1）The purpose of this study was to evaluate college students using a self–administered test of the emotional domain and to recognize which subjects showed improvement on a self–assessment sheet through practical technical training.
2）A total of 28 senior students of a clinical engineering training college （20 men and 8 women; mean age, 21.5 years） volunteered to participate in this experiment. Before and after clinical practice, self–administered evaluations were performed with a self–assessment sheet, which presented 70 questions regarding the emotional domain.
3）After practical training, students showed improvement in 18 questions regarding the emotional domain, and statistical analysis showed that the values for 8 of these self–assessment questions were significantly higher after clinical practice than before clinical practice.

Objective: Opioid analgesics are normally administered as monotherapy. However, we experienced a patient in whom alleviations of cancer pain, coughing and dyspnea were successfully achieved with the combination therapy of morphine and a fentanyl patch (FP), and the case is reported herein. Case Report: A woman in her fifties, suffering from sigmoid colon cancer, liver and lung metastases, and associated pain complicated with coughing and dyspnea, manifested symptomatic alleviations following the facilitation of treatment with morphine sulphate. Taking into consideration that oral intake would become difficult at some time in the future, treatment switchover to FP was planned. However, in view of the efficacy of fentanyl against coughing and dyspnea having not yet been firmly established, a low dose of morphine sulphate for coughing and dyspnea continued and cancer pain was controlled with FP. Thus, through continued combined use of the two ingredients, morphine and fentanyl, until treatment end, symptomatic alleviations of pain, coughing and dyspnea were able to be achieved. Conclusion: For patients experiencing difficulty with oral intake and suffering from coughing and dyspnea in addition to cancer pain, combined use of a low dose of morphine and FP is considered useful in achieving a stable alleviation of such symptoms.

Purpose: From shortly after the fentanyl patch became commercially available, we have been using it as part of our armamentarium for cancer therapy to produce a reliable analgesic effect from the active treatment period to the terminal stage in patients who are expected to develop resistance to oral analgesics. To confirm the usefulness of fentanyl patch, a retrospective study was conducted to determine its efficacy and safety. Method: A survey was conducted of 28 cancer patients who were undergoing pharmacological pain control. The following parameters were recorded: opioids administered prior to fentanyl patch use, reasons for switching to fentanyl patch, duration of administration and dosage of fentanyl patch, pain score before switching to fentanyl patch, adverse effects (nausea, vomiting, constipation and drowsiness), and the results of clinical tests. Results: The major reasons for switching to fentanyl patch were: "pain control with oral agents was expected to become difficult in future" and "adverse effects of chemotherapy were noted or were likely to develop". The mean duration of fentanyl patch use was 133 days, during which time the pain score and the constipation symptom were significantly reduced. No significant difference was found with nausea, vomiting, drowsiness or the results of clinical tests. Conclusion: It is concluded that fentanyl patch is a highly useful opioid for analgesia when administered during chemotherapy for cancer and continued to the terminal stage.

A correction of a coauthor's name from Chigusa Nakamura to Chigusa Nakagawa on the author list and the abstract.

BACKGROUND/AIMS: There are controversies for the management of esophageal neoplasia due to its variety among countries. In this study, we tried to uncover the different managements on esophageal neoplasia between Korea, Singapore, and Japan. MATERIALS AND METHODS: We administered ten questionnaires to Korean, Japanese, and Singaporean endoscopists. The questionnaire consisted of endoscopic images from ten different esophageal neoplasms. RESULTS: For Barrett esophagus (BE) with adenocarcinoma (P=0.013) and well-differentiated- type squamous cell carcinoma (P=0.007), all (100%) of the Japanese endoscopists selected endoscopic resection as treatment, whereas 25~40% of the Korean and Singaporean endoscopists selected surgical resection. For BE with low grade dysplasia (P=0.002) and flat-type squamous dysplasia (P<0.001), observation without endoscopic treatment was preferred in Japan, whereas endoscopic treatment was preferred in Korea and Singapore. Similar findings between three countries were; (i) medication for BE, (ii) endoscopic treatment for BE with high grade dysplasia and elevated-type squamous dysplasia, and (iii) operation for moderately-differentiated or poorly-differentiated typed SCC. CONCLUSIONS: Our survey addresses different managements on esophageal neoplasia between Korea, Singapore, and Japan. More advanced or aggressive treatments are preferred in Korea and Singapore than in Japan for the management of BE with LGD, flat-type squamous dysplasia, BE with adenocarcinoma, and WD-typed SCC.
Adenocarcinoma ; Asian Continental Ancestry Group ; Barrett Esophagus ; Carcinoma, Squamous Cell ; Esophageal Neoplasms ; Humans ; Japan ; Korea ; Neoplasms, Glandular and Epithelial ; Singapore ; Surveys and Questionnaires

Endoscopic papillectomy (EP) for ampullary adenomas achieves cure rates ranging from 76% to 90%, and recurrence rates are as high as 33%. If remnant or recurrent lesions after prior EP are endoscopically visible and are not suspected of intraductal extension into the biliary or pancreatic duct, repeated snaring and cutting can be performed until all visible lesions are completely resected. However, endoscopic ablative therapies, particularly argon plasma coagulation, can be attempted for tiny or uncertain remnant and recurrent lesions. In addition, intraductal radiofrequency ablation has recently been attempted for residual intraductal lesions after EP at several institutions. Although still under investigation, it has shown some promise. It might be offered as an alternative to surgery, particularly in patients who are unfit for surgery or those who refuse to undergo surgery.