著者
清水 祥子 加藤 孝和 飯田 みゆき 芦原 貴司
出版者
一般社団法人 日本不整脈心電学会
雑誌
心電図 (ISSN:02851660)
巻号頁・発行日
vol.42, no.1, pp.14-25, 2022-03-04 (Released:2022-03-17)
参考文献数
16

症例は83歳男性,高血圧症,脂肪肝で通院.初診時は53歳.30年間にわたる心電図経過の中で,5種類のQRS波形を呈した間欠性完全右脚ブロック,間欠性軸右方シフトを呈した.71歳時には洞調律で完全右脚ブロック型,QRS軸は+15°〔C15〕であったが,74歳時には洞調律で完全右脚ブロック型のまま,QRS軸が+60°と右方にシフトした〔C60〕.76歳時に心房細動が初発したが,〔C60〕は不変であった.78歳時,先行RR間隔が1.01秒以上では間欠性ながら〔C15〕に戻った.79歳時には,先行RR間隔が0.98秒以上では間欠性に不完全右脚ブロック型を呈したが,QRS軸は+60°〔I60〕のまま不変であった.80歳時には,〔C60〕,〔C15〕,不完全右脚ブロック型でQRS軸+15°〔I15〕の3種類のQRS波形を認め,83歳時には〔I60〕に加え,さらに先行RR 間隔が0.44~0.48秒と極端に短い状況では,QRS幅0.08秒でQRS軸+70°の過常期伝導と考えられる正常QRS波形〔N70〕を認めた.このように,QRS波形が右脚ブロック型のままでQRS幅とQRS軸のそれぞれが異なる臨界先行RR間隔で変化する現象は,右脚の伝導障害のみでは説明困難であり,ヒス束内縦解離によるtriple pathwayを想定することにより,はじめて説明可能と考えられた.
著者
Itsuko Miyazawa Aya Kadota Katsuyuki Miura Motozumi Okamoto Takashi Nakamura Tsuyoshi Ikai Hiroshi Maegawa Atsushi Ohnishi
出版者
The Japan Endocrine Society
雑誌
Endocrine Journal (ISSN:09188959)
巻号頁・発行日
vol.65, no.5, pp.527-536, 2018 (Released:2018-05-28)
参考文献数
31
被引用文献数
22

The prevalence of obesity is increasing globally in patients with diabetes. This study aimed to examine 12-year trends of increasing obesity in Japanese patients with diabetes, and their clinical features. The study used results of the Shiga Diabetes Clinical Survey, which recorded medical performance in diabetic patients in 2000, 2006 and 2012. Data were analyzed from 14,205, 14,407 and 21,449 adult patients in these three years, respectively. Overweight and obesity prevalence and the clinical features of diabetes patients were examined, stratified by body mass index (BMI) and age. The prevalence of overweight (BMI 25–30 kg/m2) and obesity (BMI ≥30 kg/m2) were 27.0% and 5.1% in 2000, 28.9% and 7.3% in 2006 and 30.9% and 10.0% in 2012. Glycemic control, blood pressure and serum lipid profile improved over 12 years in all BMI categories. However, glycemic and triglyceride control were insufficient in obese patients aged <65 years (hemoglobin A1c 7.5 ± 1.4%, triglyceride 197.7 ± 178.4 mg/dL in 2012). The percentage of patients who used antihypertensive and lipid-lowering drugs increased and patients with higher BMI had increased frequency of using these drugs, both in young and old age groups. Higher BMI was significantly and positively associated with albuminuria. In summary, overweight and obesity have increased in Japanese diabetic patients, particularly for younger generations. Findings suggest that obesity may lead to poorer glycemic control, blood pressure and lipid profiles. Overweight and obesity are important modifiable risk factors for diabetes, suggesting that more active weight-control interventions are warranted.
著者
後藤 洋三 鈴木 光 村瀬 一郎
出版者
Japan Society of Civil Engineers
雑誌
地震工学論文集 (ISSN:1884846X)
巻号頁・発行日
vol.29, pp.1362-1380, 2007 (Released:2010-07-30)

2006年8月14日に発生した首都圏広域停電が様々な事業体や防災機関の情報システムに与えた影響を調査し, 地震時の突発的な停電に対する現存の情報システムの脆弱性と事業体の減災力への影響を分析した. 幸い停電はお盆休み期間中の早朝に発生し, ほぼ1時間以内に回復したため, 人的物的な被害は小さく, 情報システムについても調査できた被害事例は少なかった. しかし, 周辺機器への非常用電源の接続の不備でシステムが機能しなかった事例や, 一度ダウンしたシステムを再起動し点検するのに長時間を要した事例, 非常用電源が普及してきた反面停電が長期化した場合の対応, 情報システムが不測のダウンをした場合代換え機能不備など, 今後参考にすべき調査結果が得られた.
著者
Yu Kurahara Yoshinobu Matsuda Kazunari Tsuyuguchi Akihiro Tokoro
出版者
The Japanese Society of Internal Medicine
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
pp.9013-21, (Released:2022-02-26)
参考文献数
15
被引用文献数
4

Objective The incidence and clinical importance of delirium in COVID-19 have not yet been fully investigated. The present study reported the prevalence of delirium in patients with COVID-19 and identified the factors associated with delirium and mortality. Methods We performed an observational, retrospective study of patients diagnosed with COVID-19 at the Kinki-Chuo Chest Medical Center. Univariate and multivariate logistic regression analyses were used to explore delirium risk factors. Patients or Materials All consecutive patients diagnosed with COVID-19 at the Kinki-Chuo Chest Medical Center. Results We identified 600 patients [median age: 61.0 (interquartile range: 49.0-77.0) years old], of whom 61 (10.2%) developed delirium during their stay. Compared with patients without delirium, these patients were older (median age 84.0 vs. 56.0 years old, p <0.01) and had more comorbidities. Based on a multivariate analysis, age, dementia, severe disease, and lactate dehydrogenase (LDH) levels were independent risk factors for developing delirium. For every 1-year increase in age and 10-IU/L increase in LDH, the delirium risk increased by 10.8%-12.0% and 4.6%-5.7%, respectively. There were 15 (24.6%) in-hospital deaths in the group with delirium and 8 (1.6%) in the group without delirium (p <0.01). Delirium was associated with an increased mortality. Conclusion Delirium in patients with COVID-19 is prevalent and associated with poor clinical outcomes in Japan. Despite difficulties with COVID-19 patient care during the pandemic, physicians should be aware of the risk of delirium and be trained in its optimal management.
著者
Masaharu Akao Hisashi Ogawa Nobutoyo Masunaga Kimihito Minami Kenjiro Ishigami Syuhei Ikeda Kosuke Doi Yasuhiro Hamatani Takashi Yoshizawa Yuya Ide Akiko Fujino Mitsuru Ishii Moritake Iguchi Hiromichi Wada Koji Hasegawa Hikari Tsuji Masahiro Esato Mitsuru Abe for the Fushimi AF Registry Investigators
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-22-0023, (Released:2022-03-13)
参考文献数
32
被引用文献数
17

Background:Atrial fibrillation (AF) increases the risk of stroke and death. Oral anticoagulants (OAC) are highly effective in reducing the risk of stroke, and direct oral anticoagulants (DOAC) became available worldwide in 2011.Methods and Results:The Fushimi AF Registry is an on-going prospective survey of AF patients in Fushimi-ku, Kyoto, Japan. The study cohort consisted of 4,489 patients (mean age 73.6 years, 59.6% male, mean CHADS2score 2.03), enrolled in 2011–2017. From 2011 to 2021, antithrombotic therapy has undergone a major transition; the proportion of patients receiving OAC has increased from 53% to 70%, with a steady uptake of DOAC (from 2% to 52%), whereas the proportion of patients receiving antiplatelet agents has decreased from 32% to 14%. Over a median follow-up of 5.1 years, the incidence of stroke/systemic embolism (SE), major bleeding, and all-cause death was 2.2%, 1.9%, and 4.9% per patient-year, respectively. The incidence of stroke/SE (1.6% vs. 2.3%; P<0.01), major bleeding (1.6% vs. 2.0%; P=0.07), and death (4.2% vs. 5.0%; P<0.01) was lower among patients enrolled in 2014–2017 than in 2011–2013, despite comparable baseline characteristics (age 73.2 vs. 73.7 years, CHADS2score 2.03 vs. 2.04, and HAS-BLED score 1.67 vs. 1.77, respectively).Conclusions:Over the past 10 years, there has been a major transition in antithrombotic therapy and a decline in the incidence of adverse events in AF patients.
著者
望月 美也子 重村 隼人 長谷川 昇
出版者
The Japan Society of Home Economics
雑誌
一般社団法人日本家政学会研究発表要旨集
巻号頁・発行日
pp.201, 2005 (Released:2005-12-08)

【目的】炎症性腸疾患は、腸粘膜に慢性の炎症または潰瘍を引き起こす難治性特定疾患の総称であり、過剰な過酸化物の生成により発症することが明らかとなっている。我々は、既に、脂肪細胞において、緑茶がSOD活性を増加させ、過酸化物の生成を抑制することを明らかにしている(第54回日本家政学会、東京、2003)。そこで、本研究は、2,4,6-trinitrobenzene sulfonic acid(TNBS)によって誘発される、炎症性腸疾患動物モデルに対する緑茶カテキン(-)-epigallocatechin-3-gallate (EGCG)の保護効果を確かめるために行われた。【方法】雄SDラット(180±20g)を用い、EGCG(30mg/kg)を10日間連続的に経口投与した。炎症性腸疾患は、TNBS50%エタノール水溶液(120mg/Kg)を直腸内投与することにより誘発させた。12時間後、大腸を採取し、炎症部位のダメージスコア、好中球浸潤の指標であるmyeloperoxidase(MPO)活性、superoxide dismutase(SOD)活性を測定した。【結果・考察】本研究の結果、TNBSによる潰瘍、出血を伴う炎症性大腸炎の症状と、MPO活性の有意な増加が見られた。この際、あらかじめ緑茶カテキンの主成分であるEGCGを投与しておくと、粘膜肥厚と出血が抑えられ、白血球の浸潤も抑制された。この原因として、EGCGがSOD活性を有意に増加させたため、ラジカルが補足され、腸粘膜が過酸化物による損傷から保護されたことによると考えられる。以上の結果を総合すると、EGCGは炎症性腸疾患に有効であることが明らかとなった。
著者
池上 敏幸 山田 弘幸 原 修一
出版者
日本音声言語医学会
雑誌
音声言語医学 (ISSN:00302813)
巻号頁・発行日
vol.60, no.2, pp.140-147, 2019 (Released:2019-05-24)
参考文献数
27

7例の構音障害児について,外的語音弁別能力(他者が発した語音を弁別する能力)を聴覚的絵ポインティング課題にて検討した.対象とした構音障害児は,すべて構音訓練を受けたことがなかった.健常3歳児および4歳児(各10例)を対照群とした./k//s/を語頭音とした2モーラ語「かめ」「さめ」に,後続音を統一した「あめ」「まめ」を加えた四分の一選択課題を行い,正答数および語彙選択率を算出し,反応時間を計測した.その結果,語頭音/k/を置換している構音障害児群の外的語音弁別能力は,健常4歳児群と同程度であった.しかし,語頭音/s/を置換している構音障害児群に関しては,健常3歳児群と同程度の外的語音弁別能力であることが示唆された.構音障害児の外的語音弁別能力には,構音の誤り方の種類によって,弁別しやすい音と弁別しにくい音がある可能性があり,正しい構音の獲得には,自己の産生音に対する構音の自覚が重要であると考えられた.
著者
鈴木 みずえ
出版者
日本転倒予防学会
雑誌
日本転倒予防学会誌 (ISSN:21885702)
巻号頁・発行日
vol.2, no.3, pp.3-9, 2016-03-10 (Released:2016-06-27)
参考文献数
14
被引用文献数
2

人口の高齢化に伴って認知症高齢者の数は増大し,入院患者における認知症高齢者の割合も増加している。認知症高齢者の場合には,認知症という脳神経系の疾患による症状や加齢による心身機能の変化に伴って,転倒リスクに関連する身体機能も変化しやすく,潜在的なニーズが満たされないことから危険な行動を起こして転倒している。認知症高齢者の中核症状に関連した転倒リスクを明確にするとともに,認知症高齢者の視点からのニーズやこのような転倒を引き起こすプロセスも踏まえて,的確にケアをすることが重要である。認知症高齢者のニーズや転倒リスクは多様であることから多職種チームで転倒予防に取り組まなければならない。今後,これらのエビデンスに基づき,わが国の高齢者施設の状況に合わせて実行可能で継続性の高いプログラムの実践が望まれる。
著者
正木 澄江 岡田 昌毅
出版者
産業・組織心理学会
雑誌
産業・組織心理学研究 (ISSN:09170391)
巻号頁・発行日
vol.28, no.1, pp.43-57, 2014 (Released:2019-08-05)

The purpose of this study was to examine the fostering process of personal meaning in work among employees. Semi-structured interviews were conducted with 14 business persons in their 30s working for Japanese private companies. The verbal protocols for each participant were analyzed according to the modified grounded theory approach (M-GTA). As a consequence, 6 category groups, 14 categories, 14 sub-categories, and 59 concepts were created based on data. The major findings were as follows: 1) the process of meaning in work is understood in terms of employees deepen the personal understanding of working, while heading one’s worth in society, 2) the process is facilitated by the societal involvement and work practice in organization, and 3) interpersonal conflict promote the meaning in work significantly.
著者
水垣 源太郎
出版者
社会学研究会
雑誌
ソシオロジ (ISSN:05841380)
巻号頁・発行日
vol.40, no.2, pp.41-57,174, 1995-05-31 (Released:2017-02-15)

This paper examines the socio-cultural conditions on which radical charismatism developed in a Japanese newly risen religious cult, Aum Shinrikyo (Supreme Truth). This cult started as a Yoga circle in 1984 with asceticism and traditional technics that could bring a variety of extraordinary sensory experiences. Those experiences during Yoga and ascetic discipline obtained their significance only in man-to-man dialogue with the venerated master Shoko Asahara. Through the dialogues the dogma was associated with each disciple's experiences. The dyad between the master and respective ascetic was a charismatic relations sustained by the followers' one-sided irrational faith and it functioned as a plausability structure of the dogma. At the beginning the master formed the dogma and the worldview system to control the experiences' variety in terms of Buddhist transmigration, when he was an exemplary prophet subject to authority of the traditional values. But in competition with his rivals and outer-society he needed to make himself high to the historical supreme missionary prophet. He introduced eschatology to his dogma and identified himself as the Resurrected Christ. Under his own authority he began to introduce various knowledge and technics that derived from different cultural roots, and more efficient modern technics that brought more intense extraordinary sensory experiences and strengthened the plausability structure. Their expressed dogma and worldview appeared unsystematic and incoherent but the followers' faith firm. We can see in this case charismatism as an irrational basis of a society alternative to ritual. This paper refers to two (sub-)cultural conditions as promoting and sustaining radical charismatism: first, "experientialism" that puts the source of reality in one's inner experience; Second, " 'sampling' culture" or " 'remix' culture" that com-bines sampled values and ideas to some story and consume it, in contrast to cultivationalism that strives to establish one's own value on which you can systematize more and more values and ideas different through confrontation with them. For the disciples only the charismatic relationship with the master was reversed from a mere plausability structure into the supreme value itself and they could utilizes the variety of knowledge and thechnics as means in recruiting. But they gathered people with so different interests, and the diversity radicalized the charismatism.