This study investigated differences in job satisfaction between nurses and midwives. Furthermore, this study aimed to identify the factors associated with job satisfaction among midwives. An anonymous, self-administered survey was administered to nurses and midwives working at general hospitals with delivery facilities in the Kanto region using Google Forms. The questionnaire included individual factors, the Revised Nurse Job Satisfaction Scale （Revised JSN）, the Nurse Self-Learning Motivation Scale, and the Nurse Work Motivation Scale. The t-test was performed to examine the differences in the Revised JSN scores between nurses and midwives, with job type as the independent variable. A multiple regression analysis was performed with the subscales of the Revised JSN, which exhibited significant differences between nurses and midwives, as the dependent variable, and the subscales of both the Learning Motivation Scale and Work Motivation Scale as the independent variables （p＜0.05）. The job satisfaction subscales, namely, “relationship with colleagues” and “salary,” exhibited significantly higher mean scores among midwives, whereas “opportunities for learning” was lower. The multiple regression analysis revealed a positive correlation between the subscales “relationship with colleagues,” “salary,” and “opportunities for learning” and the subscale “willingness to engage in current work from the Work Motivation Scale. Midwives with higher work motivation exhibited significantly greater job satisfaction and satisfaction with learning opportunities in their workplace environments. High work motivation plays a crucial role in fostering professional identity and enhancing job satisfaction among midwives. To further enhance job satisfaction among midwives with high work motivation, a postgraduate education system for midwives is highly recommended.

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This study examined the factors that influence disaster-nursing practices among clinical nurses, focusing on regional differences between Kanto and Tohoku. Furthermore, this study aimed to clarify issues related to disaster-nursing practices. In this cross-sectional study, a web-based survey was administered to nurses affiliated with disaster-based hospitals in Kanto and Tohoku. The survey items included （1） disaster preparedness behaviors, （2） disaster self-efficacy （disaster SE）, （3） knowledge of disaster-nursing practices, and （4） open-ended statements regarding disaster-nursing practices. Descriptive statistics, propensity score matching, and multiple regression analysis with knowledge of disaster-nursing practices as the dependent variable were used. Free descriptions of the challenges of disaster-nursing practices were also analyzed. In total, 1,345 and 622 valid responses were obtained from Kanto and Tohoku, respectively. The number of respondents in both regions was adjusted to 574 by matching. The responses that were favorable for disaster-nursing practices and significantly higher in Tohoku than in Kanto were “understanding of CSCATTT for disaster preparedness,” “understanding of manuals,” “dealing with infected patients,” “disaster SE,” and “pre- and postgraduate education.” Multiple regression analysis revealed that disaster preparedness behaviors, disaster SE, and postgraduate education were significant items in order of increasing standardized coefficients. In the content analysis of issues associated with disaster-nursing practices, 14 categories were extracted; the most frequent codes were “Insufficient practical education/training” and “Insufficient establishment of continuing education.” Disaster-nursing knowledge was influenced by disaster preparedness, disaster SE, and postgraduate education. Moreover, the knowledge gained from the disasters was used for awareness and education in Tohoku. These results suggest the need to strengthen continuous and practical education in disaster-nursing practices.

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Advancements in medical science have expanded the roles of pharmacists, leading to increased challenges in pharmaceutical education. A significant challenge lies in bridging the gap between basic pharmaceutical sciences and pharmacotherapy. To address this issue, the Showa University School of Pharmacy introduced a course titled “From Fundamentals of Pharmaceutical Sciences to Pharmacotherapy” for second-year students in 2021. This study evaluated student perceptions created by this course through a survey conducted among second-year students at the Showa University School of Pharmacy. The results indicate that the course enhanced students’ recognition of the connection between fundamentals of pharmaceutical sciences and pharmacotherapy, and boosted their motivation to learn. Group-based learning also contributed to a deeper understanding of the subject matter. Further evaluation is required to examine the long-term effects of this course on students’ motivation to learn and clinical practice. These insights will support the ongoing development of teaching strategies aimed at effectively bridging the gap between basic and applied pharmaceutical sciences. Continuous, multifaceted research is necessary to refine educational strategies and enhance the overall learning experiences of pharmacy students.

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Fontan surgery is a palliative procedure designed for patients with single-ventricle physiology, in whom biventricular repair is not possible. Fontan circulation features a unique hemodynamic configuration, where venous blood from the superior and inferior vena cavae is directed into the pulmonary arteries without passing through the heart. A single ventricle supports systemic circulation. This report describes the perioperative management of two pediatric patients with Fontan circulation who underwent oral surgery under general anesthesia due to severe dental treatment phobia. The first case was a 9-year-old male scheduled for an upper lip frenectomy, and the second was a 17-year-old female requiring tooth extraction. Both patients presented with Fontan circulation and significant dental fear, making conscious sedation a challenging and potentially unsafe. In patients with Fontan circulation, strict management of pulmonary vascular resistance （PVR） is essential. Intravenous sedation was considered; however, concerns regarding due hypercapnia from respiratory depression and the risk of inadequate analgesia or sedation, which could trigger to sympathetic activation and elevate PVR, led to the decision to proceed with general anesthesia for both cases. The anesthetic plan was carefully tailored to each patient’s cardiovascular status. Potential causes of anesthesia-induced circulatory depression were anticipated in advance, allowing the procedures to be carried out without intra- and post-operative complications.

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Laparoscopic myomectomy （LM） carries a risk of endometrial perforation, particularly in cases involving submucosal fibroids or fibroids located near the endometrial lining. In such cases, postoperative placement of an intrauterine device （IUD） can help prevent intrauterine adhesions if perforation occurs. This case report describes the uterine intramyometrial migration of an FD-1® IUD inserted immediately after LM. Three months postoperatively, transvaginal ultrasound and MRI revealed that the IUD had migrated into the myometrium. The IUD was successfully removed using combined hysteroscopic and laparoscopic guidance, without injury to adjacent intra-abdominal organs. The patient’s postoperative recovery was uneventful. This report highlights the importance of careful IUD placement following LM, particularly in light of the temporary weakening of the uterine wall during the early postoperative healing phase. To reduce the risk of uterine perforation or device migration, the use of transabdominal ultrasound guidance during insertion is recommended For patients with IUD migration into the myometrium, comprehensive imaging evaluation and combined hysteroscopic and laparoscopic approaches can facilitate safe surgical removal.

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Schwannoma is a benign tumor derived from Schwann cells and can develop throughout the body; however, its occurrence on the lips is relatively rare. Herein, we report a case of schwannoma on the lower lip.
A 28-year-old woman presented with a painless swelling on the right side of her lower lip, which had been present for ＞10 years. The patient visited our department in October 2022 for further examination and treatment. Magnetic resonance imaging revealed a well-defined, elastic mass measuring 20×10-mm with healthy mucosal coloration. The mass exhibited low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. Based on these findings, a clinical diagnosis of a lower lip tumor, was made, and surgical excision was performed under general anesthesia in January 2023. Histopathological examination revealed that the mass was encapsulated by a fibrous capsule with a mixture of areas containing spindle-shaped nuclei and Verocay bodies, as well as regions with a sparse reticular arrangement of cells and vacuolar degeneration in the stromal tissue. The mass was positive for S100 protein on immunohistological examination, leading to a diagnosis of Antoni AB mixed schwannoma. Nine months after surgery, the patient is doing well without recurrence.

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Struma ovarii is a rare tumor, accounting for 2％-4％ of ovarian teratomas. Preoperative assessments based on imaging or tumor markers frequently fail to reliably predict struma ovarii diagnosis due to features overlapping with those in ovarian malignancy. Accurate diagnosis is particularly challenging because of the rarity of struma ovarii and its nonspecific nature of presentation. Here, we report a case of a preoperatively suspected malignant ovarian tumor that was histopathologically diagnosed as benign struma ovarii. A 57-year-old female patient was referred to our hospital after the incidental detection of a suspected uterine fibroid during routine gynecological screening. Transvaginal ultrasonography revealed a solid mass in the left adnexa, and magnetic resonance imaging demonstrated a mass of 40mm in diameter with mixed cystic and solid components. The lesion exhibited low signal intensity on T2-weighted images, early enhancement on contrast-enhanced T1-weighted images, and mild diffusion restriction, which raises the suspicion of ovarian malignancy. Imaging findings could not exclude malignancy despite normal tumor marker levels; therefore, a laparotomy was planned and performed. A rapid intraoperative frozen section diagnosis indicated a benign tumor, which prompts total hysterectomy and bilateral salpingo-oophorectomy. Subsequent histopathological analysis confirmed benign struma ovarii diagnosis. The patient underwent postoperative follow-up for 6 months, during which no recurrence was observed. Struma ovarii typically has strong enhancement without diffusion restriction; however, some cases may present with mild diffusion restriction. This case highlights the diagnostic challenges in differentiating benign struma ovarii from ovarian malignancy, thereby requiring careful diagnostic consideration.

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