The purpose of this study is to clarify the changes over time of the QOL of the adult stage early breast cancer patients for pre-operative and a single year post-operative period, for reviewing from the standpoints of personal, pathological, psychological and cognitive aspects. Investigations were conducted using the self-rated questionnaire including the categories as QOL-ACD, QOL-ACD-B, GSES, SRS-18, resilience scale and personal attributes for the different periods of pre-operative, 1 week, 2 weeks, 3 months and 1 year after surgery. The two-way layout repeated measures ANOVA of complete data of 44 subjects revealed the following:
1.In terms of the disease factor, especially lymph node metastases, the deteriorated activity QOL is recognized during the one to 2 weeks after operation among the subjects with the dissected axillary lymph nodes so rehabilitation exercise and support to complement the patients' shortage of self-care on and after the day of surgery. No significant difference of QOL was identified with the extent of breast dissection.
2.In terms of psychological and cognitive factors, QOL is low among the highly depressive patients group in pre-operative stage including the QOL-ACD total score, social attitude QOL and face scale QOL. It suggests the necessity of enhancement of nursery assistance during the pre-operative early stage for the patients expected to be hospitalized both with the emotional assistance where adequate information about the breast cancer is provided to the affected outpatients and cognitive assistance where understanding of the breast cancer and its primary therapy is facilitated. In terms of the resilience, interaction is identified between positive future orientation and social attitude QOL;during the pre-operative and one year period after operation, however, no significant difference of QOL is seen among the highest and lowest QOL groups.
3.In terms of personal factors, psychological condition QOL with husband was significantly lower than those without spouse at the time of 2 weeks after surgery.

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The purpose of this study was structured about common concepts which distill from work the various situations in weaning process of the heart failure patients. The participants were heart failure patients who had mechanical ventilation management for more 24 hr in CCU or ICU. Date was collected by semi-structured interview, and qualitative research based on the analysis of the grounded theory.
As result, core category was [Fight with body and soul against sputum threaten patients' life], Related categories were [The state of tense and serious threat to patients death], [Accepting the present conditions that undesirable life], [Encouraging oneself with coexists happiness and anxiety, and make recovery], [Getting over difficulties with medical stuff], [Repeat trial and error and get breathing], [Holding earnest through in the critical situation], [Keep holding an element to survive].
The work of heart failure patients in weaning process from mechanical ventilation extracted as core category [Fight with body and soul against sputum threaten patients' life] and 7 categories related to it. Extract categories, it developed that some categories were related in various situation in weaning process from mechanical ventilation.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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Backgound - It is important to maintain the pressure in the cuff of an endotracheal tube at a proper level. In order to measure this pressure, a manometer must be connected to the cuff. It has been questioned whether the cuff pressure actually decreases each time a measurement is made. The purpose of this study was to evaluate whether the pressure decreases while measuring the cuff pressure and to evaluate a proposed technique to minimize this decrease in cuff pressure.
Method - I made a system for checking cuff pressure continuously. This system has a manometer between the cuff and pilot valve. Using this system, cuff pressure was measured in the standard manner by connecting the bulb manometer, measuring the pressure and disconnecting the bulb manometer. During the procedure, the cuff pressure was measured continuously. An alternative technique was evaluated. The three-way stopcock near the pilot balloon was closed and a syringe was used to pressure the manometer to 30 cmH₂O. Then the three-way stopcock was opened and the cuff pressure was measured.
Results - When the cuff pressure was measured in the standard manner by connecting the bulb manometer, measuring the pressure, then disconnecting the bulb manometer, the cuff pressure decreased each time the manometer was connected and disconnected. The pressure decreased more when the manometer was connected. When the cuff pressure was measured with the alternative technique using a syringe to pressure the manometer to 30 cmH₂O prior to checking the pressure, the pressure decreased only slightly.
Conclusion - Maintaining proper cuff pressure is important to prevent aspiration of oral secretions and to prevent ventilator associated pneumonia. Using this alternative technique was useful in this bench test to maintain the pressure in the cuff. Further studies are necessary to determine the value of this technique on patients.

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