著者
野原 理子 冨澤 康子 齋藤 加代子
出版者
東京女子医科大学学会
雑誌
東京女子医科大学雑誌 (ISSN:00409022)
巻号頁・発行日
vol.87, no.5, pp.146-150, 2017-10-25 (Released:2017-10-25)
参考文献数
8

Purpose: In Japan, although much effort has been made to promote the work-life balance of women and to achieve a society with prosperity and vitality, consideration of working environment including childcare support is still behind. It is necessary to construct an effective system to support childcare for both men and women. This study aimed to examine the system of sick child leave and improvement of childcare environment, by investigating the situation of absence due to illness among nursery children in Tokyo.Methods: All the children who attended three nurseries in Tokyo between April 2011 and March 2016 were studied. The investigation was conducted for 4 days during August 2016. Data for age, sex and days of absence due to illness were extracted from either the attendance lists or health records of the children in each nursery for the period of 2011-2015. Children who were absent for the whole month were excluded from analysis for that month. This study was approved by the Tokyo Women's Medical University Ethics Committee (Approval Number 4040).Results: A total of 1,834 children (989 boys and 845 girls) were studied. The average annual number of days of absence due to illness per person by class was 19.3 days in the 0-year-old class. The number decreased with age, and was 5.4 days in the 5-year-old class. The average frequency of sick absence per month was the highest in July and the lowest in June.Conclusion: The present study showed that sick absence was the highest among the 0-year-old nursery children, indicating that a fine-tuned childcare support system such as allowing more sick child leave in the first year may be helpful to improve working environment.
著者
森永 頼鷹 河野 仁彦 大下 隆司 高橋 一志 石郷岡 純
出版者
東京女子医科大学学会
雑誌
東京女子医科大学雑誌 (ISSN:00409022)
巻号頁・発行日
vol.86, no.臨時増刊1(医学部精神医学講座 石郷岡純教授退任記念特別), pp.E150-E153, 2016-01-31

15 0 0 0 OA (1)炎症とは

著者
加藤 秀人
出版者
東京女子医科大学学会
雑誌
東京女子医科大学雑誌 (ISSN:00409022)
巻号頁・発行日
vol.90, no.1, pp.1-13, 2020-02-15 (Released:2020-02-26)
参考文献数
69

Stress responses are part of an important system in maintaining the homeostasis of a living organism. After acute inflammation, if tissue repair is incomplete or stress is not completely removed with an excessive and prolonged inflammatory response, damage is accumulated in living organs and chronic inflammation persists. Thus, irreversible tissue and organ damage occurs, which is accompanied by fibrosis. Further, inflammatory diseases, such as fibrotic diseases, autoimmune diseases, allergies, and arteriosclerosis, account for most causes of deaths in humans; therefore, it is extremely important to understand mechanisms of inflammation and to establish a control method. Inflammation is caused by a complex influence of various molecules and cells that form networks through inflammatory cytokines. Since various factors influence each other, the onset time, degree, and duration of inflammation may differ. This article explains the mechanism of inflammation, presents findings on its regulatory factors and methods, and enumerates the innate immune system receptors (pattern recognition receptors) and responsible cells (neutrophils, innate lymphoid cells, natural killer T cells) that cause inflammation. This article thus aims to understand the complex networks involved in inflammation.
著者
阿部 光司 廣瀬 翔子 本田 隆文 安川 久美 武藤 順子 髙梨 潤一
出版者
東京女子医科大学学会
雑誌
東京女子医科大学雑誌 (ISSN:00409022)
巻号頁・発行日
vol.92, no.3, pp.110-115, 2022-06-25 (Released:2022-06-25)
参考文献数
12

An 18-month-old boy developed toxic shock syndrome (TSS) after a minor burn. He sustained a second-degree burn (superficial partial thickness) over 4-5% of the total body surface area on the right upper arm and lateral chest. Four days later, he developed a fever and was brought to the emergency room of our hospital. At presentation, he had tachycardia and peripheral coldness despite the fever. There were no signs of infection at the burn site, but diffuse erythema was observed on the left upper arm and lateral chest. He was admitted to the pediatric intensive care unit for suspected TSS and compensated shock. Gradually, his condition stabilized and he was transferred to the general ward on day 4 of hospitalization. On day 7, desquamation away from the wound was observed. Staphylococcus aureus positive for the TSS toxin-1 gene was detected in the wound culture on admission, and we diagnosed probable TSS. Based on the course and physical examination findings, the patient was treated for TSS and had a good outcome without developing hypotension or multiple organ failure. TSS progresses rapidly and can be fatal, so it is important to be aware of TSS when treating febrile children with burns.
著者
鈴木 恵子
出版者
東京女子医科大学学会
雑誌
東京女子医科大学雑誌 (ISSN:00409022)
巻号頁・発行日
vol.87, no.Extra1, pp.E54-E64, 2017-05-31 (Released:2017-07-31)
参考文献数
22

Acute encephalopathy in childhood is life-threatening and may cause death or neurological sequelae. Acute-phase clinical symptoms are pyrexia, seizures, and disturbance of consciousness. Many cases of influenza-associated encephalopathy in childhood have been reported in Japan, which is diagnosesd by its characteristic clinical course and finding from magnetic resonance imaging (MRI) of the head. Several cases have been characterized by hypercytokinemia, therefore, anti-proinflammatory cytokine therapy, such as methylprednisolone pulse therapy and intravenous immunoglobulin therapy, has been recommended for treating encephalopathy. Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is a subtype of influenza-associated encephalopathy. However, AESD can be induced not only by influenza virus but also by other pathogens. The clinical course is characterized by a febrile seizure (usually >30 minutes) as the initial neurological symptom on day 1, followed by recurrent seizures on days 4-6. On days 3-9, lesions can be detected in the subcortical white matter by diffusion-weighted MRI. Although the mortality rate due to AESD is not high, associated neurological sequelae are frequently observed. An excitotoxic injury with delayed neuronal death is considered to be the primary pathogenic mechanism of AESD, although hypercytokinemia and metabolic failure can also occur. Control of the initial and recurrent seizures may affect outcomes.
著者
西山 圭子 小森 万希子 立石 実 松本 卓子 冨澤 康子
出版者
東京女子医科大学学会
雑誌
東京女子医科大学雑誌 (ISSN:00409022)
巻号頁・発行日
vol.87, no.6, pp.165-169, 2017-12-25 (Released:2017-12-25)
参考文献数
22

Medical doctors actively participate in academic meetings and study intensively to achieve self-improvement in medical science and practice and thereby develop possibilities for future career success. It is important and valuable experience to learn techniques for questions and answers and discussions at academic meetings and to interact with people at social gatherings, along with reading academic books and journals. Participation or making academic presentations at academic societies is indispensable to becoming a specialist. Establishment of daycare nursery centers in academic meetings has been proposed as one of the positive actions to improve the environment to enable female doctors to continue to work actively. Here, we present information useful for the organizers of academic meetings at the time of setting up daycare nursery centers. The use of daycare centers differs depending on the academic society and is affected by factors such as whether the number of uses is small or conversely waiting for cancellation; the cost burden also varies. We find good examples of safety management, including cooperation with neighboring doctors. As the number of female doctors and the demand for academic daycare centers will increase, each academic society must secure nursery teachers, a place, and a budget to establish daycare nursery centers.
著者
中村 史雄 石津 綾子
出版者
東京女子医科大学学会
雑誌
東京女子医科大学雑誌 (ISSN:00409022)
巻号頁・発行日
vol.91, no.1, pp.11-18, 2021-02-25 (Released:2021-03-16)
参考文献数
58

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has a wide range of clinical manifestations, including acute respiratory distress syndrome, severe inflammation, abnormal blood coagulation, and cytokine storm syndrome. SARS-CoV-2 uniquely facilitates its entry and expansion in host cells through the spike protein consisting of S1 (receptor binding domain) and S2 (fusion peptide domain). The S1 binds to angiotensin-converting enzyme 2 (ACE2), the host cell receptor. The cleavage at the boundary of S1 and S2 by Furin protease and subsequent digestion within the S2 by TMPRSS2 activate the S2 fusion peptides, which are necessary for the entry of SARS-CoV-2 into host cells. After infection, SARS-CoV-2 RNA genome encodes viral proteins including structural proteins, RNA polymerases/helicases, and modulators of host-defense system, which inhibit type I-interferon-related immune signaling and signal transducer and activator of transcription 1 (STAT1) signaling. In contrast, SARS-CoV-2 infection activates the proinflammatory cytokines, such as interleukin 6 (IL-6) and tumor necrosis factor α (TNFα). In severe cases of COVID-19, these alterations in immune signaling may induce a state of systemic immune dysfunction. Recent studies also revealed the involvement of hematopoietic cells and alteration of cellular metabolic state in COVID-19. We here review the pathogenesis of COVID-19, primarily focusing on the molecular mechanism underlying SARS-CoV2 infection and the resulting immunological and hematological alterations.
著者
鈴木 美紀 竹内 恵 内山 真一郎 Miki SUZUKI Megumi TAKEUCHI Shinichiro UCHIYAMA
出版者
東京女子医科大学学会
雑誌
東京女子医科大学雑誌 (ISSN:00409022)
巻号頁・発行日
vol.84, no.臨時増刊1(医学部神経内科学教室 内山真一郎教授退任記念特別), pp.E73-E79, 2014-01-31
著者
吉田 雅博
出版者
東京女子医科大学学会
雑誌
東京女子医科大学雑誌 (ISSN:00409022)
巻号頁・発行日
vol.88, no.Extra1, pp.E35-E37, 2018-01-31 (Released:2018-02-28)
参考文献数
8
被引用文献数
1

It is important to develop clear and reliable clinical practice guidelines through consensus. It is thought that this way of thinking should be considered with the selection of the member, the scope establishment, conflict of interest management, a systematic review, recommended making, and all finalized processes throughout.The Delphi method is known as one of the effective and popular consensus formation methods. However, it has rarely been used in the development of guidelines. Therefore, I investigated the utility of the Delphi method for this purpose.In this method, an expert votes independently on each theme, and subsequent votes are gathered based on these results, until consensus is achieved.Delphi is the name of a place in ancient Greece that housed the temple of Apollo, which is famous for an oracle. This method was named after this place because it was believed that the process involved the use of expertise to arrive at the truth (the Delphi oracle) that was known only by the Almighty God.
著者
塚原 富士子 丸 義朗
出版者
東京女子医科大学学会
雑誌
東京女子医科大学雑誌 (ISSN:00409022)
巻号頁・発行日
vol.91, no.1, pp.19-28, 2021-02-25 (Released:2021-03-16)
参考文献数
63

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in late 2019. It has been rapidly spreading worldwide ever since. The majority of COVID-19 infections are asymptomatic or mildly symptomatic. However, old age or comorbidities can result in a cytokine storm, which eventually leads to death. To date, no drug has been clinically proven effective to treat COVID-19, and development of effective drugs against SARS-CoV-2 is urgently required. Several drugs used in treating other diseases are being evaluated. Clinical trials on many new antiviral drugs and vaccine candidates are also rapidly ongoing. In this review, we summarized the currently used drugs and newly developed vaccines for the treatment of COVID-19.
著者
村上 てるみ 石垣 景子 佐藤 孝俊 梶野 幸子 齊藤 崇 大澤 真木子
出版者
東京女子医科大学
雑誌
東京女子医科大学雑誌 (ISSN:00409022)
巻号頁・発行日
vol.83, no.1, pp.E36-E41, 2013-01-31

福山型先天性筋ジストロフィー(FCMD)は大脳形成異常、精神遅滞を特徴とする先天性筋ジストロフィーで、責任遺伝子はα-ジストログリカンの糖鎖付加に関与するFKTN遺伝子である。,私たちは以前、FCMD患者がウイルス感染による発熱性疾患罹患後に、高クレアチンキナーゼ(CK)血症や尿中ミオグロビン高値を伴い、時に呼吸不全から死に至る急激な筋力低下の増悪を呈することを報告した。これまでの報告では、発症時期や原因ウイルス、好発年齢の考察は行ったが、治療法については十分な検討がなされていなかった。今回、1971年1月から2012年7月までに東京女子医科大学小児科に発熱性疾患で受診したFCMD患者245名のうち、急激な筋力低下増悪を呈した23名を対象に、筋力低下増悪時の治療について検討した。23名のうちステロイドを投与された患者は12名であり、投与しなかった患者は11名であった。ステロイド投与群、非投与群共に、罹患前の運動機能レベルまで回復したが、回復までにかかる期間に統計学的有意差を認めた。今回の検討でステロイド投与により筋力回復までの期間が短縮されることが示唆された。FCMD患者において、高頻度にウイルス感染後の筋力低下増悪を生じる機序は不明だが、急激な筋力低下増悪による呼吸不全から死に至る例もあり、保護者や医療者は認識する必要があると考える。
著者
田宮 貞仁
出版者
東京女子医科大学学会
雑誌
東京女子医科大学雑誌 (ISSN:00409022)
巻号頁・発行日
vol.22, no.2, pp.87-87, 1952-05-25

東京女子医科大学学会第53回例会 1952年2月29日 東京女子医大臨床講堂
著者
鈴木 麻耶 中神 朋子 柴崎 千絵里 廣田 尚紀 内潟 安子
出版者
東京女子医科大学学会
雑誌
東京女子医科大学雑誌 (ISSN:00409022)
巻号頁・発行日
vol.87, no.Extra2, pp.E261-E268, 2017-11-30 (Released:2018-02-15)
参考文献数
16

Aim: Recently, artificially sweetened beverages (ASBs) have inundated the market because of their low calorie value. We examined the prevalence and related factors of ASB intake among patients with type 2 diabetes (T2DM) using questionnaires.Methods: This study randomly selected 209 patients with T2DM who visited our center between December 1 and 20, 2016. For validation of questionnaires on ASB and sugar sweetened beverage (SSB) intake, 1-month beverages' record was performed in 40 patients with and without DM.Results: The agreement between the recorded information and answers to the questionnaires on ASB/SSB intake was over 75 %. The prevalence of ASB and SSB intake was 27 % and 17 %, respectively. In total, 71 % of patients initiated ASB intake after T2DM onset. Multivariable logistic regression analysis showed that ORs (95 % CIs) for intake of ASB related to age 60-69 and ≥70 years old compared with <60 years old were 0.2 (0.1-0.5) and 0.1 (0.03-0.3). The corresponding values for HbA1c 6.5-7.1 and ≥7.2 % compared with <6.5 % were 2.6 (0.9-6.9) and 2.9 (1.1-7.6).Conclusion: The prevalence of ASB intake anticipated from questionnaires was 27 %, with 71 % of these patients initiating ASB intake after T2DM onset. Not older age and a higher HbA1c were independently related to ASB intake.
著者
奥山 直美 宮永 嘉隆
出版者
東京女子医科大学学会
雑誌
東京女子医科大学雑誌 (ISSN:00409022)
巻号頁・発行日
vol.53, no.10/11, pp.1190-1191, 1983-11-25

第3回学内免疫談話会 昭和58年7月9日 中央校舎1階会議室