.There is a need to investigate evaluative methods and increase the number of case studies in the future in order to make it possible for nurses to deliver skincare suited to the patient’s condition; based on accurate observation and assessment; and in accordance with radiation dermatitis skin conditions, attributes of radiation dermatitis patients, and risk factors. It is hoped that we will build evidence in terms of skin care for radiation dermatitis.放射線療法により引き起こされる皮膚炎に対するスキンケアついて、これまでわが国で検討されている看護に関連した研究の傾向や今後の課題を明らかにすることを目的とし、放射線皮膚炎に対するスキンケアについて文献検討を行った。具体的には、医学中央雑誌WEB 版を用いて発行年の制限は行わず、「放射線療法」、「皮膚炎」、（または、「放射線皮膚炎」）、「スキンケア」でキーワード検索を行い、会議録、議事録を除き、看護に関連する文献に絞ったところ、14件が該当した。　結果、以下のことが明らかとなった。１）症例研究が６件（42.9％）を占めた。頭頸部がん患者を扱った文献が多かった。２）放射線皮膚炎の観察・評価項目は、有害事象共通用語基準（CTCAE ver.4、日本語訳JCOG 版）におけるGrade 分類をそのまま活用していた文献が８件（57.1％）、「発赤」、「びらん」、「乾燥」、「落屑」など皮膚の観察状態を評価項目として活用していた文献は14件（100.0％）、「疼痛」、「掻痒感」などの患者の自覚症状を観察していた文献は11件（78.6％）であった。３）スキンケアは、洗浄に関する文献が11件（78.6％）であり、その洗浄方法では「弱酸性の刺激の少ない洗浄剤（または石鹸）で洗う」「ぬるめのお湯で流す」、「擦らず撫でるように洗う」といった基本的な洗浄方法について記述されている文献が多かった。保湿や創傷管理に関する文献は12件（85.7％）であった。４）スキンケアを実施することで、皮膚炎の改善や悪化を防ぐことができたと記述している文献は12件（85.7％）と多かったが、その成果を示す根拠は乏しかった。　今後、放射線皮膚炎の患者の属性やリスク要因、放射線皮膚炎の皮膚状態に応じて、看護師が的確な観察やアセスメントを行った上で、患者の状態に合わせたスキンケア方法が実施できるように、さらに症例数を増やし評価方法を検討することが必要であると考えられた。放射線皮膚炎に対するスキンケアにおけるエビデンスの構築が求められる。論

高齢者に対する足浴は有酸素運動となるか

　本研究の目的は足浴が膝関節などの運動器に負担をかけない有酸素運動となるか検討することである。高齢者29名（平均73.2歳）を対象に、3人1組で開始42℃、終了時40℃の足浴を30分間行った。脈拍数、前額部および両下肢皮膚温の測定、主観的な運動感の評価を行い、分析は対応のある一元配置分散分析、Friedman検定を行った。結果、脈拍数の増加が認められたが、40％の運動強度となる脈拍数になった者はいなかった。前額部皮膚温は足浴による影響の傾向がみられ（ P = 0.058）、下肢皮膚温は影響が認められた（ P ＜ 0.000）。主観的評価では「運動した感じ」、「身体が軽くなった感じ」、「足が軽くなった感じ」の変化に有意差があった（いずれも P ＜ 0.000）。足浴が有酸素運動となるかの指標としては、脈拍数のみではなく、酸素消費量等の観点からの検討も必要と考えられた

Expression and characterization of protein disulfide isomerase family proteins in bread wheat.

[Background]The major wheat seed proteins are storage proteins that are synthesized in the rough endoplasmic reticulum (ER) of starchy endosperm cells. Many of these proteins have intra- and intermolecular disulfide bonds. In eukaryotes, the formation of most intramolecular disulfide bonds in the ER is thought to be catalyzed by protein disulfide isomerase (PDI) family proteins. The cDNAs that encode eight groups of bread wheat (Triticum aestivum L.) PDI family proteins have been cloned, and their expression levels in developing wheat grains have been determined. The purpose of the present study was to characterize the enzymatic properties of the wheat PDI family proteins and clarify their expression patterns in wheat caryopses. [Results]PDI family cDNAs, which are categorized into group I (TaPDIL1Aα, TaPDIL1Aβ, TaPDIL1Aγ, TaPDIL1Aδ, and TaPDIL1B), group II (TaPDIL2), group III (TaPDIL3A), group IV (TaPDIL4D), and group V (TaPDIL5A), were cloned. The expression levels of recombinant TaPDIL1Aα, TaPDIL1B, TaPDIL2, TaPDIL3A, TaPDIL4D, and TaPDIL5A in Escherichia coli were established from the cloned cDNAs. All recombinant proteins were expressed in soluble forms and purified. Aside from TaPDIL3A, the recombinant proteins exhibited oxidative refolding activity on reduced and denatured ribonuclease A. Five groups of PDI family proteins were distributed throughout wheat caryopses, and expression levels of these proteins were higher during grain filling than in the late stage of maturing. Localization of these proteins in the ER was confirmed by fluorescent immunostaining of the immature caryopses. In mature grains, the five groups of PDI family proteins remained in the aleurone cells and the protein matrix of the starchy endosperm. [Conclusions]High expression of PDI family proteins during grain filling in the starchy endosperm suggest that these proteins play an important role in forming intramolecular disulfide bonds in seed storage proteins. In addition, these PDI family proteins that remain in the aleurone layers of mature grains likely assist in folding newly synthesized hydrolytic enzymes during germination