Hepatic disorder consists of acute and chronic hepatitis. Most patients with acute hepatitis are cured without transitioning to chronic hepatitis. Chronic hepatitis progresses to liver cirrhosis and can even lead to hepatocellular carcinoma, irrespective of the etiology. Liver cirrhosis is classified into compensated and decompensated cirrhosis. Patients develop no symptoms until they progress to decompensated cirrhosis, a reason why the liver is called the silent organ. Jaundice, ascites, portal hypertension, and encephalopathy are symptoms of liver failure. It is important to start treatment before progression to cirrhosis. One such chronic liver disease that can lead to cirrhosis is hepatitis B. Carriers of hepatitis B are diagnosed by a positive result on the HBs antigen assay. If nucleic acid analog treatment is started at an appropriate time, chronic hepatitis B does not progress. One characteristic of hepatitis B virus infection that clinicians must keep in mind is that immune-suppression treatment or chemotherapy causes the virus to repopulate, thereby resulting in severe hepatitis. Hepatitis C virus infection was once the main cause of post-transfusion hepatitis. After the discovery of hepatitis C virus, 99.9% of new infections after blood transfusion were eliminated. Now, over 95% of patients can be cured by oral drug treatment. Fatty liver disease consists of alcoholic and nonalcoholic fatty liver disease that results from obesity and metabolic syndrome. In Japan, obesity and metabolic syndrome have become major health problems, leading to dramatic increases in the prevalence of fatty liver disease. Nonalcoholic fatty liver disease has become the most rapidly increasing cause of cirrhosis and hepatocellular carcinoma. As a result, nonalcoholic fatty liver disease has become a major public healthcare concern at the national level.

The medical care has been developed drastically in recent years, in the field of genetic medicine for diagnosis, treatment, and prevention of illness. In this study, we investigated the need for learning genetic medicine in the nurses for care of the patients with genetic issues. The coverage period was from January to February 2017 and the object was 1,800 clinical nurses. As a result, more than 90% of nurses had come across the patients, and the family of some genetic diseases. However, the ratio of nurses who had been involved actually with such patients and the family was low, and most of them had no chance to learn genetic medicine. To be prepared for the time when the genetic medicine spreads from the research field to a clinical site, it is necessary for the nurses to acquire the knowledge of the genetic medicine to provide the nursing care that fulfill the need of patients, and the family. Therefore, it is required to add a support system of education on genetic medicine for the nursing professions on-site.

Cardiac injury following blunt chest trauma can be fatal; therefore, immediate transportation, correct diagnosis, and early surgical treatment are critical. We describe right atrial appendage rupture due to blunt chest trauma sustained in a motor vehicle accident. A 25-year-old male who was transported to our hospital immediately after a traffic accident arrived in a state of shock. Focused assessment with sonography for trauma revealed cardiac tamponade and pericardiocentesis improved his hemodynamics. Chest computed tomography (CT) showed a right atrial appendage rupture. A clamshell thoracotomy proceeded in the operating room and a large volume of blood erupted. We clamped and sutured three ruptures and placed a drain. The postoperative course was uneventful, and arrhythmia did not occur. The drain was withdrawn on post-operative day (POD) 4 and the patient was discharged from hospital on POD 15 without sequelae. A clamshell thoracotomy is more prompt than a median sternotomy, it does not require specialized equipment, and it is an effective approach to resuscitation after severe chest trauma. The outcome of a ruptured right atrial appendage determined by preoperative CT and cardiac tamponade treated with pericardiocentesis was good. The present report describes this patient and our findings from a literature review.