著者
望月 隆弘 衣笠 えり子 草野 英二 大和田 滋 久野 勉 兒島 憲一郎 小林 修三 佐藤 稔 島田 憲明 中尾 一志 中澤 了一 西村 英樹 野入 英世 重松 隆 友 雅司 佐中 孜 前田 貞亮
出版者
一般社団法人 日本透析医学会
雑誌
日本透析医学会雑誌 (ISSN:13403451)
巻号頁・発行日
vol.45, no.9, pp.853-862, 2012-09-28 (Released:2012-10-05)
参考文献数
23

【目的】ビタミンE固定化ポリスルフォン膜ダイアライザ(VPS-HA)が,血液透析患者の貧血や,貧血治療薬(ESA)の投与量に影響を与えるか否かを検討した.【方法】主要なエントリー基準は,機能分類IV型ポリスルフォン(PS)膜を3か月以上使用し,直近3か月はTSAT 20%以上で,ESA製剤の変更がなく,ヘモグロビン(Hb)値は10.0g/dL以上12.0g/dL未満を満たす患者とした.研究参加は48施設で,305症例がエントリーされた.エントリー患者を,VPS-HAに変更する群(151名)と,従来のIV型PS膜を継続する群(154名)の2群に分け(中央登録方式),研究開始時のHb値を維持(10.0≦Hb<11.0g/dLおよび11.0≦Hb<12.0g/dL)するESA投与量を主要評価項目とした.その評価指標としてエリスロポエチン抵抗性指数(erythropoietic resistance index:ERI)を用いた.【結果】研究は1年間実施された.目標Hb値10.0≦Hb<11.0g/dLの範囲では差はなかったが,目標Hb値11.0≦Hb<12.0g/dLの範囲で,VPS-HA群はIV型PS膜群に比して良好なESA反応性を示した.とくにVPS-HA群のDarbepoetin alfa(DA)投与例では,8か月以降で開始時と比較して統計的有意差をもってERIが減少していた.またIV型PS膜群のrHuEPO投与症例では,統計的に5,7,10か月で,開始時と比較してERIが増加していた.VPS-HAとIV型PS膜の群間比較では,11か月目でVPS-HA群のDA投与例でIV型PS膜群に比して,ERIが有意に減少していた.【結語】目標Hb値11.0≦Hb<12.0g/dLの範囲で,ビタミンE固定化膜は,IV型PS膜に比べてDA投与量が減少しており,ESA投与量軽減効果が期待できる(UMIN試験ID:UMIN000001285).
著者
小林 伸
出版者
日経BP社
雑誌
日経パソコン (ISSN:02879506)
巻号頁・発行日
no.571, pp.109-112, 2009-02-09

全自動とシーンモード/シーンモードを選ぶには/カスタム機能の設定も/撮影画像はすぐに確認
著者
古林 千恵 矢野 久子 尾上 恵子 脇本 寛子 脇山 直樹 畑 七奈子 山本 洋行 脇本 幸夫
出版者
一般社団法人 日本環境感染学会
雑誌
日本環境感染学会誌 (ISSN:1882532X)
巻号頁・発行日
vol.27, no.6, pp.412-418, 2012 (Released:2013-02-05)
参考文献数
12
被引用文献数
1 1

高齢社会の到来と医療費の削減を背景に,入院期間の短縮,在宅医療の普及が推進されている.退院後,引き続き自宅での医療が必要な場合には,短い入院期間中にこれらの医療に関する新たな技術を習得することが求められている.今回,清潔間欠自己導尿(CIC)の継続指導チェックリスト作成のために患者10名を対象に,導入時および継続指導の実態を調査した.CIC導入時の問題点として,口頭指導のみでCICを開始させた場合があった.また,手順指導を行なった場合であっても患者の個別性や身体的機能,異常時の対応,自宅の状況などを考慮した指導にいたっていないことや膀胱過拡張予防の理解,排尿記録の目的を理解した記載が行われていないことが明らかになった.外来では,残尿が無いように排尿をさせる体位や手順確認を含めた継続指導を行っていなかった.これらのことから,膀胱過拡張予防の理解,上部尿路保護を意識した排尿量の保持と排尿間隔でCICを実施する排尿記録の記載を中心とした継続指導が重要であることが明らかになった.以上を踏まえ,問題点の抽出を行い継続指導チェックリストを作成した.
著者
及川 寧己 竹原 孝 雷 興林 深沢 洋規 山口 勉
出版者
一般社団法人 資源・素材学会
雑誌
Journal of MMIJ (ISSN:18816118)
巻号頁・発行日
vol.136, no.10, pp.110-116, 2020-10-31 (Released:2020-10-27)
参考文献数
17

Elucidating the sealing capacity of caprock is very important because CO2 sequestered in deep aquifers can remain there for several hundred years in the CO2 sequestration. Threshold capillary pressure is a key property affecting sealing capacity, and therefore, the ability to measure the threshold pressure of a target rock conveniently is highly sought after. In this study, data collected during the CO2 injection process in triaxial compression tests of mudstone supposed to be a caprock were used to measure threshold pressure via the dynamic method. These triaxial tests were conducted to study the mechanical properties of mudstone below depths of 1000 m. The threshold pressure for 23 out of 26 test samples was successfully measured. Measured values ranged from 0.54 to 1.57 MPa, which was within a reasonable range compared to the results reported by three other studies that used similar mudstone specimens. A small amount of shrinkage induced by a pore pressure decrease, which was caused by a threshold pressure, was observed in the experiment. The threshold pressure showed a positive correlation with the shrinkage, implying that this pressure might be estimated from the shrinkage. Thus, a volumetric elastic constant was calculated from the shrinkage assuming that the decrease in mean pore pressure was half of the threshold pressure. The mean volumetric elastic constant was 0.92 GPa, which was about 40% lower than that of the rocks from which the test samples were obtained. These results indicate that the shrinkage value cannot be directly used to estimate the threshold pressure, and that a correction of this shrinkage value is necessary.
著者
林 克樹 Katsuki Hayashi
出版者
同志社大学人文学会
雑誌
人文學 = Doshisha University Jinbungaku (Studies in Humanities) (ISSN:04477340)
巻号頁・発行日
no.201, pp.1-24, 2018-03-15

仏教において核心的な事柄である「涅槃」を、ショーペンハウアーがどこまで正確に捉えていたかを考察する。『大般涅槃経』に説かれる「アーユスのサンカーラを捨てる」ことに相応する「生への意志の否定」によって「涅槃」を受け止めたショーペンハウアーは、「涅槃」の本質的な構造契機である「正覚・滅度・新生」を、未だ明確に主題化してはいないとはいえ、予料的にはほぼ余すところなく射程に入れていたことが明らかとなる。
著者
寺井 仁 三輪 和久 松林 翔太
出版者
日本認知科学会
雑誌
認知科学 (ISSN:13417924)
巻号頁・発行日
vol.22, no.2, pp.223-234, 2015-06-01 (Released:2015-12-01)
参考文献数
33

Reconstructing explanations perform a crucial role not only in the progress of science,but in educational practice and daily activities including comprehension of phenomena. We focused on the transition of attention on a key fact that contradicts the preceding explanation and has a central role in its reconstruction. We used a short story as an experimental material in which the participants first constructed a prior explanation and reconstructed it. The experimental results are summarized as follows. First, when the prior explanation was rejected, a new explanation was required, after attention on the key fact was inhibited. Second, hypothesized premises not inconsistent with the prior explanation were sought to protect the prior explanation. Third, the explanation reconstruction was facilitated by having the participants focus on the key fact. Last,attention on the key fact was recovered through explanation reconstruction.
著者
髙橋 誠 猪俣 雅之 福井 美規子 渡辺 祐子 佐々木 佳子 鈴木 直哉 徳村 麻衣子 川原 昇平 吉嶋 抄苗 地主 隆文 青田 忠博 小林 道也
出版者
一般社団法人 日本腎臓病薬物療法学会
雑誌
日本腎臓病薬物療法学会誌 (ISSN:21870411)
巻号頁・発行日
vol.2, no.3, pp.19-26, 2013 (Released:2018-04-02)
参考文献数
9

血清シスタチンC 濃度(CysC)は血清クレアチニン(Cre)と比較して優れた腎機能の指標である。近年、Cre 値から換算される推定クレアチニンクリアランス(CCr)や推定糸球体濾過量(eGFRcreat)に代わってCysC から換算される推定糸球体濾過量(eGFRcys)が用いられることが多くなってきている。しかしながら、多くの患者におけるこれらのパラメータの比較を行った報告は少ない。そこで本研究では、北海道消化器科病院の入院患者1163 名を対象に、eGFRcys に対してeGFRcreat ならびにCCr の比較を行うとともに、それぞれの指標間の差異の原因を明らかにし、腎機能評価に影響を及ぼす要因を特定することを目的とした。 まず、各患者の腎機能評価指標の平均値について比較したところ、CCr とeGFRcreat はほぼ同じ値であったが、eGFRcys はこれらの値よりも大きく、eGFRcys とeGFRcreat ならびにeGFRcys とCCr の差の平均は、それぞれ27.6、21.4 であった。また、eGFRcys とeGFRcreat またはCCr の差が平均値(27.6、21.4)を上回るあるいは下回る患者に分け、患者の腎機能評価に影響を及ぼす因子を多変量ロジスティック回帰分析により解析した。その結果、[eGFRcys ‐ CCr] と血清アルブミン値の間には有意な相関性が認められた。さらに、[eGFRcys ‐ eGFRcreat] では性別、肥満度ならびに血清アルブミン値に有意な関連性が認められた。以上の結果より、eGFRcreat やCCr は eGFRcys に比べて低値を示し、その程度は腎機能の評価に影響を与えるものであった。また、その差に影響を与える因子は、筋肉量ではなく、栄養状態であると考えられる。
著者
小林 哲
出版者
日本商業学会
雑誌
流通研究 (ISSN:13459015)
巻号頁・発行日
vol.21, no.1, pp.1-12, 2018

<p>医療や教育サービスにおいて,サービス終了時に便益を享受することができず,その後しばらくして便益がもたらされることがしばしば存在する。このような現象は便益遅延性と呼ばれており,顧客満足の評価や顧客参加の在り様に大きな影響をもたらすことが指摘されている。</p><p>しかし,このサービスにおける便益遅延性は,私たちにひとつの理論的な問題を提起する。便益遅延性がサービスの基本特性である生産と消費の同時性(不可分性)に反するというのがそれである。もし,サービスにおいて生産と消費が同時になされるのであれば,消費すなわち便益の享受が遅延することはない。一方,医療やサービスにおいて便益が本当に遅延するのであれば,それはサービスの基本特性である生産と消費の同時性に反することになり,この種の医療や教育は"サービスではない"とみなすこともできる。そこで,本稿では,サービスの基本特性に立ち返り,便益遅延性の発生メカニズムを探ることで,このような矛盾が生じる理由を明らかにし,サービス・マネジメントの新たな可能性について考察する。</p><p>結論を先に述べるならば,医療や教育サービスにおける便益遅延性は,サービス・デリバリー(生産)と便益の享受(消費)との間に顧客資源が介在することによって生じる。さらに言えば,便益遅延性は,このような顧客資源介在型サービスの特徴のひとつに過ぎない。したがって,医療や教育サービスの成果を高めるには,便益遅延性のみならず,それをもたらす顧客資源介在型サービスの特徴を理解しマネジメントする必要がある。</p>
著者
西川 真理子 西 一也 川野 留美 山本 啓子 小林 洋子 原田 由加 渡邊 達夫
出版者
Japanese Society for Oral Health
雑誌
口腔衛生学会雑誌 (ISSN:00232831)
巻号頁・発行日
vol.42, no.5, pp.682-688, 1992-10-30 (Released:2010-10-27)
参考文献数
21
被引用文献数
2 2

The purpose of this study was to evaluate the plaque removal effect of a dentifrice containing granulated zeolite. Fifteen volunteers, who were nurses, dental hygienists and dentists between the ages of 21 and 42 years participated in the experiments. Following professional toothbrushing, the subjects refrained from toothbrushing for 3 days. Then daily professional toothbrushing was performed by trained dental hygienists with the experimental dentifrice for 5 days. No oral hygiene procedure was performed for 3 days after the first clinical trial. The second trial with the control dentifrice was done for 5 days. During each trial, the subjects stopped all personal oral hygiene procedures. The plaque removal effect was evaluated using plaque scores before and after toothbrushing. At 24 and 72 hours after toothbrushing, the inhibitory effect on plaque formation was calculated. The results showed that the experimental dentifrice was significantly more effective in removing plaque on the lingual surfaces and gingival margins and the interproximal gingival margins of the teeth than the control dentifrice. Significant difference was also found between the two dentifrices in removing plaque in pits on the occlusal surfaces. There was no significant difference in the inhibitory effect of the two dentifrices on plaque formation. This suggests that the dentifrice containing granulated zeolite improved the effect of toothbrushing. A questionnaire survey indicated that many subjects preferred the dentifrice containing granulated zeolite. No clinical side effects were observed in the two dentifrices.
著者
林 敏 Min Lin
出版者
国際仏教学大学院大学
雑誌
仙石山論集 = Sengokuyama Journal of Buddhist Studies (ISSN:13494341)
巻号頁・発行日
no.1, pp.79-113, 2004-09-30

I. Brief Introductory StudyA. A survey of the original textThis information about original text is based on the photocopies (No.10-23) of "Dr. Tōru Haneda羽田亨 Depiction of the Collections of Xiyu Unearthed Historical Documents" stored at Haneda Museum. But as I had no access to the photos myself, I had to rely on Prof. Toshinori Ochiai's 落合俊典 own handnotes. The Foshuo zhaoming pusa jing first appears in the "Suspicious or Apocryphal Sutras" section of the Fa jing lu法經録 scroll 2 (594A.D). Later, it is mentioned in the Ren shou lu仁壽録 (602), Datang neidian lu大唐内典録 (664), Da zhou lu 大周録 (695), Kai yuan lu 開元録 (730), Zheng yuan lu 貞元録 (800), etc. In all these, it is considered as a suspicious or apocryphal sutras. Because of this reason, it did not appear in the official Canon for more than a thousand year until it was discovered in the Dunhuang. However, the text has not been published so far. In fact, it had something to do with the famous Dunhuang collector Li Shengduo李盛鐸 (1856-1937) who was then a high official during the Qing Dynasty. Li took advantage of his postion and privately stored and collected many works discovered at Dunhuang. This sutra was among those texts. According to Prof.Toshinori Ochiai's research, this text was bought by a Japanese businessman during World War II. It was then stored in an institution of a certain Japanese company, but it was not made accessible to the public. Fortunately, a well-known Japanese historical linguist Dr. Tōru Haneda (1882-1955), was allowed to research the text and recorded it in his description: "A Catalogue of Dunhuang Secret Works." Dr. Tōru Haneda's study was also included in his Catalogue. He also had the text block-printed. This edition is based on photocopies of Dr. Tōru Haneda's collection photocopies No.10-23, P932.During World War II, research had to stop, and the 17 cases of collection were transferred to Hyōgo-ken, Taki-gun, Ōyama-son兵庫縣多紀郡大山村. Later Dr. Tōru Haneda committed them to the care of Dr. Zenryū Tsukamoto 塚本善隆 (1898-1980), and Dr . Zenryū Tsukamoto to Dr. Tairyō Makita 牧田諦亮. In 1998, Dr. Tairyō Makita agreed to make pubic the Catalogue of Danhuang Secret Works. Prof. Ochiai has published a series of studies on this collection. This catalogue has two volumes. In volume I it records 736 works, and volume II lists 432 texts. This represents the same amount as Mr.Wang Chongming's Lishi jianchang dunhuang xueben mulu 李氏鑒藏敦煌寫本目録 of the "Dunhuang yishu sanlu敦煌遺書散録" of the "Dunhuang yishu zongmulu suoyin敦煌遺書總目録索引". From Dr. Haneda catalogue we can get a general idea about Li Shengduo's original text. No.84 of the catalogue says: "the Foshuo Zhaoming pusa jing written in the Six Dynasties." On the margin of page 2 of the photographs (No.10-23) of the Zhaoming pusa jing stored in Haneda Museum has a seal stating: "Dunhuang Stone Cave Secret Works" On the left bottom on page 10 there is a seal reading "Li Shengduo, my family and my relatives make offerings to the Buddha."B. Format of the Zhaoming Pusa jingThe above mentioned depiction which is stored at the Haneda Museum and called "Dr. Haneda's Depiction of the Collections of Historical Documents Unearthed in the Western Regions" contains photographs No.10-23 which end with the characters "the Foshuo Zhaoming Pusa jing ". The size and shape must be similar to the original text. This manuscript has only one scroll. Its cover folio is missing, and it is neatly written in regular-style caligraphy, with some traces of lishu style. One page contains 23 lines to 28 lines. The details are as follows: On the 1st page there are 2 lines (missing line to line 2); on the 2nd, 28 lines (line 3 to 30); on the 3rd, 28 lines (line 31 to 58); on the 4th, 23 lines (line 59 to 81); on the 5th, 23 lines (line 82 to 104); on the 6th, 23 lines (line 105 to 127); on the 7th, 23 lines (line 128 to 150); on the 8th, 3 lines (line 151 to 173); on the 9th, 23 lines (line 174 to 196); on the 10th, 11 lines (line 197 to 207). There are 158 lines with each 17 words,49 lines with 20 words, and 8 lines with 16 words, thus the 207 lines, have a total of 3,565 words.C. Previous Research on the SutraMr Eiichi Matsumoto松本榮一was the first scholar who studied the sutra. In his Dunhuang huade yanjiu敦煌畫的研究 chapter I, section II, there are several pictures, one of them being Ryōchyū's 良忠 "Guang jing xu wen zhuan tong ji觀經序文義傳通記" which cites part of the Zhaoming Pusa jing. Huiyuan, Zhiyi, Jicang, Shandao also list and make comparasions in their notes. They conclude that the pictures are from the Zhaoming Pusa jing. In his ground-breaking contribution at the International Conference commemorating the l00th anniversary of the discovery of Dunhuang caves, Prof. Ochiai discussed the Zhaoming pusa jing and Dr. Haneda's depiction "A Catalogue of Dunhuang Secret Works". He comes to the following conclusions: 1. The Zhaoming pusa jing is listed a "Suspicious or Apocryphal Sutras" in the traditional catalogues. 2. The Zhaoming pusa jing is an important historical document for the Chinese Pure Land Buddhism. 3. The sutra was compiled during a period of intensive debates on Buddhist philosophy, between the early 5th and the middle 6th century.D. The Contents of the Zhaoming Pusa jingThe opening part of the Zhaoming Pusa jing is missing. But we can see that its organization is different from the traditional three-part style: preface, purport and entrusting the circulation of the sutra. It consists of questions and replies between the the Zhaoming pusa and the Buddha. Ānanda 阿難と Śāriputra 舎利佛appear twice. Its doctrinal contents are very complicated, showing influences from such classical sutras as Pure Land, Nirvāṇa-, Prajñāpāramitā-, Saddharmapuṇḍarīka-, Avataṃsaka-, and Vimalakīrti-sūtra. Its main tenet is that the Buddha-nature already exists in everyone's mind. Everyone can reach the highest destination of great wisdom and enlightenment if one sincerely confesses one's sins to the Buddha, strictly obeys religious regulations, believes in retribution, chants the scriptures and the name of the Buddha, bathes in the Prajñā brightness, and enters the Buddha-nature. The purpose of the sutra is to help the common believer to find wisdom and enlightenment, and also to promote morality with the hope of finding happiness in this life and the next rebirths. It can be divided into the following sections: 1. From the beginning to line 19, they are questions and replies between the Zhaoming Pusa and Buhhda. The main teaching is that if a man does not practice love-kindness and obey religious regulations, he cannot maintain his human existence, will not become enlightened and cannot free himself. It will be impossible for him to get enlightened and to free himself, as the Zhaoming Pusa did. 2. Line 20 to line 56: mention all phenomena 萬法i.e., the five senses and consciousness, the six aspects六事 of the mindfulness of breathing, the eighteen characteristics peculiar to the Buddha, and the sixty-two perverted views, etc., arise on the basis of mind. If one sincerely confesses his sins to the Buddha, he will not fall into the hell. 3. Line 57 to line 67: the Zhaoming Pusa asks Buddha about chanting this sutra and praying to the Buddha .Buddha says it can prevent followers from falling into the Three Bad Destinies 三途, and help them to obtain Buddha's wisdom. 4. Line 68 to line 94: relate the story of Aṣatāśatru's killing his father. The sutra teaches us that sincere confession can help get rid of one's sin. It serves as an emphasis of the idea of retribution. 5. Line 95 to line 147: the sutra stresses that all living creatures have the Buddha-nature in their minds. If they listen to or chant this sutra, they will surely attain wisdom. 6. Line 148 to line 207: the Buddha explains why and how one can obtain the Dharma power and teaches the Zhaoming Pusa 250 discipline rules and three thousand monastic regulations 三千威儀.II. The text of the Zhaoming Pusa jing is contained in Li Shengduo's Collection (not summarised here): please refer to the Japanese version of this paper p.86-106.
著者
福嶋 直弥 鈴木 美紀 小川 諒 林 北見 高梨 潤一 大橋 高志
出版者
日本神経学会
雑誌
臨床神経学 (ISSN:0009918X)
巻号頁・発行日
pp.cn-001078, (Released:2017-10-26)
参考文献数
23
被引用文献数
2 21

症例は20歳女性.11歳時に急性散在性脳脊髄炎を発症し,その後,再発を繰り返した.17歳時には片側大脳皮質にFLAIR高信号を伴う痙攣発作で入院.18歳時に血清抗ミエリンオリゴデンドロサイト糖蛋白質(myelin oligodendrocyte glycoprotein; MOG)抗体陽性と判明した.今回,多相性散在性脳脊髄炎(multiphasic disseminated encephalomyelitis; MDEM)の診断で当科に入院した.抗MOG抗体陽性例でMDEMがみられることは以前から知られているが,近年,痙攣を伴う片側大脳皮質脳炎を来すことが報告された.本症例のように両方の病態を呈した症例の報告はなく,抗MOG抗体の関連する自己免疫疾患の病態を考える上で興味深い.
著者
木村 尚 平林 平八郎 徳吉 睦生
出版者
一般社団法人 粉体粉末冶金協会
雑誌
粉体および粉末冶金 (ISSN:05328799)
巻号頁・発行日
vol.10, no.4, pp.172-180, 1963

A continuous method of producing iron strip from powder has been developed. Iron powder directly conversed to green strip by roll compacting, and which was continuously sintered, hot rolled and cooled in hydrogen atmosphere and coiled up. The effects of various continuous powder rolling factors, such as the sintering temperature, roll speed, and hot rolling lood on the properties of hot rolled strip were investigated with Husquvarna Star electrolytic iron powder and H&ouml;gan&auml;s sponge iron powder.<BR>In general, with increasing the sintering temperature and hot rolling lood the physical and mechanical properties of iron strip by powder rolling were improved, whereas the effect of roll speed was different, depending upon the sinterability of iron powder. These properties obtained were considerably well for the powder metallurgical product, although the sintering time was short. According to the repeated hot rolling or annealing and cold rolling, the pro. perties of the iron strip were equal to those of the conventional iron strip, especially the one made from Husquvarna Star iron powder showed superior magnetic properties.