Prompt improvement of a pressure ulcer by the administration of high viscosity semi-solid nutrition via a nasogastric tube in a man with tuberculosis: a case report

INTRODUCTION: Semi-solid nutrition with high viscosity has the advantage of reducing gastroesophageal reflux and diarrhea and shortens the duration of administration compared with liquid nutrition. This is the first report describing the administration of semi-solid nutrition with high viscosity via a nasogastric tube, which achieved a remarkable improvement in the patient's nutritional state. CASE PRESENTATION: A 67-year-old man (mongoloid race, Japanese) with tuberculosis, a pressure ulcer and malnutrition was admitted to our hospital. He also had right hemiplegia, dysphagia and aphasia as sequelae of a cerebral hemorrhage. Before his admission, he had been treated at another hospital with 600 kcal/day of liquid nutrition via a nasogastric tube, which was insufficient and induced severe malnutrition. After he was admitted to our hospital, we increased the quantity of his liquid nutrition without success because of complications, specifically diarrhea and gastroesophageal reflux. As it was difficult to confirm whether or not he would accept gastrostomy feeding, we administered semi-solid nutrition with high viscosity (20,000 mPa x s) via a large-bore nasogastric tube (18 French). Soon after he was started on semi-solid nutrition, his pressure ulcer and malnutrition improved without diarrhea or complications accompanying the large-bore nasogastric tube. CONCLUSION: When patients have problems with liquid nutrition, such as diarrhea or gastroesophageal reflux, semi-solid nutrition via a nasogastric tube is a useful method of achieving improvements in nutritional state in a short period of time

Evidence for the Involvement of a Src-Related Tyrosine Kinase inXenopusEgg Activation

AbstractRecently, we have purified a Src-related tyrosine kinase, namedXenopustyrosine kinase (Xyk), from oocytes ofXenopus laevisand found that the enzyme is activated within 1 min following fertilization [Satoet al.(1996)J. Biol. Chem.271, 13250–13257]. A concomitant translocation of a part of the activated enzyme from the membrane fraction to the cytosolic fraction was also observed. In the present study, we show that parthenogenetic egg activation by a synthetic RGDS peptide [Y. Iwao and T. Fujimura, T. (1996)Dev. Biol.177, 558–567], an integrin-interacting peptide, but not by electrical shock or the calcium ionophore A23187 causes the kinase activation, tyrosine phosphorylation, and translocation of Xyk. A synthetic tyrosine kinase-specific inhibitor peptide was employed to analyze the importance of the Xyk activity in egg activation. We found that the peptide inhibits the kinase activity of purified Xyk at IC50of 8 μM. Further, egg activation induced by sperm or RGDS peptide but not by A23187 was inhibited by microinjection of the peptide. In the peptide-microinjected eggs, penetration of the sperm nucleus into the egg cytoplasm and meiotic resumption in the egg were blocked. Indirect immunofluorescence study demonstrates that Xyk is exclusively localized to the cortex ofXenopuseggs, indicating that Xyk can function in close proximity to the sperm–egg or RGDS peptide–egg interaction site. Taken together, these data suggest that the tyrosine kinase Xyk plays an important role in the early events ofXenopusegg activation in a manner independent or upstream of calcium signaling

1-year tolvaptan efficacy in ADPKD

Autosomal dominant polycystic kidney disease (ADPKD) develops into end-stage kidney disease by 65 years of age in an estimated 45%-70% of patients. Recent trials revealed that tolvaptan inhibits disease progression both in early-stage or late-stage ADPKD ; however, stratified analysis showed a difference of favorable factors correlated with tolvaptan efficacy between early-stage and late-stage ADPKD. Thus, we examined the efficacy of tolvaptan in ADPKD with a wide range of estimated glomerular filtration rates (eGFR). We enrolled 24 patients with eGFR 35.3 (28.0-65.5) ml / min / 1.73m2 and evaluated treatment effect as ΔΔeGFR (ml / min / 1.73m2 / year) or ΔΔtotal kidney volume (TKV) (% / year) that was calculated as post-treatment annual change - pre-treatment annual change. Pre ΔeGFR was significantly low in eGFR responders, defined as ΔΔeGFR > 0 ml / min / 1.73m2 / year. In eGFR responders, pre ΔeGFR, post ΔeGFR, eGFR, TKV, and proteinuria were significantly correlated with ΔΔeGFR. In TKV responders defined as ΔΔTKV > 5 % / year, we identified hypertension history, proteinuria, TKV, and post ΔTKV as significantly correlated factors with ΔΔTKV. In conclusion, pre ΔeGFR may be a predictive factor of therapeutic efficacy on kidney function. Tolvaptan may have greater efficacy in early-stage ADPKD with rapid GFR decline or with well-controlled blood pressure

中学校技術・家庭科（家庭分野）における体験的な学習活動の効果 : 幼児との関わり方を考え工夫する授業を目指して

As families grow more diverse in form and have fewer children, home life has changed. Now there are very few opportunities for junior high school students to interact with preschool-age children. Home economics classes could include opportunities to interact directly with those children. The aim in providing such experience would be to help junior high schoolers understand persons of a different generation than themselves, and develop compassion and kindness. Anticipating situations in which it would be difficult to provide childcare experiential activities in the school environment, this research consisted of classes that included hands-on activities like role-playing instead. The benefits were then verified. To better understand the junior high schoolers, they were administered a questionnaire before the classes began. They were asked about their experience and interest in interacting with infants and small children. Then a one-hour class was given to four different classes of second-year junior high schoolers. Changes in the students following the class were analyzed in comparison with earlier answers. The results indicate that after the class, students were more interested in small children and had a better understanding of them. Additionally, role-playing gave students new awareness and made them think effectively about relevant matters during interactions with small children

D-braneworld cosmology

We discuss D-braneworld cosmology, that is, the brane is described by the Born-Infeld action. Compared with the usual Randall-Sundrum braneworld cosmology where the brane action is the Nambu-Goto one, we can see some drastic changes at the very early universe: (i)universe may experience the rapid accelerating phase (ii)the closed universe may avoid the initial singularity. We also briefly address the dynamics of the cosmology in the open string metric, which might be favorer than the induced metric from the view point of the D-brane.Comment: 6 pages, 3 figures, minor corrections, accepted for publication in Phys. Rev.

Resting energy expenditure depends on energy intake during weight loss in people with obesity: a retrospective cohort study

Abstract Objective: Resting energy expenditure (REE) decreases if there is reduced energy intake and body weight (BW). The decrease in REE could make it difficult for patients with obesity to maintain decreased BW. This study aimed to investigate the correlation among changes in REE, energy intake, and BW during the weight loss process in patients with obesity. Materials and methods: We conducted a retrospective cohort study of patients hospitalized for the treatment of obesity in Japan. Patients received fully controlled diet during hospitalization and performed exercises if able. REE was measured once a week using a hand-held indirect calorimetry. Energy intake was determined by actual dietary intake. Results: Of 44 inpatients with obesity, 17 were included in the analysis. Their BW decreased significantly after 1 week (−4.7 ± 2.0 kg, P < 0.001) and 2 weeks (−5.7 ± 2.2 kg, P < 0.001). The change in REE after 1 and 2 weeks was positively correlated with the energy intake/energy expenditure ratio (r = 0.66, P = 0.004 at 1 week, r = 0.71, P = 0.002 at 2 weeks). Using a regression equation (y = 0.5257x – 43.579), if the energy intake/energy expenditure ratio within the second week was 82.9%, the REE after 2 weeks was similar to the baseline level. There was no significant correlation between the change in REE and BW. Conclusions: Our data suggest that changes in REE depend on energy intake/energy expenditure ratio and that the decrease in REE can be minimized by matching energy intake to energy expenditure, even during the weight loss process

コウトウ キョウイク カイカク ノ ソウゴ コウイ ブンセキ : ビデオ エスノグラフィー ケンキュウ ノ ネライ ト コウガクブ トシ コウガク エンシュウ ノ ジッサイ

ビデオエスノグラフィーは、当事者的知識を十分に摂取しながら行うビデオ分析であり、我々は この方法で、高等教育改革の現場を研究した。生涯学習社会の到来を受けて、日本の高等教育は現在第 2 次世界大戦直後以来の改革期にある。すなわち、「知識」より「生涯学習能力」の獲得を志向した、 自発性を尊重するような様々な取り組みがなされ始めている。この高等教育の現場に対し、ワークプレ ース研究を行った。Ｂ大学工学部都市工学演習α班を分析対象とした調査の結果、①演習の課題解釈に は「従来の指標の相対化の要求の程度」を巡って２つの解釈があり得たこと、②班内にはその２種類の 解釈に対応した葛藤・対立的相互行為が存在したこと、③にもかかわらず、班内葛藤を生きる当事者が ともに専門性（「都市工学」）を志向していたこと、④したがって、課題理解のいかんにかかわらず、 班活動の全体が「都市工学演習」と呼び得るものになっていたこと、⑤その一方で、最終審査会場（ジ ュリー）ではこの２重性が十分レリバントなものとして浮かび上がって来ていなかったこと、これらの ことがわかった。諸結果を総合すると、学生の自主的活動を尊重するタイプの、新しい学習方法の吟味・ 評価のためには、学生によるその方法の実践状況の分析が有意義であるだろうこと、また、それは、場 合によっては教員の評価のパラダイムを変える力を持つだろうことなどが予測された。なお、本報告は、 文科省科学研究費補助金「高等教育改革のコミュニケーション分析－現場における文化変容の質的検討 －」（基盤研究（Ｂ）、 課題番号 １８３３０１０５、研究代表者：樫田美雄）ほかによる研究成果 の一部である

タショクシュ レンケイ ハイブリッドシミュレーター オ カツヨウシタ シミュレーション エンシュウ ノ ジッシ ト ヒョウカ : ウィズコロナ ジダイ ノ キョウイク ジッセン ニ ムケタ トリクミ

COVID-19の感染拡大により，臨地実習先である附属病院からの受け入れ人数制限の要請があり，2022年度の基礎看護学実習Ⅱは時間を区切って臨地で実習する学生と学内学習をする学生を交互に配置することとなった．臨地での実習時間が限られている状況において，実習目標が達成できるよう本学に今年度から導入された多職種連携ハイブリッドシミュレーターを活用したシミュレーション演習を計画・実施した．本シミュレーション演習に参加することで，学生は呼吸器系疾患患者の観察，フィジカルアセスメントに関する自信を獲得し，高い学習満足度を得ることができたので実践報告する

Drug efficacy against aortic dissection

Objective: Aortic dissection is a life-threatening disease. At present, the only therapeutic strategies available are surgery and antihypertensive drugs. Moreover, the molecular mechanisms underlying the onset of aortic dissection are still unclear. We established a novel aortic dissection model in mice using pharmacologically induced endothelial dysfunction. We then used the Japanese Adverse Drug Event Report database to investigate the role of pitavastatin in preventing the onset of aortic dissection. Methods and results: To induce endothelial dysfunction, Nω-nitro-L-arginine methyl ester, a nitric oxide synthase inhibitor, was administered to C57BL/6 mice. Three weeks later, angiotensin II (Ang II) and β-aminopropionitrile (BAPN), a lysyl oxidase inhibitor, were administered with osmotic mini-pumps. False lumen formation was used as the pathological determinant of aortic dissection. The incidences of aortic dissection and death from aneurysmal rupture were significantly higher in the Nω-nitro-L-arginine methyl ester, Ang II, and BAPN (LAB) group than they were in the Ang II and BAPN (AB) group. Pitavastatin was administered orally to LAB mice. It significantly lowered the incidences of dissection and rupture. It also decreased inflammation and medial degradation, both of which were exacerbated in the LAB group. The Japanese Adverse Drug Event Report database analysis indicated that there were 113 cases of aortic dissection out of 95 090 patients (0.12%) not receiving statins but only six cases out of 16 668 patients receiving statins (0.04%) (odds ratio: 0.30; P=0.0043). Conclusion: Our results suggest that endothelial dysfunction is associated with the onset of aortic dissection and pitavastatin can help prevent this condition

Functional tooth number and mortality

Aim: Previous studies on the association between intraoral conditions and mortality in community-dwelling older individuals reported that fewer present teeth (PT) are significant risk factors for mortality. However, how the number of PT relative to the number of functional teeth (FT), including both present and rehabilitated teeth, influences mortality has not been investigated fully. This study examined the impact of the number of FT on mortality among community-dwelling Japanese older adults. Methods: This study was a retrospective, observational and population-based follow-up study, which examined 1188 older individuals who participated in an annual geriatric health examination from 2009 to 2015. The average follow-up period was 1697.0 ± 774.5 days. The primary outcome was all-cause mortality at follow-up. The numbers of PT and FT of each participant were counted during an oral examination. In addition, demographics, clinical variables, blood nutrient markers, physical functions and perceived masticatory function were measured. Results: Kaplan–Meier analysis, followed by a log-rank test, revealed that fewer PT (P < 0.001) and FT (P = 0.002) were significantly associated with a reduced survival rate. Cox's proportional hazard analysis indicated that the number of FT, but not the number of PT, was a significant independent mortality risk factor after adjusting for demographics, clinical variables, nutrient markers and physical functioning (P = 0.036, hazard ratio: 2.089). Conclusions: Current results suggest that the number of FT more strongly predicts all-cause mortality than the number of PT among community-dwelling older adults. Further studies are necessary to consider the confounding of socioeconomic status and disability status