医学部を目指し、Natureなど科学・医学記事を英語で読む

医学部学士編入指導例---3

Nature, Nature Medicineだけではなく、The New England Jornal of Medicineの記事も多く取り上げています。過去の出題問題を勉強するのも大切ですが、最新の医学関連雑誌の記事を勉強することが何より求められるのが「医学部学士編入試験」です。最新の記事は、受験の知識にとどまらず、話題そのものが興味深く、学術への飽くなき知識欲に答えてくれます。そんな中から、ほんの一部ですが、紹介してゆきます。

◎Murder or Mercy? Hurricane Katrina and the Need for Disaster Training(NEJM)
△Human genome more variable than previously thought(N)
○Fatal outcome of human influenza A (H5N1) is associated with high viral load and hypercytokinemia(NM)
◎H5N1 Influenza — Continuing Evolution and Spread(NEJM)
◎BECOMING A PHYSICIAN(The Script)  Benjamin Brody, B.A.(NEJM)
(N)=Nature
(NM)=Nature Medicine
(NEJM)=New England Journal of Medicine

揺らめく意識

「医学部学士編入対策問題」に選んだ記事が、NatureDigest11の「英語でNature」でとりあげられています。単語・表現の説明、日本語訳もあります。「無料公開記事」になっているので、ご参考に。

=========================
揺らめく意識 - pp26 - 28 無料公開記事
Flickers of consciousness
doi:10.1038/ndigest.2006.061126
Original source: Nature 121-122 (2006); doi:10.1038/443121b

脳に損傷を負って意識が戻らないまま身体は生き続けている状態を、一般に「植物状態（vegetative state）」とよんでいます。しかし最近、「植物状態」と診断されていても外部からの刺激に対して脳内活動を示す患者がいることが、脳スキャンを使った研究で示されたため、その定義や基準が揺らいでいます。　Nature では、この話題を2006 年9 月14 日号の論説記事およびNews で取り上げました。以下の論説記事を読んで、研究の内容をより詳しく知りたい場合には、News（Michael Hopkin, Nature 443, 132-133）にも挑戦してみましょう。
http://www.nature.com/ndigest/journal/v3/n11/pdf/ndigest.2006.061126.pdf

医学部学士編入受験指導例(2)

次の英文を読んで、ここで述べられているinflammation(文全体で)について、４００字程度でまとめなさい。［＊印のついた語句は注を参照にしなさい。］

   What does an injured toe or a splinter* in a finger have to do with your risk of developing Alzheimer's disease, suffering a heart attack or dying from colon cancer*? More than you might think. As scientists look deeper into the fundamental causes of those and other illnesses, they are starting to see links to an age-old immunological defense mechanism called inflammation --- the same biological process that turns the tissue around a splinter red and causes swelling in an injured toe. If they are right --- and the evidence is starting to look pretty good --- it could radically change doctors' concept of what makes us sick. It could also prove a great source of profit to drug companies looking for new ways to keep us well.

[同志社大学（法・工）2005年]　全文（設問設定は当RJ-Netschool）　

→for_m-2.pdfをダウンロード

これに関連して、_Nature Medicine_の今月号（10月）に以下の記事があります。

・    Controlling immune response may cut bird flu death rate p1105　Helen Pearson

・    Fatal outcome of human influenza A (H5N1) is associated with high viral load and hypercytokinemia pp1203 – 1207

[Abstract]

Avian influenza A (H5N1) viruses cause severe disease in humans^{1, 2}, but the basis for their virulence remains unclear. In vitro and animal studies indicate that high and disseminated viral replication is important for disease pathogenesis^{3, 4, 5}. Laboratory experiments suggest that virus-induced cytokine dysregulation may contribute to disease severity^{6, 7, 8, 9}. To assess the relevance of these findings for human disease, we performed virological and immunological studies in 18 individuals with H5N1 and 8 individuals infected with human influenza virus subtypes. Influenza H5N1 infection in humans is characterized by high pharyngeal virus loads and frequent detection of viral RNA in rectum and blood. Viral RNA in blood was present only in fatal H5N1 cases and was associated with higher pharyngeal viral loads. We observed low peripheral blood T-lymphocyte counts and high chemokine and cytokine levels in H5N1-infected individuals, particularly in those who died, and these correlated with pharyngeal viral loads. Genetic characterization of H5N1 viruses revealed mutations in the viral polymerase complex associated with mammalian adaptation and virulence. Our observations indicate that high viral load, and the resulting intense inflammatory responses, are central to influenza H5N1 pathogenesis. The focus of clinical management should be on preventing this intense cytokine response, by early diagnosis and effective antiviral treatment.

[参考] (Nature 3 August 2006)

Bird flu not set for pandemic, says US team p490　H5N1 virus fails to cause epidemic in ferret experiment. Erika Check

「主題」がはっきりした英文

次の英文を読んで、下線部its flawsについて、具体的かつ簡潔に200字程度でまとめなさい。
Sweden has the most comprehensive health care system in the world. All Swedish citizens are covered by national health insurance financed by contributions from the state and employers.
   Medical treatment is just one component of Sweden's broad system of health maintenance. For example, people who are sick or must stay home with sick children receive 90 percent of their salaries. Swedes are given parental leave at the birth of a child, and all Swedes are guaranteed a pension.
   This comprehensive system is not without its flaws. The first problem is its costs. Socially responsible wellness is expensive, running about35 percent of each employee's salary, in fact a rate far in excess of the rest of the world. As a result, the system faces a serious payment crisis in the immediate future and in the long term.
   Sweden's medical system is also very inefficient. Swedes have not solved the twin problems of getting rid of waiting lines and getting physicians and other health care workers to work. With salaries of these medical personnel guaranteed, regardless of how many patients they see, the system is marked by a lack of productivity. When reporters visited Sweden's largest hospitals on a weekday morning, a peak period when 80 of 120 surgeons were on duty, they found 19 of 24 operating rooms vacant. Their photos of dark and empty operating rooms-at a time when there was a one- to two-year waiting period for hip replacements and eye operations --- provoked a public outcry. Due to public pressure and greater accountability, efficiency is up.[慶応・看護より]

医学部学士編入受験指導例

ほんの一部ですが紹介します。英文については個々人で入手してください。また、体験指導を希望される方は、メールで問い合わせてください。なお、Nature記事以外の基礎力確認の指導素材もあります。

指導問題例

１．Homing in on the genes for humanity(725,17, August 2006 Nature)
HAR1Fについて２００字で要約しなさい。

２．Preventing cancer(720, 17, August 2006 Nature)
第３段落にあるthe next biggest threatについて２００字程度で説明しなさい。

３．Alzheimer disease research in Japan: public funding（後半Traditionally,以下を中心に）
[July, 2006 NM]
日本におけるアルツハイマー病研究と公的助成についての現状と展望について４００字程度でまとめなさい。（その際に棒グラフの黄色部分について言及すること）

４．Health agency backs use of DDT against malaria(250-1 21 September 2006 Nature)
１．.何についての文章か。『（　　　　　　　　）について』、と言うように簡潔に
２．これまで何が問題で利用できなかったのか。
３．どのような問題の解決に役に立つのか。
４．ここで話題の「薬品」の長所はどういう点か。
５．使用に際しては、どのような使い方を推奨しているか。
６．ここで話題の「薬品」がりようできなくなった象徴的人物とはだれか。full-name、カタカナで書きなさい。
７．かつてはどんな利用がなされていたのか。