A successful paper is written through the effective processing of a study. First of all,ideas,which occur in daily experience,should be organized so that the reader can easily understand them. Their originality should be investigated and reviewed through available literature before starting any experiments. The purpose of the study should be clarified and then the materials and methods well designed with effective implements. The results of the study should be expressed in tables and figures. Their reliability and statistical significance,however,should be evaluated scientifically.
　In the discussion,the scope should be focussed,establish originality and show essence logically. The conclusion must be determined by the study without fiction or fantasy.
　In the case report,crucial and important points must be stressed with significant information.

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　The main advantage of a two-piece（2-pc）stoma appliance is that it is possible to wear a base plate for several days and to change pouches of various types according to time,place and occasion. The coupling part is one of the most important elements in evaluating 2-pc stoma appliance. In this study,we investigated the double lock type coupling of the New Assura 2-pc developed by Coloplast,and evaluated its utility in 49 ostomates.
　The results are as follows: 1. The fact that the lock ring was moved from plate to pouch makes the Self Plate softer and more comfortable to wear. 2. It is easy to attach and remove the pouches when accustomed to its use,and the locking system functions safely. 3. Most ostomates were satisfied with this appliance because it can be worn comfortably,and 53.1％ of them preferred it to previous appliances. In conclusion,we may say that the double lock type coupling meets all requirements for coupling,such as ease of attachment,resistance to accidental removal,but also ability to be easily removed. This is also the reason why the product in general has been highly evaluated.

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　Following discharge,ostomy patients experience various anxieties during daily activities. Therefore,self-help groups are one of the most important support systems for ostomy patients. In order to improve the QOL of ostomy patients,we conducted research on the psychosocial aspects and self-care inclinations that contribute to ostomy patients wanting to join self-help groups. The subjects were 79 colostomy and urostomy patients（34 self-help group members,45 non group members）who had an operation at one of two university hospitals in Ishikawa Prefecture. We interviewed them during home visits on daily activity and self-care,and mailed three psychosocial questionnaires（Spilberger State-Trait Anxiety Inventory,Rosenburg Self-esteem Scale,and Norbeck Social Support Questionnaire）. The results suggested that the effect of participating in self-help groups facilitated the change in physical image. The main factors associated with the joining of self-help groups were,in order of importance,irrigation evacuation method,feeling rejected by family or loved ones,need for the long-term support of the community. These can be used as determining factors in predicting the kind of self-care patients who join self-help groups.

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A study was conducted to investigate postoperative defecative dysfunction in rectal cancer patients following sphincter-saving resections. The study covered 58 patients with rectal cancer who had undergone sphincter-saving resection more than 4 months previously.
　Data collection consisted of an：interview with a questionnaire and a survey of the medical records.
　Characteristic symptoms of postoperative defecative dysfunctions were as follows：a small volume of stool at each defecation,and periodic frequent bowel movement,frequent bowel movement occurring within a short period,a thin stool,perianal pain,a feeling of remaining stool,nocturnal defecation,soiling,uncontrollable defecation and breaking wind,the inability to discriminate between stool and wind and the desire to defecate,but failure to do so.
　The relationships among the various symptoms of defecative dysfunction were examined,and a symptom framework was constructed by factor analysis. As a result,a “Defecative Dysfunction Assessment Scale”（DDAS） was developed. Its concurrent validity was clarified using the Mie University Scale,and it was determined that the DDAS will be a valuable tool in future defecative dysfunction assessment.

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　A study was conducted investigate relationships between postoperative defecative dysfunction,self-care behavior and physiological factors. In particular,the relationship between self-care behavior and psychosocial factors was examined. The study involved 58 patients with rectal cancer who had undergone sphincter-saving resection more than 4 months previously. Data collection consisted of an: interview with a questionnaire and a survey of the medical records. The findings were as follows:
　Self-care behavior,defined as a patient's attention to self during daily life,definitely improved postoperative defecative dysfunction. This behavior included eating foods that increase stool volume and promote bowel movement,anal self～stimulation to promote defecation,life style improvements and exercising the pelvic floor muscles.
　Patients who received preoperative irradiation therapy showed no improvement in defecative dysfunction.
　Self-care activities that had a favorable effect upon defecative dysfunction were related to self-esteem and coping style.
　The most important instructions given to a patient involved selection of proper food,methods of promoting defecation,way to improve life style and information on the anticipated defecative dysfunctions and their remedies.

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　We witnessed a case of recurrent ascending colon cancer lhat developed on a stoma siｔe. Peritoneal dissemination of the cancer prohibited remarking of the stoma. According to the tumor progression,the stoma changed its shape. We selected one piece-type pouch having a soft skin barrier and remarked the stoma gages each time,at our stoma clinic.The patient was admitted to our hospital for small bowel obstruction. After admission,we concentrated on skin care around the area of the stoma. These cares improved the quality of the patient's life.

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　A new management system for the jejunal pouch will be present. It was constructed for a 14-year-old girl who suffered from Megacystis Microcolon Intestinal Hypoperistalsis Syndrome. Before that time she was managed with Foley's catheter which was inserted into the jejunostomy. Because of the deformity and depression of the jejunal stoma,leakage of the jejunal contents was observed. We developed a new flange which consisted of denture base resin and a stoma shape made of dental impression material.
　As for the results,1. the flange did not need to be changed as often as before,2. Skin trouble decreased,3. the time required to change the flange was shortened,4. it was an inexpensive management system.

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