[Objective]In clinical practice, it is important that patients experience symptomatic improvement or at least gain a certain level of satisfaction early on during a series of treatments. Most patients decide whether or not to return to the clinic based on these factors. At our school, students are trained in protocols from three different treatment styles:modern acupuncture, meridian acupuncture (based on classic acupuncture) and traditional Chinese medicine. In this study, we investigated the characteristics of each style, such as the presence of immediate effects and the types of sensations perceived by patients.
[Methods]Questionnaires were given before and after treatment to 177 patients who came to the clinic associated with our teacher training course for acupuncture, moxibustion and massage. We received valid responses from 169 patients. The practitioners surveyed were second-year students who had treated the surveyed patients 1.2 times on average prior to answering the questionnaire. Before treatment, patients were asked about their main complaints and symptoms, and afterward about changes in their symptoms, satisfaction level and other sensations. The resulting data was subjected to statistical analysis.
[Results]The style chosen by most practitioners was modern acupuncture, followed by meridian acupuncture, and then traditional Chinese acupuncture. Most lower back, leg and joint pain was treated with modern acupuncture protocols, while internal disorders were more often treated with meridian acupuncture or traditional Chinese acupuncture. All three styles were able to alleviate symptoms and achieve patient satisfaction with no statisticallysignificant differences among the three groups.
[Discussion]The results demonstrated that training practitioners in these three styles for one year helped them achieve positive and immediate effects. While there are many different styles of acupuncture, in actual clinical practice, the style is less important than how much a patient feels the effect of the treatment.
[Conclusion]All three styles, modern acupuncture, meridian acupuncture and traditional Chinese acupuncture, were able to alleviate symptoms and achieve patient satisfaction with no statistically significant differences among them.

1) During clinical clerkships at an outpatient clinic, medical students recognized the importance of medical interviews for problem-solving and for the physician-patient relationship.
2) The clinical clerkships were well accepted by patients.
3) Students worked harmoniously as members of medical teams.

This study was conducted to examine the effects of different types of swimming on vision, including contrast sensitivity, depth perception, static visual acuity, number of eyeblinks, and pain scale. Six college water-polo players swam (A) at a water flow rate of 0 m·sec^-1 with floating, (B) at 0.83±0.04 m·sec^-1 with floating, (C) at 1.09±0.05 m·sec^-1 with floating, (D) at 0.83±0.04 m·sec^-1 doing the front crawl (50%VO₂max), and (E) at 1.09±0.05 m·sec^-1 doing the front crawl (80%VO₂max) for 15 min on a swimmill. To avoid the effect by chlorine, the free radical residual chlorine concentration was fixed at 0 ppm in the swimmill.
We found no significant differences in vision before and after A. On the other hand, contrast sensitivity during the test decreased significantly in C and E (p<0.05) . Depth perception and number of eyeblinks increased significantly in C and E (p<0.05) . Subjects had a high pain scale in C and E (p<0.01) . Thus it seems that water flow may disturb of vision. We conclude that it is impor. tant for swimmers to prevent impairment of vision.

Objective: As part of the revision on remuneration for medical services in 2012, a new system has been implemented to allow an additional fee for inpatient pharmaceutical services to be added to the basic hospitalization fee.
Methods: We at Kitasato University Kitasato Institute Hospital satisfied all institutional requirements for the new system and were preparing to introduce it from April 2012; however, there was concern about the increased workload due to the additional work of preparing diaries for pharmaceutical services used in calculating the additional fee.
Results: We therefore developed a database titled Diary System for Inpatient Pharmaceutical Services for the preparation and management of diaries.  This system allows pharmacists from various divisions to enter data simultaneously and realizes the unified management of records of services performed at various places in the pharmacy.
Conclusions: Since entered data are automatically reflected in the inpatient pharmaceutical service diary and the monthly summary, an advantage compared to paper diaries in terms of efficiency may be expected.  Furthermore, the monthly summary of the number of service hours by ward and service type may also be used for service analysis.

BACKGROUND : Because of its high incidence, sensitivity to specific antibiotics, and rare but severe complications, campylobacter enteritis needs to be confirmed or excluded accurately and rapidly. We investigated the validity of Gram staining of a stool sample as a quick and useful method of diagnosing campylobacter enteritis in patients with acute diarrhea presenting at primary healthcare centers.
MATERIALS AND METHODS : Stool samples obtained from 64 patients with acute diarrhea were sent to a laboratory for Gram staining and culture. To estimate the usefulness of Gram staining, we calculated the sensitivity, specificity and likelihood ratio (LR) of Gram staining. Subject profiles, symptoms and peripheral white cell counts were also examined to see if they could raise the pre-test probability prior to the Gram staining test.
RESULTS : Of 64 subjects with acute diarrhea, 38 had C. jejuni (n=37) or C. coli (n=1) (campylobacter group), and 26 had other causes (control group). Gram staining revealed campylobacter-like bacteria (Cb-like bacteria) in 22 samples from the campylobacter group and 3 from the control group, yielding a sensitivity and specificity of 0.58 and 0.88, respectively. The positive LR was 5.02 (95%CI : 1.67-15.05), and the negative LR was 0.48 (0.32-0.71). Other factors such as patient age, disease duration, fever, abdominal pain and leucocytosis failed to raise the pre-test probability prior to Gram staining test. Taking a thorough history of food intake can raise the pre-test probability, although this may be difficult and was not evaluated in this study.
CONCLUSION : Gram staining can assist in making the diagnosis of campylobacter enteritis in patients with acute diarrhea, but it cannot be used alone to make or exclude the diagnosis.

Oral mucositis is reported to occurs in 40% of cancer patients on chemotherapy, suggesting the need for early oral care intervention in such patients. However, the oral care depends on each nurse and there has been no special document on the oral care for patients in the Respiratory Medicine and the Hematology/Oncology Ward, in which are managed around 100 regimens of chemotherapy per month. Here, to develop an oral care assessment sheet (OC sheet), we conducted a questionnaire survey of 24 ward nurses on oral care for chemotherapy patients and evaluated their assessment abilities using an oral care assessment test that was compliant with the items of the Eiler’s Oral Assessment Guide. The questionnaire survey revealed that nurses performed certain observations and/or interventions without basis and confidence, and that they did not always have patients’ cooperation while assessing their oral condition. They also tended to give inconsistent instructions. Use of the OC sheet enabled nurses to provide early oral care interventions and to confirm the utility of the chosen intervention. Test scores after the introduction of the OC sheet were significantly higher than before, indicating that use of the OC sheet improved nurses’ assessment and nursing care abilities.

Objective: The purposes of this trial were to demonstrate the feasibility and effectiveness of the hybrid of intracavitary and interstitial brachytherapy (HBT) for locally advanced cervical cancer patients in the phase I/II prospective clinical trial. Methods: Patients with FIGO stage IB2-IVA uterine cervical cancer pretreatment width of which was ≥5 cm measured by magnetic resonance imaging were eligible for this clinical trial. The protocol therapy included 30–30.6 Gy in 15–17 fractions of whole pelvic radiotherapy concurrent with weekly CDDP, followed by 24 Gy in 4 fractions of HBT and pelvic radiotherapy with a central shield up to 50–50.4 Gy in 25–28 fractions. The primary endpoint of phase II part was 2-year pelvic progression-free survival (PPFS) rate higher than historical control of 64%. Results: Between October 2015 and October 2019, 73 patients were enrolled in the initial registration and 52 patients proceeded to the secondary registration. With the median follow-up period of 37.3 months (range, 13.9–52.9 months), the 2- PPFS was 80.7% (90% confidence interval [CI]=69.7%–88%). Because the lower range of 90% CI of 2-year PPFS was 69.7%, which was higher than the historical control ICBT data of 64%, therefore, the primary endpoint of this study was met. Conclusion The effectiveness of HBT were demonstrated by a prospective clinical study. Because the dose goal determined in the protocol was lower than 85 Gy, there is room in improvement for local control. A higher dose might have been needed for tumors with poor responses.