Objectives
In recent years, the importance of ethics in the nursing has been increasing, and ethical practices the nursing professionals are being demanded. In global nursing, for instance when Japanese nurses work in a developing country, they face different socioeconomic status and cultures. These characteristics may affect the ethical aspect. However, no literature review of Global Nursing Ethics (GNE) has been conducted until now. The purpose of the integrative literature review is to investigate the literature concerning GNE from the viewpoint of the kind of literature, the countries where the primary authors live, and the major topics related to ethics.We then will generalize on the present condition of GNE.
Methods
Our review was based on the methodology of Cooper's integrative review. We searched the literature of the last ten years using the Pubmed database, CHINAL, and Japana Centra Revuo Medicina. 86 literatures that met our criteria were analyzed.
Results
1. 53 out of the 86 literatures contained “Information”.
2. Regarding where the primary authors live, 42 live in the United States, 11 in the United Kingdom, and seven in Canada.
3. The numbers of major topics reviewed were: 1) nursing ethics between each country, (a) 21 ethical issues related to immigration of nurses, (b) ten related to global nursing cooperation, (c) seven regarding comparison of nursing ethics between countries; 2) nursing ethics on a global scale, (a) 12 related to interpretation and use of global code of ethics for nurses, (b) 11 related to ethical consideration in global nursing research.
Conclusions
1. Most literatures contained “Information”, and this indicates that the knowledge of GNE has been spreading. Although the importance of GNE has been recognized, future research may be required.
2. The top three authors are from English speaking countries indicating that geographical bias exists in the countries that deal with GNE.
3. GNE depends on the context, so, it is necessary to pay attention to where and how they are used.

Fourteen patients with 22 solitary aneurysms of the iliac artery were operated in a 16-year period (1983 to 1999). Patients were divided into two groups. The non-ruptured group consisted of 6 patients who underwent surgical intervention before aneurysm rupture, and their mean age was 78.5 years. The ruptured group consisted of 8 patients who underwent surgical intervention for aneurysm rupture, with a mean age of 68.5 years. Although seven patients underwent emergency surgery for aneurysm rupture, less than half of them were operated upon within 24hr after the onset of aneurysm rupture. The average size of aneurysms was similar in the two groups (common iliac artery aneurysms: non-ruptured 47mm vs. ruptured 44mm in diameter, internal iliac artery aneurysms: non-ruptured 55mm vs. ruptured 55mm). Two patients died in the ruptured group, in which the operative mortality rate was 25%. Six patients (75%) of the ruptured group had hypovolemic shock, and two of them died during surgical repair. Of the patients with shock, two patients had intestinal ischemia after operation. Intestinal ischemia was one of the serious complications of ruptured iliac aneurysms. These results suggest that in patients with shock from ruptured iliac artery aneurysms, strategy for treatment is an important determinant of the outcome.

Surgical results in eight octogenarians who were operated upon for abdominal aortic aneurysms were compared to those of 42 patients under 80 years of age. Seven of eight octogenarians were operated on an emergency basis, and four of them were ruptured aneurysms. The size of the ruptured aneurysms was over 6cm in all cases of both groups. Postoperative complications occurred more frequently and postoperative mortality were significantly higher in octogenarians than in patients under 80. Early surgical intervention is recommended for elderly cases with large abdominal aortic aneurysms.

A 51-year-old woman, who had undergone mitral valve replacement with the Starr-Edwards ball valve 21 years ago, was hospitalized with cardiac failure. Preoperative cineangiograms showed delay of the ball movement during the early diastolic phase. Re-replacement of the mitral prosthetic valve with a CarboMedics prosthetic valve and tricuspid annuloplasty was successfully performed. The postoperative period after the initial implantation of the Starr-Edwards ball valve is the longest among patients reported in Japan. The cause of prosthetic valve insufficiency may have been granulomatous hyperplasia on the valve seat.

　　A 56-year-old woman was referred to our hospital because of an abnormal finding in the right pulmonary hilum on chest X-ray. Enhanced chest computed tomography showed hyperplastic bronchial arteries dilating and winding around the trachea and bronchi. A racemose hemangioma of the bronchial artery with multiple bronchial artery aneurysms (diameter <20mm) was seen displacing the trachea and both main bronchi. Bronchoscopy showed submucosal tumor-like lesions at the distal trachea and in both main bronchi, and a dusky-red elevated pulsatile lesion at the orifice of the left B3b＋c. We performed coil embolization of the bronchial artery aneurysm to prevent abrupt rupture of the bronchial aneurysm.