Bbackground and Aim : We studied the relationship between profile of mood status (POMS) and Tokyo University Egography (TEG) in breast cancer patients a waiting surgery and their acceptance of the disease.
Patient and Methods : Ten preoperative breast cancer patients agreed to take our survey, conducted through 3 30-minute interviews pre and postoperatively and after discharge using commercially available POMS and TEG score sheets.
Results : Two classified as TEG-adapted child showed high scores pre- and postoperatively for POMS-anxiety, depression, and confusion. Both said in interviews that they did not want to see their mastectomy scars (post operatively) and that they were “all right” because their loss was concealed by their clothes (after discharge). These statements indicated a delay in their acceptance of mastectomy. Six others showed high scores either pre- or postoperatively for anxiety, depression, and confusion. Their average scores of show that their “tension-anxiety” score was higher before surgery than after (p < 0.08), as were their “vigor” scores (p<0.08).

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Aim : We studied training and support of Japanese non-governmental organizations (NGOs) in sending nurses to take part in international cooperation activities.
Methods : We identified 137 Japanese medical/health NGOs through NGO directories and sent them self-administered questionnaires. We asked the NGOs for information on nurses they dispatched from April 1989 to September 1998.
Results : Of these, 74 NGOs (53%) responded and 27 had dispatched nurses. The 20 that completed the questionnaire had dispatched 404 nurses ; 150 (37%) to Asia. Of the 18 NGOs with counterpart organizations, only 8 had contracts with dispatched nurses. Many NGOs did not have rules or regulations on vacation, health checkups, or security. Training centered on the NGOs and the countries to which nurses were sent. Technical support from senior nurses was available at only 4 NGOs.
Conclusion : NGOs training and support for nurses is inadequate. Unlike Governmental Organizations recruit volunteer nurses and train them before sending them abroad, most NGOs recruit experienced nurses with enough ability to work on their own, the outcome of international cooperation by NGOs thus depends mostly on the personal competence of individual nurses.

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Background and Aims : We studied the status of self-care education in gustatory changes associated with cancer chemotherapy.
Methods : A questionnaire was mailed to 1, 000 nurses in charge of wards at 500 hospitals in the nation wide, receiving replies from 634 (response : 63.0%). After excluding erroneous or incomplete questionnaires and replies that no patients met conditions, replies were analyzed using Berelson's B method.
Results : About 59% of nurses were educated in gustatory changes associated with chemotherapy in cancer patients. Self-care was most frequently taught by menus adjusted to gustatory changes, followed by monitoring for signs and symptoms and gargling to recover gustatory function. Gargles types varied, with Isodine, lemon water, and oral cryotherapy frequently used.
Conclusions : Meals suited to gustatory changes have been gradually established. Guidance in gustatory changes for patients and families is indispensable before chemotherapy. The efficacy of lemon water gargling is ambiguous, and more interventive research is necessary.

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Background & Aims : To access the present state of truth-telling of cancer diagnosis and cancer pain management at Takasaki National Hospital.
Methods : Physicians were polled by questionnaire.
Results : Twenty-five of 48 physicians responded, and the results were as follows : truth-telling of cancer diagnosis was done by 32% of the responding doctors. A “case by case” response was given by the other 68%, and the majority gave priority to the family's wishes. As for epinephrine medication into the heart and heart massage, the doctors who replied “not performed” were 88% and 72%, respectively. Concerning cancer pain, 92% of the doctors relied on the patient's complaint for its assessment. Mostly, the order of painkiller medication was first non-steroid anti-inflammatory drug (NSAID) and then soon on to morphine, with the use of pentazocine between the two. Forty-two percent of the physicians told their patients that they were being treated with morphine. The most common reasons for discontinuing morphine were “difficulty of intake” (34%) and “side effects” (32%), highlighting the importance of the management of side effects.
Conclusions : Education for the physicians before and after graduated university is important for the development of palliative care in the area kernel hospital.

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A 60-year-old man diagnosed with chronic active hepatitis with hepatitis C virus infection was treated with interferon (IFN)-alpha. A successful response was obtained with normalization of serum alanine aminotransferase (ALT) and the disappearance of serum hepatitis C virus-ribonucleic acid (HCV-RNA). Serum ALT remained within normal levels and serum HCV-RNA was not detected during observation. Six years later, the level of serum PIVKA-II increased and hepatocellular carcinoma (HCC) was detected by CT examination. Partial hepatectomy of segment 4 was performed following transcatheter arterial embolization. Histological examination of the surgical specimen showed moderately differentiated HCC, and chronic hepatitis, bridging fibrosis with mild activity of necro-inflammatory reaction. These results suggest that even patients with chronic hepatitis C infection who show complete response to interferon therapy should be followed up at 3 to 6 month intervals associated with examinations for serum tumor markers and ultrasonographic screening for the potential development of HCC.

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