Authorship：Corresponding author  

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Authorship：Corresponding author   Publishing type：Research paper (scientific journal)  

DOI： 10.7759/cureus.61392.

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Authorship：Corresponding author   Publishing type：Research paper (scientific journal)   Publisher：Informa UK Limited  

DOI： 10.1080/00498254.2024.2344664

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Authorship：Corresponding author  

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Authorship：Corresponding author  

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Authorship：Corresponding author   Language：Japanese   Publisher：日本救急医学会-関東地方会  

看護師が行うECクランプ法によるマスク換気時のマスクフィットの特徴を明らかにし,エアリークの発生要因とその改善策を示すことを目的とした。救命救急センター常勤看護師20名全員の下顎部のカバー率は高かったが鼻部のカバー率は低かった。各対象者の最大換気量とマスク保持反対側の頬部・口角部・口角部上部のカバー率には正の相関が認められ,とくに最大換気量とマスク保持反対側の頬部に強い相関が認められた。本研究の結果,マスク換気時に十分な換気量を得るためにはマスク保持反対側の頬部・口角部を確実に押さえることが重要であることが示唆された。(著者抄録)

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Authorship：Corresponding author   Publishing type：Research paper (scientific journal)   Publisher：Pharmaceutical Society of Japan  

DOI： 10.1248/yakushi.23-00058

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Authorship：Corresponding author   Language：Japanese   Publisher：(一社)日本がん看護学会  

目的:がん相談支援センターのがん看護専門看護師が行う,治療中止と同時に療養の場を選択する進行がん患者とその家族への相談支援の実際を明らかにすることである.方法:専門看護師経験年数が5年以上,かつ,相談支援経験年数が1年以上のがん看護専門看護師10名を対象とした半構造化面接を行い,データを質的に分析した.結果:がん看護専門看護師による相談支援の実際は,【がん治療中止に対する患者と家族の複雑な思いや本心を推察する】【病態やADLから今後起こりうる症状と残り時間を予測する】【患者・家族に合わせて現状への理解を助ける】【患者を取り巻く関係者の相違を埋める】【思いを受けとめ,情報提供よりも心理的安寧を優先させる】【患者の生き方や力を尊重し,これからの過ごし方について意向を確認する】【患者・家族への相談支援の効果とチーム医療の最大限の機能の発揮を常に考慮して,方略を立てる】【がん看護専門看護師としての信念や倫理的価値観を基盤とし,患者・家族への支援につなげる】であった.考察および結論:がん看護専門看護師は,がん患者が予後に直面することを助け,残り時間を予測しつつ,今後の過ごし方への意思決定支援を行っていた.患者と家族の最善なQOLを根幹とし,患者の納得感とともに残りの人生を歩む支援として,患者の意思決定を尊重した最終的な療養支援体制の調整が示唆された.(著者抄録)

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Authorship：Corresponding author  

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Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.jopan.2021.11.007

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Publishing type：Research paper (scientific journal)   Publisher：Frontiers Media SA  

In amyotrophic lateral sclerosis (ALS), neurodegeneration is characterized by distal axonopathy that begins at the distal axons, including the neuromuscular junctions, and progresses proximally in a “dying back” manner prior to the degeneration of cell bodies. However, the molecular mechanism for distal axonopathy in ALS has not been fully addressed. Semaphorin 3A (Sema3A), a repulsive axon guidance molecule that phosphorylates collapsin response mediator proteins (CRMPs), is known to be highly expressed in Schwann cells near distal axons in a mouse model of ALS. To clarify the involvement of Sema3A–CRMP signaling in the axonal pathogenesis of ALS, we investigated the expression of phosphorylated CRMP1 (pCRMP1) in the spinal cords of 35 patients with sporadic ALS and seven disease controls. In ALS patients, we found that pCRMP1 accumulated in the proximal axons and co-localized with phosphorylated neurofilaments (pNFs), which are a major protein constituent of spheroids. Interestingly, the pCRMP1:pNF ratio of the fluorescence signal in spheroid immunostaining was inversely correlated with disease duration in 18 evaluable ALS patients, indicating that the accumulation of pCRMP1 may precede that of pNFs in spheroids or promote ALS progression. In addition, overexpression of a phospho-mimicking CRMP1 mutant inhibited axonal outgrowth in Neuro2A cells. Taken together, these results indicate that pCRMP1 may be involved in the pathogenesis of axonopathy in ALS, leading to spheroid formation through the proximal progression of axonopathy.

DOI： 10.3389/fneur.2022.994676

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Authorship：Corresponding author   Language：Japanese   Publisher：医学図書出版(株)  

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Authorship：Corresponding author  

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Authorship：Corresponding author   Language：Japanese   Publisher：日本手術看護学会  

A大学附属病院で麻酔科外来を受診する患者のうち、全身麻酔の手術を受けるがん患者に抑うつの実態と周術期がん患者の精神的負担について、入院前待機時期、手術前日、術後3日目の3時点で質問紙調査を実施した。135名の患者から同意が得られ、最終的には入院待機時期、入院前日は88名(男性57名、女性31名)、術後3日目には85名が分析対象となった。入院前待機時期の抑うつ群は40名であり、手術前日および術後3日目にも抑うつ群に該当していたのは23名であった。入院前待機時期の抑うつ群、非抑うつ群の基本属性を比較した。その結果、配偶者の有無に有意差が見られ、抑うつ群は非抑うつ群と比較して有意に配偶者のいる割合が低かった。入院前待機時期に抑うつ状態である患者の多くは、手術前日、術後3日目も変わらず抑うつ状態を呈していた。周術期がん患者には入院前待機時期から抑うつに対する看護介入を行う必要があることが示唆された。

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Authorship：Corresponding author  

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Authorship：Corresponding author  

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Authorship：Corresponding author   Language：Japanese   Publisher：看護理工学会  

看護師によるマスク換気にヘッドバンド(HB)を使用することの有効性を,換気量とマスクフィット圧力分布に着目し検証することを目的とした.看護師40名を対象としてクロスオーバー法で調査を行った.対象者は気道シミュレータに従来用いられているE-Cクランプ法(親指と人差し指でマスクを保持し残りの指で下顎を挙上する方法,以下C法)と,C法に加えてHBを使用する方法(以下H法)でのマスクフィットを行った.換気量に加え,圧力測定シートを用いてマスクフィットの圧力分布を測定した.結果,換気量はH法のほうが有意に増加した.圧力値は,鼻部,右頬部,右口角部,左口角部でH法が有意に高く,加圧面積は顎部以外のすべての部位でH法が有意に高かった.さらに,C法とH法の最大換気量の差には右口角部の加圧面積の差が最も影響していた.これらのことから,看護師によるマスク換気にHBを使用することで,E-Cクランプ法よりも右口角部がカバーされ,換気量が増加する可能性が示唆された.(著者抄録)

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J06462&link_issn=&doc_id=20220214250001&doc_link_id=2200839&url=https%3A%2F%2Fkango-sakuin.nurse.or.jp%2Fnid%2F2200839&type=%E6%9C%80%E6%96%B0%E7%9C%8B%E8%AD%B7%E7%B4%A2%E5%BC%95Web&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00014_1.gif

Authorship：Lead author,　Corresponding author   Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japanese Pharmacological Society  

DOI： 10.1254/fpj.20088

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Authorship：Lead author,　Corresponding author   Language：Japanese   Publisher：日本肥満学会  

CiNii Books

CiNii Research

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Other Link： https://search.jamas.or.jp/link/ui/2021323704

Language：Japanese   Publisher：日本手術医学会  

周麻酔期看護師とは、麻酔にかかわる術前から術後までの医療の流れの中で、患者にとって最善の麻酔が施されるように看護師として麻酔業務を補助する役割を果たす者として、2010年に聖路加国際大学大学院修士課程で養成が開始された。2016年度には横浜市立大学大学院修士課程に同様の教育課程が開講した。筆者は、横浜市立大学大学院周麻酔期看護学分野の1期生として2018年に修士課程を修了し、同年から周麻酔期看護師として活動している。現在までに、本邦では6大学で養成が行われ、各施設で周麻酔期看護師が活動しており、その活動の場はより一層の広がりを見せている。一方、公的には未確立な制度であること、標準化された教育プログラムがないため各養成施設が手探りで実施しているという課題もある。周麻酔期看護学の発展やチーム医療、麻酔医療の安全と質の向上に貢献するためにも、教育の情報を発信・共有していくことは重要である。本稿では筆者が修士課程中に経験した周麻酔期看護学実習について報告する。筆者は、約1年半の実習の中で145症例を経験した。本学では、麻酔科医とマンツーマンで担当麻酔症例の麻酔計画について、綿密なディスカッションを繰り返すことを基本とした実習が行われる。質の担保された周麻酔期看護師の育成にあたり、教育プログラムの確立や実習後の評価方法の確立が今後必要になると考えられた。(著者抄録)

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Authorship：Corresponding author   Language：Japanese   Publishing type：Research paper (bulletin of university, research institution)  

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Authorship：Corresponding author   Language：Japanese   Publisher：日本救急医学会-関東地方会  

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Authorship：Corresponding author   Language：Japanese   Publisher：(公社)日本看護科学学会  

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Authorship：Corresponding author   Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：Japanese   Publisher：日本手術医学会  

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Authorship：Corresponding author   Language：Japanese  

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Authorship：Corresponding author   Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：日本未病システム学会  

CiNii Books

CiNii Research

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Other Link： https://search.jamas.or.jp/link/ui/2019231075

Language：Japanese  

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Authorship：Corresponding author   Language：Japanese  

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Authorship：Corresponding author   Language：Japanese  

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Authorship：Corresponding author   Language：Japanese   Publisher：(公大)横浜市立大学医学部看護学科  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J05163&link_issn=&doc_id=20190408440006&doc_link_id=1900106&url=https%3A%2F%2Fkango-sakuin.nurse.or.jp%2Fnid%2F1900106&type=%8D%C5%90V%8A%C5%8C%EC%8D%F5%88%F8Web&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00014_1.gif

Authorship：Corresponding author  

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Authorship：Corresponding author  

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Authorship：Corresponding author   Language：Japanese   Publisher：(公社)日本看護科学学会  

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Authorship：Lead author,　Corresponding author   Language：Japanese  

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Language：Japanese   Publisher：(公大)横浜市立大学医学部看護学科  

能動的学習法を取り入れた新しい看護英語教育プログラムを、基礎看護学関連科目の履修を終えた看護学科1年次生102名を対象に、これらの学生を5〜6名のグループに配置し、プログラムの有用性を検証した。事前学習に100名、ロールプレイには91名が参加した。プログラムに参加した学生からの評価表の回収率は100%であった。旧プログラム参加者と新プログラム参加学生の自己評価を比較したところ、「患者さんからの質問に答えた」「私の英語を患者さんは理解できた」の項目において、新プログラム参加学生の自己評価が旧プログラム参加学生よりも有意に高かった。新プログラムにおける学生の自己評価と模擬患者による他者評価を比較したところ、評価表の全項目において、学生による自己評価が模擬患者における他者評価よりも有意に低かった。英語に対する学生の自己評価を高め、学習効果を促進するためには、各年次さらに卒業後も含め継続的に英語学習を進められる工夫が必要と考えられた。

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J05163&link_issn=&doc_id=20180417340006&doc_link_id=1800310&url=https%3A%2F%2Fkango-sakuin.nurse.or.jp%2Fnid%2F1800310&type=%8D%C5%90V%8A%C5%8C%EC%8D%F5%88%F8Web&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00014_1.gif

Language：Japanese   Publishing type：Research paper (bulletin of university, research institution)  

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Authorship：Lead author,　Corresponding author  

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Authorship：Corresponding author   Language：Japanese   Publisher：(公大)横浜市立大学医学部看護学科  

ヒューマンファクター工学で代表とされるSHELモデルをもとに、医療への応用を目的に開発された医療事故分析モデルであるP-mSHELLモデルを用いて、臨地実習におけるヒヤリ・ハット事例を教材として捉え、学生と教員が共に振り返ることのできるインシデント報告書に改定する試みを行った。学生(当事者)の要因を把握するだけなく、発生要因を網羅的に把握することを目指し項目を設定したことで、指導する教員と学生が発生要因を体系的に検討し、インシデントを振り返るとともに学科全体でインシデントへの対応について検討することが可能となることが期待でき新書式が確認された。新書式の運用にあたっては、インシデントに対する学生の内省を促しつつ、報告によっては多くの学生が教訓をえらえることを実習オリエンテーションや講義で周知する必要があると考えられた。また、今後、インシデント報告書を通して、教員もインシデント分析技術を習得することも求められると推測された。

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Authorship：Corresponding author   Language：English  

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Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

Skin barrier function is often deficient in obese individuals, but the underlying molecular mechanisms remain unclear. This study investigated how skin structure and lipid metabolism, factors strongly associated with barrier function, differed among 50 Japanese women of greatly varying body mass index (BMI). Subjects receiving breast reconstruction surgery were chosen for analysis to obtain skin samples from the same site. The subjects were classified into two groups, control (BMI < 25 kg/m2) and obese (25 kg/m2 ≤ BMI < 35 kg/m2), according to standards in Japan. Hematoxylin and eosin staining was used to assess skin thickness, Ki-67 immunostaining to examine keratinocyte proliferation, and real-time polymerase chain reaction to measure skin expression levels of genes associated with lipid metabolism. Total lipids, cholesterol, and fatty acids were also measured from these same skin samples. In the obese group, structural changes included epidermal thickening and an increase in the number of Ki-67-positive (proliferating) cells. Both skin cholesterol and fatty acid levels exhibited an "inverted-U" relationship with BMI, suggesting that there is an optimal BMI for peak lipid content and barrier function. Decreased lipid levels at higher BMI were accompanied by downregulated expression of PPARδ and other genes related to lipid metabolism, including those encoding acetyl-CoA carboxylase and HMG-CoA reductase, the rate-limiting enzymes for fatty acid and cholesterol synthesis, respectively. Thus, elevated BMI may lead to deficient skin barrier function by suppressing local lipid synthesis.

DOI： 10.1371/journal.pone.0193830

PubMed

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Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER JAPAN KK  

Obesity results from excessive energy intake and physical inactivity, and predisposes one to various diseases. One of these reasons is that enlargement of adipocytes raises the lipid metabolic abnormalities that affect various organs. The skin is one such organ, and it has been reported that subcutaneous adipocyte cells secrete various factors and these factors are involved in reduction of dermal collagen fibers and fragility of the skin in obesity. The present study explored the efficacy of Kaempferia parviflora (KP) in preventing obesity-induced dermatopathy. We used Tsumura Suzuki obese diabetes (TSOD) mice as an obesity model. TSOD mice were fed a standard diet (MF) mixed with either an ethanol extract from KP (KPE), polymethoxyflavonoid-rich extract from KP (PMF), or polymethoxyflavonoid-poor extract from KP (X). We then evaluated the effect of these three KP fractions on aging-like skin damage induced by UVB irradiation. KPE and PMF caused a significant decrease of mouse body weight, and suppressed the increase in the thickness of the subcutaneous fat layer. In addition, KPE shifted the frequency of subcutaneous adipocyte sizes towards smaller cells possibly via its polypharmacological actions. Scanning electron microscopy revealed that the stereostructure of the collagenous fibers in the dermis was better retained in the KPE and PMF groups, in that order. These results offer the first evidence that KPE can attenuate obesity-induced dermatopathy more effectively than PMF, suggesting that KPE (or KP) might be a candidate supplement for preventing obesity-related skin disorders.

DOI： 10.1007/s11418-016-1027-8

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Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：TAYLOR & FRANCIS INC  

Aim of the study: Our previous research suggested that obesity induces structural fragility in the skin. Elastic fibers impart strength and elasticity. In this study, we determined whether elastic fibers decrease in the skin of obese mice. Materials and Methods: To confirm alterations in elastic fiber content due to obesity, we used spontaneously obese model mice (TSOD) and control mice (TSNO). Furthermore, to evaluate the elastin structure and gene expression dependent on the severity of obesity, an obesity-enhanced mouse model was developed by feeding a high fat diet to TSOD (TSOD-HF). Back skin samples were stained with hematoxylin and eosin and Elastica van Gieson for microscopic examination, and the samples were stained for immunohistochemical analysis of neprilysin. Gene expression levels were determined using a real-time PCR system. Results: The abundance of elastic fibers beneath the epidermis was remarkably reduced and fragmented in TSOD as compared with TSNO. Fibrillin-1 mRNA levels in TSOD were significantly suppressed compared with those in TSNO, whereas neprilysin mRNA levels and immunohistochemical expression in TSOD were significantly increased, as compared with those in TSNO. The reduction of elastic fibers was enhanced and the expression levels of elastic fiber formed factors were significantly suppressed in TSOD-HF, as compared with those in the TSOD. Conclusions: The abundance of elastic fibers was reduced and fragmented in obesity, suggesting that the reduction in elastic fibers is initially caused by increased neprilysin and decreased fibrillin-1 expression, which may inhibit formation and stabilization of elastic fibers, resulting in skin fragility in obesity.

DOI： 10.1080/03008207.2016.1255205

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Authorship：Corresponding author   Language：Japanese   Publisher：メヂカルフレンド社  

CiNii Books

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Other Link： http://search.jamas.or.jp/link/ui/2017034091

Authorship：Lead author   Language：Japanese   Publisher：(一社)日本未病システム学会  

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Authorship：Corresponding author   Language：Japanese   Publisher：(一社)日本未病システム学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：NATURE PUBLISHING GROUP  

Proteoglycans (PGs), a family of glycosaminoglycan (GAG)-protein glycoconjugates, contribute to animal physiology through interactions between their glycan chains and growth factors, chemokines and adhesion molecules. However, it remains unclear how GAG structures are changed during the aging process. Here, we found that polyamine levels are correlated with the expression level of heparan sulfate (HS) in human skin. In cultured cell lines, the EXT1 and EXT2 enzymes, initiating HS biosynthesis, were stimulated at the translational level by polyamines. Interestingly, the initiation codon recognition by 43S preinitiation complex during EXT2 translation is suppressed by let-7b, a member of the let-7 microRNA family, through binding at the N-terminal amino acid coding sequence in EXT2 mRNA. Let-7b-mediated suppression of initiation codon depends on the length of 5'-UTR of EXT2 mRNA and its suppression is inhibited in the presence of polyamines. These findings provide new insights into the HS biosynthesis related to miRNA and polyamines.

DOI： 10.1038/srep33549

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Collapsin response mediator protein 2, CRMP2, has been identified as an intracellular signaling mediator for Semaphorin 3A (Sema3A). CRMP2 plays a key role in axon guidance, dendritic morphogenesis, and cell polarization. It has been also implicated in a variety of neurological and psychiatric disorders. However, the invivo functions of CRMP2 remain unknown. We generated CRMP2 gene-deficient (crmp2(-/-)) mice. The crmp2(-/-) mice showed irregular development of dendritic spines in cortical neurons. The density of dendritic spines was reduced in the cortical layer V pyramidal neurons of crmp2(-/-) mice as well as in those of sema3A(-/-) and crmp1(-/-) mice. However, no abnormality was found in dendritic patterning in crmp2(-/-) compared to wild-type (WT) neurons. The level of CRMP1 was increased in crmp2(-/-), but the level of CRMP2 was not altered in crmp1(-/-) compared to WT cortical brain lysates. Dendritic spine density and branching were reduced in double-heterozygous sema3A(+/-);crmp2(+/-) and sema3A(+/-);crmp1(+/-) mice. The phenotypic defects had no genetic interaction between crmp1 and crmp2. These findings suggest that both CRMP1 and CRMP2 mediate Sema3A signaling to regulate dendritic spine maturation and patterning, but through overlapping and distinct signaling pathways.

DOI： 10.1111/gtc.12399

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：PHARMACEUTICAL SOC JAPAN  

Visceral obesity induces the onset of metabolic disorders such as insulin resistance and diabetes mellitus. Adipose tissue is considered as a potential pharmacological target for treating metabolic disorders. The fruit of Terminalia bellirica is extensively used in Ayurvedic medicine to treat patients with diseases such as diabetes mellitus. We previously investigated the effects of a hot water extract of T. bellirica fruit (TB) on obesity and insulin resistance in spontaneously obese type 2 diabetic mice. To determine the active ingredients of TB and their molecular mechanisms, we focused on adipocyte differentiation using mouse 3T3-L1 cells, which are widely used to study adipocyte physiology. We show here that TB enhanced the differentiation of 3T3-L1 cells to mature adipocytes and that one of the active main components was identified as gallic acid. Gallic acid (10-30 mu m) enhanced the expression and secretion of adiponectin via adipocyte differentiation and also that of fatty acid binding protein-4, which is the target of peroxisome proliferator-activated receptor gamma (PPAR gamma), although it does not alter the expression of the upstream genes PPAR gamma and CCAAT enhancer binding protein alpha. In the PPAR gamma ligand assay, the binding of gallic acid to PPAR gamma was undetectable. These findings indicate that gallic acid mediates the therapeutic effects of TB on metabolic disorders by regulating adipocyte differentiation. Therefore, TB shows promise as a candidate for preventing and treating patients with metabolic syndrome.

DOI： 10.1248/bpb.b16-00064

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Language：Japanese   Publisher：(一社)日本創傷・オストミー・失禁管理学会  

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Authorship：Corresponding author   Language：Japanese   Publisher：(一社)日本小児臨床アレルギー学会  

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Language：Japanese   Publisher：(一社)日本創傷・オストミー・失禁管理学会  

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Language：Japanese   Publisher：日本「性とこころ」関連問題学会  

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Language：Japanese  

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Other Link： http://search.jamas.or.jp/link/ui/2017040212

Language：English   Publishing type：Research paper (scientific journal)   Publisher：SAGE PUBLICATIONS INC  

Excessive wound exudates are troublesome symptoms of malignant fungating wounds. In particular, such exudates may cause periwound moisture-associated dermatitis (MAD). In this study, we focused on factors that contribute to skin irritation by exudates in breast cancer patients with malignant fungating wounds. Our aim was to identify the relationship between MAD surrounding malignant fungating wounds and levels of various candidate irritating factors in their exudates. We recruited 20 breast cancer patients with exudates from malignant fungating wounds and collected three types of exudate samples: pooled exudate, swab, and fresh exudate samples. We measured the pH, concentrations of polyamines (putrescine [PUT], cadaverine [CAD], spermidine, and spermine), and matrix metalloproteinases (MMP2 and MMP9) in the exudates and cultured them for bacteria. Differences between participants with and without MAD were assessed using Fisher's exact test or the Mann-Whitney U test. Of the 20 participants, 14 had MAD. There were no significant differences in median pH and MMP activity between patients with and without MAD. The level of PUT was significantly higher in the MAD than in the non-MAD group (p = .008), and CAD was detected only in the MAD group (p = .016). Prospective studies are needed to clarify correlations and causal relationships between polyamines and erythema and identify therapeutic targets for preventing the development of MAD.

DOI： 10.1177/1099800415594452

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Language：Japanese   Publisher：(公大)横浜市立大学医学部看護学科  

目的:本研究は、2型糖尿病患者の皮膚の加齢性変化に対する肥満重症度の影響を明らかにすることを目的とした。方法:2型糖尿病患者を対象とし、BMI25未満を非肥満群、BMI25以上を肥満群とした。肥満群は肥満の重症度により3群(I:BMI25-30、II:30-35、III:35-40)に分類し、皮膚の加齢性変化に関わる因子(角質水分量、pH、糖化蛋白;AGEs)を評価した。結果:対象者23名(平均年齢52.8歳)が調査に参加した。皮膚の生理機能に影響を及ぼす年齢、糖尿病の重症度に関して各群間で有意な差は認められなかった。角質水分量は、非肥満群49.9±9.3、肥満I群43.1±9.6、II群38.6±12.2、III群20.9±9.6であり、肥満重症度が高い対象者ほど減少傾向が認められ、特に肥満III群で有意に低値であった。pH値、AGEsの値は各群間で有意な差は認められなかった。結論:2型糖尿病患者では、肥満重症度が高い患者ほど角質水分量が低下することが明らかとなり、これらの対象者には皮膚障害の予防に向けた保湿ケアの重要性が示唆された。(著者抄録)

DOI： 10.15015/00000474

CiNii Books

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Other Link： http://id.nii.ac.jp/1246/00000474/

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CiNii Research

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Impaired cutaneous wound healing is a serious complication of diabetes mellitus (DM). Currently, little is known about reepithelialization in DM. However, recent studies identified aquaporin 3 (AQP3), a transmembrane protein that functions as a pore-like passive transporter, to be a key molecule in cutaneous epidermal wound healing. AQP3 expression is downregulated in response to tumor necrosis factor-alpha (TNF- α). Given that systemic TNF-α levels are functionally connected to impaired healing in diabetic mice and that both diabetic and Aqp3-deficient animals exhibit impaired reepithelialization, the authors hypothesized that impaired AQP3 expression might contribute to diabetes-impaired wound healing. In the present study, the authors examined AQP3 expression in the regenerating epidermis during cutaneous full thickness wound healing and in intact skin of a streptozotocin-induced diabetic rat model. Aqp3 messenger RNA expression levels were decreased in wounds of DM rats compared to controls. Immunohistochemical analysis showed an absence of AQP3 in the stratum spinosum of the regenerating epidermis in the DM group, whereas the stratum basale was positive for AQP3 in both groups. In summary, these findings suggest that there may be a relationship between impaired AQP3 expression and diabetes-delayed reepithelialization. Thus, future nursing studies should focus on this mechanism in diabetic wound healing.

DOI： 10.1177/1099800412437032

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Aging is accelerated, at least in part, by pathological condition such as metabolic syndrome (MetS), and various molecular pathways such as oxidative stress are common mediators of aging and MetS. We previously developed the aging-like skin model by single ultraviolet (UV) irradiation on the MetS model mice. Recent studies revealed that mineralocorticoid receptor (MR) signaling plays a pivotal role for various tissue inflammation and damages in MetS. Although previous studies reported that MR is expressed in the skin and that overexpression of MR in the skin resulted in the skin atrophy, the physiological or pathological functions of MR in the skin are not fully elucidated. Here, we show the involvement of MR signaling in the aging-like skin changes in our own model. Elevations of oxidative stress and inflammation markers were observed in the MetS mice, and the UV-evoked aging-like skin damages were attenuated by topical antioxidant. MR expression was higher in the MetS mouse skin, and notably, expression of its effecter gene Sgk1 was significantly upregulated in the aging-like skin in the UV-irradiated MetS mice. Furthermore, topical application of MR antagonist spironolactone suppressed Sgk1 expression, oxidative stress, inflammation, and the aging-like changes in the skin. The 2-week UV onto the non-MetS mice, the more usual photoaging model, resulted in the skin damages mostly equivalent to the MetS mice with single UV, but they were not associated with upregulation of MR signaling. Our studies suggested an unexpected role of MR signaling in the skin aging in MetS status.

DOI： 10.1111/acel.12017

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Obesity is recognized as a risk factor for delayed cutaneous wound healing. The authors hypothesized that the secretion of matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) from subcutaneous adipose tissue correlates with disorder of the healing process in obese subjects. Findings from previous studies on the expression of MMPs and TIMPs in obese adipose tissue are inconsistent. Since these conflicting results could be due to the effect of several intrinsic factors, the authors conducted a simple in vitro experiment to clarify the change in profile of MMPs and TIMPs in excessively matured adipocytes. The authors cultured the induced adipocytes under conditions of high or low glucose and with or without insulin supplementation. Oil red O staining and its dye extraction assay revealed excessive lipid accumulation in high glucose and insulin-supplemented adipocytes. Additionally, there was altered expression of adipokines, similar to the change in adipose tissue in obese subjects. Under these conditions, the expression/activity of MMP8 was promoted and the expression of MMP3 and TIMP3 was inhibited. Further studies to determine the effect of other obesity-related factors, such as insulin resistance, on MMPs and TIMPs are required.

DOI： 10.1177/1099800411410870

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Both physiological skin aging and pathologic photo-aging caused by ultraviolet (UV) irradiation are mediated by latent inflammation and oxidative stress. Although numerous animal skin-aging models have used UV irradiation, most require massive doses or long-term irradiation. To establish a more refined skin-aging model, we focused on an animal model of metabolic syndrome (MS) because MS involves damage to various organs via oxidative stress or inflammation, similar to the changes associated with aging. We hypothesized that MS skin might exhibit more aging-like changes after milder, shorter-term UV irradiation than would normal animal skin under similar conditions, thus providing a useful model for skin aging. The authors therefore examined the skin from Tsumura Suzuki obese diabetic (TSOD) mice (MS model) and control Tsumura Suzuki non-obese (TSNO) mice before and after UV irradiation. Skin from TSOD mice had a thinner epidermis and dermis, a thicker fatty layer, reduced density and convolution of the fragmented collagen fibers, and upregulated expression of tumor necrosis factor (TNF)-α, a dual marker for inflammation and aging, compared to the skin from TSNO mice. UV irradiation affected TSOD skin more severely than TSNO skin, resulting in various changes resembling those in aged human skin, including damage to the dermis and subcutaneous fatty tissue, infiltration of inflammatory cells, and further upregulation of TNF-α expression. These results suggest that UV-irradiated TSOD mice may provide a new model of skin aging and imply that skin from humans with MS is more susceptible to UV- or aging-related damage than normal human skin.

DOI： 10.1177/1099800411401013

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DOI： 10.1111/j.1600-0625.2011.01409.x

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The purpose of this study was to test the hypothesis that obese diabetic mice exhibit marked skin fragility, which is caused by increased oxidative stress and increased matrix metalloproteinase (MMP) gene expression in the subcutaneous adipose tissue. Scanning electron microscopy of skin samples from Tsumura-Suzuki obese diabetic (TSOD) mice revealed thinner collagen bundles, and decreased density and convolution of the collagen fibres. Furthermore, skin tensile strength measurements confirmed that the dorsal skin of TSOD mice was more fragile to tensile force than that of non-obese mice. The mRNA expressions of heme oxygenase 1 (Hmox1), a marker of oxidative stress, Mmp2 and Mmp14 were increased in the adipose tissue of TSOD mice. Antioxidant experiments were subsequently performed to determine whether the changes in collagen fibres and skin fragility were caused by oxidative stress. Strikingly, oral administration of the antioxidant dl-α-tocopherol acetate (vitamin E) decreased Hmox1, Mmp2 and Mmp14 mRNA expressions, and improved the skin tensile strength and structure of collagen fibres in TSOD mice. These findings suggest that the skin fragility in TSOD mice is associated with dermal collagen damage and weakened tensile strength, and that oxidative stress and MMP overexpression in the subcutaneous adipose tissue may, at least in part, affect dermal fragility via a paracrine pathway. These observations may contribute to novel clinical interventions, such as dietary supplementation with antioxidants or application of skin cream containing antioxidants, which may overcome skin fragility in obese patients with diabetes.

DOI： 10.1111/j.1600-0625.2011.01409.x

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Wound infection is a form of host damage resulting from an imbalance in pathogen virulence and the host immune response. However, at present, diagnosis is based solely on bacterial numbers or inflammatory signs and is therefore not precise. Thus, infection diagnosis requires indicators of both of these factors. We focused on wound fluid because it includes both bacteria and host cells. The purpose of this study was to establish biomarkers that reflect both bacterial and host factors using the reverse transcription-polymerase chain reaction method on the centrifugal precipitation of wound fluids (wound fluid RT-PCR). We created full thickness wounds in animal models of the three groups: control, colonization and infection, which were conditioned by administration of different concentrations of Pseudomonas aeruginosa dispersion. Messenger RNA expression in bacteria and host cells was analysed. Expression of bacterial housekeeping genes was detected in the samples in the colonization and infection groups. Expression of host housekeeping genes was detected in all samples from the three groups. Expression of toxA, encoding the virulence factor exotoxin A, was detected in 90% of samples in the infection group only. Expression of Foxp3, encoding the transcription factor forkhead box P3, was detected in 100% of samples only in the colonization group. These results revealed that wound fluid RT-PCR analysis reflected both bacterial virulence and the host immune status, and we determined the combination of novel biomarkers that can discriminate these three groups. We anticipate that wound fluid RT-PCR could be applied in the future to diagnose wound infection.

DOI： 10.1111/j.1600-0625.2011.01404.x

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DOI： 10.1111/j.1524-475X.2012.00800.x

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Quorum sensing is a cell density-dependent gene regulation system in bacteria. N-(3-oxododecanoyl) homoserine lactone (3-oxo-C12-HSL) is used in the las quorum-sensing system in Pseudomonas aeruginosa, which is an opportunistic pathogen that causes many human diseases. Although many studies have investigated the sole effects of quorum sensing on several types of mammalian cells, including lung cells, little is known about the effects of quorum sensing on the cells associated with wound healing. To better understand the mechanism of bacterial wound infection, we investigated the effects of 3-oxo-C12-HSL on cells using a rat full-thickness wound-healing model. We found that the wound contraction was significantly increased at 24 h after the administration of 3-oxo-C12-HSL to the surface of granulation tissue. Differentiation of fibroblasts to myofibroblasts was induced in the in vivo wound-healing model and was confirmed in vitro using the rat fibroblastic cell line Rat-1. Cyclooxygenase (Cox)-2 expression was also induced in Rat-1 cells by 3-oxo-C12-HSL. This finding suggested that Cox-2 upregulation may be related to the inflammatory findings in the histological examinations, in which infiltrating polymorphonuclear neutrophils were observed at the wound site. Taken together, these results imply that mammals have a potential defense system against invading pathogens by responding to the presence of 3-oxo-C12-HSL and inducing the differentiation of fibroblasts to myofibroblasts as well as inflammation for accelerating wound healing.

DOI： 10.1111/j.1574-695X.2011.00796.x

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BACKGROUND: Skin maceration is recognized as a risk factor for the development of certain skin lesions. In health care settings, incontinence-associated skin maceration is highly prevalent in the elderly. However, the effect of senescence on maceration has not been fully elucidated. OBJECTIVE: To reveal the enhancement of the maceration-induced ultrastructural alteration and barrier function of the epidermis by aging. METHODS: Skin maceration was reproduced by exposure to agarose gel in human and rat. The ultrastructural alterations in human and rat tissue were observed by transmission electron microscopy. The skin barrier function was evaluated by noninvasive methods in human, and by the transdermal penetration of small- and large-fluorescent molecules in rat. In order to reveal the effect of aging on the skin maceration, we compared these parameters between young and aged rats. RESULTS: In macerated skin, we observed expansion of the interstices of the stratum corneum, spinosum, and basale of the epidermis; disruption of the intercellular lipid structure in the stratum corneum; a decreased number of cell processes in the stratum spinosum and basale. The transdermal penetration test in the rat using two types of fluorescein indicated that maceration disrupted skin barrier function. Furthermore, senescence-enhanced ultrastructural and functional alterations were revealed in the rodent studies. CONCLUSION: This study demonstrates that aging enhances skin maceration. Considering that maceration is a risk factor for the skin damage, the development of technology to promote skin barrier recovery after maceration in the elderly is warranted.

DOI： 10.1016/j.jdermsci.2011.03.005

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER IRELAND LTD  

Ethoparmacological relevance: Salacia reticulata, a herbal medicine which has been used for the treatment of early diabetes in Ayurvedic medicine, is reported to have an anti-obesity effect and to be useful in the treatment of diabetes mellitus, insulin resistance and other metabolic diseases.
Aim of the study: The present study was performed to elucidate the mechanism of action of Salacia reticulota with special attention to the adipocytes as the tissue primarily involved in the pathology of metabolic diseases.
Materials and methods: Mouse-derived adipocyte precursor 313-L1 cells were treated with differentiation inducers in the presence or absence of Salacia reticulata (SRCD). We determined triacylglycerol accumulations, differentiation makers, released glycerol and adiponectin. Mangiferin, the primary component of SRCD, was also treated to 3T3-L1 cells.
Result: Concurrent administration of the extract of SRCD and differentiation inducers resulted in a significant inhibition of differentiation into mature adipocytes. SRCD also exhibited significant inhibitory action on the expression of genes and proteins of peroxisome proliferator-activated receptor (PPAR)gamma and CCAAT-enhancer binding protein (C/EBP)alpha, as well as on the activity of glycerol-3-phosphate dehydrogenase (GPDH), a differentiation marker, and caused a reduction in the concentration of released adiponectin. However, SRCD had no influence on lipolysis as indicated by the release of glycerol into the culture medium. The primary component of SRCD, mangiferin, was investigated for its effect on adipocytes; mangiferin caused no suppression of fat accumulation, suggesting that a component of SRCD other than mangiferin may be involved in the inhibition of adipocyte differentiation.
Conclusions: The above results suggest that the inhibitory action of SRCD on adipocyte differentiation, and not the promotion of lipolysis, is involved in the suppression of fat accumulation. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.jep.2011.04.012

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Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER JAPAN KK  

Kaempferia parviflora Wall. Ex Baker (KP) has been used as a folk medicine in Laos and Thailand to lower blood glucose levels, improve blood flow, and increase vitality. This study investigated the preventive effects of KP on obesity and its downstream symptoms (various metabolic disorders) using Tsumura, Suzuki, Obese Diabetes (TSOD) mice, a multifactorial genetic disease animal model in which metabolic diseases develop spontaneously, similar to metabolic syndrome in humans, and Tsumura, Suzuki, Non-Obesity (TSNO) mice as the corresponding control mice. When feed that was mixed with KP (1 or 3%) was given ad libitum to TSOD and TSNO mice for 8 weeks, body weight increase, visceral fat accumulation, lipid metabolism abnormalities, hyperinsulinemia, glucose intolerance, insulin resistance, hypertension, and peripheral neuropathy were suppressed in TSOD mice, but no marked differences were observed in TSNO mice. Because KP had preventive effects on metabolic diseases, including antiobesity effects, only in obese animals, we propose that KP will be extremely valuable as a medicine or component of food in alternative health care.

DOI： 10.1007/s11418-010-0461-2

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：HINDAWI PUBLISHING CORPORATION  

"Boiogito" is a Kampo preparation which has been used since ancient times in patients with obesity of the "asthenic constitution" type, so-called "watery obesity", and its effect has been recognized clinically. In this study, we investigated the anti-obesity effect of Boiogito in the TSOD (Tsumura Suzuki Obese Diabetes) mouse, a model of spontaneous obese type II diabetes mellitus. Boiogito showed a significant anti-obesity effect in TSOD mice by suppressing body weight gain in a dosage-dependent manner. In addition, Boiogito showed significant ameliorative effects on features of metabolic syndrome such as hyperinsulinemia, fasting hyperglycemia and abnormal lipid metabolism. Regarding lipid accumulation in TSOD mice, Boiogito showed a significant suppressive effect on accumulation of subcutaneous fat, but the effect on the visceral fat accumulation that constitutes the basis of metabolic syndrome was weak, and the suppressive effect on insulin resistance was also weak. Furthermore, Boiogito did not alleviate the abnormal glucose tolerance, the hypertension or the peripheral neuropathy characteristically developed in the TSOD mice. In contrast, in the TSNO (Tsumura Suzuki Non-Obesity) mice used as controls, Boiogito suppressed body weight gain and accumulation of subcutaneous and visceral fat. The above results suggested that Boiogito is effective as an anti-obesity drug against obesity of the "asthenic constitution" type in which subcutaneous fat accumulates, but cannot be expected to exert a preventive effect against various symptoms of metabolic syndrome that are based on visceral fat accumulation.

DOI： 10.1093/ecam/nep012

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The extracts of Salacia reticulata (Salacia extract), a plant that has been used for the treatment of early diabetes, rheumatism and gonorrhea in Ayurveda, have been shown to have an anti-obesity effect and suppress hyperglycemia. In this study, the effects of Salacia extract on various symptoms of metabolic disorder were investigated and compared using these TSOD mice and non-obese TSNO mice. Body weight, food intake, plasma biochemistry, visceral and subcutaneous fat (X-ray and CT), glucose tolerance, blood pressure and pain tolerance were measured, and histopathological examination of the liver was carried out. A significant dose-dependent decline in the gain in body weight, accumulation of visceral and subcutaneous fat and an improvement of abnormal glucose tolerance, hypertension and peripheral neuropathy were noticed in TSOD mice. In addition, hepatocellular swelling, fatty degeneration of hepatocytes, inflammatory cell infiltration and single-cell necrosis were observed on histopathological examination of the liver in TSOD mice. Salacia extract markedly improved these symptoms upon treatment. Based on the above results, it is concluded that Salacia extract has remarkable potential to prevent obesity and associated metabolic disorders including the development of metabolic syndrome.

DOI： 10.1093/ecam/nep052

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER TOKYO  

In Ayurvedic medicine, Salacia reticulata is known to be useful against various metabolic diseases, including diabetes and obesity. In this study, we attempted to clarify the antiobesity mechanism and the safety of S. reticulata in vivo and in vitro. We gave ordinary MF feed, alone or mixed with S. reticulata (0.3 or 1.0%), to Tsumura Suzuki obesity diabetes (TSOD) mice (spontaneous obese type II diabetes model mice) and Tsumura Suzuki non-obese (TSNO) mice (the corresponding reference animals), ad libitum for 2 months. As compared with the TSNO control mice, the TSOD control mice became obese due to fat accumulation and developed various signs of metabolic diseases. The TSOD mouse group receiving S. reticulata showed the following effects: suppression of body weight increase and fat accumulation, alleviation of abnormal lipid metabolism and abnormal glucose tolerance, and suppression of intrahepatic fat accumulation. Also, S. reticulata prevented the mesenteric adipocyte hypertrophy recognized in TSOD mice. In the TSNO controls, the feed containing 1.0% S. reticulata exerted a suppressing effect on body weight increase and fat accumulation, but the feed containing 0.3% S. reticulata did not show any effect at all. In an in vitro experiment using mouse-derived adipocyte precursor 3T3-L1 cells, S. reticulata significantly suppressed fat accumulation in the differentiation induction phase and maturation phase. This suggested that the metabolic disease-preventing effects of S. reticulata, including the antiobesity effect, may involve suppression of differentiation and accumulation in the adipocytes.

DOI： 10.1007/s11418-010-0401-1

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Suspected deep tissue injury (DTI) is a new category of pressure ulcer (PU), and defined as an ulcer that developed from a deep tissue (subcutaneous tissue) region and deteriorates towards the superficial skin. DTI is a serious clinical problem because it cannot be detected at an early stage and rapidly deteriorates to a deep PU. Consequently, there is a requirement for the identification of novel biomarkers to detect damage to the deep tissue including deep muscle tissue. For this purpose, it is essential to understand the molecular and cellular mechanisms of DTI formation and deterioration. This article reviews the recent progress in studies on the hypoxia-related mechanisms of DTI, and introduces our attempts to establish novel biomarkers for detecting deep muscle damage. Hypoxia-inducible factor 1 alpha subunit (HIF1-alpha) is a widely used marker for hypoxic conditions. We detected increased expression and localization of HIF1-alpha in the deep muscle tissue of PU model rats, indicating that HIF1alpha is a key molecule in DTI and a valuable biomarker for hypoxia in DTI in the research field. From the biochemical aspect, we focused on creatine phosphokinase (CPK). CPK is an intracellular enzyme related to energy metabolism, and its level in serum has been extensively used as a diagnostic marker for muscle injury. We attempted to estimate muscle injury from the CPK levels in exudates, which can be collected non-invasively and reflect the microenvironmental conditions. Our results using PU model rats suggested that exudate CPK could be a more sensitive biomarker than serum CPK for deep muscle tissue injury, and could be applicable for clinical diagnosis of DTI.

DOI： 10.1016/j.jtv.2009.10.004

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Abstract: Pressure ulcers that develop from deep tissue are known as deep tissue injuries (DTI). Although several mechanisms, including ischemic hypoxia, are attributed to pressure ulcer formation, the mechanisms involved in DTI formation are still unclear. Previous studies have suggested that hypoxia is involved in DTI in vitro, but it has yet to be determined whether hypoxia is also involved in DTI in vivo. Therefore, this study aimed to investigate whether hypoxia is involved in DTI using a newly established DTI model. Rats were divided into control, low pressure DTI, and high pressure DTI groups. Results of wound healing tests indicated that more severe DTI resulted in prolonged healing time, more severe inflammation and muscle damage, higher levels of exudate creatine phosphokinase, and greater muscle edema. Increased hypoxia was observed in severe DTI-nuclear localization of hypoxia-inducible factor-1α was markedly increased in the high pressure DTI group, while the low pressure group showed more increased cytoplasm localization compared to the control group on day 3. Study results revealed that hypoxia is involved in DTI in vivo.

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Language：Japanese   Publisher：メディカルトリビューン  

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CiNii Research

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Other Link： https://search.jamas.or.jp/link/ui/2010219350

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Language：Japanese   Publisher：(公社)日本看護科学学会  

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DOI： 10.1248/yakushi.128.1081

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：PHARMACEUTICAL SOC JAPAN  

Visceral fat accumulation has been reported as the most important risk factor for the development of various metabolic disorders. In this study, the preventive effects of Bofutsushosan, a Japanese Kampo preparation, on obesity and various metabolic disorders were investigated focusing on visceral fat accumulation using Tsumura, Suzuki, Obese, Diabetes (TSOD) mice, which showed significant accumulation of visceral fat, and developed metabolic disorders including glucose intolerance, hyperlipidemia, hypertension and hyperinsulinemia. At 2 months after initiation of the study, the control TSOD mice developed various metabolic disorders such as marked obesity and visceral fat accumulation, increases in the levels of blood glucose, insulin, total-cholesterol (TC) and triglyceride (TG), and abnormal glucose tolerance, hypertension and peripheral neuropathy as distinct from the control Tsumura, Suzuki, Non-Obesity (TSNO) mice, which do not develop obesity and various metabolic disorders. In the TSOD mice treated with Bofutsushosan, body weight gain and visceral/subcutaneous fat accumulation were significantly suppressed. Biochemical parameters in plasma (glucose, TIC, insulin and tumor necrosis factor-alpha (TNF-alpha) level) were significantly suppressed, and abnormal glucose tolerance, elevation of blood pressure and peripheral neuropathy accompanying progression of metabolic disorders were also significantly suppressed. On the other hand, in TSNO mice, Bofutsushosan showed no noteworthy impacts on most parameters except for an improvement of the lipid plasma level. The above results suggested that Bofutsushosan could be effective in preventing obesity and various metabolic disorders.

DOI： 10.1248/bpb.31.1362

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Physiologically, anemia often occurs during pregnancy because of an increase in circulating plasma volume. Pregnancy anemia is found prenatally in 50-75% of women. Based on the present survey performed in our obstetrics and gynecology ward, 52% of women experienced anemia during their pregnancy. This suggests that normal physiological changes due to pregnancy alone are not the only factors contributing to pregnancy anemia. Therefore to study the influence of lifestyle on pregnancy anemia, we investigated prepregnancy lifestyles on the assumption that the accumulation of several factors over a long period is usually the cause of anemia. The present results suggest that (i) the probability of anemia is slight in late pregnancy, if a normal Hb concentration is maintained in early pregnancy; (ii) the menstrual cycle is involved in the onset of anemia during early pregnancy; (iii) the number of meals taken and the level of alcohol consumption influence Hb concentration in late pregnancy. We believe that these findings provide a useful information source for advising patients on avoiding pregnancy anemia, which we can also use as guidance for outpatients at puberty. In conclusion, to prevent pregnancy anemia it is important to keep a regular menstrual cycle before pregnancy, and to take 3 meals/day and abstain from alcohol before and during pregnancy.

DOI： 10.1248/yakushi.128.1081

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Iron-deficiency anemia not only causes insufficient oxygen delivery to the body of the mother, but creates serious conditions in the fetus, such as insufficient oxygen delivery and poor development, and its treatment has become an important issue. To elucidate the mechanism of the anemia-ameliorating action of Tokishakuyakusan, we investigated the effect of administration of Tokishakuyakusan on anemia-related parameters and the serum transferrin and erythropoietin levels, erythrocyte morphology, and bone marrow cells in pregnant rats and in pregnant rats with iron-deficiency anemia. The results showed that Tokishakuyakusan significantly improved the low erythrocyte count, hemoglobin, and hematocrit values of the pregnant rats in the iron-deficient state, increased the proportion of normal erythrocytes in terms of erythrocyte morphology, increased the proportion of erythroblasts among bone marrow cells, and also significantly increased the erythropoietin and transferrin levels in the blood. These findings suggested that Tokishakuyakusan promotes erythrocyte differentiation in iron-deficiency anemia, and that it possesses anemia-ameliorating efficacy.

DOI： 10.1248/bpb.30.1523

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：PHARMACEUTICAL SOC JAPAN  

In order to more closely examine the effect of Toki-shakuyaku-san and an iron preparation in vivo in an animal experiment, we prepared anemic rats, divided them into 4 groups, i.e., an untreated group, a Tokishakuyaku-san group, an iron-preparation group and a Toki-shakuyaku-san+iron-preparation group, and assessed the results of laboratory parameters, hematology, and general symptoms of anemia. The results showed trends toward improvement in indices of anemia, i.e., erythrocyte (RBC) count, hemoglobin (Hb), hematocrit (Ht) and serum iron (Fe), and improvement of anemic symptoms in the 3 treated groups. Examination of erythrocyte morphology showed that erythrocyte destruction had occurred only slightly in the 3 treated groups. The organ weight measurements showed an increase in the weight of the heart and spleen in the untreated group, but tended to be closer to normal in the 3 treated groups. The number and wet weight of the feces in the untreated group were markedly lower than normal, but increased in the Toki-shakuyaku-san group. In the iron-preparation group, the hemorrhage of stomach and pigmentation of the tail which seem to be a side effect of iron were observed, but was not seen in the Toki-shakuyaku-san group. The results animal experiment more closely examined the results of clinical study, and we concluded that by using Toki-shakuyaku-san and the iron preparation in combination, it is possible to lessen the adverse reactions such as gastrointestinal symptoms, and that more ameliorative effect on the anemic state can be expected.

DOI： 10.1248/bpb.27.871

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PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

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Language：English   Publishing type：Research paper (scientific journal)  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：PHARMACEUTICAL SOC JAPAN  

We prospectively studied and compared the usefulness of Kampo medicine (Sino-Japanese traditional herbal medicine) "Toki-shakuyaku-san" and an oral iron preparation in the treatment of hypochromic anemia associated with uterine myoma. The study subjects consisted of 25 patients who were diagnosed as having hypochromic mild to moderate anemia associated with menorrhagia attributable to uterine myoma. They were divided into the Toki-shakuyaku-san group (n=10) and the oral iron group (n=15). We monitored the blood counts, subjective symptoms, and occurrence of side effects after oral administration of either preparation for 4 and 8 weeks in these subjects. In regard to the blood counts and improvement of the laboratory parameters of anemia, while marked improvement was observed in the oral iron group, no significant improvement was noted in the Toki-shakuyaku-san group. On the other hand, in terms of improvement of the signs and symptoms of anemia, such as facial pallor, spoon-shaped nails and dizziness, the latter group also showed significant improvement. In addition in the Toki-shakuyaku-san group, resolution of symptoms such as hypermenorrhea, dysmenorrhea, feeling cold, dizziness, headache and shoulder stiffness was also noted. While side effects were encountered in 80.0% of patients in the oral iron group, no significant side effects were observed in the Toki-shakuyaku-san group. From these findings, it is considered that Toki-shakuyaku-san may be useful for resolving the symptoms of mild or moderate anemia associated with uterine myoma.

DOI： 10.1248/yakushi.123.817

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PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：PHARMACEUTICAL SOC JAPAN  

We examined whether dietary intake of cattle liver-supplemented food induces reproductive effects in dams and developmental effects in embryos in the mouse model. Seven groups of 19 to 35 female mice each were given either powdered food or the food supplemented with crude liver homogenate, its lipophilic component, the defatted liver homogenate or vitamin A (retinol palmitate) during a 25-d period spanning from a week prior to mating to gestation day 18 (GD18). Fetal mortality and incidence of external abnormalities of the fetuses whose dams were given the diet supplemented with the crude liver homogenate increased dose-dependently with an increase in the supplemented amount of the crude liver homogenate. On the other hand, the defatted liver homogenate did not induce any reproductive or teratological effect. The vitamin A (VA)-supplemented food (950 IU/5 g food as VA) induced approximately the same levels of the incidence of total external abnormalities appearing at the same affected regions or organs as the foods supplemented with the 700 mg crude liver homogenate (1029 IU/5 g food as VA) and its lipophilic component (950 IU/5 g food as VA). The content of VA (as 1029 IU/5 g food) in the crude liver homogenate was found to be approximately equal to that in the lipophilic component (950 IU/5 g food as VA). Therefore, it was concluded that VA plays an important role in induction of the lethal and teratogenic effects in the fetuses whose dams were given the powdered foods supplemented with the crude liver homogenate and its lipophilic component.

DOI： 10.1248/bpb.26.553

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PubMed

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Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：Japanese   Book type：Dictionary, encyclopedia

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Total pages：167  

ASIN

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Language：Japanese  

CiNii Books

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Language：Japanese   Book type：General book, introductory book for general audience

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Language：Japanese  

CiNii Books

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Language：Japanese   Publisher：公益社団法人 日本薬理学会  

日本の医療事故の報告件数 ( 日本医療機能評価機構 ) は、2017 年は 3,598 件あり、10 年以上その報告が増加しています。その医療事故の当事者は看護 師が１番多く、特に経験年数 5 年以内の看護師が引き起こしています。事故内 容としては、治療や処置に関する事項 26.7%、薬剤そのものに関する事項 8.6％ であり、その発生場面は、静脈注射＞内服＞末梢静脈点滴の順で発生が多く、 その他、薬の過剰投与、薬剤の勘違い、患者の勘違い、投与方法の勘違い、 確認・観察怠った、連携できていなかった、技術・手技の未熟、知識の不足な どが挙げられています。ヒヤリ・ハットにおいても、1 年間に31,218 件 (2017 年 ) の報告があります。その内、薬剤に直接関する事項は41.4％と1 番多く、ヒヤリ・ハッ トの当事者も看護師が１番多いです。つまり、看護師による薬の医療事故、事 例が非常に多いという実態があります。

薬の作用機序や薬物動態についてどのくらい理解していますか。薬の知識が つくと患者の身体的状態によって治療の効果や起こり得る副作用の予測がつき、 何をいつ観察したらよいか、何を注意したらよいかがよりみえてきます。また、薬 の使い方や投与方法、つまり与薬の科学的根拠もわかってきます。今回はよく使 われる薬を例にとって看護職に求められる薬理学の安全に関するの知識につい て一緒に考えてみたいと思います。

患者にとっての最適な治療とは何でしょうか。看護職は患者の生活からも薬の 効果を考え、適切な与薬が提案できたらよりよいと考えます。

DOI： 10.34597/npc.2019.1.0_s1-3

CiNii Research

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Language：Japanese   Publisher：(公社)日本薬学会  

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Language：Japanese   Publisher：(公社)日本薬学会  

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Language：Japanese   Publisher：公益社団法人 日本薬理学会  

近年、患者の高齢化や病態の複雑化により外科手術件数が増加している。手術以外にも術前の説明、検査や処置の鎮痛鎮静管理等の広い範囲（周麻酔期）で患 者さんへの手術や麻酔管理における安全と充実が求められている。そこで本学では、2016年4月に大学院修士課程として周麻酔期看護師養成講座を開設した。周麻酔 期看護師とは、周麻酔期におけるCareとCureを統合した看護実践、教育、相談、調 整、研究、倫理に関する看護実践能力を持つ者であり、周麻酔期の包括的な患者管 理の充実及び患者の QOL 向上のために、麻酔管理を安全に実践できる看護師であ る。現在の日本の社会的な必要性に応じて、専門看護師（CNS）の教育課程を基準 に、専門性獲得のために麻酔の知識・技術に特化した講義・演習・実習を各大学院 が独自にプログラムを実施し、各病院内認定でその職能を果たしている。本学大学 院では、周麻酔期看護学分野修了時の到達目標は、「Care」としては CNS の教育 課程の単位を修得、修士号の学位を取得し、実践、教育、相談、調整、研究、倫理に 関する実践能力と周麻酔期の包括的な管理が理解できることとしている。「Cure」としての麻酔管理の知識・技術（医学の講義と実習）の到達目標は、麻酔科医教育ガイドラインに基づき、麻酔科後期研修医 1 年目の 3 か月修了程度と設定している。ま た、医師の役割は病気の診断、治療であるが、看護師の役割は患者の置かれている 状況を正確に判断し、患者の恒常性を維持することである。そのため、例えば、周麻 酔期看護師は高血圧の治療は行わないが、手術中の血圧上昇の症状に対しては医 師の指示の下、適切な血圧に維持する。また、術後の強い疼痛や嘔気による苦痛を 患者が示した場合には、患者の状態が正常ではないと判断し、症状に対応した与薬 や処置などのケアを行う。事前に取り決められた範囲から症状が逸脱した場合は治 療を医師が行う。

手術中の麻酔は全身麻酔薬と麻薬性鎮痛薬と筋弛緩薬などによって患者個別に 調整し、薬剤の投与量を最小限に効果を発揮させ副作用を抑えるバランス麻酔を 行っている。また、硬膜外麻酔を併用することで、術中の疼痛や術後疼痛を抑えるこ とができる。周麻酔期看護師は周術期の患者の身体状態をアセスメントし麻酔を管 理するが、アセスメントするために看護師が必要な薬剤の知識は何か今回考えてみ よう。

DOI： 10.34597/npc.2018.1.0_s1-2

CiNii Research

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Language：Japanese   Publisher：公益社団法人 日本薬理学会  

日本の医療事故の報告件数（日本医療機能評価機構）は、2017 年は 3,598 件あり、10 年以上その報告が増加しています。その医療事故の当事者は看護 師が１番多く、特に経験年数 5 年以内の看護師が引き起こしています。事故内 容としては、治療や処置に関する事項 26.7%、薬剤そのものに関する事項 8.6％ であり、その発生場面は、静脈注射＞内服＞末梢静脈点滴の順で発生が多く、 その他、薬の過剰投与、薬剤の勘違い、患者の勘違い、投与方法の勘違い、 確認・観察怠った、連携できていなかった、技術・手技の未熟、知識の不足な どが挙げられています。ヒヤリ・ハットにおいても、1 年間に31,218 件（2017 年） の報告があります。その内、薬剤に直接関する事項は41.4％と1 番多く、ヒヤリ・ハッ トの当事者も看護師が１番多いです。つまり、看護師による薬の医療事故、事 例が非常に多いという実態があります。

薬の作用機序や薬物動態についてどのくらい理解していますか。薬の知識が つくと患者の身体的状態によって治療の効果や起こり得る副作用の予測がつき、 何をいつ観察したらよいか、何を注意したらよいかがよりみえてきます。また、薬 の使い方や投与方法、つまり与薬の科学的根拠もわかってきます。今回は高齢 者によく使われる薬を例にとって看護師に求められる薬の知識と技術について一 緒に考えてみたいと思います。

患者にとっての最適な治療とは何でしょうか。看護師は患者の生活からも薬の 効果を考え、適切な与薬が提案できたらよりよいと考えます。

DOI： 10.34597/npc.2018.2.0_s1-2

CiNii Research

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Language：Japanese   Publisher：(公社)日本薬学会  

J-GLOBAL

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皮膚障害は肥満の合併症の一つとされるが、その関連は十分明らかではない。本研究の目的は、肥満者の肥満度・減量と皮膚障害・生理機能の関連の検討である。デザインは非ランダム化クロスオーバー試験であり、BMI25以上の対象者に3ヵ月間の減量プログラムを実施した。初回、中間回、最終回に腹部、上腕、大腿の皮膚状態(角質水分量、pH、経皮水分喪失量、粘弾性、臨床所見)を評価した。対象者は41名であり、前期実施群が22名、後期実施群が19名となった。BMI27.5以上の対象者には、「間擦部の湿疹性局面」(p=0.035)、「色素沈着と粗ぞう化」(p=0.042)が多く観察された。最終回時点では、BMIとpHが正の相関(腹部p=0.044;上腕p=0.037;大腿p=0.013)、R0が負の相関(腹部p=0.044;上腕p=0.027;大腿p=0.001)を示した。最終回までにBMIは有意に減少した(p<0.001)。BMI減少率は、中間回までのR0の増加率(腹部p=0.001;上腕p=0.008;大腿p=0.005)および最終回までの皮膚pH低下率(腹部p=0.001;p<0.001;大腿p=0.045)と有意に相関した。肥満度は特有の皮膚所見に関連し、皮膚生理機能の変化としてpH上昇、変形能低下が観察された。また、肥満に伴う皮膚生理機能変化は、減量により改善する可逆的変化であることが示唆された。(著者抄録)

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Event date： 2022.11

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