Background/Purpose: The purpose of this study is to clarify the effectiveness of interventions for breast cancer patients with psychological distress by a clinical psychologist on the basis of the contents of the interventions and counseling. Methods: The participants were 20 inpatient and outpatient women aged from 33 to 73 years who had been diagnosed with breast cancer. The interventions were conducted on the basis of patients' complaints about anxiety and/or depression or by a medical doctor's request. The interventions employed unstructured, one-on-one interviews. Each interview usually lasted no more than 60 minutes. Results: The 20 cases were classified into the following categories: (1) 15 general (nonpsychiatric) cases, consisting of (1-1) 9 cases at the cancer-notification and progressive-therapeutic stages and (1-2) 6 cases at the progressive-relapse stage; and (2) 5 specific (psychiatric) cases, consisting of (2-1) 3 cases at the cancer-notification and progressive-therapeutic stages and (2-2) 2 cases at the progressive-relapsestage. As for the general cases, interventions were found to be effective in all 9 cases at the cancer-notification and progressive-therapeutic stages but in only 2 of 6 cases at the progressive-relapse stage. In specific cases, effective interventions were found at the cancer-notification, the progressive-therapeutic, and the progressive-relapsestages. Conclusion: This study suggested that interventions for breast cancer patients by a clinical psychologist are effective. The psychological interventions had two roles: to assess the patients properly and to interview the patients as purposefully as a medical team member would.

Objective:It is well known that the use of benzodiazepines is associated with falling in elderly people, but there have been few researches focused on changes in the dose of benzodiazepines and falls. If the association between changes in the dose of benzodiazepines and falling becomes clear, we may take an action to prevent falling.In this study, we investigated the association between changes in the dose of benzodiazepines and falling among elderly inpatients in an acute-care hospital.
Design:Falling generally results from an interaction of multiple and diverse risk factors and situations, and medication history of each subject must be considered in this study. We conducted a case-crossover study in which a case was used as his/her own control at different time periods. Therefore covariates that were not time-dependent were automatically adjusted in this study.
Methods:Subjects were patients who had falling at one hospital between April 1, 2008 and November 30, 2009. Data were collected from incident report forms and medical records. Odds ratio for changes in the dose of benzodiazepines were calculated using conditional logistic regression analyses.
Results:A total of 422 falling by elderly people were eligible for this study. The odds ratio for increased amounts of benzodiazepines was 2.02(95% Confidence Interval(CI):1.15, 3.56). On the other hand, the odds ratio for decreased amounts of benzodiazepines was 1.11(95%CI:0.63,1.97).
Conclusion:There was an association between increased amounts of benzodiazepines and falling. Hence, it is considered meaningful to pay attention to falling when amounts of benzodiazepines are increased to prevent falling in hospitals.

The purpose of this study was to investigate the effect of weight reduction on the anti-mutagenicity of human saliva. Subjects were 16 male college judo players. The anti-mutagenicity of the saliva was measured using the umu test. There was an inhibiting effect of the saliva on the mutagenicity of AF-2. However, a modifying effect of the saliva on Trp-P-1 was not observed. On the day before a competition and 7 days after the competition, the inhibiting capacity of the saliva for the mutagenicity of AF-2 decreased and increased in two non-weight reduction and two weight reduction groups, respectively. However, on the day before the competition, the changed body weights (r=−0.77, p<0.01) and BMI (r=−0.77, p<0.01) were significantly correlated with that of the inhibiting capacity of the saliva for the mutagenicity of AF-2. In addition, the BMI at 20 days before the competition was not significantly but markedly correlated with it (r=0.50, p=0.057). At 7 days after the competition, however, these correlations were not found. These findings suggest a unique correlation between the anti-mutagenicity of human saliva and body weight or BMI.
Saliva ; competition ; Human ; Body Weight ; g <3>

The purpose of this study was to investigate the effect of weight reduction prior to a competition on the salivary cortisol level for first-rate judo players. Subjects were divided into three groups by the weight reduction rate. On the day before the competition, the cortisol levels of the low- and high-weight reduction group showed a tendency to decrease and were significantly lower than that of the non-weight reduction group (p<0.05). However, with regard to the change in the stress indices, there was a difference between the high- and low-weight reduction groups. In the high-weight reduction group alone, there was a significant increase in the stress indices on the day before the competition (p<0.05). These findings suggest that the HPA axis is affected during the relatively early stage of weight reduction and mental stress is increased at the higher weight reduction rate.
Reduction (chemical) ; Weight ; competition ; Salivary ; Levels

A survey of physical mesurements, blood pressure, blood mesurements and frequency of food consumption was conducted on 152 males and 229 females, aged 40 to 65 years, from three rural districts in Saga prefecture. The districts were Ariake (flatland area), Kohhoku (intermediate area) and Yamanouchi (mountainous area). While, on the aged -above 70 years, a questionnaire on daily living and health condioion was investigated.
The results were summarized as follows:
1) The values of skinfold thickness differed little among the districts. The rate of obesity by skinfold thickness both in male and female was lower than the result of National Dietary Survey in 1981. However, the average skinfold thickness in females were higher a little compared with the values of our suruey in same region in 1971.
2) The prevalence rate of anemia in females was remarkably high (below 12g/dl of hemoglobin, 34%). It presumed that agricultural work load might heavy, and nutrients intake correspond to the work load was insufficient.
3) From the results of frequency of food consumption, inhabitants in Ariake compared with Kohhoku more frequently intaked modern food e. g. meat, milk. On the other hand, Kohhoku was higher in blood pressure, HDL-cholesterol/total cholesterol ratio, and lower in triglyceride, total choresterol than Ariake. We guessed that the food consumption pattern mainly affect on the results of blood pressure and serum lipids.
4) In relation to the correlation matrix which calculated on all districts, the higher the obesity, the higher the blood pressure, triglyceride, total cholesterol and cholinesterase activity, whereas the obesity decreased HDL-cholesterol and HDL-cholesterol/total cholesterol ratio.
5) Among 90 persons aged above 70 years, the rate of ones who can not work from physically disability, and who have any desease was 18%, 51% respectively.

The aim of this study was to investigate the end of life care provided by long-term care facilities and nursing homes. A cross-sectional survey of all long-term care facilities and nursing homes in Kobe was performed in July 2013. Questionnaires were sent to 350 facilities with an 89.7％ response rate. In total, 121（39％）of respondents stated that end of life care was available, and 151（48％）responded that facilities were willing to provide end of life care for terminally ill residents. One hundred fifty-two（48％）and 183（58％）of respondents answered that facilities were available for managing residents with percutaneous endoscopic gastrostomy, and transfusion, respectively. Seventy-two（23％）of respondents reported that facilities for managing the use of narcotics were available. In conclusion, a minority of long-term care facilities and nursing homes ware available for providing end of life care for residents, though approximately 50％ were willing to do so.

Investigation on the working time, energy expenditure and fatigue were carried out for members of three families engaged principally in raising silk worms.
Group examinations of physical conditions and blood constituents and survey of nutritional intake were performed on the residents, including the above families, in a community in Fukueisland, Nagasaki-prefecture.
The results were as follows;
1) The average values of energy expenditure on a most busy day in a raising period of silk worm calculated to be 3150 kcal (max. 3500 kcal) for males, 2340 kcal (max. 2890 kcal) for females of the above three families. Their working times on this day were about 14 hours.
2) The physical fatigue of the subjects was estimated by means of Fliker frequency, near point and threshold of patellar reflex. Remarkable changes of these values were found, suggesting the heavy physical load of the raising works, and the changes were more remarkable in olders and females than in youngers and males.
3) Donaggio's reaction and Na/K in the first urine of morning were investigated at an interval of five days during one period of silk worm raising.
The Donaggio's reaction values were increased about two times higher in the latter term, on the other hand Na/K dropped in the former term of the period.
4) The group examinations of the inhabitants in the community showed that the body fat of silk raising farmers were fewer than that of the farmers engaged in other kinds of farming reported by the present authors.
Blood values (Ht, Hb and TP) of them in 1975 were lower than in 1974, because one more raising period was added and so the physical load of them might be greater in '75 than in '74.
5) The nutritional intakes of silk raising farmers were almost as same as these of the farmers in other districts.

At Nippon Medical School, a "Basic Clinical Training Course" is provided as an introduction to clinical medicine. Medical students undergo initial clinical skills training with simulators. We describe the technique of effective training to acquire clinical skills and the results of student evaluations and a questionnaire survey.1) The training consisted of 8 practicums, including internal examination, funduscopic examination, otoscopic examination, breast examination, auscultation (heart sounds and lung sounds), and collection of blood samples. Medical students moved in rotation once per time period (45 minutes) and performed practical training in each unit, which comprised 2 practicums.2) The training with the prescribed number of 50 students in 4 time periods was efficiently performed for 2 days and required 9 trainers per day. Student evaluations and a questionnaire survey revealed the interest and enthusiasm of medical students and showed they thought highly of the training.3) The training was efficiently performed and was thought to help reduce the teaching load of instructors. The educational effect of the training can be strengthened by increasing the convenience of the clinical simulation laboratory, by reinforcing the education of clinical skills and attitudes in clinical clerkship, and by evaluating these factors after the completion of the clinical clerkship.

Since the discovery of the first strain in 1961 in England, MRSA, the most notorious multidrug-resistant hospital pathogen, has spread all over the world. MRSA repeatedly turned down the challenges by number of chemotherapeutics, the fruits of modern organic chemistry. Now, we are in short of effective therapeutic agents against MRSA prevailing among immuno-compromised patients in the hospital. On top of this, we recently became aware of the rise of diverse clones of MRSA, some of which have increased pathogenic potential compared to the classical hospital-associated MRSA, and the others from veterinary sources. They increased rapidly in the community, and started menacing otherwise healthy individuals by causing unexpected acute infection. This review is intended to provide a whole picture of MRSA based on its genetic makeup as a versatile pathogen and our tenacious colonizer.
Adenosine ; Chemistry, Organic ; Chromatography, Micellar Electrokinetic Capillary ; Clone Cells ; Colon ; England ; Fruit ; Humans ; Methicillin ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Sprains and Strains ; Staphylococcus ; Staphylococcus aureus

Objective: Combination therapy with glecaprevir and pibrentasvir (G/P) has been shown to provide a sustained virologic response (SVR) rate of >97% in patients with chronic hepatitis C virus (HCV) infection in the first published real-world Japanese data. However, a recently published study showed that the treatment was often discontinued in patients ≥75 years old, resulting in low SVR in intention-to-treat (ITT) analysis. Thus, our aim was to evaluate real-world data for G/P therapy in patients ≥75 years of age, the population density of which is high in “rural” regions.Patients and Methods: We conducted a multicenter study to assess the efficacy and safety of G/P therapy for chronic HCV infection, in the North Kanto area in Japan.Results: Of the 308 patients enrolled, 294 (95.5%) completed the treatment according to the protocol. In ITT and per-protocol analyses, the overall SVR12 rate was 97.1% and 99.7%, respectively. The old-aged patients group consisted of 59 participants, 56 of whom (94.9%) completed the scheduled protocol. Although old-aged patients tended to have non-SVR factors such as liver cirrhosis, history of HCC, and prior DAA therapies, the SVR12 rates in old-aged patients were 98.3% and 100% in the ITT and PP analyses, respectively. Of 308 patients enrolled, adverse events were observed in 74 patients (24.0%), with grade ≥3 events in 8 patients (2.6%). There was no significant difference in any grade and grade ≥3 adverse events between the old-aged group and the rest of the study participants. Only one patient discontinued the treatment because of adverse events.Conclusion: G/P therapy is effective and safe for old-aged patients.