Oren-to extract alone was administered to 28 patients who had pain in the tongue but without organic lesions, and who had either a “hypofunctioning constitution” or a “normal functioning constitution”. The patients were predominantly women in their 50's. Treatment was continued for at least two months. The results were excellent in nine, good in 15, and unchanged in four. No side-effects attributable to Oren-to were observed. When the effect was compared in patients with and without dryness of the mouth, no significant difference was found. Thus it was shown that Oren-to was effective in the treatment of pain in the tongue in patients with either 'hypofunctioning constitution“ or ”normal functioning constitution“, regardless of whether they ”had dryness of the mouth or not. It seems that this preparation is also effective for the treatment of pain in the tongue in patients with psychosomatic disease who have a “hypofunctioning constitution” or “normal functioning constitution”. We discuss our study focusing on this condition.

With aging of inpatients, the prevention of falls in old people is an important task nurses have to take upon themselves. In our hospital, we have been tackling the task in earnest by utilizing a fall prevention assessment score sheet. Our efforts have resulted in changes in the attitude of nurses as shown by a survey. (1) By working on the nursing plan with use of the fall prevention assessment score sheet, nurses have become alert to risk factors for falling. (2) They have realized that assistance suited to the needs of each patient is vital and that collaboration between patients, their families and hospital staff contributes to the prevention of falls greatly. (3) The use of an intervention manual has made it easy for nurses to cope with falls and consequent injury. (4) To share information of every factor for falling among the nursing staff has added greatly to the prevention of the recurrence of the fall.
Prevention ; Fall, NOS ; Surveys ; Attitude ; Knowledge acquisition using a method of assessment

Transmucosal Immediate-Release Fentanyl（TIRF）can be a key-drug for breakthrough cancer pain. Prescription audit is needed because there are concerns about tolerance or serious adverse events including respiratory suppression and addiction due to inappropriate use of these drugs. The aim of this audit study is to evaluate appropriateness of TIRF prescriptions, reasons of violation, and adverse events in the real-world setting. A retrospective chart review was conducted in 31 patients who had breakthrough cancer pain and were treated with TIRF. A 2-step algorithm was generated：baseline pain and administration situation of other opioid rescues. TIRF was prescribed appropriately in six patients（19.4％）. Reasons of violation were as follows：prescriptions only for using same drug with around-the-clock opioids（fentanyl transdermal patches, n＝19）, and patients could take oral medicines and use of morphine or oxycodone rescues would be preferable（n＝12）. TIRF was initiated with a minimum dose in all patients and no serious adverse events were observed. Although TIRF was used widely for breakthrough cancer pain, prescription was not necessarily done appropriately. Detailed assessment of breakthrough cancer pain and consideration of the use the other rescue medication would be required.

Purpose: The present study aims to evaluate the effect of analgesics in cancer patients based on their pain descriptions. Methods: The relationship between the words that patients used to describe their pain due to cancer and the efficacy of treatment with analgesics such as non-steroidal anti-inflammatory drugs (NSAIDs) or opioids was evaluated. Results: We recorded 529words that were used by 164patients to describe their pain and pain quality and classified them into 108types of pain.For patients who used the actual word 'dull' or one with a similar meaning, treatment with opioids was effective. However, treatment with opioids was less effective in patients who used words such as "numb" and "tingling". Conclusion: We were able to gain a good understanding of cancer pain by listening to the actual words that patients used when complaining of pain. These findings suggested that we could choose a suitable medication through evaluation of the actual words cancer patients used to describe their pain and successfully relieve their pain. Palliat Care Res 2009: 4(1): 207-213

Europe has a long history with its own traditional medicines. In Germany, the practice of traditional European and Asian medicine along with modern medicine is called Integrative Medicine. The pain clinics at Munich University, TCM Klinik Bad Kotzting, Immanuel Klankenhaus and Zen Haus Klinik are well-known centers of Integrative Medicine in Germany. We visited these hospitals and clinics and report on the state of their treatment.
Four-week programs in chronic pain, traditional Chinese medicine, natural therapy, and traditional Japanese medicine with aromatherapy are given at these facilities. Moreover, Complementary and Alternative medicines are widely covered by public or private insurance. And one reason for the spread of Integrative Medicine may be these social conditions, in addition to historical background.

The Great East Japan earthquake and tsunami disaster that occurred on March 11, 2011 seriously destroyed Japanese social activities the medical system included. We provided medical support to the damaged area, and mainly performed Oriental medicine. Traditional methods using physical diagnoses and the treatments with herbs, acupuncture, and massage were effective, where any infrastructure had suffered or any modern medical facilities had been destroyed. Acute phase infectious disease, common colds, and hypothermia were dominant. Allergies increased two weeks later, and there was much mental distress, and chronic pain symptoms one month later. We prescribed Kampo herbal medicines for common colds, hypothermia, allergies, and mental distress. Moreover, we also performed acupuncture and kneaded patients' body to reduce pain, stiffness, and edema. These treatments were effective for both physical and mental distress. Thus we believe that Oriental medicine is valuable in disaster situations.