Delayed endolymphatic hydrops (DEH), a disease entity different from Ménière's disease, typically develops in patients experiencing profound, long-term hearing loss in 1 ear. This condition was first reported by Kamei et al. ('71), Wolfson and Leiberman ('75) and Nadol et al. ('75). Schuknecht ('78) defined DEH and classified it into 2 types : ipsilateral and contralateral. The underlying pathophysiologic mechanism for DEH development was explained as progressive endolymphatic hydrops in the inner ear due to delayed atrophy or fibrous obliteration of endolymphatic resorption system, resulting from previous inner-ear injury. According to the literature, the period between the onset of preexisting deafness in 1 ear and DEH onset ranges from several months to 74 years. The cause of preexisting deafness is unilateral profound deafness due to obscure etiology since early childhood in more than half of the cases of both types of DEH. Other causative disorders of the inner ear leading to DEH are mostly due to inflammation (viral and bacterial) and trauma (physical and acoustic). Ipsilateral DEH is more common than the contralateral type. The age at onset in contralateral DEH is generally higher than that of ipsilateral. Medical treatment may be effective in both types of DEH. Complete relief from episodic recurrent vertigo is expected in 65% of cases within 5 years after the onset of vertigo. Labyrinthectomy or vestibular nerve section in the deaf ear is curative in ipsilateral DEH, but no satisfactory surgical therapy is available for contralateral.

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Cardiac function by echocardiogram, respiratory function test, and arterial blood gas analysis were evaluated during a 2-month rehabilitation program in a pool of 38°C water in 10 patients (72.7±5.6 years of age) with stable chronic obstructive pulmonary emphysema between 1996 and 1998. Ejection fraction increased significantly and left systolic and diastolic ventricular dimensions decreased significantly after the program. The ratio of forced expired volume in 1 second to forced vital capacity (FEV_1.0%) increased significantly after the program, while the ratio of vital capacity to predicted normal value (%VC) did not change. Although PaO₂ was not increased, PaCO₂ was decreased after the program. Changes in respiratory function and arterial blood gas were considered due to respiratory muscle training against hydraulic pressure, decreased dead space in the respiratory tract by elevated diaphragm, and increased respiratory tract pressure by breathing out into water. Furthermore, the improvement in cardiac function may be derived from increased venous return by hydraulic pressure. Therefore, breathing exercise by head-out water immersion may be useful in treating heart failure due to chronic pulmonary emphysema.

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We assessed short-and long-term results of coronary rotational atherectomy (RA) in a consecutive series of 30 patients with 32 lesions. All lesions were complex and calcified (type B 2 or C). Minimal lumen diameter (MLD) was 2.71±0.46mm, and diameter stenosis 78±9%. Adjunctive low- or high-pressure balloon angioplasty or stenting after RA was conducted for all lesions, with procedural success obtained in 28 (87.5%). Final MLD was 2.17±0.69mm and diameter stenosis 20±14% after RA. Coronary artery dissection occurred in 7 lesions (25%) and delayed filling in 2 (7%). No patient had major complications, e.g., in-hospital death, Q-wave myocardial infarction, or emergency coronary artery bypass surgery. Angiographic follow-up was conducted for 17 lesions. MLD was 1.31±0.80mm and diameter stenosis 52±25%. Restenosis was seen in 8 lesions (47%), all of whom had success of target lesion revascularization. RA is thus useful in “debulking” and “lesion modification”, with a high success rate in complex lesions, and restenosis rates similar to balloon angioplasty.

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Life expectancy at birth and selected age differs by prefecture in Japan. In Gunma Prefecture, male life expectancy exceeds the Japarese average, while femalelife expectarcy folls below the average. Life expectancy by prefecture is closely related to death from cerebrovascular disease, ischemic heart disease, malignant neoplasm reg and less of gender.
Among malignant neoplasms, female life expectancy is related to esophageal and gastric cancer, and male life expectancy to colon, lung and liver cancer. Malignant neoplasm ranks 45 th in man and 33 rd in women as a cause of death and life expectancy after removal of a malignant neoplasm is 45 th in men, and 46 th in women. Such a phenomen on unigue in the Kanto region to Gunma Prefecture.

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The aim of this paper is to study the degree of truth telling of diagnosis to cancer patients in the teaching hospitals and to identify the optimal support by nurses. The survey was conducted on October 1st, 1999 at wards. Two hundred twelve patients were studied and their average age was 64.2 (standard deviation of 14.4).
60.4% of doctors told diagnosis as “cancer or malignant tumor”, 34.9% as “tumor” who depend on the patient's decision whether to tell malignancy or not and the remaining 4.7% did not tell the diagnosis. On the other hand, 55.2% of nurses want doctors to tell “cancer or malignant tumor”. Interestingly, the percentage is lower than that of the doctors. The agreement between doctors and nurses here is 84.9%. Among 15.1% where doctors and nurses are not in agreement on the truth telling, only 25% of them discussed whether to tell the truth or not. It is also found that the nurses are not emphasizing “patient' s desire” or “right to know”
It was revealed that nurses are not involved in the truth telling process of cancer patients. The challenge for us is to establish a system on truth telling so that the nurses can have routine discussion with doctors and provide more patient support.

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We studied how body color is expressed in nursing charts to promote nursing information sharing. A self-descriptive questionnaire was sent to 881 hospital nurses and 775 (87.9%) responded. We found that
(1) The number of color expressions per nurse was 24.1±10.1 on the average.
(2) The number of color expressions increases as a nurse becomes more experienced, peaking at 30.9+9.9 for nurses working 9 years. (p<0.01)
(3) Some 64.1% of such expressions were in color names used in chromatics, and 35.9% in terms of shade or tone rather than color names.
(4) The mode of color expression varies with experience. In the first year, most nurses used simple colors, while in the 6th year and onward, they use noncolor technical terms and life - related terminology.
We thus found that color expression is complicated even in assessing nursing needs. It is therefore necessary to standardize common terminology and to provide related training.

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Family support is required for recovery and vitality in hospitalized patients. Our subject was a 66 year-old woman with frequent, rapidly changing multiple conditions underlying disorders. Nurses supported the family members who regularly supported the patient. This gave us an opportunity to observe family nursing.
The patient had chronic renal failure, receiving hemodialysis 3 times a week. She was operated for rectoplasty. Some 44 days after operation, she suffered subdural hematoma and was hospitalized twice in the ICU. Rehabilitation started 3 months later. To understand the effect of nursing through patient and family support, we analyzed the process of nursing using the Calgary Family Intervention Model, confirming the effect of family nursing.
In an aging society, the number of patients with multiple diseases is expected to increase, making the patient and family the unit of nursing. More research is needed to design better family based intervention.

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