コウナイホウ LeFort IIガタ コツキリジュツ ニヨリ チュウガンメン ノ カンオウ オ カイゼン サセタ コッカクセイ カガク ゼントツショウレイ

The patient was a 15-year 6-month female, and her chief complaint was severe nasomaxillary hypoplasia with anterior crossbite. After extraction of bilateral upper and lower third molars, the preoperative orthodontic treatment was initiated at 15-year and 7-month old. After 10-month orthodontic treatment, she received a surgery of intraoral LeFort II midfacial advancement using a piezoelectric braze. The naso-maxillary LeFort II segment was placed forward and downward by 8.0 mm using a Rigid External Distractor (RED) system, and internal rigid fixation was performed. For the mandible, the bilateral intraoral vertical ramus osteotomy was also performed, resulting in 6.0 mm mandibular setback. After 6-month of postoperative treatment, multi-bracket appliances were removed. At 7-month after surgery, the satisfactory facial profile and acceptable occlusion were obtained

Effect of CNT exposure on alveolar macrophages

Background Nanomaterials are widely used in various fields. Although the toxicity of carbon nanotubes (CNTs) in pulmonary tissues has been demonstrated, the toxicological effect of CNTs on the immune system in the lung remains unclear. Methods and finding In this study, exposure to Taquann-treated multi-walled CNTs (T-CNTs) was performed using aerosols generated in an inhalation chamber. At 12 months after T-CNT exposure, alveolar inflammation with macrophage accumulation and hypertrophy of the alveolar walls were observed. In addition, fibrotic lesions were enhanced by T-CNT exposure. The macrophages in the bronchoalveolar lavage fluid of T-CNT-exposed mice were not largely shifted to any particular population, and were a mixed phenotype with M1 and M2 polarization. Moreover, the alveolar macrophages of T-CNT-exposed mice produced matrix metalloprotinase-12. Conclusions These results suggest that T-CNT exposure promoted chronic inflammation and fibrotic lesion formation in profibrotic macrophages for prolonged periods

特別支援学校における医療的ケアに関する多職種間の連携・協働が困難となる要因と看護師の配慮・工夫 ―看護師のインタビューから連携・協働を考える―

　特別支援学校では，看護師と教員がお互いの専門性を理解し，連携・協働していくことが求められるが，医療現場とは異なる教育の場での活動に戸惑いを感じる看護師も多い．そこで，本研究は，1．連携・協働が困難となる要因，2．効果的な連携・協働のための看護師の配慮・工夫，以上の2点を明らかにすることを目的に実施した．調査はA市の特別支援学校に勤務する看護師5名に半構成的インタビューを行い，インタビュー内容の逐語録からコード，サブカテゴリー，カテゴリーを順に抽出し，分析を行なった．その結果，連携・協働が困難となる要因では，看護に必要な情報の不足や学校での看護の専門性や役割分担に関連する要因が抽出された．また，効果的な連携・協働のための看護師の工夫・配慮としては，情報収集や情報共有，専門職間のお互いの理解とお互いの役割・立場を尊重する関係性に関連する内容が抽出された．学校で似通った役割が求められる看護師と養護教諭においても，看護師がお互いの役割や専門性を理解し，尊重しながら対応することで，それぞれの専門性を発揮できる協働につながると示唆された

特別支援学校における医療的ケアに関する養護教諭と看護師との連携・協働が困難となる要因と養護教諭の配慮・工夫 ―養護教諭のインタビューから効果的な連携・協働を考える―

　特別支援学校への看護師の配置が制度化され10年以上が経過した．養護教諭は，これまで自分たちが担っていた役割の一部を看護師と共有することになり，役割分担や連携に戸惑いがあったことが推察される．そこで，1．看護師との連携・協働が困難に感じる要因，2．効果的な連携・協働のための養護教諭の配慮・工夫を明らかにすることを目的に，看護師と共に特別支援学校で働いた経験のある養護教諭にインタビューを実施した．インタビュー内容の逐語録から，コード，サブカテゴリー，カテゴリーを順に抽出し分析を行った．その結果，看護師との連携・協働が困難に感じる要因では，特別支援学校における看護師の役割に関する要因と情報共有に関する要因に分類された．また，効果的な連携・協働のための配慮・工夫では，情報共有とコミュニケーションの方法に関する配慮・工夫，特別支援学校での看護師の立場に関する配慮・工夫，看護師の専門性の発揮に関する配慮・工夫に分類された．養護教諭と看護師が効果的な連携・協働を行っていくためには，養護教諭が，学校関係者と看護師を繋ぐ役割を担い，看護師が特別支援学校での看護師の専門性を発揮できるよう環境を整えていくことが必要であることが示唆された

Association between low-dose pulsed intravenous cyclophosphamide therapy and amenorrhea in patients with systemic lupus erythematosus: A case-control study

<p>Abstract</p> <p>Background</p> <p>The risk for amenorrhea following treatment of systemic lupus erythematosus (SLE) patients with low-dose intravenous cyclophosphamide (IVCY) has not been fully explored. Our objective was to ascertain the incidence of amenorrhea following treatment with low-dose IVCY and the association between amenorrhea and the clinical parameters of SLE.</p> <p>Methods</p> <p>A case-control retrospective study of premenopausal women ≤ 45 years old who had been treated for SLE with low-dose IVCY (500 mg/body/pulse) plus high-dose glucocorticoids (0.8-1.0 mg/kg/day of prednisolone; IVCY group) or glucocorticoids alone (0.8-1.0 mg/kg/day of prednisolone; steroid group) in our hospital from 2000 through 2009 was conducted using a questionnaire survey and medical record review.</p> <p>Results</p> <p>Twenty-nine subjects in the IVCY group and 33 subjects in the steroid group returned the questionnaire. A multivariate analysis revealed that age at initiation of treatment ≥ 40 years old was significantly associated with amenorrhea [<it>p </it>= 0.009; odds ratio (OR) 10.2; 95% confidence interval (CI) 1.8-58.7]. IVCY treatment may display a trend for association with amenorrhea (<it>p </it>= 0.07; OR 2.9; 95% CI 0.9-9.4). Sustained amenorrhea developed in 4 subjects in the IVCY group and 1 subject in the steroid group; all of these patients were ≥ 40 years old. Menses resumed in all subjects < 40 years old, irrespective of treatment.</p> <p>Conclusions</p> <p>Although low-dose IVCY may increase the risk for amenorrhea, our data suggest that patients < 40 years old have a minimum risk for sustained amenorrhea with low-dose IVCY treatment. A higher risk for sustained amenorrhea following treatment with IVCY is a consideration for patients ≥ 40 years old.</p

Curated genome annotation of Oryza sativa ssp. japonica and comparative genome analysis with Arabidopsis thaliana

We present here the annotation of the complete genome of rice Oryza sativa L. ssp. japonica cultivar Nipponbare. All functional annotations for proteins and non-protein-coding RNA (npRNA) candidates were manually curated. Functions were identified or inferred in 19,969 (70%) of the proteins, and 131 possible npRNAs (including 58 antisense transcripts) were found. Almost 5000 annotated protein-coding genes were found to be disrupted in insertional mutant lines, which will accelerate future experimental validation of the annotations. The rice loci were determined by using cDNA sequences obtained from rice and other representative cereals. Our conservative estimate based on these loci and an extrapolation suggested that the gene number of rice is ~32,000, which is smaller than previous estimates. We conducted comparative analyses between rice and Arabidopsis thaliana and found that both genomes possessed several lineage-specific genes, which might account for the observed differences between these species, while they had similar sets of predicted functional domains among the protein sequences. A system to control translational efficiency seems to be conserved across large evolutionary distances. Moreover, the evolutionary process of protein-coding genes was examined. Our results suggest that natural selection may have played a role for duplicated genes in both species, so that duplication was suppressed or favored in a manner that depended on the function of a gene

大学を拠点とする多職種による子育て支援事業 “子育てコラボサロンどーなつ”の実践

　地域における子どもとその養育者の多様な悩みや問題に対応するために、看護学科と社会福祉学科の教員がそれぞれの専門性を活かして協働する子育て支援事業として、"子育てコラボサロンどーなつ″ を2018年度に開設した。 本稿は2019年度に実施した保育士・幼稚園等専門職を対象とする講座および子育て中の保護者を対象とする講座の活動内容、参加者およびボランティアとして参加した学生のアンケート結果をまとめて報告する。 講座の参加者はいずれの回も少人数であったものの、子どもと保護者が安心して参加し、講義や参加者同士の交流を通して子育てに前向きになれるような働きかけができた。 また、本事業のコンセプトである「多職種の専門性を活かした協働」と「大学を拠点とした活動」の強みを活かして「子育て支援のコミュニティ形成」に向けて一歩を踏み出すことができた

Diagnostic reliability of magnetic resonance imaging for central nervous system syndromes in systemic lupus erythematosus: a prospective cohort study

<p>Abstract</p> <p>Background</p> <p>Previous studies of magnetic resonance imaging (MRI) as a diagnostic tool for central nervous system (CNS) syndromes in systemic lupus erythematosus (SLE) contained several limitations such as study design, number of enrolled patients, and definition of CNS syndromes. We overcame these problems and statistically evaluated the diagnostic values of abnormal MRI signals and their chronological changes in CNS syndromes of SLE.</p> <p>Methods</p> <p>We prospectively studied 191 patients with SLE, comparing those with (n = 57) and without (n = 134) CNS syndrome. CNS syndromes were characterized using the American College of Rheumatology case definitions.</p> <p>Results</p> <p>Any abnormal MRI signals were more frequently observed in subjects in the CNS group (n = 25) than in the non-CNS group (n = 32) [relative risk (RR), 1.7; 95% confidence interval (CI), 1.1-2.7; <it>p </it>= 0.016] and the positive and negative predictive values for the diagnosis of CNS syndrome were 42% and 76%, respectively. Large abnormal MRI signals (ø ≥ 10 mm) were seen only in the CNS group (n = 7; RR, 3.7; CI, 2.9-4.7; <it>p </it>= 0.0002), whereas small abnormal MRI signals (ø < 10 mm) were seen in both groups with no statistical difference. Large signals always paralleled clinical outcome (<it>p </it>= 0.029), whereas small signals did not (<it>p </it>= 1.000).</p> <p>Conclusions</p> <p>Abnormal MRI signals, which showed statistical associations with CNS syndrome, had insufficient diagnostic values. A large MRI signal was, however, useful as a diagnostic and surrogate marker for CNS syndrome of SLE, although it was less common.</p

モンゴルザイライヤギ 3シュウダン ノ トウキタイジュウソンモウリツ ト カシミヤモウセイサンリョウ

モンゴル国における優良ヤギ品種の確立を目的としてカシミヤ毛生産関連遺伝子のクローニングを試みている。その研究対象のリソース・ファミリーとしてBayandelger(BD),Gobi Gurvan Saikhan(GGS)およびZalaajinst White(ZW)の3集団をモンゴル国内に維持している。今回,本ヤギ集団における体重の加齢および季節的変動,並びにカシミヤ毛生産量からそれらの品種特性を調査した結果,以下の成績が得られた。1. GGS, ZW, BD集団の同一個体の冬季間における体重の損耗率を比較した結果,4歳齢の春にはGGSとZW集団には有意差は認められなかったが,この2集団とBD集団間に有意差が認められた(p<0.05～0.01)。体重損耗率はBD集団で最も低く23.70%で,次いでGGS集団の24.90%であった。最も体重の重かったZW集団は冬季間の損耗が36.06%で3集団の中で最も大きかった。2. GGS, ZWおよびBDのカシミヤ毛生産量は,それぞれ333.11±8.32g, 268.07±12.30gおよび222.86±5.32gであった。カシミヤ毛の直径は16-19,15-16.5および12-15μmであることから,BD集団のカシミヤ毛が最も細く,毛色形質を考慮すると優良な品種と判断された。冬季間の体重損耗率が最も少ないのは,細い毛による体温保温効果と関係しているものと推察された。3. BD集団におけるカシミヤ毛の長さ(5.68±0.39cm),直径(16.53±0.10μm)および毛生産量(222.86±5.32g)のそれぞれの間における相関では,長さと生産量の間に強い相関(0.747)が認められた。To establish excellent goat breeds in Mongolia, we have performed the cloning of genes related to cashmere production. As a genetic pool for this purpose, we have maintained Bayandelger (BD), Gobi Gurvan Saikhan (GGS), and Zalaajinst White (ZW) in Mongolia. In this study, the breed traits of the 3 goat populations were evaluated based on age-related and seasonal changes in body weight and cashmere production, and the following results were obtained. 1. Weight loss during winter was compared among individuals in the GGS, ZW, and BD populations. No significant difference was noted between GGS and ZW, but a significant difference was observed between the two populations and BD (p<0.05-0.01) in spring at the age of 4 years. Weight loss was the lowest in BD (23.70%), followed by GGS (24.90%). The heaviest ZW showed the greatest weight loss during winter (36.06%) among the 3 populations. 2. The cashmere yields in GGS, ZW and BD were 333.11±8.32, 268.07±12.30, and 222.86±5.32g, respectively, and the cashmere diameters in these populations were 16-19, 15-16.5 and 12-15μm, respectively. Therefore, considering the hair color trait, BD, with the thinnest cashmere, may be an excellent breed. The lowest weight loss during winter seen in this population may be associated with the heat-retaining effects of the thin cashmere. 3. In BD, the correlation coefficients between cashmere length (5.68±0.39cm) and production (222.86±5.32g), and between cashmere diameter (16.53±0.10μm) and production were 0.747 and 0.137, respectively, showing a marked correlation between length and production

乳幼児期における子育ての現状と看護職に対しての支援ニーズ －大学周辺のコミュニティの調査－

　本研究の目的は，大学周辺のコミュニティにおいて，乳幼児をもつ養育者が認識する子育ての現状および看護職への支援ニーズを明らかにし，今後の子育て支援への示唆を得ることである．保育園および幼稚園に通園する乳幼児の主な養育者と，大学が開催している乳幼児対象の育児サークルの参加者を対象に自記式質問紙調査を実施した．その結果，主な養育者以外に子育てに関わる者がいると回答した人が95%，配偶者が主に関わっており，大半が夫婦で子育てをしている状況であった．養育者の7～ 8割は同年齢の友人から情緒的・情報的サポートを受けており，道具的サポートは家族内から5割程度しか受けていなかった．今後希望する子育て支援として「子どもの預かり」「子ども・養育者同士の交流」がみられ，「保育園・幼稚園」の場での支援を希望していた．看護職に希望する支援は「病児保育」「病気や怪我の時の対応や相談」「健康に関する育児相談・情報提供」であった．今後，看護職は子どもが活動する施設の関係職者と協働して子ども・養育者へのケアを実践することが望まれる