Most types of mammalian cells generate a contractile force that is likely the basis for motility and morphological changes. In non-muscle cells, it is thought that the cellular functions are accompanied by both changes. Because their contractile force levels are extremely low, non-muscle cell contraction has not been detected. To assess the non-muscle cell contraction, cell imaging analysis and a collagen gel method have been used, but the detected parameters were indirect alterations. To detect an actual force development by non-muscle cells, a collagen fiber method was established, using 3D-reconstituted fibroblasts in a collagen matrix. In a collagen fiber made by NIH3T3 fibroblasts （fibroblast fiber）, a calf serum-induced time- and dose-dependent force development was detected as an actual non-muscle cell contraction. In this fibroblast fiber contraction, we revealed that the intracellular signaling pathways could be distinguished from those in the typical muscle cell contractions. In this review, we demonstrated the details of both the fibroblast fiber reconstitution and the force measurement method. Moreover, the intracellular signaling pathways were assessed in comparison with the previously described methods. We propose that collagen fiber is a useful tool for understanding non-muscle cell contraction.

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A university hospital is facility where both teaching and clinical training are closely incorporated tightly, i.e. all of the staff nurses are also nursing teachers who perform both teaching and duty work. However, it is difficult to separate the two roles, and thus the consideration of balance is very important. In the clinical environment, self-learning must be done with hopefully plenty of patients who present many points to learn. Such aspects have not been well discussed to date in reports. In this report we have included these aspects; we studied 23 volunteers, who are all over clinical rudder Level 2, by using the “semi-structured interview technique”. The results showed that the staff nurses have the following: 1） an “uneasiness and embarrassment regarding clinical teaching”, 2） “that there is not sufficient room, and the interest is light for clinical teaching”, 3） “lack of cooperation with the leader”, and 4） “relation the awareness of being a role-playing model in real adjustment and the training instruction”. We conclude that staff nurses are functioning as a role-playing model in real life, and they are finding students’ progression through corporation and communication methods. The teaching system by the staff nurse is quite beneficial based on the following important points: 1） to emphasize concern of professionalism of the staff nurse, 2） a good opportunity to verify their knowledge, 3） to improve their communication skills, and 4） to share learning and the sense of achievement for teaching.

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Perioperative practice is performed in an operating room as well as on the ward, so that a nursing student understands perioperative patients. Most of the operating room practice is completed within the several hours when the patient is undergoing surgery. It is said that the coaching of nursing students is the responsibility of the nurse in the operating room. The aim of this study was to assess the situation of coaching using the operating room practice recording paper and to evaluate the effect of recording paper on practical instructors. We conducted a survey on coaching using operating room practice recording papers for 38 operating room nurses. The data was analyzed by simple tabulation and qualitative analysis. This research was approved by the ethics committee which is the organization to which the authors belong （No. 214）. We obtained responses from 34 operating room nurses （response rate 89.5％）. The results of this study clarified the following: Operating room nurses who have not taken nursing practice instructor training courses have to coach nursing students, which includes coaching nursing students at the same time as carrying out multiple roles of the concurrent duties in the operating room situation. Further, we extracted 186 codes, 38 sub-categories, and 12 categories from the words obtained from the free description about coaching using recording paper. Regarding the effect of recording paper on practical instructors, the following were identified: “the effect of the instructor side felt by the operating room nurse” “the effect of the nursing students side felt by the operating room nurse” and “thinking about coaching of the operating room nurse”.

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Lung cancer is a major cause of cancer-related mortality worldwide. A mass screening program for lung cancer has been conducted since 2011 in Tsuzuki-ku, Yokohama, Japan. It includes a chest X ray for those age > 40 years. We investigated the tendency of lung cancer screening in the Tsuzuki area of Yokohama. The attendance rate for lung cancer screening program has been increasing every year in Yokohama City, including within the area of Tsuzuki. The rates of positive screening tests ranged from 8%～11%; they have been decreasing every year because of the output changes from film to digital. According to the higher rate, the cancer detection rate is also higher than the national data surveillance. Old inflammatory changes and bronchiectasis are the major results for false positive, and interstitial pneumonia is the next. However, this investigation revealed some problems yet to be resolved, such as, the difference of perception in judgment “d” and “e” between the guidelines and our area of Tsuzuki. Further investigations are needed to resolve these problems.

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uberculosis（TB）, an infectious disease that causes diverse symptoms in various organs of the body, is difficult to diagnose unless persons with suspected TB undergo close examination. Here, we encountered a case diagnosed with tuberculous granuloma based on histopathology after surgical diagnosis and the treatment of an atypical-appearing cervical cyst. In terms of atypical lesions, it is crucial that the tuberculous lesion must be listed as one of the differential diagnoses. We discuss tuberculous granuloma of the neck, along with the results of a literature review.

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In a phase I trial at Showa University Clinical Research Center, we found an elevation of serum transaminases in healthy male volunteers hospitalized for 9 days. We report the cases in whom controlled energy intake attenuated the elevation of transaminase values which seemed to be caused by excessive energy intake. Both aspartate transaminase （AST） and alanine transaminase （ALT） values at day 8 were significantly elevated compared with those at day 1 in the group who took the 2,500kcal/day diet for the whole period （cohorts 1, 2）. In contrast, serum AST and ALT values were not elevated in cohort 3 （2,200kcal/day diet for the whole period）, cohort 4 （2,500kcal/day diet switched to 2,200kcal/day diet at day 4） and cohort 5 （2,200kcal/day diet switched to 2,300kcal/day diet at day 4）. In conclusion, the elevation of serum transaminase values in hospitalized healthy male volunteers seemed to be induced by unbalanced excessive energy intake. The findings suggested that an adequate energy balance reduced the number of abnormal laboratory data unrelated to investigational drugs.

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Dengue virus infection is a vector-borne infectious disease. It occurs in tropical and subtropical areas throughout the world. In Japan, only imported cases of dengue fever had been reported. However, in August 2014, an autochthonous case of dengue fever was reported in a patient with no history of foreign travel. Our department recently encountered two patients with dengue infection: one was an imported case and the other a domestic infection case. We report these two cases and provide a review of the literature. Case 1 was a 12-year-old boy with a history of travel to Thailand. Hence, he was considered an imported case of dengue. Case 2 was an 11-year-old girl who had not traveled outside Japan, but had visited of Yoyogi Park in Tokyo, she was considered an domestic infection case. Owing to severe fatigue, the patients required hospitalization, and they were discharged after symptomatic improvement was achieved through fluid therapy. In Japan, dengue should also be differentiated from other febrile diseases presenting as severe fatigue in patients without overseas travel.

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A branchiogenic cyst is a relatively rare disease which arises in the branchial tissue remnant during fetal life. We performed a parotid duct imaging examination, and a recurrent neck abscess was then identified as a cystic disease which communicated with the parotid duct. Here, we report the experience of a case of branchiogenic cyst diagnosed by histopathological findings which revealed ciliated columnar epithelium in the cyst wall. A 13-year-old boy had been suffering from repetitive swelling of the left parotid region since childhood. In May 2011, the 13-year-old boy was treated with oral treatment in a nearby hospital, but his condition was not ameliorated. He was referred to our hospital, and abscess formation in the left parotid region was found on contrast-enhanced computed tomography （CT） scans of the neck. His condition improved with conservative management, but abscess formation occurred 5 times in about one year. We performed a parotid duct imaging examination for investigation, and a cystic lesion which communicated with the parotid duct was identified. Most neck abscesses in children are caused by inflammation of cervical lymph nodes. In the case of the differential diagnosis of recurrent abscesses in the parotid region, we must consider the possibility of branchiogenic cysts as one of the underlying diseases, but when the fistula tract is not clearly identified, a parotid duct imaging examination and CT scans following the parotid duct imaging examination, as in the present case, seem to be effective.

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Alveolar soft part sarcoma（ASPS）is a very rare malignant mesenchymal cancer of all soft part sarcoma（incidence rate: 0.5-1％, of all soft part sarcoma）. In particular, primary ASPS of the female genital tract is extremely rare. We present a case report on primary uterine cervical ASPS of a 50-year-old woman. She presented to this hospital with a cervical polyp which included atypical interstitial cells. Various examinations revealed findings suspicious of malignant cervical tumor（3cm）. Moreover endocervical biopsy also indicated possible ASPS. Therefore, this mass was treated by modified radical hysterectomy and bilateral salpingo-oopholectomy. The pathologic findings of the hysterectomy specimen showed a typical alveolar pattern of tumor cells and the immunohistochemical stain for TFE3 was clearly positive. Based on these results, we eventually diagnosed uterine cervical APSP. At 13 months post-treatment, there is no sign of recurrence of ASPS.

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