This study was conducted to document a correlation between the age distribution of patients with cervical cancers and their genotype patterns of human papilloma virus (HPV). Retrospective analysis was performed on 53 patients in the clinical stage of CIN 3 and above. The patients were treated in our hospital during the period between January 2008 and May 2011. The age distribution showed that the patients in their twenties accounted for 28.0%, those in their thirties 34.0%, those in their forties 24.0%, those in their fifties 4.0%, and those in their sixties and older 10.0%, the average of the subjects was 39.5 years. This distribution pattern also indicated that the women aged 49 and younger are prone to cervical cancer. The overall detection rate of positive HPV in the high risk group was 97.1%. The detection rates varied according to the HPV genotypes, being 41.2% in HPV16, 17.6% in HPV52, 13.2% in HPV58, and 5.9% in HPV18. The average ages of patients at the stage of CIN3 and above who demonstrated the positive and negative results for HPV16/18 were 35.4 years and 44.7 years, respectively. During the follow-up period of 40 months, 27 of 179 patients with positive HPV of the high risk group showed development of grades from below CIN2 to those CIN3 and above. Of the patients positive for HPV16/18, 30.9% demonstrated a further development of the lesions, whereas there were only 8.1% in the patients negative for HPV16/18. These studies suggested a significant connection between the viral infection of HPV16/18 and the development of cervical cancer in young women.

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　　It is often reported that the number of cases of cervical spinal cord injury without fracture resulting from falls have increased in recent years with a aging population. 　　We reviewed the cases of cervical spinal cord injury in the patients who were admitted within two days after the injury to our department between January 2006 and December 2012, The subjects of this study numbered 167 cases;129 males and 38 females. The frequency of occurrence of cervical spinal cord injury, according to reports by the fire departments in the southwestern part of Ibaraki Prefecture is 32.0 per million individuals per year. In our cases under review, fractures were noted in 72 individuals, whereas 95 had no fractures. As to the causes of injury, traffic accidents topped the list with 38.9%, followed by falls with 28.7%, stumbles with 20.4%, and other factors with 12.0%. Cervical spinal cord injury account for 75% of all the cases of spinal cord injury with an incident of 30-40 cases per 100 million individuals per year. In 2011, the incidence of cervical spinal cord injuries resulting from traffic accidents decreased, while that of injuries related to falls increased. Six cases of injury resulting from falls happened during repairs on the damaged houses in the aftermath of the Great East Japan Earthquake of March 2013.

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　　We investigated the detection situation of the HER-2 examination that was performed to investigate the adaptation of the molecular targeted medicine trastuzumab for mammary and gastric cancers. The HER-2 positive rate was higher in biopsy specimens than in surgical specimen. In gastric cancer, the positive rate was significantly high when it was of the papillary type, histologically. In comparison with mammary cancer, the percentage of FISH positive was high in 2＋ cases. In addition, as the results of trial investigation showed, HER-2 positive cases ware few in colon cancer.

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　　Placental abruption occurs suddenly and may cause maternal and fetal mortality. Forced delivery is the only way to improve perinatal outcome, but the aftereffects could be severe despite a high survival rate. 　　Our hospital manages approximately 170 cases of maternal transport annually, including cases of severe placental abruption. Longer transport time can lead to undesirable maternal and fetal outcome. Hence this study, we compared the perinatal backgrounds and outcome of placental abruption retrospectively between the cases managed by maternal transport and by the local hospital (our hospital). The study included 54 cases of placental abruption during the period from January 2008 to December 2012, of which 27 cases were managed by our hospital, the other halves were managed by maternal transport. There were 6 intrauterine fetal deaths but not a single maternal death. There were no significant differences in the amount of blood lost and obstetric DIC (disseminated intravascular coagulopathy) score between two groups (p＝0.342, p＝0.649), and the number of cases that needed anti-DIC therapy and blood transfusion in each group was statistically similar (p＝0.807, p＝0.115). The time taken from the on-set of placental abruption to delivery was significantly shorter for the cases managed by our hospital (in-hospital management 143±133 minutes, maternal transport management 265±176 minutes, p‹0.05), while obstetric DIC score and Apgar score showed no significant differences (p＝0.336, p＝0.780) between the two groups. Thus, it could be said there were no correlations between the time taken from onset to delivery and perinatal outcome. It should be noted, however, maternal and fetal outcome of placental abruption could be fatal even with the rapid intervention, so quick diagnosis and management at the first contact are crucial. Thus, we concluded that forced delivery managed by the local hospitals is necessary for the potential better perinatal outcome, and an ideal system to manage maternal and/or neonate transport after the delivery should be established immediately.

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　　Purpose: To elucidate the degree of self-conctribution of each member of a palliative care team and the palliative effect patients. Patients and Methods:The degree of self-contribution to intervened patients and the degree of improvements in the symptoms items listed in a Japanese version of the Support Team Assessment Schedule (STAS-J) were examined prospectively. Results: The degree of self-contribution was often higher in doctors, nurses, clinical psychotherapists and pharmacists, and lower in nutritionists. It was related to age, gender, site of primary disease and the duration of intervention. The symptom items which showed improvement were such items as pain, nausea, vomiting, appetite loss and insomnia, but delirium and depression worsened. The degree of self-contribution and the degree of improvement in symptom were correlated in seven items in the case of pharmacists but only in one in the case of other professionals. Discussion: The degree of self-conribution varied and was not always high even after the intervention of the care team. It was considered that the fact that the number of related items was larger in pharmacists than in any other professionals was probably because the pharmacists could assess the symptoms and propose drugs from an objective point of view, although character might be mostly involved. Conslusion: It is to be hoped that every one engaged in palliative care will do what is one’s forte and apply each one’s individuality properly in the future.

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　　This study was designed to evaluate the enlargement of incision sizes before and after intraocular lens (IOL) implantation in coaxial microincision cataract surgery. 　　The operation was performed on 138 eyes. NY-60 IOL was implanted with N18 cartridge, SN60WF and ZCB00 implanted with D cartridge, SN60AT implanted with C cartridge. 　 Incision sizes (mean±SD) after IOL implantation of NY-60 were 2.33±0.05 (2.2mm corneal incision), 2.30±0.00 (2.1mm corneal incision), 2.26±0.05 (2.0mm corneal incision) and 2.24±0.05 (1.9mm corneal incision), SN60AT were 2.34±0.05 (2.2mm corneal incision) and 2.43±0.05 (2.2mm sclero-corneal incision), SN60WF were 2.34±0.05 (2.2mm corneal incision), 2.29±0.04 (2.1mm corneal incision), 2.20±0.00 (2.0mm corneal incision) and 2.11±0.04 (1.9mm corneal incision), ZCB00 were 2.33±0.05 (2.2mm corneal incision), 2.27±0.05 (2.1mm corneal incision), 2.33±0.05 (2.1mm sclero-corneal incision) and 2.29±0.04 (2.0mm sclero-corneal incision). 　　Incision sizes were enlarged after implantation of IOLs in all cases. The incision sizes the IOL manufacturer recommended were not stress-free size during IOL implantation.

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　　The purpose of the present study was to reduce absorbed dose rates in air by means of the X-ray tube protector in the X-ray fluoroscopy room. We measured absorbed dose rates in air using an ionization chamber type survey meter, made the scatter radiation maps and worked out the reduction rate of absorbed dose rates in air. Absorbed dose rate in air reduced 75-90% with use of the X-ray tube protector. Especially, absorbed dose rate in air reduced 85-90% at the height of crystalline lens and thyroid gland of the X-ray technician near the patient. It was suggested X-ray protector could reduce the risk of radiation exposure of radiologists effectively.

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　　With the recent upgrade of the MRI system, it has become possible to use 3D arterial spin labeling (3D ASL), which is an MR perfusion imaging technique without use of any contrast material. In this paper, we report the effects of imaging conditions on the cerebral blood flow (CBF) level (the amount of cerebral blood flow per unit brain tissue〔ml/min・100g〕) . We also report our clinical experience with 3DASL. In respect of the imaging conditions, changes in CBF values were examined when the arm and the number of excitations (NEX) were variable. The results showed that there were no significant differences in CBF values between different regions in the brain. This was due probably to the fact that the spin of the labeled blood was unaffected although the arm influenced the spatial resolution of images and NEX affected SN ratio.

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　　While physical therapy following the treatment with the Zuggurtung method enables the active flexion movement of the knee joint to enhance bone union at an early stage, the active extension movement may impose stress on the fractured segments toward their separation; thus due caution must be exercised. The treatment outcome of patella Fractures has been improved since the introduction of the Zuggurtung method;however, this method is not always applicable depending on the fracture type, and accordingly, risks of physical therapy would differ between cases treated with and without the Zuggurtung method. This paper reports on the cases of 2 patients with fractures of the distal patella who were not appropriate to the Zuggurtung method. Treatment outcomes similar to those of treatment with the Zuggurtung method were observed by clarifying accompanying risks and aggressively maintaining flexibility and smoothness of the supra-patella tissues during and after knee brace fixation. It was thought essential to proceed physical therapy after considering associated risks based on the details and characteristics of an open reduction and internal fixation (ORIF) performed for each patient’s patella fractures.

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　　We had a case of lung tuberculosis in an 80 year-old woman, who was diagnosed 3 months after admission to a health service facility for the elderly requiring long-term care. Here we report how we coped with the situation. 　　The diagnosis was made by the use of a gene-amplification method. Predonine 7.5 mg/day was prescribed for interstitial pneumonia. TB infection prevention program included a QFT test and chest radiography, and medical interviews was carried out 42 users and 17 staffers of the facility. The program was examined for two years. It was managed by a regional Public Health Center, however, we were involved in many matters offering medical and social information of the subjects to the Center and often notifying the subjects and their family of the schedules and information. Many of the user subjects had been discharged from the facility when the investigation was over, so it was difficult to communicate with them. The QFT test was regarded important and the QFT test positive persons were treated as latent TB infection cases.

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　　Stress that care workers are experiencing inevitably has bad influence on the quality of life of those old people who need nursing care. It is, therefore, a matter of urgency to work out some effective measures to deal with the mental health problems of care workers and others engaged in nursing care services. In view of the circumstances, we hold a workshop for caregivers with an aim at increasing their power to get anger under control. The workshop had four main sessions; (1) Free discussion on anger in general; (2) Distortion of thought; (3) 10 frequently observed irrational convictions; and (4) analysis of anger. Prior to the main sessions, all participants introduced themselves and told their stories about how they work off stress. In the free discussion, a world-cafe style was adopted. In the session (2) on distortion of thought, participants pondered on irrational convictions which had been formed in them on the basis of their experience. In the session (3), each participant gave his or her convictions apt to cause anger and replaced them with rational convictions. In the analysis of anger session (4), participants were asked to recall the scene in which they fumed, and role-play. The questionnaire survey taken after the seminor found that the anger management workshop had a beneficial effect on all the participants.

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