Purpose : The aim was to verify the relation between renal failure (RF) and prognosis following surgery for ruptured abdominal aortic aneurysm (RAAA).
Methods : Among thirty-nine patients were diagnosed as having an RAAA and 33 patients received graft replacement. Perioperative factors were compared between non-survivors and survivors in patients receiving graft replacement.
Results : The mortality rate was 38% (15/39) in all patients and 27% (9/33) in patients receiving graft replacement. The preoperative serum creatinine (Cr) level was significantly (p<0.05) higher (2.3±0.5 vs 1.3±0.1 mg/dl) and systolic BP on arrival was significantly lower (71.7±5.3 vs 93.4±6.6 mmHg) in non-survivors than in survivors, respectively. There were significantly more patients with past cardiopulmonary resuscitation in non-survivors (4/9) than in survivors (1/24). The amount of intraoperative urine volume were significantly smaller in non-survivors (98±28 ml/hr) than in survivors (156±23). Postoperative renal failure which required hemodialysis was significantly more frequent in non-survivors (4/9) than in survivors (0/24).
Conclusions : RF was associated with the prognosis following surgery for RAAA. The level of preoperative Cr would be a predictive marker.

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Background and Aim : In recent years, several neonatal emergency patients born in Gunma prefecture have been transported out of the prefecture because of the lack of neonatal intensive care beds. The aim of this study was to elucidate the effects of long-distance transport on these patients.
Patients and Methods : Between January 1999 and December 2001, nine sick or premature neonates born in Gunma prefecture were transported out of the prefecture by an ambulance belonging to the Gunma Children's Medical Center. We studied the clinical features and outcomes of these patients.
Results : The diagnoses of the patients were as follows : six patients had a very low birth weight, two patients had congenital cardiac defects, and one patient had neonatal asphyxia. Between 40 minutes and 1 hour, 20 minutes were required to transport the patients a distance of between 47 and 105 km. Two patients died at one and two days of age. One of the seven patients who was discharged, an extremely low birth weight infant, suffered from severe neurological sequela from a massive parenchymal hemorrhage of the brain.
Conclusions : The poor outcomes of the patients in this study may be partially due to the long-distance transport of these patients. The number of neonatal intensive care beds in Gunma prefecture must be increased to avoid the necessity of transporting neonatal emergency patients.

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Background and Aims : The relation between nutrition and life-style related diseases was studied.
Materials and Methods : The nutritional intake of subjects in Gunma Prefecture was compared with that of the national average, and a correlation coefficient between nutritional intake and the mortality rate from various diseases was calculated.
Results : The intake of animal protein and meat in Gunma Prefecture is less than the national average, whereas salt intake is higher. A national survey in Japan has shown that the quantity of animal protein intake in each district depends on the fish and shell-fish intake, while the quantity of animal fat intake depends on meat intake. Within Gunma Prefecture, however, the amount of animal protein intake depended on meat intake, while the quantity of animal fat intake depended on the fish and shell-fish intake. In the national survey, districts with a higher meat intake had lower fish and shell-fish, salt and rice intake.
In the national survey, mortality from cerebrovascular diseases was related to a high salt intake. Within the Gunma Prefecture survey, however, mortality from cerebrovascular diseases was related to a low animal protein intake.

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Background : Radiofrequency ablation (RFA) has become a popular local treatment for hepatocellular carcinoma. We describe our experience using RFA and investigate its usefulness and potential complications. Materials and Methods : 117 tumor nodules found in 76 patients with less than three hepatocellular carcinoma nodules of less than 3 cm in diameter and in which complete coagulation was achieved were included in the study. Results : The mean observation period was 10.0±6.0 months. The rate of local and distant recurrences was 9.4% and 27.6%, respectively. Four patients died. The causes of death were 2 from hepatocellular carcinoma, 1 from liver failure, and 1 from cerebral hemorrhage. Complications included pain, fever, nausea, transient liver dysfunction, dyspnea, an elevation of biliary enzyme levels and pleural effusion. All complications were successfully treated using conservative therapy. Conclusion : Our results suggest that RFA is an effective and safe treatment for the local control of hepatocellular carcinoma.

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Background and Aim : Oxidative DNA stress is related to the development of various diseases. 8-Hydroxy-2'-deoxyguanosine (8-OHdG) is a product of oxidative DNA damage produced by specific enzymatic cleavage processes and is a popular marker for the evaluation of oxidative DNA damage. We investigated various factors influencing the excretion of 8-OHdG in the urine of 35 healthy volunteers.
Materials and Methods : Urine samples were collected from 35 healthy volunteers between the age of 20 and 34 (mean age, 22.2±3.0 years male : female ratio, 23:12) and stored at -80°C until analysis. The 8-OHdG levels were analyzed using a competitive ELISA kit. Multistage physical exercise was performed using a bicycle ergometer and continued until the subjects felt that the exercise was “very, very hard” (Borg Index 19).
Results : The mean level of urinary 8-OHdG corrected for the creatinine (Cr) concentration (μg/g Cr) was 12.0±3.5μg/g Cr (n=35). The mean level of 8-OHdG, corrected for subject weight (kg) and unit time (ng/kg/h), was 13.3±7.2 ng/kg/h. The mean levels of 8-OHdG (ng/kg/h) varied slightly with the sampling time. The mean level of 8-OHdG (ng/kg/h) at 9 : 00 tended to be higher than the levels at 12:00, 15:00, and 18:00 (not statistically different). The level of 8-OHdG (μg/g Cr) was not affected by the sampling time. No significant differences were observed between smokers and non-smokers or males and females. The mean level of 8-OHdG (μg/g Cr) after exercise was significantly elevated, compared with before exercise and the level during the recovery phase.
Conclusions : Multistage ergometer exercises caused oxidative DNA damage in healthy volunteers.

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Background and Aims : Although the former Hansen's disease patients won a law suit in 2001, few have sought psychological help. The present study examines the effect of life review, which has had positive effects on ordinary elderly in terms of life satisfaction and mood, to assess its usefulness on the psychological well-being of the former Hansen's disease patients.
Methods : Five former Hansen's disease patients volunteered to participate in the life review interviews with a clinical psychologist once a week for a month. Before and after the interviews, patients completed POMS (Profile of Mood States) questionnaires, which measured six factors related to mood, and the Life Satisfaction Scales, which focus on overall life satisfaction and psychological stability.
Results : POMS scores indicated that depression was high and vigor low for the former patients. However, tension-anxiety, anger-hate, and fatigue scores decreased. Life Satisfaction scores showed a decrease in overall life satisfaction while psychological stability varied for each participant.
Conclusions : These results suggest that a different psychological technique is needed to address problems of depression and vigor, and life review shows some utility in terms of mood improvement, but not for life satisfaction in general.

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Background and Aims : Although a growing number of Japanese nurses have participated in international cooperation programs, few studies have examined the experience and influence of nursing in foreign countries. We examined the effects of participating in international cooperation programs and its benefit to nursing care in Japan.
Subjects and Methods : Questionnaires were sent to 991 nurses belonging to the Japan Overseas Cooperation Volunteers (JOCV). 902 nurses received the questionnaires, because 89 nurses of no new address did not receive, and 397 nurses replied. The nurses were asked to describe, what they thought of their experience, what had impressed them, what they felt should be improved, and what they had learned. The descriptions were categorized and analyzed in terms of the nurses' adaptation to different cultures.
Results : The JOCV nurses acquired a transcultural viewpoint on nursing that helped them to improve their care-giving skills.
Conclusions : The experience of international cooperation improve the care-giving skills of nurses, in Japan.

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Background and Objectives : Student reports were qualitatively reviewed to determine what laboratory science students had learned during a clinical clerkship at a general medicine clinic. Subjects & Methods : Seventy-six 4th-year laboratory science students participated in a clinical clerkship at the Primary Care Unit of Gunma University Hospital between 2000 and 2001 (38 students in 2000, and 38 students in 2001). Each student observed medical interviews and physical examinations of outpatients performed by a primary care physician. The student was then asked to write a report on three topics : “case record/laboratory test plans”, “the roles of a medical laboratory technologist in future medical care”, and “the student's dream.” Three teaching staff members independently reviewed the 76 reports using a qualitative approach. Results : The mean scores for the case record/laboratory test plan reports were the same for the students in 2000 and the students in 2001. The score of the female students were 0.9 points higher than those of the males in 2001. A total of 13 items in 3 categories were identified in the reports as the roles of medical laboratory technologists in future medical care. The 5 most common items were “increasing contact with patients” (61% of students), “working outside the laboratory”(47%), “participating in team medical care”(42%), “providing value-added data”(37%), and “analyzing rapidly and precisely”(34%) in 2000, and “increasing contact with patients”(71%), “sampling and informing patients of laboratory tests”(66%), “working outside the laboratory”(50%), “participating in team medical care”(24%), and “providing value-added data”(18%) in 2001. Approximately 90% of the students in both years wished to become a medical laboratory technologist. The majority of the male students (60%) in 2000 wished to work in a research laboratory, while most female students (76%) wished to work in a hospital laboratory. Conclusions : The above results indicate that students learned the importance of “contact with patients”, “expanding occupational territories”, and “team medical care” for future medical laboratory technologists and that a clinical clerkship in a general medicine clinic is extremely effective for teaching medical communication skills to laboratory science students.

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Background and Aims : Although 80-90% of those who participate in Japan Overseas Cooperation Volunteers wish to participate again, a series of studies related to their return after coming back to Japan has not progressed very far. Accordingly, our objective in this study was to elucidate issues related to the nursing profession.
Methods : The subjects were 397 members of the nursing personnel who had returned from service in the Overseas Cooperation Volunteers. We divided the answers received to a mail-type questionnaire on “desire to participate again”, “reasons for desiring to participate again”, and “obstacles” into meaningful sentences and coded them. We then categorized them according to codes that were similar and analyzed them.
Results : Many of the subjects wanted to participate again (289, 72.8%), but only 14 (3.5%) reported the absence of any obstacles. The reasons for wanting to participate again and the obstacles were as follows. 1. The most common reason was self-fulfillment. 2. “Specialty” and “language study” were cited as both reasons and obstacles. 3. Obstacles consisted of personal issues : “family” and “self”.
Conclusions : Nurses wanted to participate again the same as members of other occupations, but the number of return participants is small, and characteristics of largely female occupations, i.e., personal issues such as “family” and “health”, emerged as obstacles.

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A high school client bore the role of a scapegoat through bad relationships between her sister and her mother, and lost her identity thereby, and finally developed anorexia. Her perfectionist and compulsive thinking may cause her symptoms. I had counseled her for 17 months once a month in a clinic. She also had medical treatments. As psychological tests, project methods were applied to the client not only to assess the client but also to treat the client, as “a tool for treatment” as following aims 1) to facilitate the client's decision making to establish her identity; 2) to help the clients' mother obviate the client's role as a scapegoat, and to change the relationships between the client and the family; and 3) to help herself recognize her own thinking patterns. The aims were achieved in disappearing anorexia, beginning to establish her identity, and changing the family relationship, and easing her perfectionist and compulsive thinking patterns thereby. In conclusion, project methods may be useful to use psychological tests, and may be afford to use as a tool for treatment.

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We report one case of empty follicle syndrome experienced at our hospital. Control ovarian hyperstimulation (COH) was used to induce ovulation, and in vitro fertilization was done. Oocytes were collected 24 hours after hCG 5000 units were injected intramuscularly. On collecting oocytes, more than 40 follicles were punctured in both ovaries, but only one growing follicle could be obtained. With the development of ART in recent years, various problems have surfaced. This empty follicle syndrome may be said to be one of them. There are many cases in which ova cannot be collected, leading to cancellation of the program. In order to reduce such cases, more careful examination of cases appears to be necessary.

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