Milrinone-induced postconditioning reduces hepatic ischemia-reperfusion injury in rats: the roles of phosphatidylinositol 3-kinase and nitric oxide

Background Ischemic postconditioning (PostC) protects the liver against ischemia-reperfusion (IR) injury. Milrinone, a phosphodiesterase 3 inhibitor, has been reported to exhibit preconditioning properties against hepatic IR injury; however, its PostC properties remain unknown. This study investigated whether milrinone has PostC properties against hepatic IR injury and the roles of phosphatidylinositol 3-kinase (PI3K) and nitric oxide synthase (NOS). Materials and methods Male Wistar rats were separated into six groups: (1) group S: animals that underwent sham operation without ischemia, (2) group C: ischemia followed by reperfusion with no other intervention, (3) group M: milrinone administered immediately after reperfusion, (4) group MW: wortmannin, a PI3K inhibitor, injected before milrinone administration, (5) group MN: l-NAME, a NOS inhibitor, injected before milrinone administration, and (6) group MD, milrinone administered 30 min after reperfusion. Except for group S, all groups underwent 1 h of warm ischemia of median and left lateral lobes, followed by 5 h of reperfusion. Biochemical liver function analysis and histologic examination were performed. Results Serum aspartate aminotransferase, alanine aminotransferase, and lactic dehydrogenase levels, histologic damage scores, and apoptotic rate in group M were significantly lower than those in group C. The inhibition of PI3K or NOS prevented this protective effect. Milrinone administered 30 min after reperfusion did not show obvious protective effects. Conclusions Milrinone-induced PostC protects against hepatic IR injury when it is administered immediately after reperfusion, and PI3K and NOS may play an important role in this protective effect

ザイタク コウレイシャ ノ ショウジョウ ニ タイスル オモイ : ショウジョウ オ ウッタエ ツヅケテイタ 1 ジレイ ノ ケントウ

　本研究の目的は、在宅高齢者の1 事例がもった症状に対する思いから、症状を訴え続けた意味を明らかにし、看護的示唆を得ることである。協力者は80 歳代の女性で、うつ病や認知症の既往はなかった。データ収集は非構造化面接法で、データ分析は質的記述的方法を用いて行った。この結果、本事例の症状に対する思いから、《自分のことがわかってもらえないいらだち》《自分のことがわかってもらえる安心感》《症状が改善しづらい》《人に頼らず生活したい》《症状が悪化し、人に迷惑をかけるのではないかという恐怖》《老人同士のつながりがある安心感》の6 つのテーマ群が抽出された。このことから本事例にとっての症状は、人に頼らず生活できるかどうかの指標となることを意味していた。また、本事例が症状を訴え続けた意味は、わかってもらえる安心感を持つこと、そして症状が増悪し人に迷惑をかけることを予防しようとする対処行動であることが示唆された。よって、看護師は高齢者が訴える症状の意味を理解し、高齢者の希望がかなえられるように援助する必要がある。　The objective of this study is to describe the thoughts an at-home elderly felt about her symptoms qualitatively, and obtain suggestions to help in nursing. The person under study is a woman in her 80’s. Data were collected through an unstructured interview and the data were analyzed by a qualitative descriptive method. As a result, six theme categories concerning how the person under study felt about her symptoms were obtained:“frustration that no one can understand her feeling,” “a sense of ease which comes from the thought that someone can understand her feeling,”“ the fact that the symptoms have not been easily alleviated,”“ the desire to live independently,”“ fear about the thought that her condition will worsen and trouble others,” and“ a sense of ease feeling she has a good relationship with other elderly people.” Thus, the symptoms in this study work as an indicator that shows whether or not the patient can live independently. Also, it was suggested that the behavior of the patient’s complaining about her symptoms can be a coping behavior in order to gain a sense of ease by having someone know how she feels and to prevent her from troubling others when her symptoms worsen

住民主体による地区活動発展のための課題

本研究は、A町B地区における住民主体による地区活動発展のための今後の課題を明らかにすることを目的とした。B地区福祉ネットワークメンバーを対象とし、地区活動の現状、今後の課題、関係機関の役割について、グループインタビューを行った。その結果、 自主的な活動継続のために、 自主財源確保、組織の柔軟な対応が必要、協力員確保のために、勧誘方法、活動内容・役割の検討が必要、利用者増加のために、楽しい会の実施、正確な情報提供、継続的な勧誘が必要、活動のマンネリ化解消・体制検討のために、利用者ヘアンケート調査が必要、協力員・ボランティアの心構えとして、リーダーシップ訓練等の研修が必要であることが課題として明らかになった

Establishment and Clinical Applications of a Portable System for Capturing Influenza Viruses Released through Coughing

Coughing plays an important role in influenza transmission; however, there is insufficient information regarding the viral load in cough because of the lack of convenient and reliable collection methods. We developed a portable airborne particlecollection system to measure the viral load; it is equipped with an air sampler to draw air and pass it through a gelatin membrane filter connected to a cone-shaped, megaphone-like device to guide the cough airflow to the membrane. The membrane was dissolved in a medium, and the viral load was measured using quantitative real-time reverse transcriptasepolymerase chain reaction and a plaque assay. The approximate viral recovery rate of this system was 10% in simulation experiments to collect and quantify the viral particles aerosolized by a nebulizer. Using this system, cough samples were collected from 56 influenza A patients. The total viral detection rate was 41% (23/56), and the viral loads varied significantly (from <10, less than the detection limit, to 2240 viral gene copies/cough). Viable viruses were detected from 3 samples with ?18 plaque forming units per cough sample. The virus detection rates were similar among different groups of patients infected with different viral subtypes and during different influenza seasons. Among patients who did not receive antiviral treatment, viruses were detected in one of six cases in the vaccinated group and four of six cases in the unvaccinated group. We found cases with high viral titers in throat swabs or oral secretions but very low or undetectable in coughs and vice versa suggesting other possible anatomical sites where the viruses might be mixed into the cough. Our system is easy to operate, appropriate for bedside use, and is useful for comparing the viral load in cough samples from influenza patients under various conditions and settings. However, further large-scale studies are warranted to validate our results

カンゴ ガクセイ ガ キジュツ シタ コウレイシャ トノ エピソード ノ トクチョウ : バメン セッテイ ト チュウシン テーマ ノ シテン カラ

　本研究の目的は、看護学生が記述した高齢者とのエピソードを「場面設定」と「中心テーマ」の視点から特徴を明らかにし、老年看護学教育の基礎資料とすることを目的とする。研究協力者は４年生大学看護学科２年生175 名であった。データ収集は“最も良く覚えている高齢者との体験を100 字程度”の自由記述で実施した。データ分析は、記述された文章の「場面設定」と「中心テーマ」を明らかにし、研究者間で内容を検討した。　記述されたエピソードは「９場面」で＜生き生きとした高齢者とのふれあい＞＜現在の日常の出来事＞＜高齢者との別れ＞＜納得のいかない出来事＞＜子どもの頃の思い出＞＜仕事や学習の場での出会い＞＜知らない人との出会い＞＜病気の高齢者とのかかわり＞＜ボランティアでのふれあい＞が場面設定として抽出され、この中で２－９の「中心テーマ」が抽出された。　看護者が持つ対象者のイメージは、看護に対する姿勢を形成する基となる。そのイメージ形成は、関心の強いエピソードから印象づけられることも多い。対象者のイメージが看護活動に影響する事を考えると、学生との間で印象づけられたエピソードや高齢者の言動の意味を討議し、高齢者を看る視点が養われるよう教育的にかかわる必要性が示唆された。　The objective of this study is to gain a new insight into characteristics of episodes which nursing students described in terms of“ the scene setting” and“ the main theme”， in hopes of using the findings as a basic resource for geriatric nursing education. The participants in the study were 175 second year students in the nursing department of a four-year college. Data were collected and analyzed by asking the participants to write about “the most memorable experience they had with elderly people in about 100 Japanese characters”. Data analysis clarified the terms "the scene setting" and "the main theme" in the description， and the contents were examined among the researchers.Regarding the scene setting， the following nine scenes were yielded: “relationship with lively elderly people”，“present daily events”， “separation from an elderly person”， “childhood memory”， “meeting through work or study opportunities”， “meeting with strangers”， “involvement with sick elderly people”， and “meeting through volunteer activities” . Among these two to nine“ main themes” were extracted.An impression is formed from the episode， and from there the participants form images about nursing. Assuming that the participants\u27 image about nursing may affect care， it can be suggested that teachers need to show direction and have students discuss the meaning of elderly people\u27s traits in order to provide students with opportunities where they can cultivate the ability to see elderly people from various points of view