This study evaluates the quality of life (QOL) for elderly community residents on both health-related and subjective QOLs, while comparing QOL-related factors between so-called “younger old” (residents in the age bracket of 65-74) and “older old” (those in that of 75 and over) in regard to QOL-related factors. Questionnaires were distributed to 929 residents in both age groups who affiliated themselves with a senior citizens’ club in City “K” in 2009. Data on 596 persons were analyzed in this study. Results pertinent to basic attributes, health status, lifestyle habits, social exchange, and QOL were analyzed in a multivariate method. Among residents in the age bracket of 65-74, the subjective sense of well-being, the frequency of going out, gender, the frequency of conversations with neighbors, financial security, and bedtime hours were looked upon as factors contributory to improvements in QOL, whereas low back pain, the frequency of mutual support among neighbors, high GDS scores, personal activities, and numbness were taken in as factors deteriorative to QOL. Among the over-75s, the subjective sense of well-being, cardiac disorders, and financial security were regarded as factors contributory to improvements in QOL, whereas low back pains and cardiac disorders were looked upon as factors deteriorative to QOL. To improve the elderly’s QOL, it is considered essential to step up their efforts to manage and relieve depression and low back pains.

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In 2010, we at Konan Kosei Hospital introduced a menu with 8 days set as a cycle for inpatients undergoing chemotherapy. We have thus far used it for 258 patients. Over the 6-month period extending from October 2011 and March 2012, we performed a questionnaire survey on 23 patients (8 with lung cancer, 5 with acute myeloid leukemia and 3 with lymphoma) about their meals. On the basis of the findings, we have made a number of improvements in the menu. 　　To the question of ease with which to eat, 96% of patients responded the meals were “easy to eat.” When it came to the volume of meals, 29% replied that breakfast was “small,” whereas 83% said lunch and dinner were “just right.” Cold chawan-mushi (custard-like egg and vegetable dish steamed in a cup) was difficult to eat for 7 patients, whereas there were indications that fish meals were also hard to eat. 　　Based on this survey, we have increased the volume of breakfast, and replaced cold chawan- mushi with hot chawan-mushi. Furthermore, in order to reduce the smell peculiar to fish, we substituted kaba-yaki (spitchcocks) and ankake (food dressed with a thick, starchy sauce) fish- cooking styles for nitsuke (fish boiled and seasoned with sugar and soy sauce) and mushizakana (steamed fish) styles. Further surveys are necessary to produce a menu suitable for as many patients undergoing chemotherapy as possible.

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　　This report is designed to evaluate the five-year management of a tool known as the Table of Communication (Inquiries) for the Home Care Support Program, whose preparation was begun by the Yanai Medical Association, Yanai Municipal Government and local home care support specialists in 2005. 　　From a questionnaire survey performed once a year on the use of the Table of Communication (Inquiries) by members of the Medical Association and care support specialists, an attempt is made here to extract and compare good and bad points inherent to the contact between 2009 and 2011. 　　In the initial phase, some members of the Medical Association did not assume a forward- looking posture in setting forth their views or failed to respond to the questionnaires delivered to them. Instead of giving up our approach, nevertheless, we kept distributing them to those members. As time went by, however, they came at last to realize it necessary to fill them out along with additional comments and promptly sent them back to the sponsors. On the other hand, there were signs that few replies with personal comments were turned in from doctors assigned to general hospitals. With awkward relations gradually dissipating over a period of five years, this tool, hailed as “Yanai Formula,&rquo; has developed into a system indispensable for attending doctors and home care support specialists. 　　Recently prepared, the Table of Communication (Inquiries) has turned out to be a useful tool, which serves to reinforce the contact between attending doctors and home care support specialists. The major factor contributory to this successful venture is that this tool has been prepared and managed by a committee of three agents - to wit: the Medical Association, the municipality and the home care support specialists. When it comes to teamwork with a general hospital’s doctors, however, there still remain many issues yet to cope with, even though it has served as an operation center, so much so that we wish this method to develop into a genuine tool of teamwork that involves general hospitals' doctors.

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　　Gallstones are frequently observed in cases with gallbladder cancer. However, no obvious evidence has proved that cholelithiasis is a risk factor for gallbladder cancer. Procedure: We presumed the ratio of asymptomatic gallbladder cancer accompanied by cho- lelithiasis in the aging-society population. The patients who were diagnosed as having choleli- thiasis but did not suffer from any gallbladder cancer were taken up in our study. The gallbladder was surgically resected and then analyzed pathologically. Results: In our hospital, 3.31% of patients suffered from gallbladder cancer or hyperplasia. The ratio of cancer carriers stood at 1.98% with that of hyperplasia carriers at 1.32%. Conclusions: According to our estimate, the ratio of gallbladder cancer among cholelithiasis patients is much higher than the one which has been recently reported. The surgical resection of the gallbladder for the sake of prevention has not been recommended. Our result suggests, however, that the surgical treatment of the gallbladder for the sake of prevention is important to avoid suffering from gallbladder cancer in the aging society. A further study is required to reconsider gallbladder resection.

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　　This study is designed to clarify the effects of increases in a rehabilitation session on the functional outcome of hip fractures in the subacute phase. 　　Of 95 patients with hip fractures admitted to our subacute care ward between November 2010 and March 2012, five patients transferred to another ward due to complications were excluded, and 90 patients were taken up. The 90 patients were divided into two groups: 22 patients who underwent rehabilitation before an increase in the frequency of rehabilitation sessions (early-phase group) and 68 who underwent rehabilitation after an increase in the frequency (later-phase group). Outcomes, such as the number of rehabilitation sessions, length of hospital stay, FIM at the time of discharge, FIM efficiency and destination after hospital discharge, were compared between the two groups. 　　In a comparison of all patients, the number of rehabilitation sessions significantly increased (p<0.001), but there was no significant difference in FIM at the time of discharge from hospital, FIM efficiency and post-discharge destination. Group “Rank A” stood out in a comparison of the degree of independence enjoyed by the disabled elderly in their daily life before they suffered injuries (p<0.05). Group “Rank I” stood out in a comparison of the degree of independence in the daily life by the elderly with dementia, while they were in hospital (p⁢0.05). The FIM efficiency of the later-phase group was significantly higher than that of the early-phase group. 　　It is presumably effective to begin intensive rehabilitation for patients whose ADL ability is somewhat reduced and those who have cognitive impairments. It has been thought that cognitive impairment was one of the factors that inhibit rehabilitation for hip fractures. However, it has been suggested that improvements in ADL are possible with increases in rehabilitation sessions for cases with mild cognitive impairment.

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A 69-year-old woman underwent total colonoscopy in a health checkup at a local clinic. Colonoscopic study revealed a submucocal tumor-like lesion at the appendiceal orifice. She was admitted to our hospital for an elaborate investigation and treatment. Abdominal plain X-ray showed calcification in the right lower abdomen. Abdominal CT scan demonstrated a high density mass in the ileo-cecal region. Thus, we diagnosed the symptom as asymptomatic appendicolithiasis. She underwent laparoscopic appendectomy. As asymptomatic appendicolithiasis is very rare, we report this case with a review of some literature.

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Pseudoaneurysm of the uterine artery is rare as a cause to delayed postpartum hemorrhage. Nowadays, uterine pseudoaneurysm is often treated by uterine artery embolization. The outcome is favorable. Here, we report a case of delayed postpartum hemorrhage following Cesarean section, which was caused from a rupture of uterine pseudoaneurysm. The patient was at the point of death from excessive bleeding but successfully treated by uterine artery embolization (UAE). In encountering a case of postpartum hemorrhage after Cesarean delivery or Dilation & Curettage, it is indispensable to check the abnormal blood flow in a color Doppler examination.

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This report takes up a 65-year-old woman. Suspecting a tumorous superior fovea in the left clavicle, she consulted with our hospital’s Department of Otolaryngology. As a result of the lymph node biopsy performed at the department, she was diagnosed as having moderately differentiated tubular carcinoma. CT scanning revealed a number of swollen lymph nodes and parietal tylosis in the sigmoid colon. Endoscopy produced no abnormalities in the upper digestive tract, but an endoscopic check of the lower digestive tract revealed an all-around Type II tumor. The ailment was pathohistologically identified as tubular carcinoma. That said, the patient was diagnosed as suffering from sigmoid colon accompanying Virchow lymph node metastasis. Then, sigmoidostomy and the dissection of the D3 lymph node were performed. Pathohistological diagnosis revealed moderately differentiated tubular carcinoma, SE, N3, HO, PO, M1 (Virchow lymph node metastasis), Stage IV. Chemotherapy was postoperatively initiated with mFOLFOX6.

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Collagenous colitis (CC) has been looked upon as a rare disease in the past years. However, as we have acquired more knowledge about this disease, the cases diagnosed as CC are on the rise. Many case reports on Lansoprazole (LPZ) are available in our country, and our hospital has had three cases in the last year. Here, we present a typical example. Case 1: An 84-year-old woman who had been taking LPZ visited our outpatient clinic, complaining of chronic watery diarrhea for three months. Colonoscopy produced no abnormal findings other than a tiny capillary vascular growth in the descending colon. However, the histopathological findings secured from the entire colonic region revealed a thickened subepithelial collagen band. She was therefore diagnosed as suffering from CC. With the administration of LPZ suspended, her diarrhea improved in two weeks. The other two cases also underwent colonoscopy to check their chronic diarrhea. Their symptoms improved in a few weeks with the intake of LPZ suspended. In the differential diagnosis of chronic diarrhea, therefore, we believe it important to take possible CC into account, review the detailed history of medicine, and perform colonoscopy and mucosal biopsy.

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　　Obstetric and gynecologic disease cannot be analyzed without “gender” taken into account, because patients are likely to fear sterility and feel embarrassed in the delivery of medical care and treatment beside stigma against disease and treatment. 　　There is the need to seriously take account of the emotion of patients with obstetric and gynecological problems particularly in a ward where a division of gynecology is juxtaposed with that of obstetrics (delivery room) and/or a gynecology division in a mutually shared ward - as is the case with such obstetrics and gynecology wards available all over the nation - as studies on privacy protection in those types of wards are barely available. That said, we studied to clarify the details of privacy protection of the sort inpatients would wish to enjoy and their impression about privacy protection and correlated factors. Made from May 2008 to May 2009, the study consisted of two researches: Research 1 employed a semi-structured interview method for 15 subjects, and Research 2 used a questionnaire survey method for 85 subjects. 　　Three important items on privacy protection were derived from the results of Research 1, and an analysis of the results of Research 2 on the basis of those 3 items suggested that briefings in the early phase of hospitalization would have a favorable impact even upon the patients’ mental reaction to subsequent privacy protection.

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