Improvement of hair thinning was observed after a novel treatment course involving basalt stone and placental extract application in a patient of androgenetic alopecia. The patient was resistant to the general home care treatment. The response to the new treatment may be attributed to the decreased scalp hardness secondary to the improved blood circulation after basalt stone massage and the hair growth-promoting action of the placental extract. Furthermore, recurrence of hair thinning was observed after suspension of this treatment; however, this hair thinning improved when the treatment was resumed.

Extended－release Oxycodone tablet has been available for cancer pain treatment since 2003 in Japan. After pure oxycodone injection became available in 2012, we have tried to switch from oral to injection when oral intake becomes difficult because of bowel obstruction, nausea or drowsiness due to progression of the disease. There is no evidence regarding the ratio of switching from oral to injection at present in Japan. We always pay attention to avoid patients drowsiness because of an overdose of opioid, because there is not enough time left for cancer patients in the terminal stage, and drowsiness takes away from the patient’s good QOL. We switched Oxycodone from oral to injection in 8 cases from June to December in 2012. At first, we assess if the patient is well controlled by oral oxycodone or not. If the patient is not relieved from the pain enough, we switch oxycodone from oral to continuous subcutaneous injection with a dose of around 75％ at first. After that we titrate the dose little by little up to an appropriate level. We were able to evaluate 5 patients out of 8 because there were 3 patients with consciousness disorder. As a result, we were able to decrease dosage to 46.4％ on average.

Objective: It is important to prevent dispensing errors for the safety of patients.  For this purpose, it is necessary to improve the dispensing process on the basis of risk priority.  Quantitative evaluation of risk in each operation makes it possible to compare the risk relatively.  In this study, we analyzed data reported in the Pharmacy Risk Error Management System (PREM-S) to evaluate the risk priority in the medicine preparation step of the dispensing process.
Methods: Data of 1,202 cases concerning medicine preparation step were extracted from in 2,458 cases reported into PREM-S between May 2010 and April 2011.  We classified the medicine preparation step into 31 categories based on the operation.  We analyzed the levels in each category as adverse effects on patient’s health by the errors and also the relationship between adverse effect and detection time.  The level represents the degree of adverse effect for the patient.
Results: Information on levels of the 31 categories was obtained from the analysis.  Eight categories included reports of effects on the health of patients.  Three categories such as calculation of powder medicine included level 4 cases.  Detection time was significantly different between level 1 and levels 2 to 4, but there was no significant difference between levels 2 to 4.
Conclusion: The results suggest that analysis of data reported in PREM-S enables evaluation of the risk priority systematically and efficiently.  Evaluation of the risk priority will contribute to prevention of dispensing errors and health effects derived from them.

  An inquiry was made into the health of 10 one-time asbestos workers now living in the southern part of Akita Prefecture who had taken screening tests for asbestosis on a regular basis. The purpose of this study was to provide pertinent information and better health support to these people at high risk of developing asbestos-related diseases. The average number of years they served as asbestos workers was 11.1±2.12 years and 29.8±4.64 years had passed sincefirst exposure. All the subjects were found to have had no idea about guarding against exposure to asbestos while at work. Neither had they been told to protect themselves from this fibrous mineral by their employers. What motivated them to take examinations for asbestosis was news reports provided by newspapers and other mass media about pulmonary disorders caused by earlier contact with asbestos fibers. Half of the subjects did not know anything about qualifications for receiving the health card for retired asbestos workers. They expressed apprehensions about their health. One subject said, “I may be taken ill anytime,” another said, “The psychological burden of always taking meticulous care of my health is overwhelming,” and still another said, “There is no way of knowing whether I am suffering from asbestosis because there is no symptom.” The latest statistics showed that the number of officially acknowledged victims of asbestos-related pulmonary diseases is increasing across the nation together with the incidence of mesothelioma. To allay the anxiety of former asbestos workers about their health, this study suggested that as the responsibilities of the medical profession, we should (1) get acquainted with the relief system and related laws, (2) help the patients maintain their quality of life by following up the their problems over a long period of time, and (3) continue research activities and make the results public so as to contribute to the relief of the patients.

In Palliative care, we meet patients with easy-bleeding superficial malignant tumors, such as head and neck cancer, skin metastasis of all kinds of cancer and unresectable breast cancer. But it is not easy to control bleeding even though we use various means, and many doctors have difficulties in stopping bleeding. We report a case with a recurrent tumor of pharyngeal cancer that showed easy-bleeding and discharged massive exudates. Although she received several alcohol local injections because of bleeding of the tumor, she needed a dressing change over 5 times in a day. It made her QOL worse. In this case, we used Mohs paste and after using it, the surface had been fixed and dried up, resulting in a decrease in bleeding, exudate, frequency of dressing change and bad odor. Mohs paste was made of distilled water, zinc chloride, zinc starch and Glycerol. Zinc chloride changes to zinc ion by water in the wound and makes protein cohere and thereafter tissues, vessels and cell membrane of bacteria are fixed chemically. We could stop bleeding for 15 days with only 20 minutes contact with Mohs paste, and massive exudates and bad odor decreased. Mohs paste, which is made in your hospital pharmacy with cheap materials, can be used for bleeding or massive exudates repeatedly if there is not a thick blood vessel anatomically under the tumor. It was effective to improve her QOL. Palliat Care Res 2009; 4(2): 346-350

Coix lacryma-jobi L. var. ma-yuen Stapf is a grass long been used in traditional medicine as a nourishing food and reported to possess pharmacological effects including anti-tumor, anti-obesity, anti-diabetic, etc. In order to evaluate the possible mutagenicity of the hot water extract of all parts (husks, pellicles, and astringent skin) of the food, we performed a reverse mutation test in bacteria, a mouse lymphoma assay and a mouse micronucleus test. The results of all tests were negative. It was concluded that the extract has no mutagenicity for living bodies.

 Since the 1960s, Japanese nurses have been working as international nursing collaborators with or for the people in developing countries in order to promote health through transferring nursing knowledge and skill. However a number of nurses reported that they did not have enough competencies as international nursing collaborators. The objectives of this study were: a) to describe the experiences of Japanese international nursing collaborators whose mission was transferring nursing knowledge and skill and b) to determine their learning needs as international collaborators, and to design educational programs (graduate program) based on the results of survey. The participants of this study were twenty-seven nurses who had had an international collaborative mission and stayed in a developing country for more than one year. Semi-structured group or individual interviews were used in order to describe activities process and leaning needs as international collaborators. The interview data were analyzed using content analysis from the viewpoint of competency and learning needs. Nurses reported needs in two major areas: Fundamental Competences and Knowledge, and Required Competences for Development of International Collaborative Tasks. Fundamental Competences and Knowledge consisted of nine components: (1) cross-cultural experiences, (2) acceptance of cultural differences, (3) professional experience, (4) degree and qualifications, (5) philosophy of nursing, (6) language, (7) interdisciplinary knowledge for international cooperation activities, (8) knowledge about own project, and (9) knowledge on theories of international cooperation. Required Competences for Development of International Collaborative Tasks consisted of thirty components which were divided into four phases (personal competences, preparation and planning phase, implementation phase, and after project.) Based on the result of this survey the investigators designed the international nursing graduate program. The program has started from the academic year of 2005 at the investigators' college. The progress of students' learning and outcomes of these educational programs should be monitored using formative evaluation.

Purpose : Rhythmic gymnasts sometimes develop severe iron-deficiency anemia. Preventing such anemia could thus enhance both their performance and health. We compared the relationship between a dietary intervention and RBC metabolism.Methods : Ten female rhythmic gymnasts were recruited for this study. Changes in the RBC delta-aminolevulinate dehydratase (δ-ALAD) activity were used as an index of biosynthesis, and changes in the haptoglobin (hp) were used to assess degradation.Results : During the one month intervention period, the athletes consumed traditional Japanese foods which provide 1500 kcal energy, 2 g/kg body weight protein, 200 g carbohydrate and 15 mg iron. No main effect of this intervention on the hematological indexes was observed. The δ-ALAD activity was significantly greater in August than in July or September. Hp concentration was significantly lower in August in comparison to the other periods.Conclusion : Dietary intervention might enhance the RBC turnover by increasing the capacity for erythrocyte biosynthesis and degradation.

Purpose : This study was undertaken to clarify the effect of heme-iron supplementation on the prevention of iron-deficiency anemia in male collegiate distance runners.Methods : Forty-one male collegiate runners were divided into three groups, consisting of a heme-iron group (HI), a citrate-iron group (CI), and a non-iron group (NI). Iron tablets (heme-iron or citrate-iron) were administered at a dose of 7 mg per day for two months. The blood components and nutritional intakes were estimated before and after the intervention.Results : The nutritional intakes did not differ among the three groups. The red blood cell, hemoglobin, hematocrit, ferritin, Glutamic-Pyruvate Transferase and γ-Glutamyl Transpeptidase levels were unchanged throughout the experimental periods. After the intervention, the serum iron levels significantly decreased in the NI group but not in the iron-supplemented groups, while the reticulocytes counts increased among the three groups.Conclusion : The small amount of heme-iron supplementation was thus found to have a preventive effect on iron deficiency anemia without causing any negative side affects.

Purpose : This study was undertaken to examine the relationship between pedometer counts and food intake in Japanese elderly people.Methods : One-hundred-eighty healthy, community-dwelling elderly people were divided into three groups according to age. The number of steps taken by each subject was recorded with a pedometer over a 30-day period in August. The dietary and nutritional intakes were estimated using a food frequency questionnaire.Results : There was no significant difference in the pedometer counts between men and women. The number of steps significantly decreased with age (p<0.01). The intake of energy, protein and carbohydrate were significantly higher in men than in women (p<0.05), and they were nearly the same among the three aged groups. The calcium and vitamin C intakes after adjusting for sex and age increased with the number of daily steps, except for the intakes of energy, protein and carbohydrates.Conclusion : A higher number of daily steps was found to be associated with the calcium and vitamin C intakes.