The effect of forearm and upper limb muscles vibration during extension and flexion movement of wrist and elbow was studied in 10 normal human subjects. In first experiment, a vibratory stimulation was applied to either the flexor carpi ulnaris (FCU) or the biceps brachii (BB) muscle during simple and simultaneous extension movement about wrist and elbow. In second experiment, vibratory stimulation was applied to either the extensor carpi radialis (ECR) or the triceps brachii (TB) muscle during simple and simultaneous flexion movement about wrist and elbow. The main new findings of the present study are as follows. During simple and simultaneous extension-flexion movements of the elbow, the application of vibration to the FCU or to the ECR produced an undershoot of the target position. However, no undershoot was observed by the application of vibration to the BB or the TB during simultaneous extension-flexion movements of the wrist. From these results, it was revealed that although there are cases where the phenomenon of undershoot resulting from vibration of the wrist and elbow during simple and simultaneous movements corresponds to the type of synaptic connection from muscle spindle group Ia sensory inputs to alpha motor neurons, as identified by Cavallari & Katz (1989) and Cavallari et al. (1992), the manifestation of undershoot is influenced by differences between the movement patterns of the wrist and elbow joints, as well as the differences between simple movement and simultaneous movement.

Case: A 40-year-old woman. Clinical diagnosis: Autistic disorder with mild mental retardation. Case report: The patient underwent pancreaticoduodenectomy for the treatment of her pancreatic cancer. We held several conferences with individuals from different medical fields and examined the influence of the patient's autistic disorder on the perioperative conditions. The senior author, a clinical psychologist, conducted repeated individual, acceptive, and sympathetic interviews with the patient and her family and maintained supportive relationships with them as an honorary family member. Thus, the clinical psychologist helped reduce the patient's anxiety about the medical treatment. Conclusion: The participation of a clinical psychologist in the medical conferences enabled the medical staff to understand the complications involved and provide mental support to the patient and her family. Palliat Care Res 2010; 5(2): 323-326

　　In the guidance of technical aspects in the “new nursing staff training guidelines” prepared by the Ministry of Health, Labor and Welfare in December 2009, We were using an e-learning method. We evaluated the achievement of nursing technology item 69 and examined the problems to be solved for the future basic nursing technical guidance. The subjects in the present study were 53 persons who joined the of rookie nursing staff of our hospital in April 2013 (new nurses are all fresh from college). Of the goals indicated in the guidelines, nursing technology item 69 was prepared for the group training course using e-learning. The trainees learned with a focus on simulation. After that each department carried out OJT and evaluation. 　　We aggregated achievement evaluations and carried out questionnaire surveys on the use of e-learning in June, September and March of the following year. We compared and examined the evaluations of achievement in comparison with the previous year evaluations. In March 2014 when the new nursing staff training program ended, it was found that those who attained “a measure of reach 1: can” or “2: as possible under the guidance” accounted for 36.5% of the total number of recruits in 2013, compared to 34.9% in 2012. The ratio of those who highly evaluated “a measure of reach 4: have knowledge” remarkably increased from4.5% to23.4%, and that of inexperienced persons or people who did not evaluate decreased from 29.2% to 4.2%. This showed that the self-learning and utilizing e-learning at their own pace proactively helped them to acquire basic nursing skills. However, a problem remained that too much time was required for evaluation, because it has been actually evaluated over 100 fields due to detailed e-learning items, the limited number of desk-top computers.

Object : The purpose of this study was to test the response of the decline in heart rate (HR) induced by compression on the eyeball (eyeball pressure : EP) and voluntary non breath (VNB) after pedaling exercise. Methods : EP ; Nine male subjects performed exercise for 3 min in a supine position using a bicycle ergometer. Immediately after the exercise all subjects received EP for 10 seconds. After that, subjects undertook the same protocol without EP (CON-E). VNB ; Four male and two female subjects performed exercise for 5 minutes using a bicycle ergometer. Immediately after the exercise subjects received VNB for 7 seconds. After that subjects undertook the same protocol without VNB (CON-V). Results : The slope of the decline in HR recovery (HR_DS) after exercise in EP increased significantly more than that in CON-E (p<0.05). However, time constant (HR_TC) in CON-E declined faster than that in EP. Thereby, the relationship between HR_DS in EP and HR_TC in CON-E correlated (r=-0.562). The HR_DS of VNB was greater than that of EP and CON-V. However the relationship between HR_DS in VNB and HR_TC in CON-V did not correlate. Conclusion : We suggest that EP affects vagal nervous activity and VNB affects strength of baroreflex sensitivity. Therefore HR_DS of EP might evaluate vagal nervous activity.

We report the successful treatment of a rare case of chronic expanding hematoma and visceral pericardium thickening constrictive pericarditis with no history of trauma or surgery. A 70-year-old woman, who had no history of trauma or surgery was admitted for exertional dyspnea. An echocardiographic study demonstrated a mass located anterior to the right ventricle that severely compressed the right ventricle toward the ventricular septum. Enhanced chest computed tomography demonstrated pericardial calcification and a 125-mm heterogeneous mass in the middle mediastinum. A mosaic pattern was seen on T1, T2-weighted magnetic resonance imaging. Surgical resection of the mass and removal of the visceral pericardium were planned to treat heart failure and to confirm the diagnosis of the mass. The mass was old degenerated coagula. Histopathological examination confirmed the diagnosis of chronic expanding hematoma. The postoperative course was uneventful. There has been no sign of recurrence 19 months after the operation.