In Japan, “cold biopsy” (forceps resection) for small polypoid lesions is performed at the time of colonoscopic examination. However the treatment by cold biopsy remains controversial because of remnants and recurrence of the neoplastic polyp. In order to evaluate this problem, the records of 7779 cases of colonoscopy in our hospital were analyzed. The curative effect of treatment for polyps was examined separately among the different procedures of polyp excision: cold biopsy, snare polypectomy and hot biopsy. The curative effect of each procedure was judged endoscopically by the rediscovery of a polyp in the same colorectal portion where the polyp was excised in the former colonoscopy. The rediscovery rate of polyp was compared separately among 341 cases of cold biopsy, 566 cases of snare polypectomy and 85 cases of hot biopsy. As a result the curative effect of cold biopsy was almost equivalent to that of snare polypectomy and hot biopsy. However, it is necessary to select the strict adaptation of cold biopsy because larger polyps exceeding 3mm in diameter cannot always be completely removed with this procedure. Cold biopsy is a clinically useful procedure to treat small neoplastic polyps of a diameter of 3mm or less if performed under strict adaptation and extreme caution.

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At present, most clinical nurses complain of excessive cumulative fatigue due to an increase in medical and nursing care duties. It may be reasonable to assume that such fatigue alters their ethical viewpoint. To our knowledge there are no reports to date which discuss the relationship between ethical views and fatigue in clinical nurses. We studied this relationship by comparing the cumulative fatigue in clinical nurses with moral sensitivity and its developmental stage. We sent a self-completed questionnaire to clinical nurses working at two general hospitals and obtained effective responses from 607 nurses. The questionnaire included the background of the subjects, the Japanese version of the Defining Issues Test (DIT) for examining moral developmental stage, the Japanese version of the Moral Sensitivity Test (MST) and the Cumulative Fatigue Symptoms Index (CFSI). The subjects were divided into two groups based on the CFSI scores (median: 19 points); the high group had scores of more than 19 points and the low group, 19 points or less. The background, DIT and MST scores were compared between the high and low CFSI groups. The chi-squared test and Mann-Whitney U test were used for the comparison. The mean age in the high group was significantly lower than in the low group. The mean number of years of experience was significantly shorter in the high group than in the low group. The educational background was significantly higher in the low group than in the high group. The position in the low group was significantly higher than in the high group. There were no significant differences in DIT scores between the high and low groups. The mean MST score was significantly higher in the high group than in the low group. From the results obtained, the conclusion seems to be that cumulative fatigue in clinical nurses is not associated with moral developmental stage, but that individuals with higher cumulative fatigue possess higher moral sensitivity.

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Aromatherapy is the well-known practice of using natural oils extracted from flowers, bark, stems and other part of plant, which are called essential oils, to enhance psychological and physical well-being. Aromatherapy is also accepted to be a form of alternative medicine and it is used for the treatment or prevention of diseases, such as pain, depression and anxiety. It is generally believed that essential oils are absorbed via the airway mucosa and the skin, where they travel through the bloodstream and can promote whole-body healing. Although the effect of essential oils on the peripheral nervous system has been well documented, the influence of essential oils on brain functions is not well understood. Therefore, in the present study, we examined the influence of odor stimulation on brain function, as assessed by measuring oxyhemoglobin (HbO₂) levels in the frontal cortex by using near-infrared spectroscopy (NIRS). The subjects (10 females, 9 males) were recruited in Showa University School of Nursing and Rehabilitation Sciences. The odors used were linalool, limonene, benzyl acetate and vanillin, which were diluted with 100% ethyl alcohol at a final concentration of 1.0%. The subjects were exposed to these odors for 30 seconds. Stimulation by linalool and limonene caused a significant increase in HbO₂ levels in the frontal cortex. On the other hand, benzyl acetate and vanillin scarcely affected HbO₂ levels in the frontal cortex. The present results strongly suggest that it is necessary to carefully choose the type of odor, when performing aromatherapy for the purpose of cerebral activation.

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As hematological disorders are generally uncommon and the various means of classification have been frequently revised, the epidemiological data of specific hematological disorders is insufficient. We conducted a retrospective study of patients diagnosed with hematological disorders and evaluated the trends in incidence. We enrolled 1824 patients who visited the Department of Hematology, Showa University Hospital between January 2005 and December 2011 (males 828, females 996). The mean patient age was 60.0 (15–98) years. Our results revealed that neoplastic hematological disorders accounted for 56% of the cases and non-neoplastic hematological disorders accounted for 44%. Among the cases of neoplastic hematological disorders, 40% were myeloid neoplasms and 60% were lymphoid neoplasms. The ratio between the incidences of lymphoid and myeloid neoplasms did not significantly vary over the research period spanning 7 years. Among plasma cell neoplasms, the proportion of neoplasms secreting lambda-type chains of immunoglobulins was significantly lower in cases of monoclonal gammopathy of undetermined significance (MGUS) than in others (P=0.04). Thus, lambda-type chain immunoglobulin secretion seems to be a risk factor for progression of MGUS. Among the non-neoplastic hematological disorders, 45.3% were iron deficiency anemia and 17.5% were immunogenic thrombocytopenic purpura. In conclusion, the results of our research provide basic information for studies concerning hematological disorders. Further epidemiological studies with accurate and exhaustive enrollment are needed to clarify the causes of hematological disorders and to evaluate their trends in incidence.

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