It is a big problem to cope with elderly patients who are increasing in a community in Niigata which has already been heavily populated by those people over 65 years of age. Aging is not a disease. However, the actual situation of patients with hematological and solid tumors in the aging community is little known. In this communication, we analyzed 293 patients (AML/ALL: 52, NHL: 112, MDS: 75, MM: 40, and others: 14) and 127 dead with hematological malignancies treated in our hospital for the past 10 years or 80 to clarify the actual changes in the trend of patients with hematological malignancies and compared them with those of patients who died of solid tumors. The population movements over the last 20 years in the Kashiwazaki area were also studied.
  Our analysis showed that the number of patients who died of solid tumors increased (1.6 times) in step with the increases in the aged population for there 20 years in the Kashiwazaki area. In addition, the incidence of gastric cancer markedly decreased for the past 20 years, while that of colorectal cancer rapidly increased (5 times). The incidence of hematological malignancies also increased with its peak shiftted to the latter haf of the 7th decade of age for the past 10 years. In addition to the increased incidence, patients with NHL and MDS increased in number by 1.5 times over the last 10 years. Especially, patients with MM showed an increase of 3 times, while the incidence of AML was not changed, even decreasing in number.
  In conclusion, the incidence of hematological malignancies as well as solid tumors has steadily been increasing with the increases in the aged population in the Kashiwazaki area, and the number of the aged patients over 70 years of age also increased. Such aged patients, however, are not available for hematopoietic stem cell transplantation. Therefore, it is urgently necessary for us to cope with the increases in the number of aged patients with hematological malignancies.

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  In recent years, new surgical wound control methods have been developed one after another, in addition to dressings using gauze. Since we have achieved good results in wound management after surgery when Octyl-2-Cyanoacrylate was used, we hereby report 20 cases treated with this new type of synthetic adhesive between June 2001 and May 2002. In every case, Octyl-2-Cyanoacrylate was applied three times to wounds after subcutaneous suture. The results were that wound infections, wound dehiscence and hemorrhage were not seen. The side effect was not recognized either. It could be used even in an arthrosis mobile department. It had an intensity of 1/3 of normal skin suture by the application of Octyl-2-Cyanoacrylate in three layers. It repelled water after it hardened. We think that we can fully use it in Day Surgery which has become increasingly common recently and will become the mainstream in the future. It is expected that Octyl-2-Cyanoacrylate will be used more widely in general surgery, gynecology, thyroid operations and facial plastic surgery.

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  Since the Infection Control Team (ICT) was organized in 1999, our hospital has been engaged in evidence-based operations against nosocomial infections. The ICT's major activities included guidance in preventive measures against infections, surveillance involving continuous environmental monitoring, proposition as regards prescription of antibacterial medicines, and consultation with clinicians about prophylaxis. The team comprising physicians, nurses, pharmacists and clinical laboratory technicians has made expert propositions to clinicians. To be concrete, the team members, with the liaison clerk playing a central role, met with physicians in charge or with other staff members of the hospital, studied the infection cases in question, and presented the study findings to the clinicians. Fundamentally, therefore, it is not that the ICT intervenes in the affairs of the clinical department by way of directions but that it presents clinicians with the ideas gained through discussion between ICT members and physicians and other hospital staffers. While cementing a relationship of mutual trust between hospital employees, the ICT is expected to engage in nosocomial infection prevention activities by joining forces transdeoartmentally.

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  In April 2000, the nursing care insurance law was enforced in Japan. From April 1999 to March 2005, 162 residents including those receiving short-stay services in the Kamitsuga geriatic health services facility visited the hospital because of injuries resulting from falls. Thirty-one cases were diagnosed as fractures of femur, 13 as fractures of spine, 10 as fractures of upper extremities, 10 as fractures of rib and 3 as subdural hematomas. Fracture accounted for 48% of all cases, and femur accounted for 40% of all fracture cases. Annual hospital visits and hospitalization frequencies kept increasing up to 2001, then turned flat after 2002, and decreased in 2004. After 2002 we took the following measures, (1) individualized care, (2) small group care and (3) analysis of the behavior of inmates with an action chart for the first seven days. These measures resulted in the decrease of falls. After 2002 injuries to lower extremities decreased, but injuries to trunk increased. Generally Fractures of lower extremities prevails in the elderly of high-ADL (activity of daily life), and fractures of trunk prevails in the elderly of low-ADL. The above-mentioned three measures were effective for those of high-ADL, but ineffective for those of low-ADL. Other measures for those of low-ADL are necessary in the future.

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  In concequence of the rapid extension of the average life expectancy of the Japanese after World War II, this country has realized a society of longevity. Although longevity is in itself something to be celebrated, many people have misgivings about health in their old age. Advances in medical technology, one of the factors which promoted the society of longevity, continued overcoming various diseases while bringing about many patients troubled with after effects. Also the number of old people suffered from chronic diseases has been increasing gradually.
  Today, people wish healthy long life from the heart, not simply longevity. Nagano Prefecture has come to be known as the area eminent for long healthy life expectancy in recent years. Behined this, there are various activities aimed at healthier life by citizens. In this paper, we report one of the activities carried out at “Yachiho village” (as a result of the affiliation with Saku machi in 2005 renamed Sakuho machi) located in the eastern part of Nagano Prefecture.
  The health care program for all villagers, which the government of Yachiho village started in 1959 with cooperation of Saku Central Hospital, produced fruit while breeding many voluntary activities by citizens. We explored the practices of the group worked on the improvement of nutrition, and studied about the essential conditions which have enabled the formation of health promotion activities by citizens.

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  Having established a facility for elderly people in a familiar neighborhood shopping center where they can mingle with many people, we are offering information and advice to them about health. A system has been created to support independent living of elderly people and encourage them to outdoor activities instead of stay-at-home. A shop was rented in F shopping center, which has many elderly shoppers and a long history. We opened the “SUKOYAKA salon” there in September 2005. In thisPaper, we examined the health promotion functions and roles of the system and described the progress of this project in the first seven months from the opening of the facility to March 2006, and the people who had visited the salon.

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  To nurses who are doing the actual hands-on work on shifts, the daily conference is indispensable for sharing information among them, working as a united body and addressing the problems of patients accurately. Up until some years ago, however, the conference in our ward had been somehow devoid of continuity and substance. So, by the use of a crosswise chart (a radar chart?), analyses were made to find out what was wrong and what the staff thought about the conference, and an effective approach to making the conference fruitful was sough. A new set of rules were laid down, which resulted in helping the conference become animated. A check of nurses' logs showed a great deal of improvement in terms of the inspector's scores.

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