It has been 20 years since patient safety in Japan was put in place after a patient mix-up accident at a university hospital in 1999. Based on the formulation of patient safety policies, system development and patient safety activities have been carried out at medical sites across the country. However, despite such on-site efforts, medical accidents continue. In 2016, several serious medical incidents occurred at special function hospitals, and in response to this outbreak, the requirements for patient safety systems at advanced treatment hospitals were significantly revised. This paper reports on the impact and prospects of patient safety, and the “Promotion of patient safety” for medical professionals, patients, and medical students through patient safety education.

The objective of this study was to assess the intrafollicular milieus across different follicle sizes and the associated outcomes of oocyte retrieval. Serum levels of estradiol and progesterone were measured on the day of oocyte retrieval in patients who underwent in vitro fertilization. Gene expression of Kiss-1, GnRH, PACAP, and their corresponding receptors within the cellular components obtained from follicles of different sizes were determined. Larger follicles contained higher levels of sex steroids compared with those in small follicles. The oocyte retrieval rate from the two different follicle sizes were identical. Intrafollicular sex steroid levels were not associated with the success of oocyte retrieval. Expression levels of Kiss-1, GnRH, and their receptor genes as well as PACAP gene expression in follicular cells of different sizes were identical, but gene expression of PACAP receptor was significantly lower in the cellular component of large compared with that of small follicles.

Drug delivery systems, drugs are administered into the amniotic fluid, may contribute to fetal therapy. The present study explored changes in the volume of amniotic fluid from E11.5 through E17.5, and kinetics of calcein-containing liposomal particles incubated in the amniotic fluid collected at E12.5, E14.5, and E16.5 in Jcl/ICR mice. The volume of amniotic fluid increased until E15.5, followed by a sharp decrease at E17.5. The calcein release rate remained within 4% until day 14 in serum and each amniotic fluid. No significant differences were noted in the release rate between the serum and amniotic fluid at various time points. Therefore, the calcein release rate of liposomal nanoparticles in the amniotic fluid remained low and did not differ from that in the serum for as long as 14 days at different time points during gestation. These observations suggest that liposomal nanoparticles remain stable for prolonged periods in the amniotic fluid.