Objectives: The aim of this study was to examine the reliability and validity of the 18 items of the Dementia Elderly Odayaka Scale (DEOS) in elderly people with dementia who lived at home. Methods: Ninety-three elderly people with dementia who lived at home and utilized a home-visit nursing service were enrolled. Three evaluators (two nurses and one family caregiver per subject) evaluated each subject twice at an interval of about two weeks. Results: A clinical dementia rating of 2 or 3 was the most common (30% of enrolled patients). With respect to the intra-rater and inter-rater reliability, the average difference between the two scores ranged between 0.5 and 0.8 for each item. The intraclass correlation coefficient using the test-retest method was 0.9 (P< 0.01), while that of the total scores evaluated by the nurses and family members was 0.7-0.8 (P< 0.01). The overall Cronbach α coefficient for the 18-item DEOS was 0.95, while the coefficients for each area ranged from 0.86-0.91. Based on a factor analysis, the 18 items were classified into 3 domains: [Personhood], [Interactions with surroundings] and [Expression of emotions]. Conclusion: The reliability and validity of the 18 items of the DEOS were verified.

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Purpose: To evaluate a novel method to diagnose injury of the postero-oblique ligament (POL) complicating injury of the medial collateral ligament (MCL) of the knee and its treatment.
Methods: Five POL-injured patients with grade III MCL injury were enrolled. Injury of the POL was diagnosed by valgus stress radiography with an external rotational force applied to the leg at 30r knee flexion (VSRE) and arthroscopy.
Results: On VSRE, in the neutral position widening of the medial joint space of the knee compared to the intact side was seen in all patients. Arthroscopy also showed marked widening of the joint space at the MCL and posteriorly to it. Intraoperatively, instability on the posteromedial side of the knee remained following the repair of the MCL alone, but stability was obtained by repair of the POL. No instability of the knee was noted on VSRE even two years postoperatively, and the patients could return to their former sport activities.
Conclusions: VSRE was effective for diagnosing injury of the POL. If the POL-injury is detected using this screening test, repair of the POL as well as MCL would be considered necessary.

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Drinking hot spring water, which has a rich mineral content, is a form of balneotherapy. The water of Shioji-no-yu, a hot spring in Ueno-village (Gunma Prefecture) is rich in silica. Inhabitants consider that drinking the water contributes to health maintenance. We studied the effect of the drinking of hot spring water on the health-related parameters. The study analyzed the participants who drank hot spring water (drinking group, n=80) and those who did not (control group, n=31). The participants in drinking group drank 500 mL of water three times (between meals) a day for four weeks. We conducted a questionnaire survey on the health-related status and the gastrointestinal symptom rating scale before and after the 4-week intervention. There found to be significant improvements in hair loss and the smell of feces in drinking group. Drinking Shioji-no-yu hot spring water may therefore prevent hair loss and improve the smell of feces. Further studies are necessary.

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Background: Mammographic dense breast or high background parenchymal enhancement (BPE) in magnetic resonance imaging (MRI) hinders diagnostic accuracy for breast tumor detection. We retrospectively investigated relationship between BPE on MRI and mammographic densities along with the influential factors.
Methods: Our study included 144 Japanese women who underwent both mammography and breast MRI using a 3T unit. The subjects were classified into either mammographically dense group or fatty group, then further categorized into 4 subgroups by the degree of BPE (minimal, moderate, mild, marked) on enhanced MRI. As influential factors, their ages, menopausal status, and experience of lactation were statistically investigated.
Results: 73.8% of mammographically dense group showed minimal or mild BPE on the breast MRI. Women with minimal BPE in the mammographically dense group were significantly older than those with mild and marked BPE. In the mammographically fatty group, women with minimal BPE were significantly older than those with moderate BPE. Also, significant differences of BPE were shown between menopausal and premenopausal women in both mammographic groups, but experience of lactation did not influence BPE.
Conclusion: BPE on MRI is considered to be affected by age and menopausal status, not by breast-feeding experience, regardless of the mammographic density.

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Purpose: This study aims to clarify what thoughts assistant head nurses embraced at the time they newly took up their posts, and how they recognized their roles.
Methods: The participants were 37 nurses who had been appointed assistant head nurses. A self-administered questionnaire was used to investigate three research themes: "Thoughts upon assuming the post of assistant head nurse"; "Recognition of the role of the assistant head nurse at the time", and "Current issues".
Result: Five categories of thought upon assuming the post of assistant head nurses were identified: (1) anxiety over responsibility; (2) perceptions regarding the ability of being needed; (3) anxiety over evaluation to themselves; (4) reticence to taking up the post; (5) enthusiasm about the promotion. Five further categories were identified regarding recognition of the roles of an assistant head nurse at the time of assumption of office: (1) cooperation with head nurse; (2) approach towards the staff; (3) environmental organization; (4) being a role model; (5) operational regulation.
Conclusion: While the assistant head nurses were bewildered by aspects of the change of position such as "the anxiety of bearing responsibility", they recognized their role as a member of staff was to focus on improvement in the workplace such as "environmental organization".

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Background and Aim: Developments in computed tomography pulmonary angiography (CTPA) and magnetic resonance imaging (MRI) have decreased the number of pulmonary scintigraphy procedures. Our objective was to evaluate the current status of respiratory nuclear medicine (NM) in Asian countries.
Methods: A questionnaire survey was conducted on eleven Asian graduate students studying NM in Japan and thirteen Japanese NM specialists. Ten questions were asked on a printed questionnaire.
Results: Japanese NM specialists preferred a combination of CTPA and ventilation-perfusion scintigraphy (V/P scan), while Asian graduate students chose CTPA only. However, few Japanese NM specialists and Asian graduate students responded that V/P scan was routinely performed. Kr-81m was used for V/P scans by ten Japanese NM specialists, meanwhile, Tc-99m-diethylenetriaminepentaacetic acid (DTPA) was used in seven Asian graduate students' countries. All Japanese NM specialists performed V/P scans on pediatric patients, but only one Asian graduate student did pediatric V/P scans.
Conclusions: Few Asian countries performed V/P scans routinely, even though they believed that it was useful in patients suspected of pulmonary embolism (PE). The unavailability, high cost, and lack of knowledge of clinicians might be limiting the popularity of V/P scans.

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