http://hdl.handle.net/10069/9255 2013-05-24T16:03:03Z 2013-05-24T16:03:03Z 川崎, 涼子 河村, 靖子 黒田, 裕美 森藤, 香奈子 http://hdl.handle.net/10069/31122 2013-03-27T14:14:39Z 2013-03-27T05:40:33Z

Title: 東日本大震災被災地　岩手県大槌町における保健師ボランティア活動報告 Authors: 川崎, 涼子; 河村, 靖子; 黒田, 裕美; 森藤, 香奈子 Issue Date: 2013-03 Citation: 保健学研究, 25(1), pp.53-58; 2013

2013-03-27T05:40:33Z 中尾, 優子 川崎, 涼子 楠葉, 洋子 野村, 亜由美 山口, 智美 http://hdl.handle.net/10069/31121 2013-03-27T14:14:38Z 2013-03-27T05:35:36Z

Title: 長崎大学大学院医歯薬学総合研究科保健学専攻看護学講座における助教キャリアアップ支援システムの構築と運用 Authors: 中尾, 優子; 川崎, 涼子; 楠葉, 洋子; 野村, 亜由美; 山口, 智美 Issue Date: 2013-03 Citation: 保健学研究, 25(1), pp.47-52; 2013

2013-03-27T05:35:36Z Ohnishi, Mayumi Nakao, Yuko Nishihara, Mika Leshabari, Sebalda http://hdl.handle.net/10069/31120 2013-03-27T14:14:37Z 2013-03-27T05:30:50Z

Title: Comparison of breast care for completion of exclusive breastfeeding between Tanzania and Japan Authors: Ohnishi, Mayumi; Nakao, Yuko; Nishihara, Mika; Leshabari, Sebalda Issue Date: 2013-03 Citation: 保健学研究, 25(1), pp.41-45; 2013

2013-03-27T05:30:50Z 今屋, 香澄 平山, 愛美 前田, 優美 本松, 邦恵 平野, 裕子 http://hdl.handle.net/10069/31119 2013-03-27T14:14:36Z 2013-03-27T05:26:24Z

Title: Ｔ団地在住の高齢者と地域住民によるインフォーマル・サービスに関する調査－「助っ人隊」の事例を中心に－ Authors: 今屋, 香澄; 平山, 愛美; 前田, 優美; 本松, 邦恵; 平野, 裕子 Issue Date: 2013-03 Citation: 保健学研究, 25(1), pp.29-40; 2013 Abstract: 目的：「助っ人隊」の認知・利用・今後の利用の現状と，それに関連する社会・経済的要因を明らかにする． 方法：T団地の60歳以上の住民271名を対象とした．調査項目は，基本属性，生活上の不安，ソーシャル・キャピタル，ソーシャル・サポートの有無，「助っ人隊」の認知・利用・今後の利用，モラール・スケール等である． 結果：「助っ人隊」の認知では同居家族がいる人，ソーシャル・サポートがある人，利用の有無では高齢，女性，無職である人で有意な差がみられた．ソーシャル・キャピタルは「助っ人隊」の認知，利用の有無，今後の利用の有無において関連がみられたが，モラール・スケール合計との間で有意差はなかった． 考察：「助っ人隊」はソーシャル・キャピタルが豊かな人ほど認知・利用されている反面，人間関係に不安がある人にも利用されている．このことから，「助っ人隊」はT団地のソーシャル・キャピタルの中で排除されかけている人達に働きかけることで，比較的中立なインフォーマル・サービスの役割を果たす機能があると考えられる．; Purpose: The purpose of this study was to identify the present conditions relevant to the current and future use of ‘SUKETTO-TAI; a voluntary informal service group in the T housing complex of Nagasaki City. Methods: A six-page questionnaire was developed and distributed to 271 residents older than 60 years of age living in the T housing complex. The questionnaire categories included basic demographics, life anxieties, social capital, social support, and a morale scale. The responses were analyzed to determine the level of recognition of ‘SUKETTO-TAI’ and to evaluate the current and potential future use of ‘SUKETTO-TAI’. Results: The finding of a statistical analysis suggested that respondents who lived with familiy members and reported having social support were likely to recognize ‘SUKETTO-TAI’. Those who were older, female, and who did not have any current jobs were likely to use ‘SUKETTO-TAI’. The data also suggested that respondents with high social capital, recognized, used and expected to use ‘SUKETTO-TAI’ in the future. However, the analysis of the morale scale scores did not find any correlations with the recognition, use or expected use of SUKETTO-TAI’. Discussion: ‘SUKETTO-TAI’ is used not only by people who are rich in social capital, but also by people who are anxious about human relationships in the community. It can be assumed that ‘SUKETTO-TAI’ plays a relatively neutral role in the T housing complex by providing informal services for people who are likely to be isolated.

2013-03-27T05:26:24Z 加藤, 克知 北川, 賀一 小山田, 常一 篠田, 謙一 西, 啓太 真鍋, 義孝 http://hdl.handle.net/10069/31118 2013-03-27T14:14:35Z 2013-03-27T05:19:36Z

Title: ぺルー･チャンカイ遺跡（プレ･インカ時代）から出土した人工変形頭蓋, とくに脳頭蓋の形態的特徴 Authors: 加藤, 克知; 北川, 賀一; 小山田, 常一; 篠田, 謙一; 西, 啓太; 真鍋, 義孝 Issue Date: 2013-03 Citation: 保健学研究, 25(1), pp.19-28; 2013 Abstract: ペルー･チャンカイ遺跡出土の人工変形頭蓋，とくに脳頭蓋の形態的特徴を計測学的に調査した．人工変形の頻度は男性52.7%，女性37.1%で，すべて前頭-後頭型の変形であった．これらの変形頭蓋では，幅径の増大と長径の短縮が顕著で，頭蓋長幅示数は男女とも超短頭型（男性94.7，女性97.6）を示した．一方，非変形頭蓋は男女とも短頭型（男性83.2，女性83.8）であった．とくに，変形頭蓋では前後方向への圧平に加え，頭頂部の上方および側方への膨隆と後頭部の平坦化が認められた．主成分分析の結果得られた第2主成分は，脳頭蓋幅径と長径間のプロポーションに関連する因子で，人工変形によって生じた変動を強く表していた．この主成分得点は，前頭-後頭型頭蓋変形の有無を判定する際の有効な指標になり得ることが示唆された．; Morphological features of cranial vaults with artificial deformations from the pre-Columbian Chancay site in Peru were examined by analyzing cranial measurements. The incidence of artificially deformed skulls was 52.7% in males and 37.1% in females. The deformations were all fronto-occipital. Deformation markedly increased the transversal diameter of the cranial vault and conversely decreased the antero-posterior diameter. The mean cranial index of the deformed group was ultra-brachycephalic (male 94.7; female 97.6), whereas the index of the undeformed group was brachycephalic (male 83.2; female 83.8). The artificially deformed vaults were characterized by parietal bulging and occipital flattening. The first two principal components extracted by principal component analysis accounted for approximately 65% of the total variance. The first component was the general size of the skull and was related to the sex of the individual, while the second factor was the proportional relationship between the breadth and length of the cranial vault. The latter represented the effects caused by artificial deformation. The results suggest that individual scores computed from the second component data are useful for discriminating artificially deformed skulls from undeformed skulls.

2013-03-27T05:19:36Z 北島, 栄二 http://hdl.handle.net/10069/31117 2013-03-27T14:14:33Z 2013-03-27T05:12:22Z

Title: 高齢者のための歩行補助具の現状とリスクマネジメント Authors: 北島, 栄二 Issue Date: 2013-03 Citation: 保健学研究, 25(1), pp.11-17; 2013 Abstract: 高齢者の安全な歩行を確保して日常生活の自立を促し，社会参加の可能性を高めることはリハビリテーションにおいて重要な課題である．そのために種々の歩行補助具が積極的に活用されている．しかし，歩行補助具に関連した事故も少なからず報告されており，また，不適切な使用方法や身体状況に合わない用具を使用している事例をしばしば見受ける． 本稿では，高齢者の歩行補助具の中で，歩行器，歩行車及びシルバーカーに焦点を当て，その利用の現状と使用時のリスクマネジメントについて概説した．

2013-03-27T05:12:22Z 山田, 彩季 江藤, 宏美 http://hdl.handle.net/10069/31116 2013-03-27T14:14:33Z 2013-03-27T05:09:04Z

Title: 骨盤位矯正における姿勢管理・鍼灸・外回転術の有効性 Authors: 山田, 彩季; 江藤, 宏美 Issue Date: 2013-03 Citation: 保健学研究, 25(1), pp.1-10; 2013 Abstract: 目的　EBMの手法を用いて，妊娠期の骨盤位矯正に関するガイドラインの推奨文を作成することである． 方法　システマティックレビュー．臨床上の疑問を，骨盤位を頭位にするためのケアとして，姿勢管理，鍼灸，骨盤外回転術（ECV）の有効性の 3 つを設定し，データベースからガイドラインおよびエビデンスレベルの高い研究を収集した． 結果　姿勢管理では 2 文献が得られ，その効果は明らかでなかった．鍼灸では 5 文献が得られ，有効・無効の両方の結果が示されていた．ECVでは11文献が得られ，有用性が明確であった．子宮収縮抑制剤，局所麻酔の併用により成功率が上昇していた． 結論　ECVの効果は明らかであり，他のケアについては更なる研究の蓄積が必要である．

2013-03-27T05:09:04Z Miyazaki, Takuro Yamasaki, Naoya Tsuchiya, Tomoshi Matsumoto, Keitaro Sengyoku, Hideyori Watanabe, Hironosuke Tomoshige, Koichi Nagayasu, Takeshi http://hdl.handle.net/10069/30921 2013-03-07T04:25:15Z 2013-03-04T07:40:38Z

Title: Video-Assisted Thoracoscopic Pericardial Window in the Treatment of Pericardial Effusion: Report of Two Cases Authors: Miyazaki, Takuro; Yamasaki, Naoya; Tsuchiya, Tomoshi; Matsumoto, Keitaro; Sengyoku, Hideyori; Watanabe, Hironosuke; Tomoshige, Koichi; Nagayasu, Takeshi Issue Date: 2013-02 Citation: Acta medica Nagasakiensia, 57(3), pp.105-107; 2013 Abstract: A 54-year-old man had a history of subxiphoid pericardial window due to suspected tuberculous effusions. Seventeen years later, following chronic heart failure and implantation of a pacemaker, he again developed pericardial and pleural effusion, requiring repeated percutaneous pericardiocentesis, pleurocentesis and chest tube drainage. A 5×5-cm section of pericardium was successfully resected with video-assisted thoracic pericardial window. No recurrence of pericardial effusion has since been encountered during 36 months follow-up. An 85-year-old woman had a history of percutaneous pericardiocentesis and pleurocentesis due to chronic pericarditis. The effusion of unknown origin was refractory to medication and additional pericardiocentesis and percutaneous pericardial and chest tube drainage. A 4×4-cm section of pericardium was also successfully resected. No recurrence of pericardial effusion has been seen during 8 months follow-up. Video-assisted thoracoscopic pericardial window is an effective procedure for treating intractable pericardial effusion.

2013-03-04T07:40:38Z Kawasaki, Naoto Yamada, Mai Mutsukura, Kazuo Satoh, Hideyo Satoh, Akira Tsujihata, Mitsuhiro http://hdl.handle.net/10069/30920 2013-03-04T14:14:55Z 2013-03-04T07:32:34Z

Title: Generalized Auditory Agnosia following a Subarachnoid Hemorrhage; A case report Authors: Kawasaki, Naoto; Yamada, Mai; Mutsukura, Kazuo; Satoh, Hideyo; Satoh, Akira; Tsujihata, Mitsuhiro Issue Date: 2013-02 Citation: Acta medica Nagasakiensia, 57(3), pp.99-103; 2013 Abstract: A 65-year-old male developed a subarachnoid hemorrhage(SAH) caused by a ruptured right internal carotid artery-posterior communicating artery aneurysm. Clipping of the aneurysm, removal of the hematoma, and external decompression were performed. Thereafter, he developed a bacterial meningitis after a spinal lumbar drainage that was done for the treatment of hydrocephalus. He was admitted to our hospital for rehabilitation 4 months after the onset of the SAH. He was still lethargic and delirious at the time of admission. He could not recognize spoken words, environmental sounds or music one month later, but was able to speak and understand the written words. He was diagnosed to have generalized auditory agnosia, based on almost normal pure tone audiometry, otoacoustic emission test, and ABR. Brain CT disclosed a right temporal and frontal lesions, but not in the left side. The eZIS and vbSEE analysis of the SPECT images disclosed a lesion in the left Heschl's transverse gyrus that could not be detected on CT. We emphasized that the detailed analysis of the SPECT images is useful to demonstrate the lesions that can not be detected by CT.

2013-03-04T07:32:34Z Nakamichi, Seiko Abe, Koh Tatsuta, Yoichi Yoda, Aya Kadota, Koichiro Inoue, Keita Takeshima, Fuminao Sakamoto, Noriho Ishimatsu, Yuji Kawakami, Atsushi Mukae, Hiroshi Kohno, Shigeru Ozono, Yoshiyuki http://hdl.handle.net/10069/30919 2013-03-04T14:14:54Z 2013-03-04T07:24:54Z

Title: Concurrent Sarcoidosis and Takayasu's Arteritis: Case Report and Review of the Literature Authors: Nakamichi, Seiko; Abe, Koh; Tatsuta, Yoichi; Yoda, Aya; Kadota, Koichiro; Inoue, Keita; Takeshima, Fuminao; Sakamoto, Noriho; Ishimatsu, Yuji; Kawakami, Atsushi; Mukae, Hiroshi; Kohno, Shigeru; Ozono, Yoshiyuki Issue Date: 2013-02 Citation: Acta medica Nagasakiensia, 57(3), pp.93-97; 2013 Abstract: A 26-year-old woman was admitted to our hospital with fever, dry cough and elevated serum CRP. Chest CT scans revealed mediastinal and bihilar lymphadenopathy, and sarcoidosis was clinically diagnosed based on additional findings. The walls of the aorta and other arteries were thickened and HLA typing was positive for HLA-B52, suggesting Takayasu's arteritis. Corticosteroid clearly improved the symptoms and the patient has remained free of recurrence since therapy was discontinued. We report the rare case of concurrent sarcoidosis and TA and review the literature.

2013-03-04T07:24:54Z Kato, Mikako Doi, Hirokazu Shinohara, Kazuyuki http://hdl.handle.net/10069/30918 2013-03-04T14:14:53Z 2013-03-04T07:16:26Z

Title: Effects of Nighttime Sleep Characteristics on Function of Attention Network in Young Children. Authors: Kato, Mikako; Doi, Hirokazu; Shinohara, Kazuyuki Issue Date: 2013-02 Citation: Acta medica Nagasakiensia, 57(3), pp.85-91; 2013 Abstract: It is well known that the characteristics of nighttime sleep is strongly linked to cognitive abilities in daytime. However, studies investigating the influence of poor-sleep characteristics on pre-adolescent children's cognitive abilities are relatively few. The present study aimed at investigating the influence of night-time sleep characteristics on pre-adolescent children's cognitive abilities by utilizing objective indicators. To achieve this goal, we analyzed the relation between attentional control ability measured by standardized behavioral task and nighttime sleep characteristics quantified by actigraph measurement. The results revealed a significant correlation between ability of executive attention and total sleep time, i.e. total length of uninterrupted sleep. To be more specific, focal attention of children with long total sleep time was more easily distracted by goal-irrelevant information than that of children with short total sleep time, which indicates that sub-component of attentional control subserved by prefrontal cortex is particularly susceptive to sleep characteristics. The implication of this findings are discussed in the context of previous studies on the relation between children's nighttime sleep characteristics and their cognitive functions.

2013-03-04T07:16:26Z Honda, Masaru Ando, Takeo http://hdl.handle.net/10069/30917 2013-03-04T14:14:52Z 2013-03-04T07:10:55Z

Title: Proximal Anterior Cerebral Artery Aneurysm: Case Presentation and Review of the Literature Authors: Honda, Masaru; Ando, Takeo Issue Date: 2013-02 Citation: Acta medica Nagasakiensia, 57(3), pp.79-83; 2013 Abstract: Purpose: Aneurysms involving the proximal segment of the anterior cerebral artery (A1) are relatively rare. We report two cases we encountered and review the literature. Cases: Two female patients were referred to our hospital. The first, a 71-year-old woman, was found unconscious and semicomatose at home. Computed tomography (CT) revealed diffuse subarachnoid hemorrhage (SAH) with intraventricular and intracerebral hemorrhage. Cerebral angiography (CAG) showed a saccular aneurysm in the right A1 and unruptured right middle cerebral artery aneurysm. The second patient was a 76-year-old woman in whom an unruptured right A1 aneurysm was found incidentally. During a 3-year observation period, the aneurysm enlarged and changed its shape. Both patients underwent surgical clipping. The first patient showed moderate disability due to SAH insult while the second showed no neurological deficits. Conclusions: A1 aneurysms are rare intracranial aneurysms, but reportedly show strong correlations with vascular anomalies. When planning surgery, use of CAG and other radiological modalities are warranted to precisely assess the origin of the aneurysm neck and any accompanying anomalies. Anatomical speculations must be confirmed intraoperatively while paying attention to perforating arteries from the A1 segment.

2013-03-04T07:10:55Z Nakajima, Hideki Tsujino, Akira Doi, Hirokazu Tateishi, Yohei Motomura, Masakatsu Shinohara, Kazuyuki Satoh, Akira Tsujihata, Mitsuhiro Kawakami, Atsushi http://hdl.handle.net/10069/30916 2013-03-04T14:14:50Z 2013-03-04T07:04:19Z

Title: An Impairment of Recognizing Emotional Facial Expressions in Parkinson's Disease Authors: Nakajima, Hideki; Tsujino, Akira; Doi, Hirokazu; Tateishi, Yohei; Motomura, Masakatsu; Shinohara, Kazuyuki; Satoh, Akira; Tsujihata, Mitsuhiro; Kawakami, Atsushi Issue Date: 2013-02 Citation: Acta medica Nagasakiensia, 57(3), pp.69-77; 2013 Abstract: Parkinson's disease (PD), one of the most common neurodegenerative disorders, is characterized by motor and non-motor symptoms. We evaluated the impairment in recognizing emotional facial expressions in PD patients using morphing techniques and investigated the related structures with brain perfusion on single photon emission CT (SPECT) using the threedimensional stereotactic surface projection (3D-SSP) technique. Finally, we demonstrated that PD patients displayed a prominent degree of hypoperfusion in the occipital lobe, while also demonstrating an impairment in recognizing the facial emotions for both anger and happiness. The ability to recognize the facial emotions for happiness has been shown to be closely associated with a decreased cerebral blood flow (CBF) in the right occipital lobe. In PD patients, an impairment in recognizing emotional facial expressions might be partially due to an occipital cortical dysfunction. As the present study is a preliminary one, further studies are thus needed to elucidate the mechanism of such impairments in recognizing emotional facial expressions in PD patients.

2013-03-04T07:04:19Z 大町, いづみ 中原, 和美 糸山, 景大 井口, 茂 平瀬, 達哉 東, 登志夫 田中, 浩二 中尾, 理恵子 川崎, 涼子 新田, 章子 横尾, 誠一 松坂, 誠應 http://hdl.handle.net/10069/29324 2012-09-26T14:13:40Z 2012-09-26T06:45:37Z

Title: 「統合ケア実習」の効果－連想法を用いて－ Authors: 大町, いづみ; 中原, 和美; 糸山, 景大; 井口, 茂; 平瀬, 達哉; 東, 登志夫; 田中, 浩二; 中尾, 理恵子; 川崎, 涼子; 新田, 章子; 横尾, 誠一; 松坂, 誠應 Issue Date: 2012-09 Citation: 保健学研究, 24(2), pp.41-49，2012

2012-09-26T06:45:37Z 堀内, 清孝 川原, 隆 横山, 由佳 山口, 智美 http://hdl.handle.net/10069/29323 2012-09-27T01:09:21Z 2012-09-26T06:31:06Z

Title: 透析導入３年未満の高齢糖尿病性腎症患者2事例の水分管理行動変容への看護介入 Authors: 堀内, 清孝; 川原, 隆; 横山, 由佳; 山口, 智美 Issue Date: 2012-09 Citation: 保健学研究, 24(2), pp.31-39; 2012 Abstract: 周知のように透析患者は透析治療と生活調整により生命活動を行っている．従って治療・療養生活は，水分・食事管理などの自己管理行動に大きく影響される．本報告では，体重管理が不安定な透析歴3 年未満の高齢糖尿病性腎症患者 2 名に，対象病院独自の透析患者看護介入用モニタリングプログラムである 3 週間のセルフケアプログラム（以下，SCP）を実施した結果，水分管理行動の変容が認められた．実施過程での水分摂取量，体重増加率，自己効力感得点，気分プロフィール測定値などの客観的情報と対象の主観的情報の変化過程がほぼ一致しており，対象を総合的に査定し介入する上でSCPが有効な手段となり得る可能性が示唆された．

2012-09-26T06:31:06Z 植田, 友貴 東嶋, 美佐子 http://hdl.handle.net/10069/29322 2012-09-26T14:13:38Z 2012-09-26T06:22:25Z

Title: 人工呼吸器を装着した患者の呼吸と嚥下の協調性に関する研究 Authors: 植田, 友貴; 東嶋, 美佐子 Issue Date: 2012-09 Citation: 保健学研究, 24(2), pp.25-29; 2012 Abstract: 気管切開をして人工呼吸器装着下での呼吸と嚥下の協調性ついて胸郭拡張のタイミングと嚥下音を分析し検討した. 　対象は人工呼吸器を装着している筋強直性ジストロフィー患者 2 名，筋萎縮性側索硬化症患者 1 名であった． 　方法はゼリー4ccを患者の良いタイミングで嚥下させ，その際の波形データを記録し，得られたデータを，吸気中嚥下，呼気中嚥下，休止期嚥下の 3 つに分類した． 　結果は 3 症例ともに休止期嚥下が最も多く68 ～ 88％を占めていた．このことから人工呼吸器を装着した患者においても呼吸と嚥下の関連性の存在は示唆された． 　さらに，吸気中及び呼気中の嚥下が14％～ 31％確認された．吸気中及び呼気中の嚥下は人工呼吸器装着患者に特徴的な嚥下パターンと考えられ，嚥下パターンの乱れによる誤嚥の可能性なども危惧された．; The aim of this study was to examine the state of coordination between breathing and swallowing in the patients who underwent tracheostomy and mechanically ventilated. We analyzed results of both the respiratory chest expansion timing and the swallowing sound recorded. 　This study enrolled two patients with myotonic dystrophy and one with amyotrophic lateral sclerosis, who were on ventilators. 　We achieved wave patterns of the subjects swallowed 4cc of jelly at their spontaneous timing. Subsequently, the data obtained was classified into three categories; inspiratory phase swallowing, expiratory phase swallowing, and swallowing at pauses. 　The result demonstrated that highest onset of the swallowing at pauses appeared in all subjects, which ranged from 68 to 88％. 　In conclusion, the subjects with mechanical ventilation, there may be a certain pattern of characteristic in timing between the breathing and the swallowing. 　Furthermore, it was confirmed 14％ to 31％ during out of inspiratory phase swallowing and expiratory phase swallowing. 　It was thought with a swallowing pattern to be characteristic of the respirator insertion patient at the time of inspiratory phase swallowing and expiratory phase swallowing, and possibility of aspiration by aberration of a swallowing pattern was felt uneasy about.

2012-09-26T06:22:25Z 楠葉, 洋子 橋爪, 可織 田上, 純子 小野, 真奈美 藤野, 裕子 森下, 暁 藤本, 裕二 浦田, 秀子 http://hdl.handle.net/10069/29321 2012-09-26T14:13:38Z 2012-09-26T06:12:56Z

Title: 医療系大学１年生がイメージする良い死 Authors: 楠葉, 洋子; 橋爪, 可織; 田上, 純子; 小野, 真奈美; 藤野, 裕子; 森下, 暁; 藤本, 裕二; 浦田, 秀子 Issue Date: 2012-09 Citation: 保健学研究, 24(2), pp.17-24; 2012 Abstract: 本研究の目的は，医療系大学 1 年生を対象に「良い死」をどのように考えているかを明らかにすることである．調査方法は，同意を得られた学生に対して「病気と診断された時に考える良い死のイメージ」及び「看取りの時に考える良い死のイメージ」について，それぞれイメージマップに記載してもらい，質的に分析した．その結果，「病気と診断された時に考えるイメージ」は14カテゴリーに，「看取りの時に考える良い死のイメージ」は18カテゴリーに分類された．青年期にある医療系大学 1 年生は，身近な死の経験が減 少する中で，リアリティが乏しく，死に対して恐れを持ちつつも，患者や家族，医療者のもつ「良い死」のイメージと共通したイメージを持っていることが明らかになった．; The purpose of this study was to explore how first year students of a medical university perceive “good death”. Students who agreed to participate were asked to each write out words and concepts which they related with “good death when a disease is diagnosed” and “good death at the end of life”, and the results were analyzed qualitatively. As result, the concept of “good death when a disease is diagnosed” could be categorized into 14 categories and “good death at the end of life” into 18 categories. Students in their young adulthood today have decreasing likelihood of experiencing deaths of people who are close to them. Although fearful, they found it difficult to hold a realistic image of death. Nevertheless, they held similar concepts regarding “good death” as those held by patients, patient families and health care providers.

2012-09-26T06:12:56Z Hirano, Yuko Itoh, Mari Miyazaki, Yukari Yamamoto, Hiromi Kusuba, Yoko http://hdl.handle.net/10069/29320 2012-09-26T14:13:37Z 2012-09-26T05:59:15Z

Title: The Socioeconomic Factors Affecting the Mental Health Status of Family Caregivers of Type 2 Diabetic Patients Authors: Hirano, Yuko; Itoh, Mari; Miyazaki, Yukari; Yamamoto, Hiromi; Kusuba, Yoko Issue Date: 2012-09 Citation: 保健学研究, 24(2), pp.9-15; 2012 Abstract: As Japan’s ‘super aged society’ develops, more and more aged caregivers are obliged to take care of patients with chronic diseases. In this study, the family caregivers of type 2 diabetic patients were targeted to identify the socioeconomic conditions that affect their mental health status. The results indicated that when the caregivers were overly concerned about the patients’ care, they had higher GHQ （General Health Questionnaire） scores（ r=.685, p<0.05）. On the other hand, the more caregivers spoke frankly about their feelings to the patients, the lower their GHQ Likert Scores were（ r=.-718, p<0.05）. Suggestions for medical staff were made to establish a support system not only for type 2 diabetic patients, but also for the family caregivers of these patients.

2012-09-26T05:59:15Z 折口, 智樹 中野, 治郎 坂本, 淳哉 沖田, 実 松坂, 誠應 川上, 純 http://hdl.handle.net/10069/29319 2012-09-26T14:13:35Z 2012-09-26T05:42:29Z

Title: 膠原病のリハビリテーションについて Authors: 折口, 智樹; 中野, 治郎; 坂本, 淳哉; 沖田, 実; 松坂, 誠應; 川上, 純 Issue Date: 2012-09 Citation: 保健学研究, 24(2), pp1-8.; 2012 Abstract: 関節リウマチに対しては，その変形予防，ADL獲得のためにリハビリテーションの方法が確立されているが，関節リウマチ以外の膠原病に対するリハビリテーションについてはあまり知られていない．関節リウマチ以外の膠原病も関節痛や筋力低下などによるADLの低下をしばしば経験する．今回，膠原病のリハビリテーションの方法について論文検索し，まとめたので報告する．

2012-09-26T05:42:29Z Yamaguchi, Nimpei Kaneko, Kenichi Iwanaga, Tetsu Komuro, Satoru Takahashi, Haruo http://hdl.handle.net/10069/28964 2012-08-07T14:13:16Z 2012-08-07T05:32:08Z

Title: Endovascular Treatment of a Carotid Artery Pseudoaneurysm in a Contaminated Wound: Report of a Case Authors: Yamaguchi, Nimpei; Kaneko, Kenichi; Iwanaga, Tetsu; Komuro, Satoru; Takahashi, Haruo Issue Date: 2012-07 Citation: Acta medica Nagasakiensia, 57(2), pp.65-68; 2012 Abstract: We herein report a case of carotid artery pseudoaneurysm following intensive treatment for hypopharyngeal carcinoma. An 81-year-old male had undergone surgery and concurrent chemoradiotherapy to treat hypopharyngeal carcinoma (T4aN1M0). This treatment led to a complete response, but pseudoaneurysms were formed at the external carotid artery in a contaminated wound. One of the pseudoaneurysms was located close to the bifurcation and thus caused intractable hemorrhaging. We performed endovascular treatment to achieve hemostasis. One year after the embolization, surgical removal of the endovascular devices from the infected area was performed. Three years have passed since the removal, and the patient is still alive without any complications. Primary endovascular treatment of an infected pseudoaneurysm could be an effective option for the treatment of acute lethal hemorrhaging.

2012-08-07T05:32:08Z Yamauchi, Taishi Hayashi, Tomayoshi Matsuo, Takayuki Matsumoto, Miki Kinoshita, Naoe Abe, Kuniko Nagata, Izumi http://hdl.handle.net/10069/28963 2012-08-07T14:13:18Z 2012-08-07T05:23:20Z

Title: Intracranial Rosai-Dorfman Disease - a Case Report and a Review of the Literature Authors: Yamauchi, Taishi; Hayashi, Tomayoshi; Matsuo, Takayuki; Matsumoto, Miki; Kinoshita, Naoe; Abe, Kuniko; Nagata, Izumi Issue Date: 2012-07 Citation: Acta medica Nagasakiensia, 57(2), pp.57-63; 2012 Abstract: Rosai-Dorfman disease (RDD) is an uncommon, non-neoplastic benign lymphoproliferative disease characterized by prominent, painless cervical lymphadenopathy with fever and leukocytosis. RDD is histologically characterized by emperipolesis, where large histiocytes become infiltrated with lymphocytes and plasma cells. Intracranial RDD is extremely rare. Only 79 cases have been reported, including the present case. Intracranial RDD is associated with headaches, seizures, and numbness caused by increased intracranial pressure. A 67-year-old Japanese woman presented with dizziness and was diagnosed with a tumor in the cerebral falx. The preoperative radiological diagnosis was meningioma. She had no lymphadenopathy. The patient underwent a craniotomy and tumor resection. The tumor consisted of lymphoid tissue with scattered lymph follicles. The infiltrating histiocytes showed emperipolesis. The histiocytes were immunoreactive for S-100 protein and CD68 and negative for CD1a, leading to the diagnosis of intracranial RDD. The postoperative course was uneventful without further therapy. The dizziness had not re-appeared and MRI demonstrated no recurrence of tumors for 7 months. Intracranial RDD shows a male predominance and occurs later in life than nodal RDD. The clinical manifestations and prognosis are variable depending on the location of the tumor and treatment. Most intracranial RDD have a benign course, but long-term follow-up is important, because recurrence has been observed.

2012-08-07T05:23:20Z Miyazaki, Takuro Yamasaki, Naoya Tsuchiya, Tomoshi Matsumoto, Keitaro Tomoshige, Koichi Tagawa, Tsutomu Nagayasu, Takeshi http://hdl.handle.net/10069/28962 2012-08-07T14:13:19Z 2012-08-07T05:12:34Z

Title: Reconstruction of the Superior Vena Cava Following Invasive Thymoma Resection by Monitoring Cerebral Oxygenation Authors: Miyazaki, Takuro; Yamasaki, Naoya; Tsuchiya, Tomoshi; Matsumoto, Keitaro; Tomoshige, Koichi; Tagawa, Tsutomu; Nagayasu, Takeshi Issue Date: 2012-07 Citation: Acta medica Nagasakiensia, 57(2), pp.53-56; 2012 Abstract: Invasive thymoma often invades adjacent organs, such as the pleura, lungs, pericardium, and great vessels; the superior vena cava and brachiocephalic vein are particularly susceptible. A 31-year-old woman was admitted after chemotherapy for invasive thymoma involving the superior vena cava and left brachiocephalic vein. During the operation, regional cerebral oxygenation was measured using the INVOSTM5100C monitor to avoid adverse effects due to long-time total clamping of the superior vena cava because left brachiocephalic vein could not be reconstructed due to total occlusion of the distal lumen. We could decide if the SVC was safely clamped with this INVOSTM5100C monitor. Then complete resection of the tumors was successfully performed, and a single artificial graft was used for reconstruction of the superior vena cava. Postoperative clinical course was uneventful, and she was discharged on the 18th postoperative day.

2012-08-07T05:12:34Z Ono, Shinichiro Kawashita, Yujo Kanetaka, Kengo Iwata, Tohru http://hdl.handle.net/10069/28961 2012-08-07T14:13:17Z 2012-08-07T05:01:42Z

Title: Laparoscopic Repair of a Ventral Hernia Using Composix E/X Dual Mesh at a Single Institution. Authors: Ono, Shinichiro; Kawashita, Yujo; Kanetaka, Kengo; Iwata, Tohru Issue Date: 2012-07 Citation: Acta medica Nagasakiensia, 57(2), pp,49-52; 2012 Abstract: Introduction: Although abdominal ventral hernias are common, there is still no consensus regarding the most appropriate technique to be used for surgical repair. We herein present our initial experiences of laparoscopic ventral herniorrhaphy to repair abdominal ventral hernias. Patients: From April 2007 to March 2009, four patients were assigned to recieve laparoscopic ventral hernia repair. The operative technique was demonstrated. Additionally clinical factors, including operative time, length of hospital stay, complications, and recurrence rates, were evaluated. Results: All of the patients were successfully treated laparoscopically without conversion to open laparotomy. The median operative time was 107.5 (range 75 - 130) minutes and the mean length of hospital stay was 13 (range 5 -19) days. There were no significant complications or hernia recurrences during a follow-up period of 36 months ( median, 28 - 42 ). Conclusion: Laparoscopic repair of abdominal ventral hernias may therefore be a feasible option with a great potential to both improve treatment outcomes and reduce surgical morbidity.

2012-08-07T05:01:42Z Tanaka, Takayuki Kuroki, Tamotsu Adachi, Tomohiko Okamoto, Tatsuya Ono, Shinichiro Abiru, Norio Kawakami, Atsushi Eguchi, Susumu http://hdl.handle.net/10069/28960 2012-08-07T14:13:14Z 2012-08-07T04:45:08Z

Title: Evaluation of the Presumable Incidence of Pancreatic Islet Cell Transplantation in Nagasaki Authors: Tanaka, Takayuki; Kuroki, Tamotsu; Adachi, Tomohiko; Okamoto, Tatsuya; Ono, Shinichiro; Abiru, Norio; Kawakami, Atsushi; Eguchi, Susumu Issue Date: 2012-07 Citation: Acta medica Nagasakiensia, 57(2), pp.45-48; 2012 Abstract: Background Pancreatic islet cell transplantation (ICT) is one of the standard treatments for type I diabetes mellitus (T1DM), based on the Edmonton protocol of 2000.1) A previous report presented the expected annual incidence of ICT recipients in Nagasaki Prefecture in 2006.2),3) This report presents variations in the background of T1DM patients followed in this department and evaluated the current annual incidence of possible ICT recipients. Methods This study reviewed 128 TIDM patients followed at Nagasaki University Hospital in 2011, examined the annual incidence of ICT recipients based on the Japanese Islet Transplant Registry criteria and the population of Nagasaki, and compared those results in 2011 with those in 2006. In addition, the annual numbers of cardiac death donors who were considered ICT donor candidates in Nagasaki over this period were examined. Results The proportion of candidates suitable to be recipients in Nagasaki changed from 4% (3/75) in 2006 to 7.8% (10/128) in 2011. The estimated incidence of suitable recipient candidates increased from 1.0 per year to 1.8 per year. On the other hand, though the estimated number of donor candidates was 2.6 per year, which was the mean for the 7 years between 2002 and 2009, only one candidate was reported in 2010 and no candidate was reported in 2011 in Nagasaki. Conclusion Although securing donors has become difficult due to a new law on organ transplantation, the demand for ICT has increased and may continue increase in the future. Therefore, it is important to confirm the criteria in brain dead donors to determine whether the pancreas should be directed to the pancreatic transplantation or pancreatic islet transplantation.

2012-08-07T04:45:08Z Masuzaki, Masako Yoshida, Atsushi Miura, Kiyonori Masuzaki, Hideaki http://hdl.handle.net/10069/28959 2012-08-07T14:13:16Z 2012-08-07T04:32:12Z

Title: Ultrasound Prediction of Amniotic Fluid Volume Authors: Masuzaki, Masako; Yoshida, Atsushi; Miura, Kiyonori; Masuzaki, Hideaki Issue Date: 2012-07 Citation: Acta medica Nagasakiensia, 57(2), pp.41-44; 2012 Abstract: Using ultrasonography, we measured the largest vertical dimension for pockets of amniotic fluid (largest vertical pocket) directly before elective cesarean delivery in 42 pregnant women and compared the results to actual amniotic fluid volume (AFV). In another 3 pregnant women of vaginal delivery suspected polyhydramnios, we performed amniocentesis and successively recorded the largest vertical pocket and actual AFV, and finally made a fitting curve and correlative equation. A high degree of correlation was found between the largest vertical pocket measured by ultrasound and the actual AFV. The equation is: Y=63.03-8.46X+0.71X2-0.01X3+0.00006X4. Using the equation obtained which relates largest vertical pocket to actual AFV; a 30mm largest vertical pocket corresponds to an actual volume of 200ml, an 80mm largest vertical pocket to 800ml, and a 120mm largest vertical pocket to 3,000ml. In conclusion, the largest vertical pocket is well reflected in the actual AFV.

2012-08-07T04:32:12Z Omagari, Katsuhisa Iwami, Haruka Kaji, Manami Ishii, Yuka Matsutake, Sachiko Ichimura, Mayuko Kato, Shigeko Takeshita, Shigeyuki Ichikawa, Tatsuki Nakao, Kazuhiko http://hdl.handle.net/10069/28958 2012-08-07T14:13:14Z 2012-08-07T04:22:57Z

Title: The Relationship between Energy Expenditure and Type or Stage of Cancer Authors: Omagari, Katsuhisa; Iwami, Haruka; Kaji, Manami; Ishii, Yuka; Matsutake, Sachiko; Ichimura, Mayuko; Kato, Shigeko; Takeshita, Shigeyuki; Ichikawa, Tatsuki; Nakao, Kazuhiko Issue Date: 2012-07 Citation: Acta medica Nagasakiensia, 57(2), pp.33-40; 2012 Abstract: Malnutrition commonly occurs in patients with cancer. This situation can be associated with increased morbidity and mortality. The etiology is not clearly understood but decreased energy intake and increased energy expenditure may be involved. We aimed to investigate the energy metabolic status including energy expenditure in patients with various cancers. The clinical features and energy metabolic status measured by indirect calorimetry of 74 patients with cancer (50 men and 24 women; mean age, 64.7 years) were obtained from the medical records. Hypermetabolism was more common and REE/kg (resting energy expenditure / kg body weight) seems to be more reliable in estimating the true energy expenditure than %REE (measured REE / predicted REE). The REE/kg and VO2 /kg (oxygen consumption per minute / kg body weight) varied among cancer types, i.e., they were significantly higher in gastric cancer than in hepatocellular carcinoma. Moreover, REE/kg and VO2/kg was significantly higher in cancer stage IV than in stage I, or stages I and II. Patients with or at risk for malnutrition should receive appropriate nutritional support, which has to be personalized according to tumor site, tumor stage, and the nutritional status of the patient. This nutritional support should improve not only the patients' quality of life but also their survival.

2012-08-07T04:22:57Z Haraguchi, Ai Ando, Takao Ueki, Ikuko Horie, Ichiro Imaizumi, Misa Usa, Toshiro Yamasaki, Satoshi Origuchi, Tomoki Kawakami, Atsushi http://hdl.handle.net/10069/28550 2012-05-16T14:13:49Z 2012-05-16T06:45:54Z

Title: A case of compressive optic neuropathy putatively caused by IgG4-related idiopathic orbital inflammation. Authors: Haraguchi, Ai; Ando, Takao; Ueki, Ikuko; Horie, Ichiro; Imaizumi, Misa; Usa, Toshiro; Yamasaki, Satoshi; Origuchi, Tomoki; Kawakami, Atsushi Issue Date: 2012-04 Citation: Acta Medica Nagasakiensia, 57(1), pp.29-32; 2012 Abstract: We report the case of a 58-year-old male presenting with an impairment of the left-sided visual acuity caused by compressive optic neuropathy, and marked bilateral proptosis. Blood test showed markedly elevated IgG4 (1830 mg/dl) and positive TSH receptor-stimulating antibodies (200%), but the thyroid function test were normal. Orbital MRI revealed abnormal soft tissue proliferation around the optic nerve and fusiform enlargement of the extraocular muscles. Systemic CT analysis detected multiple lymph node swelling, pseudotumor in the lung, retroperitoneal fibrosis, and kidney lesions. We considered that the eye manifestation was most likely caused by IgG4-related idiopathic orbital inflammation. Systemic administration of a moderate dose of prednisolone dramatically improved the compression of the optic nerve, as shown by the improvement of the visual acuity and the MRI findings. The clinical course made thyroid-associated ophthalmopathy unlikely. In conclusion, an overall consideration of the clinical picture and extensive work-up of any possible differential diagnosis including measurement of the serum levels of IgG4 was highly useful in making the diagnosis of the patient.

2012-05-16T06:45:54Z Miyazaki, Takuro Tagawa, Tsutomu Yamasaki, Naoya Tsuchiya, Tomoshi Matsumoto, Keitaro Tomoshige, Koichi Tsuchihashi, Yoshiko Morimoto, Konosuke Nagayasu, Takeshi http://hdl.handle.net/10069/28549 2012-05-16T14:13:49Z 2012-05-16T06:38:44Z

Title: Immune function in a patient with aspergillosis after lung transplantation: Case Report Authors: Miyazaki, Takuro; Tagawa, Tsutomu; Yamasaki, Naoya; Tsuchiya, Tomoshi; Matsumoto, Keitaro; Tomoshige, Koichi; Tsuchihashi, Yoshiko; Morimoto, Konosuke; Nagayasu, Takeshi Issue Date: 2012-04 Citation: Acta Medica Nagasakiensia, 57(1), pp.25-28; 2012 Abstract: We report a case that was successfully treated invasive pulmonary aspergillosis after living donor lobar lung transplantation and monitored patients' immune function with ImmuKnow® assay. A 43-year-old woman underwent living donor lobar lung transplantation for pulmonary alveolar proteinosis. Two healthy her relatives donated each lower lobe. Six months after transplantation, she was diagnosed as invasive pulmonary aspergillosis (IPA). During the anti-fungal treatment, one immunosuppressant was withdrawn and the trough level of calcineurin inhibitor was reduced to the minimum. Despite of such a low immunosuppressive status, Immuknow® assay showed that immune function was maintained in the moderate range, which encouraged us to keep this strategy for IPA. Immune evaluation by Immuknow® is useful method for monitoring and controlling patients' immune status especially in the infected condition, which revealed moderate immune level could be maintained with only two immunosuppressant drugs in the patient after recovery from IPA.

2012-05-16T06:38:44Z Nakashima, Yumiko Nazneen, Arifa Abe, Kuniko Nakayama, Toshiyuki Taguchi, Takashi Shirakawa, Toshihiko Moriuchi, Hiroyuki http://hdl.handle.net/10069/28548 2012-05-16T14:13:46Z 2012-05-16T06:29:40Z

Title: The incidence and distribution of biopsy-proven renal diseases in children Authors: Nakashima, Yumiko; Nazneen, Arifa; Abe, Kuniko; Nakayama, Toshiyuki; Taguchi, Takashi; Shirakawa, Toshihiko; Moriuchi, Hiroyuki Issue Date: 2012-04 Citation: Acta Medica Nagasakiensia, 57(1), pp.19-24; 2012 Abstract: The precise distribution pattern of pediatric renal diseases has seldom been reported especially for young children. In order to clarify the incidence and distribution of renal diseases in children, 599 renal biopsy specimens obtained from 547 pediatric patients (≦15 years old) were analyzed by routine light, electron and immunofluorescence microscopy. Among the total biopsy cases, the most common renal disease identified in childhood was IgA glomerulonephritis (IgAGN; 37%). More than 80% of patients with IgAGN were discovered by urinary screening at the school, showing asymptomatic proteinuria and/or hematuria. The other major renal diseases were minor glomerular abnormality (12.2%), Henoch-Schönlein purpura nephritis (HSPN; 10.6%), and thin basement membrane disease (7.1%). One of the major causes of pediatric nephrotic syndrome were minimal change nephrotic syndrome (58%), whereas the other causes were IgAGN (11.6%), HSPN (8.9%), membranous glomerulonephritis (5.4%), membranoproliferative glomerulonephritis (3.6%). In conclusion, IgAGN was the most common renal disease also in children as in adolescence. From the age of seven years, the incidence of IgA-GN was highest among all the pediatric renal diseases during whole childhood period, and the incidence and number of the patients increased as they grow. On the other hand, there are also many cases with non-progressive clinical courses, such as minor glomerular abnormality and thin basement membrane disease in children. The renal biopsy following routine urinary screening at the school may be important for the therapeutic and prognostic guidelines of pediatric group of patients with renal diseases.

2012-05-16T06:29:40Z Huang, Hairong Ye, Zhaojia Nagahama, Iyoko Tazoe, Hideaki Abe, Yasuyo Aoyagi, Kiyoshi http://hdl.handle.net/10069/28547 2012-11-15T01:44:39Z 2012-05-16T06:17:03Z

Title: Impact of Hypertension, Diabetes and Dyslipidemia on Ischemic Heart Disease among Japanese: A Case-Control Study Based on National Health Insurance Medical Claims Authors: Huang, Hairong; Ye, Zhaojia; Nagahama, Iyoko; Tazoe, Hideaki; Abe, Yasuyo; Aoyagi, Kiyoshi Issue Date: 2012-04 Citation: Acta Medica Nagasakiensia, 57(1), pp.13-18; 2012 Abstract: Aim Although the important role of conventional risk factors (cigarette smoking, hypertension, diabetes and dyslipidemia) in the pathogenesis of ischemic heart disease (IHD) has been established, how frequently IHD is preceded by exposure to conventional risk factors remains controversial. The present study aimed to identify the prevalence of hypertension, diabetes and dyslipidemia among patients with IHD and examine associations between each of them with IHD in a Japanese population. Methods Data were collected from health insurance claims in May 2010 for National Health Insurance beneficiaries aged 40- 79 years in Nagasaki Prefecture, Japan. One sex- and age-matched control was randomly selected for each of 42,236 patients with IHD (International Classification of Diseases, 10th Revision code: I20-25). The prevalence of hypertension, diabetes and dyslipidemia and the number of these risk factors were compared between the patients and controls. Associations between risk factors and IHD were examined using a conditional logistic regression model. Results Over 90% of patients with IHD had at least one of hypertension, diabetes or dyslipidemia. The odds of IHD were 4.5- fold (95% confidence interval [CI]: 4.3, 4.7), 4.2-fold (95% CI: 3.9, 4.6) and 5.3-fold (95% CI: 4.9, 5.7) higher for patients with hypertension, diabetes and dyslipidemia, respectively, compared with patients without any of these risk factors. Patients with several risk factors were at increased risk for IHD. Conclusion Comprehensive risk reduction strategies that encourage a healthy lifestyle and diet and promote the recognition, evaluation and management of conventional risk factors are important to prevent IHD.

2012-05-16T06:17:03Z