Search

要旨 本研究の目的は，40 代と50 代の中年期の男女を対象にして，理想自己と現実自己の差異と困難な目標への対処との関連を量的と質的の両方のアプローチから検討することであった。まず，研究1 で1200 名を対象としたWeb 調査を実施した。その結果，困難な目標への対処は「粘り強さ」「諦めの早さ」「肯定的解釈」の3 因子構造であることが示された。その中の「肯定的解釈」は現実の自己評価と関連しており，「肯定的解釈」が高いほど，理想自己と現実自己との差異が小さくなることが示された。研究２では，調査協力者の内，理想自己と現実自己の差異が大きいあるいは小さい者10 名を対象に半構造化面接を実施した。その結果，差異の小さい者からの語りから，研究１と一致する結果が見出され，「たとえ失敗してもそれをポジティブに捉える」等の語りのように，困難な目標に対して肯定的解釈をすることの重要さが示唆された。, The present study used quantitative and qualitative approaches and examined correlations in discrepancies between the ideal and actual selves and methods of managing challenging goals. Participants were middle-aged men and women in their 40s and 50s. Study 1 conducted an Internet survey of 1200 participants. The results indicated that coping strategies for challenging goals had a three-factor structure; “persistence,” “giving up speed,” and “positive interpretations.” Moreover, positive interpretations were correlated with actual self-assessment. The discrepancies between the ideal and the actual self decreased with increased positive interpretations. Study 2 conducted semi-structured interviews with 10 participants having large and small discrepancies between their ideal and actual selves. Narratives of participants with a small difference showed consistent results with Study 1, suggesting the significance of making positive interpretations of challenging goals, including not dwelling on things that do not go well.

要旨 思春期に入ったばかりの中学生は，自分の将来への夢は未だ不確かであり，「志向する生き方」についても非現実的で，漠然としたイメージを描いていることが考えられる。本研究では，その中学生に焦点をあて，中学生が自分の将来についてどのような夢や希望を持ちどのような生き方を志向しているのか，性差及び小学生と比較した学校段階の差に着目して，中学生の将来志向性の特徴を明らかにすることを目的とする。性差と小・中の学校段階の差を検討するために，性別と学校段階を独立変数，将来志向性の良識・向上志向，家庭志向，金持ち志向の各得点を従属変数とした２要因分散分析を行った結果，将来志向性の性差については，家庭志向は男子に比べて女子が，金持ち志向は女子に比べて男子の得点が有意に高いことが明らかにされた。また，将来志向性の小・中学校の学校段階による差については，良識・向上志向，家庭志向，金持ち志向のいずれにおいても，中学生に比べて小学生の得点が有意に高く，小学生の方が自分の将来を意欲的・肯定的にとらえていることが示された。, Junior high school students in early adolescence usually have uncertain dreams about their future. Their images of “ life orientation” are vague and unrealistic. The present study examined junior high school students’ dreams and hopes for their future and the types of life they intend to live by focusing on gender differences and differences between elementary school and junior high school students. We conducted a two-way analysis of variance with gender differences and developmental stages as independent variables and three types of future orientation scores (improving good sense orientation, family orientation, and rich-person orientation) as dependent variables. The results indicated that elementary school students had significantly higher scores than junior high school students for the three orientation types, suggesting that elementary school students might perceive their future more positively and ambitiously than junior high school students. Moreover, girls had significantly more family orientation than boys. In contrast, boys showed significantly more rich-person orientation than girls.

Nozomi Kinoshita, Ayumi Ota, Fumihiko Toyoda, Hiroko Yamagami, Akihiro KakehashiDepartment of Ophthalmology, Saitama Medical Center, Jichi Medical University, Saitama, JapanPurpose: To report on pars plana vitrectomy (PPV) combined with pars plana lensectomy (PPL) with a preserved anterior capsule, panretinal endophotocoagulation (EPC) throughout the pars plana, and silicon oil (SO) tamponade (PPV + PPL + EPC + SO tamponade) for neovascular glaucoma (NVG).Methods: Thirteen eyes with NVG were treated. Ten eyes also underwent SO removal and intraocular lens (IOL) implantation (SO removal + IOL). Intraocular pressure (IOP), number of medications, and visual acuity were evaluated at the first visit, immediately before and 3 months after the procedure, 3 months after SO removal + IOL, and 1 year after the procedure.Results: At the first visit, immediately before and 3 months after the procedure, 3 months after SO removal + IOL, and 1 year after the procedure, the IOPs were 29 ± 19, 23 ± 12, 13 ± 5, 17 ± 10, and 17 ± 6 mmHg; numbers of medications, 0.7 ± 1.4, 2.1 ± 2.0, 0.6 ± 0.7, 1.2 ± 1.2, and 1.6 ± 1.6; and best-corrected visual acuities converted to logarithm of the minimum angle of resolution (BCVA logMAR), 0.96 ± 0.96, 1.27 ± 0.80, 1.67 ± 0.91, 1.37 ± 0.89, and 1.90 ± 1.44, respectively. No severe hypotony or phthisis bulbi developed within 1 year after the procedure. The success rates (IOP ≤ 21 mmHg and sustained light perception) were 92.3% after 3 months and 69.2% after 1 year.Conclusion: PPV + PPL + EPC + SO tamponade might have prevented acute increases of vascular endothelial growth factor and inflammatory cytokine production postoperatively and resulted in good vision in patients with NVG.Keywords: pars plana vitrectomy, pars plana lensectomy, panretinal endophotocoagulation, silicon oil, neovascular glaucoma

Advanced glycation end products (AGEs) play important roles in the development of ocular complications in diabetes mellitus. Spontaneously Diabetic Torii (SDT) rats have marked hyperglycemia and severe ocular complications. We evaluated the effect of anti-AGE agents, aminoguanidine and pyridoxamine, and an antioxidant, probucol, on the development of diabetic retinopathy (DR) and cataract in SDT rats. Experiment 1 included five SDT rats treated with aminoguanidine, four SDT rats treated with probucol, and four untreated control SDT rats. After age 55 weeks, we evaluated DR by fluorescein angiomicroscopy and pathological study and cataract by biomicroscopy. Experiment 2 included six SDT rats treated with pyridoxamine, and six SDT rats and 10 non-diabetic normal Sprague-Dawley (SD) rats not treated with pyridoxamine. Retinopathy and cataract were evaluated as in experiment 1. Urinary pentosidine and Maillard reaction product X (MRX) levels were measured for 40 weeks in each group. Experiment 1: Mature cataracts and DR developed in all untreated SDT rats; aminoguanidine prevented cataracts and DR (p

We evaluated the effect of an aldose reductase inhibitor, fidarestat, on diabetic retinopathy (DR) and cataract in spontaneously diabetic Torii (SDT) rats. Four rat groups were included: untreated, low- and high-dose (8 and 32 mg/kg/day) fidarestat-treated SDT rats, and nondiabetic control Sprague-Dawley rats. DR and cataract were evaluated and retinal and lens sorbitol, reduced glutathione (GSH), ocular fluid vascular endothelial growth factor (VEGF), and urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) was measured. The incidence rates of DR and cataract were significantly lower in the low- and high-dose fidarestat groups vs the untreated group (p

Background/Aims: The Spontaneously Diabetic Torii (SDT) rat develops advanced diabetic retinopathy (DR). The aim of this study was to identify advanced glycation end products (AGEs) related to vascular endothelial growth factor (VEGF) expression, a cause of DR in SDT rats. Methods: One eye was obtained from six SDT rats (blood glucose, >250 mg/dl) and 10 nondiabetic normal Sprague- Dawley (SD) rats and prepared for immunohistochemical study of VEGF and AGEs (pyrraline, pentosidine, carboxy methyl lysine (CML)). Immunostaining was described as minimal, moderate, and severe. Results: In diabetic rats, for CML, five eyes had severe and one moderate immunostaining. For pyrraline, one eye had moderate and five eyes minimal immunostaining. For pentosidine, one eye had moderate and five eyes minimal immunostaining. For VEGF, three eyes each had moderate and severe immunostaining. In nondiabetic rats, for CML one eye had minimal, seven had moderate, and two had severe immunostaining. For pyrraline, four eyes had moderate and six eyes minimal immunostaining. For pentosidine, 10 eyes had minimal immunostaining. For VEGF, one eye had moderate and nine had minimal immunostaining. The prevalence rates of CML and VEGF were significantly (P

Diabetic retinopathy (DR) is a leading cause of visual loss and blindness in adults in developed and developing countries (Friedman et al., 2011). Clinical trials have shown that intensive glycemic control reduces the incidence and progression of DR (Reichard et al., 1993; Stratton et al., 2001; DCCT, 2002 ). Other metabolic factors also affect the progression and development of DR. The UK Prospective Diabetes Study Group reported that tight blood pressure control is effective for reducing the incidence of DR (UK Prospective Diabetes Study Group, 1998a, 1998b). The EUCLID study group reported that inhibitors of angiotensin-converting enzyme drugs decreased the progression of retinopathy in patients without hypertension who had type 1 diabetes with little or no nephropathy (Chaturvedi et al., 1998). Lipid-lowering therapy with fenofibrate also might reduce the progression of DR (Chew et al., 2010; Keech et al., 2007). Among the metabolic factors, although glycemic control seems to be the most important, achieving acceptable glucose homeostasis is difficult, even when patients are highly compliant. Furthermore, DR continues to develop and progress even in patients who are treated intensively to achieve better glycemic control. Therefore, it is important to find medical options other than glycemic control to prevent diabetic ocular complications. The metabolic changes that accompany hyperglycemia, such as activation of the polyol pathway (Gabbay, 1973; Lorenzi, 2007; Robison et al., 1988; 1989), activation of protein kinase C (PKC) (Frank, 2002; Liang et al., 2005; Shiba et al., 1993), increased oxidative stress (Gurler et al., 2000; Jennings et al., 1991; Pan et al., 2008; Pinto et al., 2007), leukocyte adhesion to the endothelial cells (McLeod et al., 1995; Miyamoto et al., 1996; Schroder et al., 1991), and accumulation of advanced glycation end products (AGEs)

Mikiko Takezawa, Fumihiko Toyoda, Chiho Kambara, Hiroko Yamagami, Akihiro KakehashiDepartment of Ophthalmology, Jichi Medical University, Saitama Medical Center, Saitama, JapanBackground: To clarify the mechanism of idiopathic macular hole development, we evaluated the vitreoretinal relationship in fellow eyes of those with a macular hole and normal eyes using spectral-domain optical coherence tomography. Thirty-one fellow eyes and 34 normal volunteer eyes without a posterior vitreous detachment (PVD) were included.Results: We classified six vitreomacular relationships: type 1, no PVD, five fellow eyes (16.1%) and nine control eyes (26.5%); type 2, shallow PVD with perifoveal vitreous attachment, seven fellow eyes (22.6%) and 19 control eyes (55.9%); type 3, shallow PVD with pinpoint foveal vitreous traction, seven fellow eyes (22.6%) and no control eyes (0%), type 4a; shallow PVD with a round defect in the posterior vitreous cortex over the perifoveal area with vitreous attachment to the perifoveal area, two fellow eyes (6.5%) and one control eye (2.9%); type 4b, shallow PVD with a round defect in the posterior vitreous cortex over the perifoveal area without vitreous attachment to the perifoveal area, no fellow eyes (0%) and one control eye (2.9%); type 5a, shallow PVD with no pseudo-operculum, no fellow eyes (0%) and four control eyes (11.8%); type 5b, shallow PVD with a pseudo-operculum, four fellow eyes (12.9%) and no control eyes (0%); and type 6, biomicroscopically relevant PVD, six fellow eyes (19.4%).Conclusion: Types 3 and 5b developed only in fellow eyes. Type 2 developed most often in normal eyes and seemed to cause less foveal stress. Type 3 may show the basic pathogenesis of macular holes. Progression of type 5b after type 3 induces abortion of developing macular holes.Keywords: idiopathic macular hole, optical coherence tomography, posterior vitreous detachment, fellow eye

To characterize dendritic cells (DC) in normal human corneal epithelium.Normal human donor corneal epithelium was examined by fluorescence microscopy with single and double staining for multiple markers. Morphologic studies were also performed by confocal microscopy. HLA-DRa, CD1c, and CD16 mRNA expression in the corneal epithelium was examined by RT-PCR. CD45+ cells were separated from the corneal epithelium with magnetic beads and then were stimulated with TNF-alpha and lipopolysaccharide in vitro.CD45+ cells were mainly located in the basal-cell layer of the corneal epithelium and partly in the wing/surface layers. CD45-positive cell numbers were significantly higher in the peripheral cornea (3-6 mm from the center) than in the central cornea (0-3 mm from the center). All these cells expressed HLA-DR and CD11c but not CD3, CD11b, CD14, CD19, CD56, or CD66, suggesting that these were bone marrow-derived myeloid DC. Some DR+CD11c+ DCs from the periphery expressed CD1c and CD16. HLA-DRa, CD1c, and CD16 mRNAs were detected in normal corneal epithelium. These CD11c+ DCs did not express CD123, CD1a, DC marker (CMRF56), CD40, CD80, or CD86. When CD45+ cells were isolated from the corneal epithelium by magnetic cell sorting, CD40 and CD86 expression were detected after in vitro stimulation with TNF-alpha and lipopolysaccharide.These findings demonstrate that normal human corneal epithelium contains at least three DC phenotypes, with HLA-DR+ myeloid lineage CD11c+CD16- DCs as the main population plus a small number of CD11c+CD16+ DCs and CD11c+CD1c+ DCs. These cells can be discriminated from bone marrow-derived cells in the human corneal stroma.

Aim: To report a new form of retinopathy that was observed in patients who had undergone percutaneous coronary intervention (PCI) following acute myocardial infarction (AMI). Methods: Serial ophthalmological examinations were conducted in 40 patients who underwent PCI. Thirty patients were diagnosed with AMI, and another 10 had stable angina pectoris. Results: Cotton wool spots developed in 17 (57%) patients from the group with AMI undergoing PCI (n = 30) within 2 months. Of these, 41% (seven patients) also developed superficial haemorrhages. Retinopathy was most prominent 1–2 months after AMI and then tended to become quiescent afterwards, without treatment. Conclusion: We have identified a new form of retinopathy in patients with AMI that spontaneously subsides without treatment.

PURPOSE To determine the effects of proinflammatory cytokines on differential gene expression profiles in the human corneal endothelium (HCE), by using a cDNA expression array. METHODS A human cDNA expression array technology was used to study the simultaneous expression of HCE incubated with interleukin (IL)-1alpha and tumor necrosis factor-(TNF)-alpha. Gene-specific semiquantitative reverse transcription-polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA) were performed to examine the gene and protein expression patterns revealed by the cDNA expression array, in the presence and absence of proinflammatory cytokines. Moreover, the expression of these genes was studied in ex vivo HCE of donor cornea by RT-PCR. RESULTS IL-1alpha and TNF-alpha upregulated the expression of 46 of 268 genes for cytokines, chemokines, and their receptors in stimulated HCE. The most upregulated genes in the cDNA expression array, those of monocyte chemotactic protein (MCP)-1 (CCL2), IL-8 (CXCL8), IL-6, and growth-related beta (GRObeta, CXCL2), were studied. Semiquantitative RT-PCR and ELISA analyses revealed the proinflammatory cytokine-mediated changes in the respective gene transcription and protein expression levels. The mRNAs were detected in ex vivo HCE of donor cornea stimulated with proinflammatory cytokines. CONCLUSIONS HCE can abundantly express cytokines and chemokines through the stimulation of proinflammatory cytokines. The detected genes, those of CCL2, CXCL8, IL-6, and CXCL2, in HCE could facilitate understanding of the inflammatory responses, including the production of keratic precipitates and the correlation between CE and an inflamed cornea or aqueous humor.

Nozomi Kinoshita, Ayumi Ota, Fumihiko Toyoda, Hiroko Yamagami, Akihiro KakehashiDepartment of Ophthalmology, Saitama Medical Center, Jichi Medical University, Saitama, JapanPurpose: To report a new technique of blunt needle revision with viscoelastic materials via the anterior chamber for the treatment of early failed filtering blebs and elevated intraocular pressure after trabeculectomy, in which digital ocular massage and laser suture lysis have been ineffective.Methods: A 27-gauge blunt needle attached to a syringe containing viscoelastic material was inserted into the anterior chamber from the inferior paracentesis. The needle tip was inserted into the subscleral flap space from the filtering fistula at the anterior chamber side, and the scleral flap was lifted bluntly. The needle tip was then inserted into the subconjunctival space where the viscoelastic agent was injected and the adhesion between the sclera and conjunctiva was separated bluntly. Blunt needle revision via the anterior chamber was performed 14 times in six eyes of six patients at Saitama Medical Center, Jichi Medical University from January 2007 to May 2009. All procedures were performed within 1 month after trabeculectomy.Results: The intraocular pressure remained 21 mmHg or lower for more than 6 months in three of six eyes. Slight bleeding from the iris occurred in one of the 14 procedures, and hypotony (intraocular pressure below 5 mmHg) occurred in one of the 14 procedures. No serious complications developed.Conclusion: Blunt needle revision via the anterior chamber for early failed filtering blebs is a new, simple, and safe procedure.Keywords: glaucoma, trabeculectomy, filtering bleb, needle revision, blunt needle

CONCERNING the transcription of genetic information by DNA, recent investigations, using systems of the transformation of D. pneumoniae1 and infection with some bacteriophages2–4, have demonstrated that the DNA molecule consists of an informational and a non-informational strand. Guild and Robinson1 succeeded in obtaining fractions of denatured transforming DNA in CsCl density-gradient centrifugation which seemed to correspond to each polynucleotide chain, and they examined the time course of the appearance of cells possessing the new phenotype. It was observed that the expression of the new phenotype by one fraction was retarded for about one generation period compared with the other fraction. The messenger RNA synthesized after infection with bacteriophages2,3, or the RNA synthesized enzymatically in an in vivo system2,4, were examined for hybrid formation with polynucleotide chains separated in CsCl density-gradient centrifugation. The data suggested that the messenger RNA produced in vivo can form a ribonuclease-resistant hybrid with the unique polynucleotide chain of the primer DNA.