Purpose: Several types of major needleless three-way stopcocks are used in Japan. We aimed to compare their usefulness, focusing on insertion resistance of various types of needleless three-way stopcocks, a site at which catheter-related bloodstream infection occurs.

Subjects and Methods: Six products (products A to F) that are used in clinical practice in Japan were evaluated. The types of needleless sites were split septum in 4 products and mechanical valve in 2 products, while the materials of rubber valves were isoprene rubber in 2 products and silicon rubber in 4 products.

Results: Insertion resistance and insertion energy of product A, which has a split septum and isoprene rubber, were 1182 ± 21 gf∙mm and 5158 ± 126 gf∙mm, respectively, showing significantly lower values than those of the other types tested. The pressure testing at syringe connection site of the needleless connectors showed that all types had pressure resistance at connection site against a target maximum infusion pressure or over.

Conclusion: It was suggested that product A, which has a click strength and in which the rubber valves of syringe insertion site are made of isoprene and the needleless site has a split septum, has the least insertion resistance and insertion energy, thereby being easy to use in the clinical practice.

Objective: We paid attention to a cancer taking in a lot of glucose, introduced the ketogenic diet of a severe carbohydrate intake restricting and examined the safety and effect of the chemotherapy combination.

Methods: We got approval of an ethics review board of our hospital and made the modified MCT ketogenic diet of ketones ratio 1.5-1:1 taken in for advanced colorectal cancer and breast cancer of stage IV for three months. We examined a metabolism, a nutrition, QOL and clinical effects against cancer.

Results: We examined nine patients. The non-diabetic mellitus patients suffered from ketosis by ketogenic diet, and suffer from mild acidosis by urinary excretion. The patients were accompanied by a significant decrease in 5.4% of weight loss, but the liver and the renal function was kept. The patients did not have a reduction in quality of life by the combination with the chemotherapy either. Response rate was 67 %, disease control rate was 78%. It was suggested that the effect of treatment correlated with a blood ketone body level and quality of life score.

Conclusion: The modified MCT ketogenic diet with the chemotherapy for 3 months was a safe diet in patients with cancer of stage IV, and it was suggested that the reduction of cancer was associated with blood ketone body level and quality of life score.

Objectives: Nutritional status is not adequately maintained in most children with cerebral palsy (CP). One of the reasons is difficulty in determining adequate calorie delivery. Relationship between resting energy expenditure (REE) and body mass index (BMI), and calorie delivery leading to appropriate physical development were investigated in CP children.

Methods: REE was measured with indirect calorimetry in 46 CP children[median, 8 (range, 1~17) years]. The relationship between BMI/age-matched standard ratio and REE per kg/age-matched standard ratio was analyzed. The relationship between calorie delivery and physical development was analyzed in 21 CP children[median, 6 (range, 2~17) years].

Results: BMI/age-matched standard ratio showed a decrease with age. Age-matched standard ratios of BMI and REE per kg showed negative correlation. CP children with BMI/matched standard ratios below 0.83 showed a tendency to have a higher REE per kg compared with the age-matched standard. Calorie delivery/REE ratio and body height/weight changes showed significant positive correlation. Body height and weight Z-scores were maintained almost equally when calorie delivery/REE ratio was 1.18 and 1.08, respectively.

Conclusions: CP children became thinner with age. Thinner CP children had a higher REE per kg compared with the age-matched standard. It was considered that 110% - 120% REE of the initial calorie delivery possibly leads to maintain Z-scores of body height and weight in CP children.

Purpose: Chemotherapy-induced dysgeusia has been reported to occur in 60% of patients that undergo chemotherapy. However, very few studies have objectively evaluated chemotherapy-induced dysgeusia. The aim of this study was to evaluate time-dependent changes in dysgeusia by using a taste test reagent (the Taste disk_®) and a questionnaire survey.

Patients and Methods: We enrolled 45 patients with malignant lymphoma undergoing CHOP therapy and R-CHOP therapy between January 2014 and October 2015 that agreed to participate in this study. We measured three types of taste threshold values (sweet, salty, and bitter) by using the Taste disk_® and asked patients whether the taste (salty and sweet) changed by using a questionnaire at each of the four evaluation periods (pretreatment and after courses 1, 3 and 6).

Results: The results of the Taste disk_® for salty taste indicated that 11 patients (25%) developed dysgeusia after the first course of chemotherapy, 13 patients (33.3%) after the third course and 14 patients (35.9%) after the sixth course. As the treatment progressed, the salty taste became significantly dull (p < 0.05). Similarly, the results of the questionnaire survey indicated that patients felt that the salty taste changed with time.

Conclusions: The sensation of the salty taste significantly decreased during the course of chemotherapy. It was suggested the patient wished for highly seasoned savory cuisine.