Yonago Acta Medica
Online ISSN : 1346-8049
ISSN-L : 0513-5710
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Showing 1-10 articles out of 10 articles from the selected issue
Review Article
  • Masahiko Inoue
    Type: Review Article: Special Contribution
    2019 Volume 62 Issue 2 Pages 169-181
    Published: 2019
    Released: June 20, 2019
    JOURNALS FREE ACCESS

    Intellectual disability and autism spectrum disorder are neurodevelopmental disorders that emerge during the developmental period. A significant barrier that impedes the social adaptation of individuals with these disorders is the exhibition of problem behaviors, such as self-injurious, stereotyped, and aggressive/destructive behaviors. In recent years, these problem behaviors have been collectively referred to as “challenging behavior,” in accordance with the contention that they result from an interaction between the individual and his or her social environment. Evidence-based psychosocial interventions that adopt the functional approach to treating challenging behavior are increasing. However, in order to effectively implement such interventions in educational settings and welfare facilities, it is essential to develop staff training programs and usable psychometric assessments. Accordingly, a brief overview of research studies on challenging behavior that have been conducted in Japan, as well as the various support systems that are available to individuals who exhibit challenging behavior, are presented in this article. The discussion makes it apparent that, in order to improve treatment systems in Japan that are aimed at addressing challenging behavior, it is necessary to establish not only better staff training programs, but also reliable and valid assessments measuring challenging behavior that can be readily used by teachers and parents. On the basis of this discussion, it is proposed that technological advancements must be applied to psychosocial approaches in the study of problem behaviors, in order to develop assessment system using software applications and automatic measurement system of target behaviors using sensing technology.

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  • Mitsuhiko Osaki, Futoshi Okada
    Type: Review Article: Special Contribution
    2019 Volume 62 Issue 2 Pages 182-190
    Published: 2019
    Released: June 20, 2019
    JOURNALS FREE ACCESS

    Exosomes are a subset of extracellular vesicles and their size is approximately 100 nm in diameter. They are surrounded by a lipid bilayer membrane and secreted from almost all of cells. Exosomes are generated within the endocytic system as ILV (intraluminal membrane vesicle) and secreted during the fusion of MVB (multivesicular body) with the cell membrane. Recently it has been reported that exosomes modulate cell-cell communication contributing to the maintenance of tissue homeostasis by molecules including exosomes. Moreover, exosomes released from cancer cells are involved in cancer progression. Thus, data regarding the role of the exosomes in malignant cancer will lead to development of novel diagnostic and therapeutic methods.

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Original Article
  • Yusuke Kimura, Masashi Honda, Shuichi Morizane, Katsuya Hikita, Tadahi ...
    Type: Original Article
    2019 Volume 62 Issue 2 Pages 191-197
    Published: 2019
    Released: June 20, 2019
    JOURNALS FREE ACCESS

    Background To evaluate the efficacy of Bacilli Calmette-Guerin (BCG) induction instillation therapy after second transurethral resection (TUR) in stage Ta T1 high-grade bladder cancer.

    Methods We performed a retrospective analysis of 49 consecutive new onset Ta T1 high-grade bladder cancer patients treated with second TUR at our affiliated institutions. Residual cancer rate, intravesical recurrence-free survival (RFS), and risk factors related to RFS were evaluated by univariate and multivariate Cox proportional hazard model analyses.

    Results Thirty-one patients received BCG therapy after the second TUR (BCG group), and 18 patients were treated with second TUR alone (no BCG group). There were statistically significant differences in the RFS rates between the two groups, (P = 0.037). BCG therapy was the only factor predictive of intravesical recurrence after second TUR in both univariate and multivariate analyses. After the second TUR, BCG therapy significantly decreased intravesical recurrence in the patients with residual tumors (P = 0.014). However, there was no significant difference in intravesical recurrence in the patients with no residual tumors between the two groups (P = 0.359).

    Conclusion BCG therapy after second TUR significantly decreased intravesical recurrence of residual tumors found at the second TUR.

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  • Hiroaki Komatsu, Satoru Tsukihara, Shinya Sato, Masako Sarugami, Tetsu ...
    Type: Original Article
    2019 Volume 62 Issue 2 Pages 198-203
    Published: 2019
    Released: June 20, 2019
    JOURNALS FREE ACCESS

    Background The authors wanted to understand the current situation concerning Japanese obstetricians’ and gynecologists’ ideas for and against training in other departments.

    Methods We sent questionnaires to obstetrics and gynecology (Ob-Gyn) specialists via a social networking service (SNS) in Japan. They answered anonymously using Google Forms over the internet.

    Results The respondents comprised 120 Ob-Gyn specialists, and their age ranges of 28–29, 30–39, 40–49, and 50 or more, were 5.8%, 73.3%, 15.8%, and 5.0%, respectively. Only five Ob-Gyn specialists (4.2%) had experience in other departments, specifically gastrointestinal and urology. Ninety percent of them responded that they thought training in other departments was useful for developing clinical and surgical skills. In addition, 91.0% of respondents thought that surgical knowledge and skills were necessary in the clinical practice of gynecology, while 94% stated training in urology was also necessary. However, 49.2% of respondents answered that they may feel stress training in other departments where there were many issues, including a lack of personnel and difficulties securing cases.

    Conclusion Many Ob-Gyn specialists think training in other departments is necessary, but potential problems include proper training implementation and stress management for residents. If additional training is enforced, greater flexibility in each facility will be required.

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  • Hiroaki Komatsu, Fuminori Taniguchi, Takashi Harada, Takaya Nakaso, No ...
    Type: Original Article
    2019 Volume 62 Issue 2 Pages 204-210
    Published: 2019
    Released: June 20, 2019
    JOURNALS FREE ACCESS

    Background We evaluated the necessity of urinary trypsin inhibitor for patients with threatened premature labor.

    Methods We enrolled 146 women with singleton pregnancies who were treated for threatened premature labor as inpatients. The uterine cervical length of each patient was ≤ 25 mm at 22–35 weeks of gestation on transvaginal ultrasonography. The patients were divided into two groups: the urinary trypsin inhibitor group (91 patients treated with urinary trypsin inhibitor daily) or non-urinary trypsin inhibitor group (55 patients not treated with urinary trypsin inhibitor). The childbirth outcomes were retrospectively assessed.

    Results The median cervical length measured on the day of admission was almost similar between the urinary trypsin inhibitor and non-urinary trypsin inhibitor groups. Depending on the symptoms of uterine contractions, we determined whether ritodrine hydrochloride and/or magnesium sulfate would be appropriate for treatment. The median gestational week at birth was 38 weeks in the urinary trypsin inhibitor group, and no obvious differences were observed when compared with the non-urinary trypsin inhibitor group. With regard to birth weight, no significant difference was found between the two groups (urinary trypsin inhibitor group, 2776 g; non-urinary trypsin inhibitor group, 2800 g).

    Conclusion Our data showed no significant beneficial effects of urinary trypsin inhibitor in the maternal course and delivery outcomes.

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  • Reiko Okuda, Mika Fukada
    Type: Original Article
    2019 Volume 62 Issue 2 Pages 211-220
    Published: 2019
    Released: June 20, 2019
    JOURNALS FREE ACCESS

    Background Basic social competency is defined as the fundamental ability necessary for working with diverse people in the workplace and community. This study aimed to clarify the differences in the basic social competency of university nursing students by year of study, and related factors.

    Methods The subjects were 305 first- to fourth-year university nursing students. A survey was conducted using a self-completed questionnaire. Analyses were performed by comparing basic social competency amongst different years of study, calculating correlation coefficients of occupational readiness and development of personalization and socialization with basic social competency, and multiple regression analysis of factors influencing basic social competency.

    Results The subjects analyzed were the 162 students who returned the questionnaire (the recovery rate was 53.1%, and the response rate was 100%). Basic social competency tended to decrease in second-year students and subsequently improved in fourth-year students. Specifically, the scores of Action and Teamwork were significantly high in fourth-year students. In addition, the correlation coefficient between occupational readiness and basic social competency was r = 0.566 (P = 0.01), r = 0.615 for the individual orientedness (P = 0.01), and r = 0.542 for the social orientedness (P = 0.01); and significant correlations were observed in these relevant factors. Multiple regression analyses revealed that basic social competency were influenced by occupational readiness, individual orientedness, and social orientedness (R2 = 0.47, F = 15.14, P = 0.00).

    Conclusion Basic social competency for university nursing students was significantly higher in fourth-year students, and the correlation with basic social competency was strong in the categories of occupational readiness and the development of personalization and socialization. It was suggested that clinical practice experiences promoted students’ personal growth and socialization while preparing to take a nursing job and affected the development of basic social competency.

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  • Shoko Sasaki, Mika Fukada, Reiko Okuda, Yukiko Fujihara
    Type: Original Article
    2019 Volume 62 Issue 2 Pages 221-231
    Published: 2019
    Released: June 20, 2019
    JOURNALS FREE ACCESS

    Background The majority of nurses are employed at medical institutions and acquire clinical competency through their work within their organization. Hands-on experience in the clinical setting is essential to enhance a nurse’s clinical competence. The objective of this study was to determine the impact of commitment to the practical skills of nurses within Tottori prefecture.

    Methods We studied data from 916 nurses employed at 7 publicly-funded medical facilities (national and other public institutions). Data on basic information, clinical nursing competence, and commitment were collected via an anonymous self-administered questionnaire.

    Results A total of 672 valid questionnaires were analyzed. Mean clinical nursing competence scores showed a tendency to increase with years of experience. Scores increased from years 1 to 4, and then tended to plateau or decrease slightly thereafter up to around year 9. Mean commitment scores decreased from 1 to 2 years of experience to 3 to 4 years of experience. Other than “normative factors,” mean scores tended to increase after 5 to 10 years of experience. Multiple regression analysis showed that “job involvement” at 1 to 2 years; “overall job satisfaction” at 5 to 9 years; “career commitment” at 10 to 19 years; and “job involvement” and “career commitment” at ≥ 20 years impacted results. No factors appeared to have an influence on nurses in their 3rd to 4th year of experience.

    Conclusion Based on the concepts described above, self-assessment of nursing competence scores tended to improve with years of experience. Mean commitment scores tended to decrease after 3 to 4 years of experience and thereafter plateaued or increased. Organizational commitment has not clearly been shown to affect nursing competency, but the factors that affect this parameter changed with the length of experience. Results suggest support is needed in the 1st and 2nd years to help nurses adapt to the organization while in years 5 through 9, support that takes work-life balance into consideration is needed. This indicates support should change to meet the needs of each stage in a nurse’s career. In years 3 to 4, it was suspected that the nurses’ relationship with the organization weakened. Helping nurses forge a good relationship with their organization is believed to be effective in improving clinical competency in nurses with 5 or more years of experience.

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Patient Report
  • Taiki Murakami, Shinji Tanishima, Chikako Takeda, Shinsuke Kato, Hidek ...
    Type: Patient Report
    2019 Volume 62 Issue 2 Pages 232-235
    Published: 2019
    Released: June 20, 2019
    JOURNALS FREE ACCESS

    Meningiomas constitute approximately 25% of primary spinal cord tumors, and 1% to 5% are calcified. Ossification is a rare event and the etiology of ossification in meningiomas is not well known. We present the case of a 29-year-old female with a rare case of ossified thoracic spinal metaplastic meningioma. The tumor was successfully resected, and pathology confirmed ossified metaplastic meningioma. On histopathological examination, only mature bone tissue and tumor cells were present in the region containing no psammoma bodies, suggesting that the tumor cells had transitioned to mature osteocytes.

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  • Yutaro Saito, Nobuo Ohta, Sachiko Konosu-fukaya, Fumi Shoji, Takahiro ...
    Type: Patient Report
    2019 Volume 62 Issue 2 Pages 236-239
    Published: 2019
    Released: June 20, 2019
    JOURNALS FREE ACCESS

    A 71-year-old Japanese male patient presented with a rare case of Glomangiopericytoma (GPC) of the left nasal with obstruction. Complete resection with endoscopic surgery was performed. Immunohistochemical staining for smooth muscle actin, β catenin, cyclin D1, vimentin, and factor 13 were helpful in establishing a definitive diagnosis. Extranasal treatment has been traditionally performed for successful management. However, recent advances in endoscopic treatment have enabled complete endoscopic resection of GPC, minimizing morbidity and facilitating subsequent surveillance for recurrence. Endoscopic management should be considered in suitable cases.

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Short Communication
  • Sayuri Hara, Keiko Nagata, Yuji Nakayama, Katsumi Higaki, Michiko Mats ...
    Type: Short Communication
    2019 Volume 62 Issue 2 Pages 240-243
    Published: 2019
    Released: June 20, 2019
    JOURNALS FREE ACCESS

    Graves’ disease occurs predominantly in women. Epstein-Barr virus (EBV) mainly persists in human B lymphocytes, and its reactivation stimulates antibody production. We previously suggested that the EBV reactivation-induced production of TRAb and IgM at 100 nM estradiol (pregnant level) was lower than that at 0 nM estradiol and that class switch recombination may be increased by estradiol. In this study, we examined the effect of estradiol on EBV reactivation. We identified the expression of EBV-glycoprotein 350/220 (gp350/220) in the late phase of reactivation and plasma cell differentiation of EBV-infected cells using 72A1 antibody and CD138 antibody, respectively. We found the mean ratio of gp 350/220(+) CD138(+) cells at 100 nM estradiol was higher than that at 0 nM estradiol. These results suggested that EBV-infected cells could survive with keeping the ability of antibody production in 100 nM estradiol, which is consistent with the improvement of Graves’ disease during maternity and exacerbation postpartum.

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