We present two cases of aged males with cold-induced colic successfully treated with tokishigyakukagoshuyushokyoto. The first case is a 74-year-old male with bilateral sciatic neuralgia, who had a history of right leg amputation following a traffic accident. The second case is an 80-year-old male with chills of the lower body, who has undergone excision of biliary duct cancer. Their physical status appeared normal to excessive by traditional medical examination, whereas the pulse and abdominal patterns are usually deficient in female cases in whom tokishigyakukagoshuyushokyoto is effective. The common features in our cases are age and history of trauma by injury or surgery. Although males are more tolerant of cold than females, advancing age and history of injury or surgery tend to cause cold-induced colic in males. The number of male cases that can be effectively treated with tokishigyakukagoshuyushokyoto is likely to increase in our aging society, and we conclude that it is important to consider the presence of cold when we examine male cases.

The primary aims of this study were; 1) to investigate the appropriateness of the analgesic therapy in hospitalized cancer patients, and 2) to explore the effects of the screening system by a pharmacist-palliative care physician screening team on analgesic regimens.
The pharmacist-palliative care physician screeningteam screened consecutive cancer patients about the adequacy of analgesic treatments and provided written recommendations to primary physicians. Inclusion criteria were cancer patients admitted to oncology wards, not having been consulted to palliative care team, and receiving opioid or chemotherapy. Of 62 patients screened, analgesia was inadequate in 44%, and preemptive pharmacological treatments for opioid-induced nausea and constipation was lacking in 42% of 43 patients who had received opioids. The team provided a total of 80 recommendations for 52 patients, and primary physicians followed 94% of the recommendations within one week. The pharmacist-palliative care physician screening team may contribute to better analgesia in patients not having been consulted to the specialized palliative care service.

　　To educate patients with diabetes mellitus, we use a clinical pathway. Pharmacists hold the chair of instruction on the use of drugs and insulin self-injection during the course of the pathway. Until now, teaching contents have been left to discretion of attending pharmacists. Therefore, we draw up a brochure to set standards for instruction.　　By using this brochure, it has become possible to instruct patients without relying only on the knowledge and experience of pharmacists in charge. Additionally, we have become able to share teaching contents of pharmacists with nurses.　　By publishing the brochure, intervention of pharmacists in the pathway has become smoother. For better and more efficient instruction on the use of drugs in a limited time frame in the clinical pathway, we need to overhaul of the brochure and to develop a method to evaluate patient’s understanding.

Purpose: The aim of this study was to develop a nursing intervention program for use in enhancing the self-care abilities of cancer patients receiving treatment on an outpatient basis. Method: Four-week-long combined group therapies were conducted on 15 subjects. The effects of these therapies were then examined. Results: Subjects' mean age was 56.86±11.52 years; mean duration of disease was 28.6±18.14 months. Between before and after the intervention, two scales showed significant improvements: EORTC QLQ-C30 Global health status (p<0.023) and STAI state anxiety scale (p<0.022). As a result of field note data analysis, "change of attitude toward cancer treatment at home" and "response to the program" were identified. Conclusion: Because the subjects were highly motivated individuals, with substantial self-care ability from the beginning, their ESCA scores did not show any change between before and after intervention. Nevertheless, the inner changes that occurred to the subjects indicated that their self-care ability had improved. Palliat Care Res 2009; 4(1): 201-206

PURPOSE: In Japan, about 80% of deaths occur in hospitals, especially long-term care beds. The purpose of this study was to clarify the nursing practices used for such older patients at the end-of-life stage in long-termcare wards via the modified grounded theory approach (M-GTA). METHODS: Data were obtained through semi-structured interviews of nineteen nurses working in cooperating long-term care wards, acute care wards, or hospice services (to allow for constant comparison between these types of wards) in western Japan in 2014. We analyzed the transcribed data using M-GTA. RESULTS: The core category that emerged from the analysis was “Balancing enhancement of patients' daily life quality and life-sustaining care in the face of uncertainty about the patients' character.” Eleven categories emerged, such as Seeking older patients' character with their family, Supporting families' decision making, Rebuilding patients' daily life in the ward, and Sustaining patients' life span through medical care. CONCLUSIONS: Nurses experienced uncertainty about the care needs of older patients, the ethical problems of Enhancing the patients' QOL by using risky care, and the evaluation criteria used to judge their own nursing care after the patients' death. All nurses had the goal of ensuring a natural death for all patients. Nurses' acceptance and evaluation of their own care was critically influenced by the patient's family's responses to their care after patients' death. Further research is necessary to develop evaluation criteria and educational programs for end-of-life nursing care of older adults.
Adult ; Decision Making ; Grounded Theory ; Hospices ; Humans ; Japan* ; Long-Term Care* ; Nursing ; Nursing Care ; Qualitative Research ; Quality of Life* ; Terminal Care ; Uncertainty

Purpose: To compare the effects of aging in patients with acute myocardial infarction (AMI) on their clinical background and hospitalization progress, and to examine the relationships between age and these factors.
Subject: One hundred and fifty-three patients who experienced cardiac rehabilitation after percutaneous coronary intervention (PCI) (63.8±11.1 y.o, 126 men, 27 women).
Method: The patients were divided into the middle aged group (<65 y.o, n=84), young old group (65 to 74 y.o, n=44), and old group (75 y.o≥ n=25). The differences between groups were examined in respect of 13 items about clinical backgrounds (responsibility coronary arteries, CKmax, LVEF, residual stenosis, hypertension, diabetes, hyperlipemia, smoking, and BMI) and hospitalization progress (cardiac complications, locomotorium disabilities, abnormality as 200mECG, and duration of hospitalization).
Results: Left veticular ejection fraction (LVEF) was significantly lower in the old group than in the young old group. The old group had a high rate of residual stenosis. In the coronary risk factors, all of the groups had hypertension at a high rate of 54.5% or over. The middle aged group and young old group had diabetes at about 38%. The middle aged group was prone to hyperlipemia, and had significantly a high smoking rate. Body mass index (BMI) was significantly higher in the middle aged group than in the old group. In hospitalization progress, the old group had a high rate of cardiac complications and locomotorium disability. The duration of hospitalization was significantly longer in the old group than in the other groups.
Conclusion: It would be necessary to give middle-aged persons educational guidance for the improvement of the coronary risk factors, and to provide the old persons with the suitable rehabilitation programs considering various complications.

Surveys on the snail intermediate hosts were undertaken in the paddy fields in Yatomi-cho, Aichi Prefecture, once a year over a 5-year period (1983-1987).
And the cercariae of two different avian schistosomes were detected from snails in paddy fields.
The cercariae from Polyplis haemisphaerula were identified as species beloning to the genus Gigantobilharzia and the cercariae from austropeplea ollula as species belonging to the genus Trichobilharzia.
It was concluded that the paddy field dermatitis occurring in Yatomi-cho was proved to be caused by the invasion of these cercariae.

OBJECTIVESKendo protective equipment is used without washing for a long time.Staphylococcus saprophyticus, Micrococcus luteus, andBacillus sphaericus are frequently isolated from the mask ('men' in Japanese) of kendo protective equipment during one year. To investigate the bactericidal effects of electrolyzed acidic water on these three bacteria, we observed their cellular structures by electron microscopy after treatment with such water.

METHODSEach bacterium isolated from 'men' was treated with electrolyzed acidic water and then observed under scanning and transmission electron microscopes.

RESULTSWhenS. saprophyticus was treated with electrolyzed acidic water and its cellular structures were observed under a transmission electron microscope, ghost cytoplasm was observed, in which no ribosomal granules or fibrous DNA structures were present, and the cell wall inner layer was detached from the outer layer. Under a scanning electron microscope, the structure of the cell wall surface layer was wrinkled, and round pores were partially formed, indicating that the cytoplasmic structures were flushed out of the cells treated with electrolyzed acidic water through the pores formed in the cell wall. InM. luteus, the destruction of ribosomal granules and that of DNA fibers were observed to be similar to those ofS. saprophyticus. ForB. sphaericus, the effect of electrolyzed acidic water was investigated using vegetative cells. A dissociation between the cytoplasm and cell wall wrinkled the cell surface layer.

CONCLUSIONOn the basis of above findings, electrolyzed acidic water was found to destroy the cellular structures of the three bacterial species frequently isolated from kendo men within a short time. Electrolyzed acidic water may be useful for disinfecting of kendo equipment.