子どもを持ち仕事を続ける夫婦が執る育児・家事行動に関する研究(その1)

With recent increase in the employment rate of women, the numbers of women working after marriage and having babies are increasing. For management of their work and family life, the husband\u27s cooperation is indispensable. Studies on fathers have been recently increasing, but they are still are insufficient compared to those on mothers. In this study, we investigated the involvement of couples and their task share in childcare and housework using questionnaires of 135 couples whose children were cared for in 3 nurseries in Toyama Prefecture, and analyzed differences in recognition between fathers and mothers. Of the women in their 30s who cared for their children, the traditional concept of GENDER (husband dominance, man- dominance, work for men and housework for women) was considered to be wrong m 31.9% partially right in 59.3% largely right in 7.4%, and right in 1.5%. Their working types were part-time jobs (26.2%), self-employment (11.1%), and full-time jobs (62.2%). After day nurseries, some women asked their mother-in-law or own mother to care for their children, and a small number of mother utilized prolonged care in the nurseries. Husbands were found to be more involved in playing and chatting with children, cuddling, sending the children to the nurseries and collecting, and shopping than in order childcare and household work, but none of them reached the levels that their wives expected.近年, 女性の就業承が高まり, 結婚・出産後も継続して働く,人,が増えている.そのような中で女性が仕事と家庭をうまく両立させていくためには, 夫の協力が不可欠である.最近, 父親研究が脚光を浴びはじめたものの, 母親研究ほど十分には行なわれていない.本研究は, 富山県内3ヶ所の保育施設に子どもを預けている135組の夫婦の日常から両者の育児・家事への関わりと分担の実像を探り, それに対する両者間の認識について調査し, 分析したものである.その結果, 現在子育て中の30代の女性は, 『ジェンダー』(伝統的性別認識による夫中心, 男性上位, 男は仕事・女は家庭)に対する考え方について, 「全然思わない」と答えた人が31.9%, 「いくらかそう思う」人が59.3%, 「かなりそうだと思う」人が7.4%, 「全くそうだと思う」1.5%であった.母親の就業形態は, パート勤務が26.2%, 自営業が11.1%, フルタイム勤務の人が62.2%あり, この人たちは, 保育所終了後は夫の母や実家の母に子どもを見てもらっており, 少数だが延長保育を利用している人もあった.夫の育児・家事に関わる行動では, 子どもの遊びの相手や話し相手, 抱っこ, 保育園の送り迎えと買い物に比較的多く関わりが見られたものの, 妻の期待するレベルまでにはどの項目も到達していない状況にあることが分かった

Supportive pericardial suspension for surgical airway management of tracheobronchomalacia in unilateral pulmonary agenesis

Unilateral pulmonary agenesis, a rare developmental defect of the lung, is often accompanied by tracheobronchial stenosis or malacia due to displacement, distortion, and compression of the surrounding great vessels. We present two cases of unilateral pulmonary agenesis complicated by tracheobronchial problems that were successfully managed surgically with supportive pericardial suspension.Keywords: pericardial suspension, tracheobronchomalacia, unilateral pulmonary agenesi

A novel rat model of abdominal aortic aneurysm using a combination of intraluminal elastase infusion and extraluminal calcium chloride exposure

ObjectiveAn ideal animal model of abdominal aortic aneurysm (AAA) is of great importance for clarifying unknown complex mechanisms of the pathogenesis. We introduce a new, simple technique to create reliable AAAs that simulate human aneurysms.MethodsExperimental models of AAAs were created in 71 rats by means of a 20-minute application of intraluminal elastase (30 U) and extraluminal calcium chloride (0.5M) in the 1-cm segment of infrarenal abdominal aorta (group EC, n = 26). A single application of elastase (group E, n = 24) or calcium chloride (group C, n = 21) was used as control. The treated aorta in each group was measured under physiologic conditions and harvested at 1 and 4 weeks. Successful AAA formation was defined as a dilation ratio >50%. Inflammatory response, elastolytic activity, and histology in the treated aorta were evaluated among the three groups.ResultsThe surgical procedure in each group was similarly completed for approximate 30 minutes and performed without any technical failure or operative death. At 4 weeks, the dilation ratio and wall thickness were 94.8% ± 9.9% and 125.4 ± 5.6 μm in group EC, 43.3% ± 6.3% and 149.6 ± 6.5 μm in group E, and 10.9% ± 4.2% and 152.9 ± 7.2 μm in group C. The success rate of AAA formation in group EC (92.7%) was significantly higher than that in group E (25.0%) and group C (0.0%). Less elastin content in the aortic wall was observed in group EC. At 1 week, tumor necrosis factor-α and interleukin-1β messenger RNA (mRNA) expressions were significantly upregulated, and CD3+ and CD11b+ cells were significantly infiltrated into the treated aorta of group EC, compared with groups E or C. Gelatinolytic activities and mRNA expressions of matrix metalloproteinase (MMP)-2 and MMP-9 were also significantly activated in group EC.ConclusionThe rat AAA model using a combination of intraluminal elastase infusion and extraluminal calcium chloride exposure is simple and easy to perform and is highly reliable and reproducible to create a saccular aneurysm similar to human AAAs. This model could be more useful to clarify AAA pathogenesis, mechanisms, and treatment interventions in experimental researches.Clinical RelevanceAbdominal aortic aneurysm (AAA) typically has a silent nature, and its rupture has high morbidity and mortality. There are currently no therapeutic approaches to prevent AAA, and complete mechanisms of AAA formation are still poorly understood. We developed a novel rat AAA model using a combination of intraluminal elastase infusion and extraluminal calcium chloride exposure. This model is simple and easy to perform and is highly reliable and reproducible to create a saccular aneurysm. It could become a powerful tool not only to elucidate etiopathogenetic mechanisms of AAA formation but also to explore new diagnostic and therapeutic possibilities

Autologous fibrin-coated small-caliber vascular prostheses improve antithrombogenicity by reducing immunologic response

ObjectiveWe have recently developed a thrombin-free fibrin-coated vascular prosthesis that has a high performance rate in producing graft antithrombogenicity. We hypothesized that autologous, compared with xenologous, fibrin coatings could improve the antithrombogenicity of grafts by reducing immunologic response.MethodsAutologous fibrin-coated vascular prostheses and/or xenologous fibrin-coated vascular prostheses (internal diameter, 2 mm; length, 2.5 cm) were implanted in the bilateral carotid arteries of 50 Japanese white rabbits. They were classified into 2 groups by the selection of grafts in the individual: group I (autologous fibrin-coated vascular prosthesis and xenologous fibrin-coated vascular prosthesis); and group II (group IIa: both autologous fibrin-coated vascular prostheses, or group IIx: both xenologous fibrin-coated vascular prostheses). During a maximum of 180 days after implantation, we evaluated the thrombotic, inflammatory, and immunologic responses associated with both types of graft.ResultsAll grafts were patent at each end point. In group I, both platelet deposition and anti-graft antibodies in autologous fibrin-coated vascular prostheses were significantly less than those in xenologous fibrin-coated vascular prostheses until postoperative day 30. At postoperative day 10, there were significantly fewer CD45-positive infiltrating cells in autologous fibrin-coated vascular prostheses, and intercellular adhesion molecule-1, vascular cell adhesion molecule-1, and nuclear factor-kappa B expression in autologous fibrin-coated vascular prostheses were less than those in xenologous fibrin-coated vascular prostheses. The neointimal hyperplasia in autologous fibrin-coated vascular prostheses was significantly decreased at postoperative day 180. In group II, serial changes of serum levels of immunoglobulin M, immunoglobulin G, interleukin-1β, and tissue-type plasminogen activator/plasminogen activator inhibitor-1 ratio in autologous fibrin-coated vascular prostheses were significantly less than those in xenologous fibrin-coated vascular prostheses. In both grafts, platelet deposition significantly correlated with serum immunoglobulin G level and tissue-type plasminogen activator/plasminogen activator inhibitor-1 ratio.ConclusionThese findings suggest that autologous fibrin coating in thrombin-free fibrin-coated vascular prostheses improve antithrombogenicity by reducing immunologic response and have a potential for clinical use in hybrid small-caliber vascular grafts

看護学生の実習前後におけるB型肝炎，水痘，風疹，麻疹抗体 価およびツベルクリン反応，MRSA鼻腔保菌の変化

Objectives: The first objective of this study was to examine the possible occupational risk of contracting hepatitis B virus (HBV), the varicella-zoster virus (VZV), rubella, measles, tuberculin skin test (TST) or methicillin-resistant Staphylococcus aureus (MRSA) among nursing students during clinical practice for patient\u27s care. The second objective was to investigate whether testing for the diseases increased student awareness of infection control.Methods: Sera from 56 nursing students before their clinical practice and post clinical practice were tested for the presence of HBV surface antigen(HBs), VZV, rubella and measles antibodies. The TST and the testing for the nasal carriage of MRSA were examined in 22 and 48 nursing students respectively. We also examined the effect of participation in immune status testing on the perception of nursing students for occupational infection control through the use of questionnaires.Results: After clinical practice, one student had a significant rise in the antibody titer to HBsAg. Except for HB, no significant difference was detected in the antibody titer to VZV, measles, rubella between sera from before and after the nursing practice of the nursing students. However, a (4.5%) rise from weak positive to strong positive in the in TST status was observed in one student. One student, who administered direct care to a MRSA carrier patient, contracted temporary nasal carriage of MRSA (2.2%).As for the nursing students\u27 perception, thirty-nine of fifty six students, or 69.6%, gave this affirmative answer to participation in this immune status testing for occupational infection control.本研究は，1年半にわたる看護実習における院内感染のリスクを査定し，看護教育において抗体価測定等の実施が感染予防の視点から看護学生に及ぼす効果を検討することを目的に行った.富山医科薬科大学（現富山大学）において，倫理審査委員会の承認を得，学生への説明と同意の下，56名の看護学生において実習開始前と1年半後の実習終了時にＢ型肝炎ウイルス抗体価，小児ウイルス感染症（水痘，風疹，麻疹）抗体価，ツベルクリン反応，ＭＲＳＡの鼻腔内保菌状態の変化，および意識調査を行った.その結果，実習前後で比較し，Ｂ型肝炎ウイルス抗体価において4倍以上の抗体価の上昇があった学生が1名（1.8%）みられた.ツベルクリン反応は実習前後での比較は22名に行い，実習前後で弱陽性から強陽性になった学生が1名（4.5%）いたが，発症はしていなかった.ＭＲＳＡの鼻腔内保菌状態については，48名に行い，黄色ブドウ球菌の保菌率には差がなかったが，ＭＲＳＡについては，実習後１名（2.1%）に一時的な保菌が認められた.意識調査においては，自由回答で56人中39人（69.6%）が「自分の抗体価を知ることができた」，「感染予防に対する意識が高まった」などの肯定的な回答を示した.以上から，実習中のＢ型肝炎ウイルス，結核菌，ＭＲＳＡに関しての暴露が示唆され，抗体価等の検査は学生の感染予防への意識を高める効果があった.実習時の感染については，教育機関として健診活動を強化し，学生への感染予防教育を推進する必要がある

Prognostic impact of clinical course-specific mRNA expression profiles in the serum of perioperative patients with esophageal cancer in the ICU: a case control study

<p>Abstract</p> <p>Background</p> <p>We previously reported that measuring circulating serum mRNAs using quantitative one-step real-time RT-PCR was clinically useful for detecting malignancies and determining prognosis. The aim of our study was to find crucial serum mRNA biomarkers in esophageal cancer that would provide prognostic information for post-esophagectomy patients in the critical care setting.</p> <p>Methods</p> <p>We measured serum mRNA levels of 11 inflammatory-related genes in 27 post-esophagectomy patients admitted to the intensive care unit (ICU). We tracked these levels chronologically, perioperatively and postoperatively, until the two-week mark, investigating their clinical and prognostic significance as compared with clinical parameters. Furthermore, we investigated whether gene expression can accurately predict clinical outcome and prognosis.</p> <p>Results</p> <p>Circulating mRNAs in postoperative esophagectomy patients had gene-specific expression profiles that varied with the clinical phase of their treatment. Multivariate regression analysis showed that upregulation of IL-6, VWF and TGF-β1 mRNA in the intraoperative phase (p = 0.016, 0.0021 and 0.009) and NAMPT and MUC1 mRNA on postoperative day 3 (p < 0.01) were independent factors of mortality in the first year of follow-up. Duration of ventilator dependence (DVD) and ICU stay were independent factors of poor prognosis (p < 0.05). Therapeutic use of Sivelestat (Elaspol^®, Ono Pharmaceutical Co., Ltd.) significantly correlated with MUC1 and NAMPT mRNA expression (p = 0.048 and 0.045). IL-6 mRNA correlated with hypercytokinemia and recovery from hypercytokinemia (sensitivity 80.9%) and was a significant biomarker in predicting the onset of severe inflammatory diseases.</p> <p>Conclusion</p> <p>Chronological tracking of postoperative mRNA levels of inflammatory-related genes in esophageal cancer patients may facilitate early institution of pharamacologic therapy, prediction of treatment response, and prognostication during ICU management in the perioperative period.</p