心タンポナーデを来した前縦隔原発混合型胚細胞腫瘍の１剖検例

We report an unusual autopsy case of a 4-year-old girl with acute cardiac tamponade resulting from a primary anterior mediastinal mixed germ-cell tumor that penetrated the pericardial sac. The patient was admitted for the evaluation of symptoms of nocturnal fever, cough, facial edema, and superior vena cava syndrome.She was found to have a large anterior mediastinal mass 10 cm in diameter on chest radiographs. Serological examination showed highly elevated serum alpfa-fetoprotein with normal human chorionic gonadotropin. Immediately following admission she was treated with combination chemotherapy in addition to irradiation,but she developed sudden dyspnea and died 4 days later.At autopsy,histology of the large mass occupying the anterior mediastinum exhibited a combined germ-cell tumor of mature cystic teratoma and yolk-sac tumor with extensive hemorrhage and necrosis. Immunohistochemically,yolk-sac tumor elements were strongly positive for alpha-fetoprotein. Intrathoracic invasion and metastasis were observed in the pericardium, superior vena cava,and bilateral lungs.The sudden death was apparently due to acute cardiac tamponade following bleeding from the lesions of both pericardial invasion and heavy circulatory disturbance by yolk-sac tumor elements.Article信州医学雑誌 47(6): 505-511(1999)journal articl

DCD（発達性協調運動障害）ってなに？―不器用さのある子どもの理解と支援―

健康運動科学研究所　第11回シンポジウムZoomウェビナーでのオンライン開

Longitudinal Changes in Awareness of Pulmonary Rehabilitation and COPD among Participants in a Health Festival for Citizens

目的：本研究の目的は，2 年間の同一会場における肺年齢測定会参加者の呼吸リハビリテーションと慢性閉塞性肺疾患（Chronic Obstructive Pulmonary Disease，以下，COPD）の認知度について経年変化を調査し，肺年齢測定経験がそれらの認知度向上に寄与するか明らかにすることである．方法：2018年 5月 9 日，2019年 5 月 9 日に東京都港区の桜田公園，2018年 6 月 9 日・10日，2019年 6 月 8 日・ 9日に東京都の東久留米市環境フェスティバルの 2 か所で肺年齢測定会ブースを設け，アンケートの趣旨を説明して同意を得られた551名（2018年：280名，2019年：271名）を対象に肺年齢測定，参加者の呼吸リハビリテーションとCOPDの認知度，肺年齢測定経験の有無を調査した．調査結果は調査年度別の比較とそれぞれの認知度，肺年齢測定経験の有無で群間比較を行った．結果：2018年における認知度は呼吸リハビリテーション9.3％，COPD37.1％，2019年における認知度はそれぞれ14.8％，47.2％であり，いずれの認知度も2019年で有意に高かった．また肺年齢測定経験者は，測定経験なしの者より呼吸リハビリテーション，COPDを認知している率が有意に高かった．結論：肺年齢測定経験は，呼吸リハビリテーションの認知度とCOPDの認知度を高める有効な手段である．Objective: The aim of this study was to investigate changes over time in the awareness of pulmonary rehabilitation and chronic obstructive pulmonary disease （COPD） among participants in lung age measurement sessions at the same venue over a 2-year period and to clarify whether the experience of lung age measurement contributes to increased awareness.Methods: Lung age measurement booths were set up in Sakurada Park, Minato Ward, Tokyo, on May 9, 2018 and May 9, 2019, and at the Higashikurume City Environmental Festival, Tokyo, on June 9 and 10, 2018 and June 8 and 9, 2019. In total, 551 participants （2018: 280 participants, 2019: 271 participants）agreed to participate once the purpose of the questionnaire had been explained. Participants were surveyed regarding whether they had ever received lung age measurement, and their awareness regarding pulmonary rehabilitation and COPD was measured.Results: In 2018, awareness about pulmonary rehabilitation and COPD was 9.3％ and 37.1％, respectively. In 2019, these rates were 14.8％ and 47.2％, respectively, that is, both levels were significantly higher in 2019. Significantly more participants had undergone lung age measurement than were aware of pulmonary rehabilitation and COPD and had not received lung age measurement.Conclusion: The experience of lung age measurement is a useful means of increasing awareness about pulmonary rehabilitation and COPD

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The purpose of this study was to establish a rational system for the treatment and prevention of periodontal disease in mentally deficient adults. The subjects were 45 patients institutionalized for mental deficiency, aged 17 to 52, IQ 72 to under 14. They received oral hygiene instruction as the basis for periodontal covering 3 years. At the beginning, we educated all instructors of the institution on the importance of plaque control, brushing technique, together with the method of staining plaque and recording plaque charts. The instructors taught the mentally deficient adults the brushing method in the form of daily compulsory trainings for a trainings period of one year. For the subsequent 2 years, they changed the instructive system from compulsory trainings to free trainings after lunch. The plaque accumlation rate (PI. R), gingival index (G.I) and pathological pocket rate (Po. R) were evaluated on every tooth except 3rd molar and crowned tooth every 6 months for 3 years. The subjects were divided into A, B group by the PI. R at the first 6 months examination, i. e. A group was over PI. R 26%, B group was under PL R 25%. Scaling and root planing were done in B group for 6-12 months and 30-36 months, and A group for 30-36 months only. The results were as follows ; 1) PI. R was significantly improved during the first 6 months (51.9 to 31.6%). However, immediately after the instructive system was changed, PI. R became sligtly worse, but improved again for 18-36 months by re-instruction. 2) G. I was significantly improved during the first 6 months (1.37 to 0.79). In the B group which was treated by scaling for 6-12 months, G. I was remarkably improved again at 12 months, but in the A group, by oral hygiene instruction only, G. I was gradually improved. 3) Po. R was significantly improved during the first one year (32.1 to 12.4), and after the instruction system was changed, it became sligtly worse, but improved by scaling between 30-36 months. 4) The number of subjects, who required accistance from instruction in brushing, decreased from 10 to 6 after one year, on the other hand those who needed no assistance increased from 10 to 20. The results of this study shows that oral hygiene instruction and scaling are very important for mentally deficient adults. It was shown that for plaque control daily instruction is important and the brushing method traning should be compulsory and repeated without fail