Background & Aims: Ventricular arrhythmias, including premature ventricular contraction (PVC) and ventricular tachycardia (VT), are commonly observed in pediatric patients. Radiofrequency catheter ablation (RFCA) has come to be recognized as the first-line therapy for ventricular arrhythmias in adult patients. However, indications for the RFCA of pediatric ventricular arrhythmias remain controversial. The aim of this study was to elucidate the outcomes of catheter ablation for pediatric ventricular arrhythmias. Methods: Twenty-nine consecutive pediatric patients (age, 2-15 years; 12 male and 17 female) who underwent RFCA for ventricular arrhythmia at Gunma Prefectural Cardiovascular Center between March 2006 and December 2014 were included in this study. Detailed patient medical histories were reviewed from the medical records provided. Results: The success rate of primary RFCA was 83% (24 of 29), with an overall success rate of 93% (27 of 29) including secondary ablations. No major complications, such as cardiac tamponade or atrioventricular block, were noted. The outcomes observed were comparable to those previously established in adult patients. Conclusions: RFCA for pediatric ventricular arrhythmias exhibited a good success rate and few complications. RFCA could be a viable therapeutic option for pediatric ventricular arrhythmias, even in cases of frequent PVC.

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Background and aims: Malnutrition is common in hemodialysis (HD) patients, which is known to reduce their health-related quality of life (QOL). Potential barriers to adequate nutrition can affect a patient's nutritional status, although whether they also affect the patient's QOL remains unclear. This study investigated the associations between several potential barriers and QOL among HD patients. Methods: This cross-sectional study included 36 Japanese patients receiving HD for ≥3 months. The patients completed structured questionnaires regarding any potential barriers to adequate nutrition. Clinical parameters were evaluated during monthly check-ups. Results: The presence of ≥1 potential barrier significantly associated with decreased scores in the effect of kidney disease, burden of kidney disease, cognitive function, quality of social interaction, and mental health subscales in the Kidney Disease Quality of Life Short Form. Poor knowledge was the most common potential barrier to adequate nutrition. However, difficulty chewing was significantly associated with the greatest number of decreased QOL subscale scores, even after adjustment for age, suggesting that this barrier has the greatest direct effect on QOL. Conclusions: The presence of ≥1 potential barrier significantly associated with reduced QOL, indicating the importance of evaluating potential barriers to adequate nutrition. Further study is necessary to investigate the possibility that assessment and managing potential barriers improve QOL of patients receiving HD.

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Background & Aims: This study aimed to evaluate the diagnostic performance and features of a computer-assisted diagnostic system. BONENAVI versions 1 (BN1) and 2 (BN2) were used to detect lesions on bone scintigraphy.
Methods: Bone scintigraphy of 33 prostate cancer and 27 breast cancer patients with bone metastases was evaluated. Spots detected and analyzed by BN1 and BN2 were compared with those of manual analyses by nuclear medicine physicians.
Results: The sensitivity of BN1 and BN2 was 99.2% and 97.0% for prostate cancer and 96.8% and 95.0% for breast cancer, respectively. The specificity was 64.7% and 68.0% for prostate cancer and 65.3% and 75.8% for breast cancer, respectively. Positive predictive values tended to be higher for BN2, and negative predictive values tended to be higher for BN1. BN2 showed fewer false positive spots. BN2 was superior to BN1 for detection of physiological uptake in the head and pelvis in breast cancer and in the cervical/lumbar spine in both breast and prostate cancer.
Conclusions: BN2 showed better diagnostic performance than BN1. Understanding the characteristics of lesion detection using each version of BONENAVI may be useful when evaluating new lesions on bone scintigraphy.

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Background & Aims: Normal values for Sharp's angle (SA) and the center-edge angle (CEA) in Japanese are unestablished. We examined these radiographic parameters to identify their correlation with gender, age and spino-pelvic alignment and particularly the prevalence of acetabular dysplasia in healthy adults (middle-aged or older) in Japan. Methods: In 639 members of the general population in a mountain village in Japan, the SA and CEA were measured. Correlations with gender, age and the sacro-femoral-pubic angle (SFPA) were investigated. Results: A total of 562 subjects (mean age 65.7 years; range, 40-90 years) met the study criteria. The mean SA and CEA on both sides in women were larger and smaller than in men, respectively. An association was found between the SA and age in both genders. Acetabular dysplasia, based on the SA and/or CEA, was more prevalent in women than in men and on the right side than on the left. The SFPA was associated with age and the SA in both genders but almost never with CEA. Conclusions: There were gender-associated and right-left differences in the prevalence of acetabular dysplasia. The degree of pelvic retroversion was associated with age but almost never with the CEA.

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Background & Aims: The purpose of this study was to investigate changes in facial morphology after partial maxillectomy and recovery after dento-maxillary prosthesis placement. Methods: For facial morphology measurements, the non-contact 3-dimensional (3D) digitiser and the analytical software were used for 21 patients with defects classified into Class I or II of the Aramany classification. Results: It was quantitatively demonstrated that facial deformities resulting from partial maxillectomy were due to concavities from the subnasal point to the mentolabial groove in the vertical range, and from the region around the nasal alar to the anterior cheek in the lateral range. Facial features anterolaterally expanded on the defected side in volume with the prosthesis. Facial disfigurement extended to the lower face, and improvement of these deformities was also observed with the prosthesis. Using the non-contact 3D digitiser, the direction and amount of movement of the facial components within the mid- and the lower face regions were 3-dimensionally determined, enabling rapid and accurate identification of facial deformities, and recovery of the facial morphology with prosthesis. Conclusion: This is the first study to analyse of prosthesis-induced changes in facial morphology after partial maxillectomy with a non-contact 3D digitiser.

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Background and Objectives: In Japan, local governments are required to construct community-based integrated care systems. This study investigated the distribution of home-based medical care and nursing home care facilities in a single municipality and examined the relationship between this distribution and the cooperation among residents in the region.
Methods: We evaluated the distribution of home-based medical care facilities and nursing home care facilities by district in Shibukawa City, Gunma Prefecture, Japan, using geographic information system techniques. We assessed data publically available from local governments.
Results: 84% of districts had both home-based medical care facilities and nursing home care facilities. 16% of districts lacked one or both of these facilities. We suspect a background of aging and depopulation in districts lacking one or both types of facilities. According to responses to the survey by Shibukawa City on the elderly, in districts lacking either home-based medical care facilities or nursing home care facilities or both, a high percentage of residents reported cooperation among residents. This suggested that cooperation among residents was an important local resource.
Conclusion: Most areas had both home-based medical care facilities and nursing home care facilities. Cooperation among residents was seen more frequently in districts lacking one or both of these facilities were not available. These findings are potential references when constructing community-based integrated care systems.

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Purpose: The aim of this study was to examine current research activities and needs of graduates of the Graduate School of Health Sciences to determine an applicable support system for education and research.
Methods: A questionnaire survey was distributed to 282 persons who graduated from the Graduate School of Health Sciences master's course by September 2012.
Results: A total of 183 responses were collected (the response rate was 64.9%). Results revealed that many graduates worked actively in their workplace using the knowledge and skills they learned in graduate courses; however, they also found it difficult to conduct research or practice after graduation and hoped to get support from their workplace or the university.
Conclusions: To promote an education and research support system in accordance with graduates' needs, and to assist in the establishment of a graduate network system will be helpful for their activities, strengthening the development of human resources in community health settings.

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Objective: Hospital nursing staffs are required to engage in community-based integrated nursing practice as the Japanese government promotes "aging-in-place" strategies and the construction of community-based integrated care systems. The aim of this study was to clarify the current situation regarding recognition of the Community-based nursing practice supervisor training program (extension program), and the Community-based nursing leader training course (graduate program) among university hospital nursing staffs.
Methods: An anonymous, self-administered questionnaire survey was conducted with 751 nursing staffs at A-University Hospital.
Results: A total of 674 questionnaires were returned (89.7% response rate), with 667 questionnaires analyzed (98.9% valid response rate). Altogether, 305 respondents (45.7%) knew the extension program and 395 respondents (59.2%) knew the graduate course, while 149 respondents (22.3%) were interested in or considering enrolling in the extension program, and 119 respondents (17.8%) in the graduate course. The main reason for hesitation was uncertainty about managing both work and study. A total of 231 respondents (34.6%) knew about "the Home Care Mind Concept".
Conclusion: The study suggested that knowledge dissemination activities using the cooperation system of the university hospital nursing department and the university for development of community-based integrated nursing personnel could raise motivation for enrolling in recurrent education programs.

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We report a 5-year-old boy who presented excessive height velocity and penis enlargement, diagnosed with Leydig cell tumor. On initial presentation, height was 128.0 cm (+4.95 SD), weight was 26.7 kg (+3.6 SD), and bone age was 9 years 7 months. Tanner stage was G III P I, with a 6 ml testis on the right, 4 ml testis on the left, and 9 cm penis. Investigations revealed elevated testosterone (3.40 ng/ml), and suppressed gonadotropins (LH<0.10 IU/ml, FSH<0.20 IU/ml). From these results, we diagnosed gonadotropin-independent precocious puberty. The ultrasonography and MRI scan showed a mass in the right testis. High orchiectomy was performed, and the mass was diagnosed with Leydig cell tumor histologically. After surgery, height velocity slowed down and testosterone values decreased to the undetectable level.

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