Transurethral resection (TUR) is performed on more than 100 patients annually at our hospital. In TUR, a large volume of urologic perfusion solution heated to body temperature is employed, but due to the inadequate facility in our operating room a great deal of time was required to heat and transport urologic perfusion solution. We had to leave the operating table for this purpose. To alleviate our anxiety there was a need for improvement. Recently we have developed a heating method by utilizing the warm air produced by a quilt dryer and fabricated a heating cabinet mounted on casters to facilitate transportation. With the fabrication of this unique heating cabinet, heating of urologic perfusion solution has become easy, permitting use of urologic perfusion solution at a more stabilized temperature. In addition, as the heating cabinet is mobile, there is no longer the need for transporting urologic perfusion solution. Thus, heating and transportation of urologic perfusion solution have been improved, leading to improvement of our work efficiency and nursing services.

The effect of bathing with artificial sodium sulfate on changes in the systolic blood pressure and the level of atrial natriuretic polypeptide (ANP) in plasma or atrium of normotensive male rats was studied. The following results were obtained:
1) As a result of bathing for 20 minutes at a temperature of 37°C, the systolic blood pressure lowered and the plasma ANP level decreased. The blood pressure lowered most clearly after artificial sodium sulfate bathing at a prescribed concentration (p<0.5), while the plasma ANP level decreased significantly after plain water bathing (p<0.01).
2) The atrial ANP level showed no significant change. Presumably the reason was that the quantity of atrial ANP was so large that it was not affected by fluctuations in the peripheral ANP level.
3) The temperature and duration of bathing, the concentration of bath salts, and other factors might also influence the plasma ANP level.
These results suggest that the artificial sodium sulfate bathing lowers the blood pressure by preventing heat radiation from the skin and by delicate regulatory mechanisms on ANP secretion.

The effects of bathing with artificial sodium sulfate on the systolic blood pressure and the level of atrial natriuretic peptide (ANP) in plasma and or in atrium of spontaneously hypertensive rats (SHR) were studied. The following results were obtained:
1) As a result of bathing for 20 minutes at a temperature of 37°C, the systolic blood pressure lowered and the plasma ANP level increased. The blood pressure lowered with increasing concentration of sodium sulfate (p<0.01).
2) The plasma ANP level in a standing position for 20 minutes decreased than in a normal position.
3) The plasma ANP level in SHR was higher and increased more clearly by bathing, compared to the previous results in normotensive rats (WKA). The blood pressure lowered far more in SHR than in WKA.
4) The atrial ANP level was not significantly influenced by bathing nor by changing the posture.
These results indicate that the artificial sodium sulfate bathing has more potent hypotensive effect than plain water bathing probably due to prevent heat radiation, and affects the blood pressure and the plasma ANP more significantly in SHR than in WKA. In addition, the effects of mild bathing to cardiovascular and neurohumoral systems may modulate directly or indirectly the ANP secretion.

The first step of cancer medical treatment is to eliminate anxiety about opioids. It is recommended to use printed matter in the "Guideline for Cancer Pain Management" edited by Japanese Society of Palliative Medicine,but few medical professionals actually use it. We developed the Opioids' pamphlet designed by Aichi Prefectural Society of Hospital Pharmacists; abbreviated OPA. This pamphlet is little burdened for readers; focusing on eliminating anxiety about opioids. Evaluation of the utility of the OPA and the actual conditions of patient education about the use of opioids by medical professionals were investigated, since there have been no reports on these issues. A questionnaire survey was conducted in hospitals with more than 150 beds in Aichi Prefecture. It targeted doctors, pharmacists and nurses who were practicing palliative care using opioids. There were many pharmacists and nurses who had been consulted about opioids, and most of the consultations were about addiction. 60% of pharmacists and 30% of nurses voluntarily performed patient education. Awareness of the guideline for of cancer pain management was low. OPA, which was reviewed based on the guideline, was applicable to 99% of the cases where the nurses were consulted. Its size and contents were highly acclaimed. Therefore, OPA is extremely valuable in clinical practice. Palliat Care Res 2009; 4(1): 214-227

BACKGROUND/AIMS: Twenty-four-hour esophageal impedance and pH monitoring allows detection of all types of reflux episodes and is considered the best technique for identifying gastroesophageal refluxes. However, normative data for the Japanese population are lacking. This multicenter study aimed to establish the normal range of 24-hour esophageal impedance and pH data both in the distal and the proximal esophagus in Japanese subjects. METHODS: Forty-two healthy volunteers (25 men and 17 women) with a mean ± standard deviation age of 33.3 ± 12.4 years (range: 22–72 years) underwent a combined 24-hour esophageal impedance and pH monitoring. According to the physical and pH properties, distal or proximal esophageal reflux events were categorized. RESULTS: Median 45 reflux events occurred in 24 hours, and the 95th percentile was 85 events. Unlike previous reports, liquid-containing reflux events are median 25/24 hours with the 95th percentile of 62/24 hours. Acidic reflux events were median 11/24 hours with the 95th percentile of 39/24 hours. Non-acidic gas reflux events were median 15/24 hours with the 95th percentile of 39/24 hours. Proximal reflux events accounted for 80% of the total reflux events and were mainly non-acidic gas refluxes. About 19% of liquid and mixed refluxes reached the proximal esophagus. CONCLUSIONS: Unlike previous studies, liquid-containing and acidic reflux events may be less frequent in the Japanese population. Non-acidic gas reflux events may be frequent and a cause of frequent proximal reflux events. This study provides important normative data for 24-hour impedance and pH monitoring in both the distal and the proximal esophagus in the Japanese population.
Asian Continental Ancestry Group* ; Electric Impedance* ; Esophagus ; Gastroesophageal Reflux ; Healthy Volunteers ; Humans ; Hydrogen-Ion Concentration* ; Male ; Reference Values*