Background : In our previous study, we investigated the effect of various gargles in reducing oral bacteria. In the present study we investigated the effect of gargling with various gargles in reducing oral bacteria and Candida. Methods : Eighteen healthy volunteers participated in the following experiment. Eleven gargles were used : running water, 2 and 4 fold diluted and undiluted Listerine®, 2 and 4 fold diluted and undiluted cool-mint Listerine®, 30 fold diluted povidone-iodine, Hachi Azule®, 3 % H₂O₂, and 50 fold diluted Neostelin green®. A saliva specimen was harvested before and after gargling with 30 ml of each gargle and cultured, and the numbers of bacteria and Candida colonies that grew out were compared. Results : Oral bacteria were detected in all specimens before gargling and had decreased in 50-100% of the specimens after gargling. Candida were detected in 23-38% of the specimens before gargling, and had decreased in 40-100% of the specimens after gargling. The rates of decrease in oral bacteria and Candida were highest with undiluted Listerine® and 30 times diluted povidone-iodine. Conclusions : Gargling with the gargles were effective in decreasing oral bacteria and Candida. Undiluted Listerine®and 30 times diluted povidone-iodine had the highest efficacy.

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The purpose of this study was to examine and refine the possibility for use of a proposed outcome assessment scale for dementia care. Participants were 67 nursing students and nurses who provided dementia care and agreed to participate in the survey. The participants were asked to recall conditions of patients with dementia and complete applicable numbers according to the outcome assessment measures for dementia care. As a result, Cronbach alpha was 0.889 in reliability of the 27 items. Correlation coefficients among the item scores in the first and second outcome surveys were 0.662∼0.969. Satisfactory, reliability and validity were obtained. In outcome change, the most maintained outcome item was "greeting with the patient". Improvement was seen in "expression/smile of pleasure" and "grooming" while "bathing" was maintained. "Continuation of routine living" was worsened, and the minimum maintained outcome items were "presence and fulfillment of roles" and "financial management". No answer was frequently found in "satisfaction on service" and "willingness of continuing caregiving," thus we refined these items.

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Background and Purpose : Postoperative facial deformity and oral dysfunction may strongly and adversely affect the daily lives of oral cancer patients. We studied their posthospitalization influence on these patients and the problems these patients face. Materials and Methods : Subjects were 5-oral cancer outpatients experiencing postoperative facial deformity and oral dysfunction due to jaw resection whom we interviewed 5 to 16 months after hospital discharge based on questionnaires about their lives and problems. Answers in interviews were analyzed qualitatively and inductively using the K-J method. Results : We classified answers into physical, mental, lifestyle conditions, and medical staff support. Conclusions : Patients with disorders involving facial deformity and oral dysfunction acquired coping concepts and techniques to adapt to their conditions. Our results suggested that assistance in adapting to and coping with their roles was important and depended on the attention, listening, informed consent, and comfort in their relationships with medical staff.

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Aims : This study analyzed the ethical/moral dilemma of the nurse of colorectal cancer patient S who had lived without knowing that he may have a sudden change in condition or sudden death due to hyperkalemia using the MOLAL Model (P. Crisham, 1992) as a problem-solving tool as a focus group analysis. Case progress : Patient S is a 50-year-old male colorectal patient with metastasis in the liver. He had made decision-making on therapy plans from the first time of hospitalization. This time, hydronephrosis from metastasis lead to anuria causing hyperkalemia (K7.7), and his risk of sudden death was uninformed to patient S and informed only to his wife. Therapy plan was also uninformed to patient S and the plan was performed according to his wife's decision. Patient S had died 7 days after hospitalization, complaining to his physician, "why won't you do anything?" Result of MOLAL Model analysis : It was made clear that the nurse had a dilemma between two views toward the conscious patient ; "one should tell the truth that his condition might change suddenly and have him choose his therapy plan" and "it is cruel to tell the truth at such a time". If active dialysis therapy is chosen, the patient may not be able to bear the treatment itself physically or the pain may worsen. Informing the truth to the patient within a few days of hospitalization may rather disturb the patient's peace, and it is suggested that watching over is also an important role of nurses.

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Background and Aim : This study aimed to comprehend a building process of parental and familial cure life for a child of cancer survivor and to obtain a insights on nursing care. Subjects and Methods : Based on interviews with parents, we constructed the process and meaning of the lives of child who had survived cancer for at least five years and the livers of their families. Results : Parents fought together against the disease threatening their child to build neo lives, supported devotedly by grandparents. Parents thus involved noted own self-growth and created positive meanings from their cancer experience as an indispensable event in their lives. Conclusions : Appropriate nursing care supporting parental and family relationships and effective social support are important in ensuring a successful care for both children who survive cancer and their families.

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Background and Purpose : Nursing practices and techniques vary from one country to another reflecting their respective backgrounds. Technical books on nursing techniques published in Latin American countries and those published in Japan were compared to obtain information useful in effective international nursing cooperation, and the differences were clarified and their backgrounds analyzed. Subject and Method : Nursing techniques published in technical books in these countries and Japan were compared, and different techniques between these countries and Japan were extracted and analytically compared. Results : The items extracted included "bed bath," "blood pressure measurement," "intramuscular injection," etc. The technical books in these countries indicated a lower water temperature for bed baths than in Japan, different pressures in pressuring for blood pressure measurement and different methods such as in pushing the skin in intramuscular injection. The techniques described in the technical books of these countries included techniques used in Japan but modified as a result of practical research. Conclusion : Techniques found to be different from those in Japan reflect the local social backgrounds, culture, customs, and unaccounted-for backgrounds. These matters should be considered in implementing international nursing cooperation.

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Background and Aim : Gunma information system for perinatal medicine was established in April 2006. Since the establishment, we have been collecting data on maternal and neonatal emergency transports. The aim of this study is to analyze the data on neonatal emergency transports in Gunma prefecture. Method : We investigated clinical features of newborn infants transported from April 2006 through March 2007. The number of days when premature infants could not be received by the neonatal intensive care units in Gunma prefecture during the period was also reviewed. Results : Two hundred twenty-five newborn infants were transported. Their gestational ages were between 23 and 41 weeks and the birth weights were between 512 and 4,165 g. Seventy-four infants had respiratory distress and 72 infants had low birth weights. Fourteen infants were transported from other prefectures to Gunma prefecture and three infants were from Gunma prefecture to others. Infants with birth weights less than 1,000 g could not be received by neonatal intensive care units in Gunma prefecture in a total of 55 days during the investigated year. Conclusion : The information system for perinatal medicine have made possible to reveal problems on neonatal emergency transport in Gunma prefecture. It should be discussed how we elevate the collection rate of the data on transported infants, especially those who are transported from and to other prefectures.

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Purpose : The fatigue seen in many cancer cases is considered to be decrease quality of life. We clarified factors related to such fatigue and used out result to relieve fatigue. Subjects and Methods : We conducted a questionnaire using the Cancer Fatigue Scale (CFS) on 204 cancer outpatients at the A hospital. We studied 16 factors influencing fatigue and analyzed the relationships among these factors and CFS scores. Results : The mean of total fatigue scores was 23.0 points (standard deviation : 10.0). The fatigue is strong by higher than 19 points of the CFS scores. That frequency was 64.7%. The logistic regression analysis was conducted the influence factors of fatigue. Logistic regression analysis was conducted for items showing a significant difference Performance States (PS), loneliness, hormonal therapy, and radiation therapy. Conclusion : To reduce fatigue in outpatient cancer treatment, it was suggested to that importance to assess a related factor of fatigue.

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We clarified the construct of the suffering among the families of cancer patients based on domestic and overseas studies that had been announced up to now as original article. Referencing Walker's concept analysis, we extracted the concept of suffering by looking at the general uses of the word "suffering", suffering as viewed in psychology and studies on the suffering of families of cancer patients. We found that such, suffering consisted of two constructs unpleasant psychological pain and uncertainty about the future. Also it was considered that the precedent matters of the suffering of the families were "To understand the pain of the patients" and "To be put in a difficult situation where there was no prospect". As a result of the suffering, "Depression that made one staying indoors in oneself leading a decline in a sense of emotion and joy" and "Anger that easily raised negative feelings leading inability to maintain harmonious relations with others" was revealed. "Loss of a sense of control", "Loss", "Sense of guilt", "Incompetence" "Insensibility" and "Conflict" were also found as sub-concept of "Unpleasant psychological pain". Subconcept of "Uncertainty about the future", "Therapeutic effect, disease progressing and prognosis" "Family like style including that of patients themselves", "Life after a patient's death" and "Potential genetic predisposition to ward cancer among family members" were suggested. The clinical scenes tends to deal only empirically with family suffering as these effect family quality of life during medical treatment, so an appropriate assessment is needed to reduce suffering. This is turn makes necessary to clarify the process of suffering among the families during medical treatment and to construct of a nursing model.

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We report a female patient with dermatomyositis whose erythematous lesions were successfully treated with topical tacrolimus. In spite of the usually good response of muscle symptoms to systemic corticosteroid, the skin lesions of dermatomyositis often remain resistant to conventional therapy. The skin lesions of our patient were markedly improved after four weeks of topical application of tacrolimus. The clinical efficacy of tacrolimus has been described for other skin disorders, but tacrolimus ointment is also useful for treating the skin lesions of dermatomyositis.

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A 79-year-old man was referred to our hospital because of intractable pneumonia. Cefpirome was administered before the treatment in our hospital. Sputum cultures showed MRSA (methicillin-resistant Staphylococcus aureus) with neutrophil phagocytosis of bacteria. Vancomycin (VCM) was used, but his pneumonia was not improved, and moreover, respiratory condition worsened gradually. Intubation was needed and sputum culture still showed MRSA. Antibiotic agent was changed to Linezolid (LZD) because of failure of the treatment with VCM against MRSA pneumonia and liver dysfunction. Two weeks after the LZD treatment, consolidation on the chest roentgenogram was clear and respirator was not needed any more. Although blood transfusion was needed for his anemia (Hb 6.0mg/dl) on the 13th day of his LZD administration, other side effects were not revealed. LZD is a useful antibiotic agent against MRSA pneumonia even in the elderly. On the other hand, we have to be very careful when we select LZD, to prevent drug resistance.

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There wasn't an effective therapy to lymphatic edema, and there was the patient troubled with secondary lymphatic edema after cancer operation in a considerable number till now. We do Complex Decongestive Physiotherapy (CDP) into practice to the lymphatic edema patient passing chronically. CDP is a representative conservative treatment for lymph edema symptoms conducted by combination of various physical therapies. By this treatment, improvement of ADL with it was thought to be edematous improvement. Furthermore, we introduce two examples that we regain social participation by improvement of body image, and were able to bring improvement of QOL. With an application of manual lymph drainage by expert, we aim at it becoming possible for self-care control in elastic bandage as a compression treatment and practical use of elastic compression clothes, stage wrestling in exercise therapy more. When there becomes self-care continuously, with the avoidance of phlegmon repeating itself, we can maintain QOL with a family.

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