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目的：A村の特定健康診査受診者の非肥満者を対象とした健診結果の実態及び血糖と生活習慣の関連を明らかにする．方法：A村の平成29年度特定健康診査受診者のうち，血圧や血糖等の服薬をしていない非肥満者533人を研究対象者とした．非肥満者533人を高血糖の有無による2群に分け，生活習慣との関連を分析した．結果：健診結果では，非肥満者は，LDLコレステロールの平均値が特定健診受診者全体よりも高かった．生活習慣では，非肥満者において高血糖群の方が定期的な運動をしている割合及び遅い時間の夕食をとっていない割合が有意に高く，生活習慣が良好な割合が高かった．結論：非肥満者のうち高血糖の住民は，生活習慣には留意していると考えられた．今後は，詳細な生活習慣を確認し，その結果とともに健診結果に基づく指導が重要である．, Objectives: The purpose of this study was to clarify the actual conditions of specific health checkups for non-obese individuals in A Village and the relationship between blood glucose and lifestyle habits.Method: The research participants were the 533 non-obese people who were not taking medication among of the all people who received a specific health checkup in A Village in 2017. We divided the 533 participants into two groups based on the presence or absence of hyperglycemia, and the relationship between blood glucose and lifestyle habits was analyzed.Results: Average LDL cholesterol was higher in the participants than in the recipients of specific health checkups overall. In terms of lifestyle habits, the proportion of participants in the hyperglycemic group who exercised regularly and those who did not eat dinner late at night was significantly higher than the non-hyperglycemic group, and the proportion of favorable lifestyle habits was higher.Conclusion: Non-obese people with hyperglycemia were considered to be aware of healthy lifestyle habits. It will be important for medical professional to ask more detailed questions about lifestyle during health checkups and to provide health guidance based on the results of blood test data., 原著

目的：群馬県訪問看護事業所における医療処置及び人工呼吸器装着者の事故発生状況，安全対策への取組を明らかにし，地域における安全対策の体制整備を検討する．方法：群馬県の訪問看護事業所の管理者421人を対象に自記式質問紙調査を実施した．有効回答は67人（15.9％），記述統計量を算出し，自由記述は類似性に基づき整理した．結果：医療処置の事故は訪問看護提供時間内に14件（n＝31），影響度はレベル3以下，人工呼吸療法に関する事故は介護者在宅時が11件（n＝25），影響度はレベル4が1件（4.0％），レベル5が3件（12.0％）であった．発生時の対応は，介護職のケア時間に発生した事故の検討47.4％，地域の多機関で話し合う30.6％であった．結論：人工呼吸器装着者の安全対策は，介護者のみの時間の療養者・家族が行う対策が重要であり，支援チーム，地域の多機関での事故に関する情報共有・検討が課題である．, Purpose: This study examined the development of local safety measure systems by clarifying the incidence of accidents in medical procedures and among users of ventilators, as well as initiatives for safety measures at home-visit nursing stations in Gunma Prefecture.Methods: A self-administered questionnaire was distributed to 421 administrators of home-visit nursing stations in Gunma Prefecture and valid responses were obtained from 67 respondents (15.9％). Each item was subject to descriptive statistics and open-ended answers were organized based on similarities.Results: The respondents reported 14 (45.2％) medical procedure accidents that occurred during home-visit nursing hours with an impact level on patients of 3 or lower, and 11 (44.0％) ventilation therapy accidents that occurred while the caregiver was home, one of which had an impact level of 4 (4.0％) and three of which had an impact level of 5 (12.0％). Measures taken to address accidents were investigations into accidents that occurred during care hours by care workers in 47.4％ of cases and discussions among various local agencies in 30.6％ of cases.Conclusions: Regarding safety measures for users of ventilators, measures carried out by the patient and their family while only the caregiver was home were important. In the future, it is necessary to address the sharing and review of information on accidents among support teams and various local agencies., 報告

目的：A県の高齢者向け住まいのサービス提供体制と医療的ケア及び看取りの受け入れ意向との関連を明らかにする．方法：A県の高齢者向け住まい（463か所）に勤務する管理者等を対象とし，入居者の状況，サービス提供体制等の自記式質問紙調査を実施した．サービス提供体制と医療的ケア及び看取りの受け入れ意向の有無との関連について，χ2検定又はFisherの直接確率検定を行った．結果：有効回答は130施設（有効回答率28.1％）であった．医療的ケアの受け入れ意向では，「施設に看護師が常駐」「夜間ケアを提供する職員の配置」等の11項目，看取りの受け入れ意向では，「施設に常勤の介護職員」「施設に常勤の看護師」「協力医療機関の24時間緊急往診要請への対応」「看取りのマニュアルの整備」等の14項目に関連があった．結論：高齢者向け住まいにおける医療的ケア及び看取りの受け入れには，看護職員・介護職員の配置及び医療機関等との連携の必要性が示唆された．, Objectives: To clarify the relationship between the service provision system of housing for the elderly in A prefecture and the intention to accept medical care and end-of-life care.Method: A self-administered questionnaire survey was conducted on residents’ status and components of the service provision system for managers working in residences for senior citizens in A Prefecture (463 facilities). The χ2 test or Fisher’s exact test was performed on the relationship between the service provision system and the intention to accept medical care and end-of-life care.Results: 130 valid responses were returned (effective response rate 28.1%). For the intention to accept medical care, 11 items were extracted, including “nurse resident in facility” and “allocation of staff providing night care”. For the intention to accept end-of-life care, 14 items were extracted, including“ full-time caregiver at facility”,“ full-time nurse at facility”,“ responding to 24-hour emergency visit requests with cooperating medical institutions” and“ maintenance manual”.Conclusion: It was suggested that the placement of nursing staff and cooperation with medical institutions are necessary for the acceptance of medical care and end-of-life care for the elderly., 報告

目的：全国及び群馬県の訪問看護ステーション（以下，ST）の経営状況と事業所特性及び地域特性，経営管理との関連を明らかにし，比較検討する．方法：全国2,000人及び群馬県163人のST管理者を対象とし，自記式質問紙調査を実施した．有効回答は全国473人，群馬県55人で，経営状況と各項目との関連はχ2検定及びKruskal-Wallis検定を，さらに経営状況を目的変数とするロジスティック回帰分析を行った．結果：全国では，看護師常勤・看護師非常勤・事務職員非常勤の従業者数，1人1日平均訪問回数，北海道・東北地域，収支のモニタリングが黒字に関連していた．群馬県では関連がみられず，全国に比して赤字のST割合が多く，経営管理の得点が低かった．結論：経営状況の改善には，ST規模の拡大やST管理者の収支のモニタリングに焦点を当てた行動の有効性が示唆された．群馬県では，経営管理に関する分析の強化が必要である．, Objectives: The financial status of home-visit nursing stations (STs) was analyzed in relation to business office characteristics, local community characteristics and business management, and the results between Gunma Prefecture and all prefectures in Japan were compared.Methods: A self-administered questionnaire survey was completed by 163 ST managers in Gunma Prefecture and 2000 ST managers from all over Japan. Valid responses were collected from 55 managers from Gunma Prefecture and 473 managers from all over Japan. The association between management status with each variable was analyzed by the chisquare test and Kruskal-Wallis test. In addition, logistic regression analysis was carried out with the status of management as the dependent variable.Results: For STs all prefectures in Japan, profitable business (black-ink balance) was associated with the number of employees (full-time nurses, part-time nurses and part-time clerical staff), the mean number of care receiver homes visited daily by each nurse, the district (Hokkaido/Tohoku) and revenue/expenditure balance monitoring. In Gunma Prefecture, the percentage of red-ink operation STs was higher and the score for business management was lower than in all prefectures in Japan.Conclusions: These results suggest that management actions focusing on expansion of the scale of STs and on revenue/ expenditure balance monitoring by ST managers are effective in improving the status of management. In Gunma Prefecture, reinforcement of how to analyze business management is needed., 原著

【目的】標準的な二次医療圏の回復期病院における急性期病院からの転入患者の特性と退院先を明確にし,地域完結型医療を推進するための示唆を得る.【対象と方法】 2007年度の転入患者 265人の診療記録の遡及調査を行い,記述統計および退院先により比較検討した.【結果】対象者は平均 76.5歳,脳血管疾患 47.1％で, 41.6％が入院後に介護保険を申請, 91.3％に退院調整がされた.退院先は 40.0％が施設,うち 18. 9％は介護老人保健施設であった.退院先施設が居住地の二次医療圏内である者は 77.4％で,介護老人福祉施設では 50.0％であった.退院先が自宅か否かの比較では,回復期病棟への入院,紹介元病院での入院期間,入院期間,医療処置の有無,ADL,認知機能,家族員数に有意差が見られた.【結語】加療に加え,ADL改善,認知症進行防止,介護保険の申請支援,退院調整の情報共有等とともに在宅・生活重視型施設の医療体制整備の必要性が示唆された.

Fisher syndrome (FS) is an autoimmune peripheral neuropathy that occurs in 1 person per 2 million population. The present report is of a patient with FS who presented with diplopia and discomfort of the right cheek and in whom differentiation from maxillary sinus cysts was necessary. The patient was a 43-year-old man with a history of radical surgery of the right maxillary sinus, so we suspected that his symptoms were due to postoperative maxillary sinus cysts. Although computed tomography demonstrated right maxillary sinus cysts, these cysts were not likely to be the cause of the patient's diplopia. Close neurological examination revealed external ophthalmoplegia, cerebellar ataxia, and the absence of a deep tendon reflex; on this basis, a diagnosis of FS was made. Diplopia is caused by various disorders and FS should be taken into consideration when making a differential diagnosis.

Bulletin, Music becomes a more important Merkmal than story in dance. As it seems that poiethike as a creative principle is useful for methodology of thinking the relation between dance and music, in order to investigate from this point, we want to ask choreographers who create the 21 century's dance how they confront music in their creation.

Bulletin, The goal of this research is to verify the minimalism in dance. Minimalism means to realize ultimate modernism, a pursuance of purity and autonomy as a form of art. In sixties, minimalism put an end to a pursuance of form. Then it has become an important idea in art as changing itself into post-modernism which is an idea for art of deferent point of view from modernism. When we look at minimalism in art and music, which is to say minimal art and minimal music, minimalism can be divided into three categories; (i) “Ready-made artistic materials”× “Equalization” (ii) “Natural (means unartistic) materials”× “Repeat” (iii) “Ready-made artistic materials”× “Repeat” Based on these categories, this research will verify the minimalism in dance. Minimalism in dance was first observed in sixties, as EQUALIZATION of the ready-made artistic material which is often used in minimal art (i), and marginal strategy to turning natural materials into an art work by using them REPEATEDLY (ii). In seventies, the minimalism in dance gradually became means of expressions which REPEATEDLY use artistic materials and is also used in minimal music (iii). Then (i) and (ii)－the minimal dance with primal spirit of minimalism, and (iii)－the minimal dance uses repeating which is merely means of expression of minimalism, are both recognized as minimalism in dance without being distinguished each other. Finally the minimal dance becomes the one which uses only the minimal music. However, it has not had the primal spirit of minimalism.

Recent advances in genome editing using programmable nucleases have revolutionized gene targeting in various organisms. Successful gene knock-out has been shown in Xenopus, a widely used model organism, although a system enabling less mosaic knock-out in founder embryos (F0) needs to be explored in order to judge phenotypes in the F0 generation. Here, we injected modified highly active transcription activator-like effector nuclease (TALEN) mRNA to oocytes at the germinal vesicle (GV) stage, followed by in vitro maturation and intracytoplasmic sperm injection, to achieve a full knock-out in F0 embryos. Unlike conventional injection methods to fertilized embryos, the injection of TALEN mRNA into GV oocytes allows expression of nucleases before fertilization, enabling them to work from an earlier stage. Using this procedure, most of developed embryos showed full knock-out phenotypes of the pigmentation gene tyrosinase and/or embryonic lethal gene pax6 in the founder generation. In addition, our method permitted a large 1 kb deletion. Thus, we describe nearly complete gene knock-out phenotypes in Xenopus laevis F0 embryos. The presented method will help to accelerate the production of knock-out frogs since we can bypass an extra generation of about 1 year in Xenopus laevis. Meantime, our method provides a unique opportunity to rapidly test the developmental effects of disrupting those genes that do not permit growth to an adult able to reproduce. In addition, the protocol shown here is considerably less invasive than the previously used host transfer since our protocol does not require surgery. The experimental scheme presented is potentially applicable to other organisms such as mammals and fish to resolve common issues of mosaicism in founders.

There is established concept that dendritic cells (DCs) play essential roles in the development of allergic immune responses. However, the influence of H 1 receptor antagonists on DC functions is not well defined. The aim of the present study was to examine the effect of epinastine hydrochloride (EP), the most notable histamine H 1 receptor antagonists in Japan, on Dermatophagoides farinae (Der f)-pulsed mouse bone marrow-derived DCs in vitro and in vivo. EP at more than 25 ng/mL could significantly inhibit the production of IL-6, TNF- 𝛼 and IL-10 from Der f-pulsed DCs, which was increased by Der f challenge in vitro. On the other hand, EP increased the ability of Der f-pulsed DCs to produce IL-12. Intranasal instillation of Der f-pulsed DCs resulted in nasal eosinophilia associated with a significant increase in IL-5 levels in nasal lavage fluids. Der f-pulsed and EP-treated DCs significantly inhibited nasal eosinophila and reduced IL-5. These results indicate that EP inhibits the development of Th2 immune responses through the modulation of DC functions and results in favorable modification of clinical status of allergic diseases.