著者

Toshimi Michigami Yasuhisa Ohata Makoto Fujiwara Hiroshi Mochizuki Masanori Adachi Taichi Kitaoka Takuo Kubota Hideaki Sawai Noriyuki Namba Kosei Hasegawa Ikuma Fujiwara Keiichi Ozono

出版者

The Japanese Society for Pediatric Endocrinology

雑誌

Clinical Pediatric Endocrinology (ISSN:09185739)

巻号頁・発行日

vol.29, no.1, pp.9-24, 2020 (Released:2020-01-09)

参考文献数

48

被引用文献数

28

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Hypophosphatasia (HPP) is a rare bone disease caused by inactivating mutations in the ALPL gene, which encodes tissue-nonspecific alkaline phosphatase (TNSALP). Patients with HPP have varied clinical manifestations and are classified based on the age of onset and severity. Recently, enzyme replacement therapy using bone-targeted recombinant alkaline phosphatase (ALP) has been developed, leading to improvement in the prognosis of patients with life-threatening HPP. Considering these recent advances, clinical practice guidelines have been generated to provide physicians with guides for standard medical care for HPP and to support their clinical decisions. A task force was convened for this purpose, and twenty-one clinical questions (CQs) were formulated, addressing the issues of clinical manifestations and diagnosis (7 CQs) and those of management and treatment (14 CQs). A systematic literature search was conducted using PubMed/MEDLINE, and evidence-based recommendations were developed. The guidelines have been modified according to the evaluations and suggestions from the Clinical Guideline Committee of The Japanese Society for Pediatric Endocrinology (JSPE) and public comments obtained from the members of the JSPE and a Japanese HPP patient group, and then approved by the Board of Councils of the JSPE. We anticipate that the guidelines will be revised regularly and updated.

著者

Takuo Kubota Masanori Adachi Taichi Kitaoka Kosei Hasegawa Yasuhisa Ohata Makoto Fujiwara Toshimi Michigami Hiroshi Mochizuki Keiichi Ozono

出版者

The Japanese Society for Pediatric Endocrinology

雑誌

Clinical Pediatric Endocrinology (ISSN:09185739)

巻号頁・発行日

vol.29, no.1, pp.25-42, 2020 (Released:2020-01-09)

参考文献数

79

被引用文献数

19

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Achondroplasia (ACH) is a skeletal dysplasia that presents with limb shortening, short stature, and characteristic facial configuration. ACH is caused by mutations of the FGFR3 gene, leading to constantly activated FGFR3 and activation of its downstream intracellular signaling pathway. This results in the suppression of chondrocyte differentiation and proliferation, which in turn impairs endochondral ossification and causes short-limb short stature. ACH also causes characteristic clinical symptoms, including foramen magnum narrowing, ventricular enlargement, sleep apnea, upper airway stenosis, otitis media, a narrow thorax, spinal canal stenosis, spinal kyphosis, and deformities of the lower extremities. Although outside Japan, papers on health supervision are available, they are based on reports and questionnaire survey results. Considering the scarcity of high levels of evidence and clinical guidelines for patients with ACH, clinical practical guidelines have been developed to assist both healthcare professionals and patients in making appropriate decisions in specific clinical situations. Eleven clinical questions were established and a systematic literature search was conducted using PubMed/MEDLINE. Evidence-based recommendations were developed, and the guidelines describe the recommendations related to the clinical management of ACH. We anticipate that these clinical practice guidelines for ACH will be useful for healthcare professionals and patients alike.

著者

長谷川 高生 ハセガワ コウセイ Kosei Hasegawa

雑誌

近畿福祉大学紀要

巻号頁・発行日

vol.2, pp.22-33, 2001-12-15

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In this paper, I analize the political process of transition to the democracy in Spain more in detail than in my book, From Dictatorship to Democracy - Spain and Japan - (1999). I try to examine political reality of the transitional process to the democracy, by considering the policies and disputes among the political parties and analizing the results of elections in this process. As I offered in above-mentioned book, I devide this process into four periods:the period to December of 1973, the period from January of 1974 to July of 1976, the period from July of 1976 to 1979 and the period from March of 1979. In the first period, the authoritarian strategy from above by Franco regime was executed on liiegal oppositions. But this period was ended by the assassination of L. Carrero Blanco. In the second period, C. Arias Navarro did the strategy of confrontation against democratic insistence of the labor movements and oppositions, but failed between the attack from the right and the refusal from the democratic oppositions. The third period is characterized with the strategies of consensus adopted by Adolfo Suarez. He took the policy of consent to both the arms, the conservative right and the parties of democratic opposition, and got the success of democratic transition. He could also execute the strategy of consensus to from UCD as a consociational party and to deal with the parties of AP, PSOE and PCE etc. In the fourth period the democratic system was established, but the strategy of confrontation between the ruling party and the opposition parties appeared again.