著者

中嶋 理帆 中田 光俊 Nakajima Riho Nakada Mitsutoshi

出版者

Wellness and Health Care Society

雑誌

Journal of wellness and health care = Journal of wellness and health care (ISSN:24341509)

巻号頁・発行日

vol.43, no.1, pp.1-9, 2019-08-01

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従来,右前頭葉は損傷されたとしても,ヒトが生きる上での致命的な障害を残す可能性が低いことから,脳損傷後に生じる右前頭葉機能の障害にはあまり注意が払われてこなかった。しかし,実際には右前頭葉の損傷後,麻痺や言語障害がないとしても上手く社会復帰できない患者が少なからず存在したことも事実である。近年,脳画像解析の技術が進歩し,脳機能およびそのネットワークに関する理解は飛躍的に進歩した。これらの進歩と共に,右前頭葉はヒトが社会生活を営む上で欠かすことができない種々の機能を司っていることが明らかになってきた。本項では,種々の右前頭葉機能のうち,作業記憶,視空間認知,メンタライジング,注意に焦点を絞ってその症状と関連するネットワークについて最新の知見をまとめた。さらに,近年注目されている脳腫瘍の手術法,覚醒下手術における右前頭葉機能の温存についても言及した。

著者

笠島 里美 Kasashima Satomi

出版者

Wellness and Health Care Society

雑誌

Journal of wellness and health care = Journal of wellness and health care (ISSN:24333190)

巻号頁・発行日

vol.41, no.2, pp.1-7, 2018-01-31

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IgG4 関連疾患(IgG4-relared disease; IgG4-RD)は,血清の IgG4 高値,組織での多数の IgG4陽性の形質細胞浸潤と線維増生を特徴とする疾患群である . 発見から 10 年以上経過し,全身ほぼ全ての臓器に発生しうる事や免疫異常が病因に関わる事等など,病態の理解も進んできた. 腹部大動脈瘤の一亜型に,動脈壁肥厚や炎症細胞浸潤が特徴的な炎症性腹部大動脈瘤 がある.IgG4-RD が多中心性の繊維増殖性疾患の視点から, 我々は炎症性腹部大動脈瘤の約半数が IgG4-RD である事を解明し,臨床病理像をまとめてきた . その後,心血管領域での IgG4-RD の探索を進め,大血管のみならず中型血管,冠動脈,大腿動脈等の末梢血管にまで発生することや,その多くが炎症性動脈瘤或いは動脈周囲炎を呈することも解明し,現在では1gG4 関連血管病変の概念が確立してきた . 本稿では,頻度が高く,prototype となる IgG4 関連炎症性腹部大動脈瘤から説明し, 胸部大動脈,中型動脈,心病変などについても,疾患概念,診断,臨床像,病理像,治療等の概略を示す.

著者

柳原 清子 Yanagihara Kiyoko

出版者

Wellness and Health Care Society

雑誌

Journal of wellness and health care = Journal of wellness and health care (ISSN:24341509)

巻号頁・発行日

vol.44, no.1, pp.1-7, 2020-08-03

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"House/home" and "family" have become keywords once again during the current outbreak of COVID-19. Expectations are placed on "relationships" and "bonds" as well as "family nursing," which supports the resilience of the family to emerge from the crisis. This article describes what family nursing is, what kind of support it provides, and the latest family nursing practices. At the core of family nursing lies "family systems theory," according to which the family is a system, and patients, family members and health care providers are mutually influential members of an environmental system. Family nursing practice consists of taking an overview of individuals (patients), families, and society (the setting for healthcare) through systems thinking, and making adjustments to the system using circular communication. Recently, in medical fields including home care, conflict has frequently arisen between medical staff and the family; often, there is also intra-family conflict due to the reduced ability of the family to cope. A solution-oriented approach is effective in coordinating between health care providers and family members, and between family members themselves, including support in decision-making. The "Watanabe-style" family assessment/support model is based on this solution-oriented approach. The Watanabe-style assessment/support process involves: (1) narrowing down the goals to be solved "here and now" and the target people to approach, (2) grasping the context of each person, (3) distinguishing vicious circles from interactions, and (4) coordinating relationships through circular communication aimed at breaking the vicious circles. In family nursing in the age of COVID-19, it is important to provide support with a systematic and solution-oriented approach that enables the family to respond to environmental threats.