4 0 0 0 OA 心不全の在宅医療における薬剤師の役割
- 著者
- 佐久間 詠理 川内 潤也 行田 泰明 及川 由紀枝 渡邉 淳子
- 出版者
- 公益社団法人 日本薬学会
- 雑誌
- YAKUGAKU ZASSHI (ISSN:00316903)
- 巻号頁・発行日
- vol.140, no.7, pp.869-875, 2020-07-01 (Released:2020-07-01)
- 参考文献数
- 5
In recent years, home medical care has been strongly promoted. As a consequence, the conditions managed in home medical care have become increasingly diverse. Heart failure is one of the most common disorders after malignant diseases. Patients with chronic heart failure (CHF) are often forced into hospitalization because of the inability to control symptoms with oral medications, even though they hope to stay at home. Recently, we have experienced a case where the patient required continuous administration of dobutamine at home. In order to carry out CHF care at home successfully, it is necessary to adjust the doses of catecholamine and furosemide swiftly in response to changes in patients' conditions. In this case, the patient was able to spend four months at home thanks to the cooperation of a team of a physician, nurses, and pharmacists. Catecholamine-dependent patients with terminal CHF require expensive medical infusion pumps for precise administration. However, the economic assistance to such patients remains insufficient. Furthermore, dobutamine and furosemide injections are not dispensed extramurally, and therefore might become an impediment to the cooperation of the team. In this symposium, I consider and discuss the role of pharmacists in a home medical care team for patients with terminal CHF.
4 0 0 0 医学セミナーの試み2003: 性同一性障害
2 0 0 0 OA 遺伝子変異型により分類化した血管型エーラス・ダンロス症候群の治療手法の開発
血管型エーラス・ダンロス症候群(血管型EDS,エーラス・ダンロス症候群IV型)は、血管や管腔臓器に特異的に発現するIII型コラーゲン(COL3A1)の片方のアレルの遺伝子変異で発症する.本症候群は血管破裂、消化管破裂、子宮破裂を合併し、時に突然死を呈する常染色体優性遺伝病であり,他のエーラス・ダンロス症候群と異なる疾患群と考えられている。現在のところ、根本的な治療法はなく対症療法が主となっている.本研究では血管型EDSのCOL3A1変異型(グリシン変異、splicing変異)ごとに、COL3A1変異アレルに対するRNAi(RNA interference)による発現抑制効果を検討し、これまで治療法のない血管型EDSに対する治療の可能性について臨床応用に向けた基礎的研究成果を集積することを目的とした.それぞれの変異型に対して変異部位特異的なsiRNAを作成し、変異線維芽細胞に導入した。Splicing変異においては、変異mRNAの発現を特異的に80%以上減少することができた。さらに、コラーゲンの発現増加に関わるLysyl oxidase(LOX)の発現ベクターをsiRNAと同時に導入したところ正常COL3A1の発現の増加を認めた。その後、グリシン変異、splicing変異によるdominantnegat iveメカニズム以外に、haploinsufficiencyを来すナンセンス変異に対しては、Lysyloxidase(LOX)を導入することで正常COL3A1の発現の増加を認めた。新たにsplicing異常をきたすを来す変異を同定し、スプライスを人工的に起こす発現ベクターを構築し、in vitro変異評価できるシステムを構築した。
1 0 0 0 OA エーラスダンロス症候群・新規病型の臨床的および分子遺伝学的探索
エーラスダンロス症候群(Ehlers-Danlos症候群;EDS)は、皮膚・関節の過伸展性、各種組織の脆弱性を特徴とする先天性疾患の総称です。現在、6つの大病型およびその他の病型に分類されていますが、これらの分類には当てはまらない患者さんも少なくありません。本研究では、全国からEDSを含めた遺伝性結合組織疾患疑い患者さんを収集し、詳細な臨床的分析と次世代シーケンスを用いた網羅的遺伝子解析により、新たな病型を探索しました。結果、COL5A2遺伝子変異に基づき、乳児期より顕著な皮膚過伸展性・脆弱性、重篤な後側彎症を発症する重症古典型サブタイプなどを発見することに成功しました。
1 0 0 0 OA 和時計から日本の歯車の源流を探る
- 著者
- 上田 昭夫 渡邉 淳 宮嵜 美弥子 久保 愛三 松岡 裕明
- 出版者
- 一般社団法人 日本機械学会
- 雑誌
- 日本機械学会論文集 (ISSN:21879761)
- 巻号頁・発行日
- vol.83, no.847, pp.16-00295-16-00295, 2017 (Released:2017-03-25)
- 参考文献数
- 18
The purpose of this study is to understand the nature of one of the oldest gears used in traditional Japanese clock. Today's gear manufacturing technology in Japan came mostly from Europe and America, but we do not know exactly, when and how the gears were manufactured for the first time in Japan. It is interesting to search for this history. It is also exciting to study the tooth profile, precision and accuracy of the gears, and materials of the gears at that time. So far, there have been some studies performed for the mechanism of traditional Japanese clocks/watches, but not for gears. Fortunately we have a chance this time to investigate gears for Japanese watch drive that was made in 1688. Tooth profile and pitch error were measured, and transmission error analysis was also performed. It revealed that the precision of the watch was extremely high without any rust for more than 300 years, even though they were all handmade by Japanese mechanism technician named Sukeza-emon Tsuda the III. In the old days, there was no study on conjugate tooth profile theory available, but mysteriously, tooth profile was nearly made in the form of cycloid. Moreover, the gear material investigation was very interesting: The texture of the gear material was very homogeneous and grain size is far smaller than that of today's comparable steel kind. Impurities in it were very small and scattered well in the matrix. The steel was surely made by Japanese sword smith. The ore of the steel was perhaps sand-iron and it was refined with pine charcoal. The steel was forged and forged by hand very hardly. As the result the quality of the steel of 1688 looks far better than today's industrial steel. This research enabled us to discover how Japanese gear technology was born and developed.