Background & Aims : One of the roles of the nurse who comes into contact with a patient at the end of life is to attend to a person who, although living, faces imminent death. Purposeful touch is an example of an active support method. This means that the nurse's act of touching is intended to help the patient become more comfortable, even if only slightly, and has the objective of mentally and physically healing the patient. To date, no studies concerning how patients experience touch have been reported. The aim of the present study was to clarify the process of end-of-life cancer patients finding meaning in receiving touch intervention. Methods : The study participants comprised 12 end-of-life cancer patients who underwent touch intervention by nurses for 20 minutes, two or three times per week. A semi-structured interview was carried out following each intervention, and the results of the patients' responses were analyzed according to the modified grounded theory approach. Salivary secretory immunoglobulin A (s-IgA) concentration and a visual analogue scale (VAS) on comfort level were evaluated both before and after the series of planned interventions. Results : End-of-life cancer patients passively accepted touch intervention, and subsequently rated touch to have value. They were also given a boost of power to live in comfort, an emotion that occurs as a result of continuous touch intervention. Finally, they experienced a series of processes to surrender to touch. No significant differences were found in IgA concentration in saliva taken before and after the series of planned interventions. The VAS on comfort level after the series of interventions was significantly higher than that before the interventions. Conclusions : Continuous purposeful touch intervention may positively affect patients' psychological comfort. Furthermore, patients' intentions to allow themselves to undergo touch intervention by nurses might positively affect their will to survive.

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Background & Aims : A comparative study between plasma diagnostic markers and oxidative stress-induced biomarkers localized differently in the liver has not been reported in non-alcohol fatty liver (NAFLD) and non-alcoholic steatohepatitis (NASH). Methods : Pathological observations by Hematoxylin and Eosin (HE) staining and immunostaining by specific antibodies against metallothionein (MT)-1/2 and -3, heme oxygenase -1(HO-1), adiponectin using biopsy samples and plasma diagnostic makers were determined in 37 cases. Results : The MT-1/2, HO-1 and adiponectin levels were all significantly reduced in the liver with NASH compared with NAFLD and control. MT-1/2 was most strongly stained in hepatocytes in the normal and NAFLD liver, while it was significantly reduced in NASH. Adiponectin was stained significantly less at blood vessels in NASH compared with NAFLD and controls. HO-1 was also stained significantly less in the Kupffer cells in NASH compared with NAFLD and controls. MT-3 was stained similarly among the three groups at blood vessel cells. Those biomarkers trended negatively with plasma liver injury biomarkers. Conclusions : The significantly reduced expression of oxidative stress-induced biomarkers in NASH may be associated with the degree of pathological damage. In particular, MT-1/2 appears to exert an important effect in hepatocytes against stress-induced damage in NASH.

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Objective : Linear alkylbenzene sulfonate (LAS) has been found to be a specific inhibitor of bovine brain calcineurin (CN) activity ; however, the mechanism of this inhibition remains unclear. In this study, to characterize the inhibitory effects of LAS analogues, we employed an enzymatic inhibition assay of purified rat brain CN. Design : Using p- nitrophenylphosphate (p NPP) as a substrate, the inhibitory effect of LAS against rat brain CN was confirmed with an enzymatic reaction. Enzymatic kinetic analyses were also performed using this assay system. Results : Strong inhibitory effects were observed using C₁₂-LAS to C₁₄-LAS. The IC₅₀ values for C₁₂-LAS, C₁₃-LAS, and C₁₄-LAS were 13.5μM, 5.7μM, and 2.9μM, respectively. Using a double-reciprocal plot, C₁₂-LAS was determined to have noncompetitive inhibitory effects, and the inhibitory constant (K_I) was calculated to be 13.8μM. Conclusions : The LAS analogues containing twelve to fourteen carbons in the alkyl side chain exhibited strong inhibitory effects against rat brain CN. Inhibition by C₁₂-LAS was clearly noncompetitive, with estimated to be 13.8μM. It is well known that calcineurin is an intracellular target for immunosuppressant agents. The findings presented here provide justification for further studies aimed at investigating seed compounds as sources of novel immune-suppressing drugs.

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Introduction and Objectives : Surgical ligation for varicocele is performed for the management of male infertility and chronic scrotal pain. We reviewed the outcome of the operations in our hospital. Materials and Methods : We treated 51 varicocele cases by microsurgical subinguinal varicocelectomy from March 2004 to November 2013. Their median age was 32 and there were 2 bilateral cases. Twenty-six were male infertility cases and 25 were the cases with chronic scrotal pain. Results : All operations were performed for left side and right varicolele in bilateral cases disappeared after the surgery. The average operation duration was 86.1±21.9min mostly under local anesthesia. The number of testicular arteries preserved were one for 73%, two for 15.7% and three for 2% of cases, respectively. We couldn't find an artery in 9.8% of cases, but none experienced the testicular atrophy (ductus deferens artery was preserved in all cases). After the surgery, 87% of the patients with infertility showed improvements in semen analysis results and all the patients with chronic pain experienced pain relief. There was no severe complication accompanying the surgery. Conclusions : We conclude that microsurgical subinguinal varicocelectomy was an effective treatment modality for varicocele both in cases with infertility and those with varicocele-related chronic pain.

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Introduction : Mental rotation is the ability to mentally identify an object, which is presented in a rotated manner. Moreover, mental rotation of a body part is a simple method of measuring human capacity for motor imagery. Previous studies using functional magnetic resonance imaging have reported activity in the cerebral motor-related area when subjects view a photograph of a rotated hand. The purpose of this study is to examine the relationship between characteristics and mental rotation reaction time (MRT). Methods : The study was approved by the Institutional Review Board of Gunma University. One hundred and three undergraduate students (51male and 52 female, 20.9±2.2 years old) participated in the study. Eighty four of them were right-handed and 19 were left-handed. Fifty nine had the right dominant eye and 44 had the left dominant eye. Thirty two photographs of a hand rotated 0, 90, 180, and 270 degrees were randomly displayed on a screen. Subjects were asked to push a button when the hand indicated were presented, right or left. The subject's MRT and answer were recorded respectively. MRT were compared with different angles by one-way analysis of variance and in sex, the dominant eye and the dominant hand by unpaired t-test. The IBM SPSS Statistics 20 software was used for statistic analysis. The level of significance was set at 5%. Results : In MRT, there were significant differences in degree (180 versus 0, 90 and 270, p<0.05) and in dominant eye, although not in sex and a dominant hand (p<0.05). Discussion : The study suggested that MRT was clearly influenced by the dominant eye, not by sex and the dominant hand. In other words, information processing of the cerebral function related to the MR are different according to dominant eye.

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Objective : To clarify the perception of fatigue as expressed by Japanese cancer patients, and its characteristics. Method : An open-ended questionnaire survey was carried out with 400 Japanese cancer patients and analyzed qualitatively. Results : Out of a total of 237 codes the following four categories were extracted : physical sensation, mental sensation, cognitive sensation, sensation that cannot be expressed in words. Conclusions : A physical sensation was explained as "a sensation characterized by unpleasant sensations perceived physically, a decline in physical function and a loss of physical control", a mental sensation as "a sensation characterized by a decline in motivation and willpower and by a barrier to mental well-being", a cognitive sensation as "a sensation characterized by a decline in the powers of thought and concentration", and a sensation that cannot be expressed in words as "a sensation that is difficult to express in a way that another person can understand". The fatigue expressed by Japanese cancer patients can be explained as "a sensation characterized by the decline of functional status and the discomfort associated with lack of energy", and is consistent with prior research outside of the Japanese language area.

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Oral administration of multikinase inhibitor dasatinib showed significantly higher and faster rates of CCyR and MMR than imatinib in patients with newly diagnosed chronic myeloid leukemina (CML)-chronic phase (CP). The reactivation of hepatitis B virus (HBV) is a well-known complication for HBV carrier treated with cytotoxic or immunosuppressive agent. Although dasatinib may act as an immunosuppressive agent, it is unclear whether dasatinib induces the reactivation of HBV. Here, we report the combination therapy with dasatinib and entecavir in newly diagnosed CML-CP patient with HBV carrier. A 63-year-old man with HBV carrier newly diagnosed as CML-CP. HBV DNA levels in serum showed 2.4 log copies/ml. Before administration of dasatinib, the patient received 0.5mg of entecavir daily. Six days later, HBV DNA levels decreased less than 2.1 log copies/ml. Then, 100mg of dasatinib was administrated in combination with entecavir daily. Partial cytogenic response was achieved at day 90. At one year, major molecular response was achieved. Neither adversed events (AEs) of liver function nor evidence of reactivation of HBV was observed. Combination with entecavir and dasatinib is safe and effective therapy for newly diagnosed CML-CP with HBV carrier. Accumulation of such cases is necessary to optimize the treatment approach.

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Objective : We have examined students' class assessment reports of nursing techniques of postural change associated with conducting an international distance-learning program with Sri Lanka. Method : We have connected one university in Sri Lanka with our university in Japan through Skype and have implemented a series of three courses about postural change practice. Students wrote post-class assessments about courses as well as techniques. Results : The average course-evaluation reports score was more than four on a five-point scale excluding the domains "Compared to other overseas distance learning systems you have already experienced, the overall picture and sound from Japan were of similar quality," and "The words and voice of the instructor were clearly audible". Each course presented also differences of picture sharpness. The average post-class assessment score for all arrangements was more than two on a three-point scale. Conclusions : The results have revealed that the Skype-based distance-learning program with a developing country can promote interest on innovative techniques and effectively enhance student's satisfaction with classes. However, internet communication condition is not stable and it is difficult to provide classes with more stable sound and picture quality.

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