The purpose of this study was to develop the "Itamikei", a small machine which records the subjective level of pain between 0-10. In addition to testing it's ease of operation and usefulness in the clinical practice environment. The "Itamikei" is 23 cm x 6 cm x 2 cm. It weighs 160 grams. It has 11 buttons, relating to the 0-10 Numeric Rating Scale (NRS). Each time a button is pushed the level of pain is recorded, along with the time and date. Later, this data can be transferred to computer displayed graphically showing the patient's subjective level of pain. This research was a case study for using the "Itamikei". One in-patient at the university hospital who had cancer pain was asked to use the "Itamikei" for 14 days. A graph was printed out and given to both the patient and the medical staff.
The results suggest the following:
1. Using the 0-10 NRS the patient could easily express her level of pain.
2. Because the "Itamikei" was easy to operate, the patient found no difficulty in entering her level of pain.
3. In graph form the daily transition in pain levels can be easily analyzed, and a program for managing pain can be prepare.

We describe our surgical experience of inflammatory abdominal aortic aneurysm (IAAA) in a 54-year-old man. Computed tomography (CT) with contrast enhancement revealed an infrarenal abdominal aortic aneurysm with marked thickening of the aneurysmal wall (mantle core sign) and left hydronephrosis. The left ureteral stenting was performed. Preoperative laboratory findings showed high levels of serum IgG4. The IAAA was removed and replaced with a woven-Dacron graft in situ. Histological examination revealed the IgG4 positive plasma cell, and demonstrated IAAA associated with IgG4. The postoperative serum IgG4 was reduced, but remained high. The postoperative CT revealed new right hydronephrosis, and the ureteral stent was performed. The mantle sign reduced in CT scan after steroid therapy. IAAA with hydronephrosis seems to be associated with IgG4-related sclerosing disease. In this case, the levels of serum IgG4 seems to be a good index for treatment efficacy.

Background: To obtain suggestions regarding the methods of cooperative learning in basic nursing education, the nursing students' perceptions of cooperative learning and the relationship between such perceptions and their influencing factors were elucidated.Methods: Anonymous, self-administered questionnaires were conducted among 131 nursing students at University A in the Chubu region of Japan.Results: Binomial logistic regression confirmed that cooperative learning experiences in high school, learning satisfaction at University A, social support, styles of handling interpersonal conflicts, and undervaluing others in regard to assumed competence were significant influencing factors on the cooperative work recognition scale.Discussion: Factors, including professional identity, communication ability and students' past negative experiences, may have an effect on the recognition of cooperative work. This suggests the need for the continued investigation of the aspects of cooperative learning that take these factors into account.