Purpose : The purposes are to determine current status and challenges of research concerning self evaluation of childbirth experience and to develop variables effective and useful in such research. Methods : The literature search was conducted with keywords of "childbirth experience", "self evaluation" and "scale" in CINAHL, MedLine and peer-reviewed medical journals. The articles searched were published between 1960 and 2001. Results : One hundred and thirty one articles were hit and 47 of which were selected and reviewed since they had description of self evaluation of childbirth experience and were well organized scientific papers. The gynecological, psychological and social variables affecting self evaluation were identified. Conclusion : The following challenges were identified in childbirth experience research ; 1. necessity to conduct studies using larger samples to compare evaluation of childbirth experience between those who had normal and abnormal deliveries, 2. necessity to conduct empirical research to identify the relationship between self evaluation of childbirth experience and postpartum psychological healthsuch as postpartum depression and feeling of self respect), and 3. necessity to conduct practical research concerning reconstruction and interpretation of childbirth experience.

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Purpose : The purpose of this study is to produce materials concerning anxiety for support of women receiving induced abortion and need for psychological care through questionnaire survey. Subjects and Method : The survey was conducted from September 2003 through January 2004 at 15 clinics and hospitals. It was the anonymous questionnaire to be filled in by the women surveyed. One hundred subjects who replied both before and after induced abortion were analyzed. The contents include anxiety for support, desire to be supported, support provided and feeling of self respect. Results : The women received less support from doctors and nurses when they had strong concern about response and stigma. The support determinants identified in the survey are "responsiveness concern", "stigma concern" and "woman's desire to be supported". Conclusion : It is necessary to reduce concerns about response and stigma and to enhance "woman's desire to be supported" in creating environment where women can easily receive supports by doctors and nurses.

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Background & Aims : The student nurse is required to acquire comprehensive knowledge of nursing with a strong motivation for learning. In this study, we tried to increase motivation for learning among the student nurse by the full and particular preannouncement of the exam questions in printed synopsis of lecture. Methods : The 1st year student nurses in the year 2004 (Men 12, Women 72) were included. We announced the exam questions in printed synopsis of lecture, and after exam, conducted a survey in the form of a questionnaire using Visual Analogue Scale about motivation for learning. Results : The questionnaire data established that the student nurse felt motivation for learning more strong in our lecture, than another lecture without preannouncement. The item "Hopes are raised to utilize the knowledge and learn in the clinical training" was extracted as one of the comment in student nurse, which freely expressed opinions of our lecture. Conclusions : We regard that the preannouncement of exam questions in printed synopsis of lecture is effective in increasing motivation for learning among the student nurse.

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Background and Aims : This study was to conducted identify the characteristics of difficult cases encountered by a care manager. Materials and Methods : Group interviews were taken of 16 care managers involved in care management at home care support offices in N prefecture. The questions were related to the situations, contexts and contents of difficult cases encountered by the care managers. The reported items were qualitatively analyzed. Results : Many of the care managers encountered difficulties in the stages of "planning" and "implementation" of the care management process. The contents in relation to difficult cases identified were "family coordination", "persuasion of service utilization", "chchallenges requiring professional interventions", etc, where time, specialized knowledge and appropriate collaborations of supporters were essential in care management. Conclusion : It is critical that the characteristics of difficult cases are recognized by care managers for improving the quality of care management under the long-term-care insurance system.

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A case of many kinds of tooth abnormalities with exposed odontomas was reported. The patient was a 14-year-old healthy Japanese boy. The abnormalities of teeth and those details are as follows :
1. morphologically deformed the first and second molars of both jaws and both sides with the decreased number of cusp and taurodontism,
2. over-retention of the first and second deciduous molars of the lower right side and that of the first deciduous molar of the lower left side and exposed odontomas fused with these three deciduous teeth,
3. morphologically deformed the first premolars of the both jaws of both sides,
4. microdontism of the upper second premolars of both sides and the lower second premolar of left side.
The cause is unknown, although hereditary factor is suspected.

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A 62-year-old man was administered pegylated interferon α-2a and ribavirin for chronic hepatitis C. He had come to our hospital for treatment of chronic hepatitis C and diabetic triopathy. After diet and insulin therapy blood glucose levels (HbA1c ; 6.0-6.8%, glycosylated Alb ; 18.5-20%) were adequately maintained for a year. However, AST and ALT levels ranged from 50 to 60 mU/ml by ursodeoxycholic acid and Stronger Neo-Minophagen C. Although liver function improved after interferon and ribavirin combination therapy, visual acuity decreased due to diabetic retinopathy deterioration. After the end of interferon and laser photocoagulation therapy, visual acuity improved.

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We successfully performed laparoscopy-assisted inguinal hernioplasty via an anterior approach under observing the hernia condition laparoscopically, for a case of recurrent inguinal hernia after mesh repair. We repaired the hernia by inserting another mesh plug into the hernia orifice without removing the placed mesh.
It was possible to recognize easily and accurately the hernia sac even for recurrent inguinal hernia after tension-free repair by using a laparoscope. Thus, we can perform a repair with a minimally invasive approach by inserting another mesh plug into the hernia orifice without performing unnecessary adhesiolysis in the inguinal canal. The patient has been no signs of recurrence 4 years after surgery.

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