Objective : Causes of nontraumatic posterior interosseous nerve (PIN) palsy include space-occupying lesions, constrictions of the PIN, and supinator syndrome. The purpose of this study was to identify these causes using Ultrasonography (US). Methods : We performed US in seven cases (seven elbows) with palsy and examined the PIN and surrounding structures. Results : We identified the three causes by the following US findings : 1) A space-occupying lesion in two elbows. Both were low-echoic and diagnosed as ganglion. In these two cases, the PIN was elevated by the lesion and compressed against the arcade of Frohse. 2) A diffusely swollen PIN with constrictions was found in three cases. 3) A PIN showing a reduction in caliber beneath and a swelling (pseudoneuroma) proximal to the arcade of Frohse, compatible with supinator syndrome was also identified. Conclusion : US is useful for the diagnosis of nontraumatic PIN palsy.

Purpose: A report of effective occupational therapy for delirium patients with cancer is uncommon. We report a patient of carcinomatous meningitis, in whom her daily activity is improved by occupational therapy. Case: Firstly, we supported her meals and then started occupational therapy accepting her interest. Although degree of confusion and her performance status was not varied from beginning to end, she could concentrate our programmed works and change her way of feelings. Also occupational therapy promotes reminiscence about her life review and friendship among other patients even in delirium condition. Conclusion: Occupational therapy can reduce cancer patients' impatience, anxiety and solitary feelings and improve quality of life.

Purpose: The incidence of early gastric cancer is increasing in older patients alongside life expectancy. For early gastric cancer of the upper third of the stomach, laparoscopic functionpreserving gastrectomy (LFPG), including laparoscopic proximal gastrectomy (LPG) and laparoscopic subtotal gastrectomy (LSTG), is expected to be an alternative to laparoscopic total gastrectomy (LTG). However, whether LFPG has advantages over LTG in older patients remains unknown. Materials and Methods: We retrospectively analyzed data of consecutive patients aged ≥75 years who underwent LTG, LPG, or LSTG for cT1N0M0 gastric cancer between 2005 and 2019. Surgical and nutritional outcomes, including blood parameters, percentage body weight (%BW) and percentage skeletal muscle index (%SMI) were compared between LTG and LPG or LSTG. Survival outcomes were also compared between LTG and LFPG groups. Results: A total of 111 patients who underwent LTG (n=39), LPG (n=48), and LSTG (n=24) were enrolled in this study. To match the surgical indications, LTG was further categorized into “LTG for LPG” (LTG-P) and “LTG for LSTG” (LTG-S). No significant differences were identified in the incidence of postoperative complications among the procedures. Postoperative nutritional parameters, %BW and %SMI were better after LPG and LSTG than after LTG-P and LTG-S, respectively. The survival outcomes of LFPG were better than those of LTG. Conclusions LFPG is safe for older patients and has advantages over LTG in terms of postoperative nutritional parameters, body weight, skeletal muscle-sparing, and survival.Therefore, LFPG for upper early gastric cancer should be considered in older patients.