著者

藤岡 泉 笠井 靖代 寒川 早織 芥川 香奈 有馬 香織 渡邊 理子 宮内 彰人

出版者

一般社団法人 日本周産期・新生児医学会

雑誌

日本周産期・新生児医学会雑誌 (ISSN:1348964X)

巻号頁・発行日

vol.57, no.1, pp.91-97, 2021 (Released:2021-05-10)

参考文献数

15

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てんかん合併妊娠の周産期管理の課題を明らかとするため,2014年から5年間に当センターで分娩した15, 344例のうち,てんかん合併妊娠58例(0.38%)を抗てんかん薬の服薬状況に基づき4群に分け,周産期予後を後方視的に解析した. 4群の内訳は,a群(服薬あり怠薬なし)22例,b群(服薬あり怠薬あり)4例,c群(服薬なし妊娠判明後中止)1例,d群(服薬なし妊娠前から)31例であった.分娩週数・出血量・児体重・Apgar score,臍帯血pHに有意な差はなかった.妊娠中の発作は13例(22.4%)で認め,怠薬した症例などにみられた.バルプロ酸が必須の患者では妊娠判明後の薬剤変更が発作原因となる可能性があった.母乳育児は混合を含めると55例(94.8%)が行っていた. 妊娠前から母児の影響を考慮した薬剤の選択と,本人が妊娠中の発作コントロールの重要性を十分に理解することが重要である.

著者

有馬 香織

出版者

公益財団法人史学会

雑誌

史学雑誌 (ISSN:00182478)

巻号頁・発行日

vol.117, no.12, pp.2101-2118, 2008-12

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There were two customs gates in operation at the port of Hyogo (present day Kobe) during in late medieval Japan. The northern gate had been placed under the authority of Todaiji Temple, the southern gate under Kofukuji Temple. This article discusses how the northern customs house was being operated as of 1445, based on an analysis of three customs ledgers compiled during that year: Hyogo-kitaseki-irihune-nocho 兵庫北関入船納帳 held by the University of Tokyo Faculty of Letters (A), Hyogo-kitaseki-irihune-nocho 兵庫北関入船納帳 held by the Kyoto Metropolitan History Museum (B), and Hyogo-kitaseki-zassen-nocho 兵庫北関雑船納帳 held in the Todaiji Temple archives (C). The key to understanding how vessels were processed at the customs gates are practices surrounding fuda 札, a ticket that could be purchased cheaply by any vessel with a permit (kasho 過書) to pass through the gate, thus exempting them from high custom fees. Since the northern and southern gates were connected, customs exempt vessels passing out the southern gate would be relieved of the fuda (fudagari 札狩) they had purchased at the northern gate. How the customs gates were managed is clarified by the author based on an examination of the differences existing among the three ledgers. First, (A) and (B) are ledgers recording deferred customs fees payments, while (C) lists payments made at the time of passage. Secondly, the content of (C) was recorded in two stages, the second more detailed than the first. Next, while having the same title (A) and (B) were kept separately, since the latter contains the term kubo 公方, and the former does not. Finally, there is no content that corresponds in (A) and (C), while the information in (B) and (C) concerning fuda matches. The changing content of (C), the differences between (A) and (B) and the complementary relationship between (B) and (C) all reflect changes in management of the northern gate that occurred together with Todaiji's direct takeover of operations, which was characterized by efforts to increase customs revenue by stricter limitation and regulation of vessels exempt from duties and to firmly establish the new system.