看護理工学会

The Society for Nursing Science and Engineering

看護理工学会誌 6巻2号

目次

論 説

  • 8K硬性内視鏡システム:その過去,現在,未来
    日本語抄録 English Abstract
    8K硬性内視鏡システム:その過去,現在,未来
    千葉敏雄1,2,3 谷岡健吉3,4
    1. 昭和大学医学部
    2. 早稲田大学理工学術院
    3. 一般社団法人メディカル・イノベーション・コンソーシアム
    4. ニューヨーク州立大学

    われわれは,超高精細8K画像(7680×4320ピクセル)を撮影可能なカメラ技術を基にして,医師がより安全に効率のよい内視鏡手術を行えるような8K内視鏡を開発してきた.2013年の8K腹腔鏡下動物実験を皮切りに,2014年11月の8K腹腔鏡下胆嚢摘出手術などを経て,2017年には真に医療現場で実用可能なレベルの8K内視鏡カメラの小型軽量化にいたった.2014年には2kg以上あった8K内視鏡カメラは,カイロス株式会社により370gにまで軽量化され,2017年にはクラス1医療機器として製品化された.8K内視鏡は従来のハイビジョン内視鏡(1920×1080ピクセル)とくらべ16倍の解像度をもっていることから,これまで見づらかったような細い血管や膜構造,重要な神経の判別などの明瞭な見分けが可能になる.内視鏡手術の効率が上がるだけでなく,手術の安全性も高まるため,患者の早期回復を促し医療経済上の効果も見込めることから,従来の内視鏡手術を大きく変えるものとして期待できる.

    8K超高解像度,硬性内視鏡システム,腹腔鏡下手術,胆嚢摘出術
    8K UHD rigid endoscopic system:The past, present and future
    Toshio Chiba1,2,3 Kenkichi Tanioka3,4
    1. School of Medicine, Showa University
    2. Faculty of Science and Engineering, Waseda University
    3. Medical Innovation Consortium
    4. State University of New York

    Medical endoscopic applications of an 8K ultra-high-definition(UHD;7680×4320 pixels)imaging technology has started from 8K UHD laparoscopic animal experiment in 2013. After 8K UHD laparoscopic cholecystectomy in 2014 using a prototype 8K UHD camera weighing over 2 kg, Kairos Co., Ltd succeeded in reduction of the camera weight to 370 g which was truly practical in the medical field and finally commercialized as a medical device in 2017 in Japan. Using our 8K UHD endoscope with 16-times resolution compared with conventional high-definition(HD;1920×1080 pixels)endoscope and an 8K UHD large monitor, surgeons can observe thin blood vessels, thin membrane structures, and important nerve fibers which have been hard to see clearly. We believe that our 8K UHD endoscopic imaging is very likely to changes the future of endoscopic surgery with an improvement of surgical efficiency, safety and medical economic effects.

    8K ultra-high definition(UHD),rigid endoscopic system,laparoscopic surgery,cholecystectomy
  • 看護師さんはキャビンアテンダント?
    日本語抄録 English Abstract
    看護師さんはキャビンアテンダント?
    土肥健純1,2
    1. 東京電機大学総合研究所特命教授
    2. 東京大学名誉教授

    看護師さんの仕事内容は,旅客機の搭乗客の世話をするキャビンアテンダントとは異なります.現在の臨床医学の現場では,看護師さんは,患者さんの世話だけでなく,医師と同様に多くの医療機器を使わなければなりません.すなわち看護師さんは,医師に指示された治療・検査以外にも患者さんの容体管理にも医療機器を用いています.看護師さんが,使用や研究の対象とする医療機器としては,①詳しい理解を必要とする医療機器,②看護分野への積極的使用を目的とする医療機器,③看護師さんの肉体労働を支援する医療機器,④看護に便利な医療機器の開発,があげられます.また,すでに解決済みとされていた仕事のなかにも,まだ問題が残されているものもあります.

    看護理工学,医療機器,肉体的負担,高齢社会
    Is a nurse a cabin attendant?
    Takeyoshi Dohi1,2
    1. Tokyo Denki University
    2. The University of Tokyo

    The work contents of the nurse is different from a cabin attendant taking care of the embarkation visitor of the airplane. In the site of the current clinical medicine, the nurse does not take care of the patient and must use many medical equipment like a doctor. In other words the nurse uses medical equipment for condition management of the patient as well as treatment and inspection ordered by a doctor. For the medical equipment which nurse targets for use and the research, there are following types.(1)Medical equipment with the knowledge that is deeper than a thing of an instrument,(2)Medical equipment for the purpose of the active use to the field of nursing,(3)An instrument supporting manual labor of the nurse,(4)Development of the medical equipment which is convenient for nursing. Actually, in the work of the nurse, there are many problems that were already solved. On the other hand, there is even solved work when a problem is found newly.

    nursing science and engineering,medical equipment,physical burden,aging society

原 著

  • (英文論文)A comparison of the movement of the mandible in infants between breastfeeding and bottle-feeding(母乳と哺乳瓶哺乳時の下顎運動の比較)
    日本語抄録 English Abstract
    母乳と哺乳瓶哺乳時の下顎運動の比較
    松原まなみ1 井上 円2
    1. 関西国際大学保健医療学部看護学科
    2. 女子栄養大学栄養科学研究所

    生後3~4日の正期産の健常新生児を対象に,動画解析ソフトを用いて吸啜時の下顎運動と吸啜波を,直接母乳と人工乳首による哺乳の2群間で比較した.下顎運動の指標として吸啜時における顎関節の①吸啜周期,②開口角,③下顎変位量,および④開口・閉口時の加速度を計測した.2群間の比較は対応のないt検定を用いた.A群(完全母乳栄養児)10名,B群(混合栄養児)14名の吸啜周期に有意差はなかったが,開口角,下顎変位量,開口・閉口時の加速度については,いずれもA群のほうがB群とくらべて有意に大きかった.(p<0.001).また,吸啜波はB群よりA群のほうが大きな振幅を示した.開口角,下顎変位量,開口・閉口時の加速度を含む下顎運動は人工乳首の哺乳より直接母乳のほうが有意に大きかったことから,人工哺乳より母乳のほうが吸啜に対してより大きな運動エネルギーを必要とすることが示唆された.

    母乳哺育,哺乳瓶哺乳,新生児,下顎運動
    A comparison of the movement of the mandible in infants between breastfeeding and bottle-feeding
    Manami Matsubara1 Madoka Inoue2
    1. Kansai University of International Studies, Graduate School of Health Science
    2. Institution of Nutritional Sciences, Kagawa Nutrition University

    Aim:To compare mandibular movements in infants between breastfeeding and bottle-feeding. Methods:A total of 24 full-term infants, aged 3-4 days, with birth weight 〓2500g and no medical problems were recruited. The infants were divided into two groups by their mother’s choice. Group A included 10 infants who were exclusively breastfed after birth, while group B included 14 infants who were bottle-fed first and then were additionally breastfed at each feeding after birth. The mandibular movements including the sucking cycle, the time intervals of jaw opening and closing, the mandibular displacement, the acceleration of mandibular movements, and the maximum angle at jaw opening were measured at each feeding to draw sucking waveforms using a motion analysis software. Unpaired student T-test was performed to compare mandibular movements between the infants in group A during breastfeeding and those in group B during bottle-feeding. Results:The acceleration of mandibular movements, the mandibular displacement, and the maximum angle at jaw opening were significantly greater during breastfeeding than during bottle-feeding(p<0.001 for all). The amplitudes of the waveforms were larger during breastfeeding than during bottle-feeding. Conclusion:The mandibular movement was significantly greater during breastfeeding than during bottle-feeding. Breastfeeding might more require kinetic energy in mandible to obtain milk than bottle-feeding.

    breastfeeding,bottle-feeding,infant,mandible,movement

速報

  • 完全閉じ込め症候群(TLS)となったALS患者のコミュニケーション
    日本語抄録 English Abstract
    完全閉じ込め症候群(TLS)となったALS患者のコミュニケーション -脳波(ERP)を用いたAndroidスマートフォンアプリの開発-
    加納尚之1
    1. 島根県立大学

    意識や聴覚や思考能力はあるものの,目も開けられず,完全に閉じ込められた状態になる完全閉じ込め症候群(Totally Locked-in Syndrome:TLS)となってしまった筋萎縮性側索硬化症(Amyotrophic Lateral Sclerosis:ALS)患者のための意思伝達補助装置(Communication Aids:CA)の開発が切望されている.そこで,視覚刺激や聴覚刺激に関連して出現する事象関連電位(Event-Related Potential:ERP)を意思情報として利用するAndroidスマートフォンアプリを開発した.患者家族や医療関係者からの簡単な質問に対する患者のYESまたはNOの意思を特定する.これにより,本アプリは患者と家族,そして医療関係者との日頃の会話の一助となり,TLSとなったALS患者の生活の質は大きく改善する.

    筋萎縮性側索硬化症(ALS),完全閉じ込め症候群(TLS),意思伝達補助装置(CA),事象関連電位(ERP)
    Communication of ALS patients with totally locked-in syndrome -Development of android-smartphone application by utilizing event-related potential-
    Naoyuki Kano1
    1. University of Shimane

    Amyotrophic Lateral Sclerosis(ALS)patients are unable to successfully communicate their desires, although their mentality is normal, and so, the necessity of Communication Aids(CA)is realized. Therefore, the author focused on Event-Related Potential(ERP)which is elicited for the target by visual and auditory stimuli. P200, N200, P300, and N400 are components of ERP. These are brain potentials that are elicited when the subject focuses attention on stimuli that appears infrequently. It is possible for ALS patients to communicate their desires by utilizing ERP as their intention information. So,“Communication System by utilizing Android-Smartphone Application”was developed for Totally Locked-in Syndrome(TLS)patient. It consists of the smartphone, the electroencephalogram(EEG)module and three electrodes. The caregiver asks ALS patient some simple questions. And ALS patient answers“YES”or“NO”to the caregiver. This system can detect their answer.

    amyotrophic lateral sclerosis(als),totally locked-in syndrome(tls),communication aids(ca),event-related potential(erp)
  • 実践報告

    • (英文論文)Exploration of communication robot use for older patients in an acute hospital based on case trials(症例を通じた急性期病院入院中の高齢者向けコミュニケーションロボット活用の探索)
      日本語抄録 English Abstract
      症例を通じた急性期病院入院中の高齢者向けコミュニケーションロボット活用の探索
      野口博史1 小谷野結衣子2 森 浩美2 小見山智恵子2 真田弘美3,4 森 武俊1,3
      1. 東京大学大学院医学系研究科ライフサポート技術開発学(モルテン)寄付講座
      2. 東京大学医学部附属病院看護部
      3. 東京大学医学部附属グローバルナーシングリサーチセンター
      4. 東京大学大学院医学系研究科健康科学・看護学専攻老年看護学/創傷看護学分野

      われわれは急性期病院において精神的な症状をもつ高齢者とロボットを会話させる試みを行ってきた.1つには,PepperとRoBoHoNというヒューマノイド型のロボットを病棟に常時配置し内蔵のソフトウエアで稼働させる試みを行い,病棟看護師の観察により患者が明るい表情を示す様子を確認できた.2つにはランダムにフレーズを繰り返し発話させるものや,家族のことや子供の頃など特定のトピックについて会話するソフトを開発し会話させた.ソフト開発を通じて高齢者への会話導入には腕を振るなどの注意を引く動作の重要性を確認した.加えて,繰り返しの発話を聞くことでリハビリに積極的になる症例を経験し,会話をすることで1名をのぞく10名の方では喜ばれ,自発的な発話が増える症例も見られた.これらから,ロボットの会話により急性期病院の高齢者において精神的な症状の緩和だけでなく,活動への参加意欲や社会性の向上などの効果も見られる可能性があると考えられる.

      ロボット,入院高齢者,認知機能低下,精神症状
      Exploration of communication robot use for older patients in an acute hospital based on case trials
      Hiroshi Noguchi1 Yuiko Koyano2 Hiromi Mori2 Chieko Komiyama2 Hiromi Sanada3,4 Taketoshi Mori1,3
      1. Department of Life Support Technology (Molten), Graduate School of Medicine, the University of Tokyo
      2. Department of Nursing, The University of Tokyo Hospital
      3. Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo
      4. Department of Gerontological Nursing/Wound Care Management, Division of Health Science and Nursing, Graduate School of Medicine, The University of Tokyo

      We attempted to realize robot communication with older patients with psychological symptoms in an acute hospital using two approaches:the feasibility study and robot application investigation study. For the feasibility study, two robots, Pepper and RoBoHoN, with their initial applications were placed near the nurse station. The ward nurse observed that almost all the patients felt happy. For the robot application investigation study, we developed two original applications:a robot saying several sentences randomly and repetitively and a robot talking with the patients based on programed topics such as family and childhood. The study revealed that calling patients using their names and waving a hand was important to attract attention of hospitalized older patients.The nurse observed that a patient became willing to enter rehabilitation positively after hearing the robot speaking. In addition, we observed that 10 out of 11 patients felt happy to listening to the robot. The results indicated that the robots have the capability to decrease the psychological symptoms, provide encouragement for active involvement in the treatments such as rehabilitation, and increase the sociality of the older patients.

      robot,older patients,cognitive impairment,psychological symptoms