In 2004, we introduced the electronic medical record system that included the cutting-edge applications. However, there existed two major problems to solve in replacing the system in 2009; one was an absolute improvement of the system performance, the other was to offer the chronological and intuitive image of a patient's medical information. The former has been achieved by introducing the 64 bit Linux servers, and two-layer client/server connection, along with high specification PC clients. The latter has been achieved by developing the new applications which are designated as the Medical Viewer and Medical Explorer. We have also developed and introduced the cutting-edge tools (e.g. the prescription knowledge tool, the USB memory authentication and management system). When considering the future prospects, greater efforts should be made to develop the cutting-edge tools for supporting clinical decision making and also to provide precise data for the administrative management.

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　The purpose of this study was to reveal the process, how the families are supporting the employment of the disabled with higher brain dysfunction in adolescents.
Methods: The survey was conducted by a semi-structured interview, and following an interview guide, the interviewees were asked to talk freely. The research was performed by a semistructured interview. The interview was performed one to two times, and the interview time was approximately 60 minutes per person.
Results: The research partnership was the mother of the family 11.The process of family support for the employment [Parents are a guide] was the underlying core topic and nine categories were extracted. Nine categories were [Parents recognize their children's disability] [Treating their disabled family members with the help of surrounding people] [Take a strong stance.] [Ask to understand the condition of his disability]. [Inspiring him to try repeatedly] [watching without forcing him] [protecting him against deception] and [ind a place for him]
Conclusion: The families’ support process to [Find a place] and [Involving surrounding people] for them who tended to seclude themselves from society also was clarified.
　Has been suggested that nurses need to [Involving surrounding people] that support for families.

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Background; Magnetic resonance urography (MRU) is a new technique using heavily weighted T2 images. The present study described the clinical usefulness of MRU.
Patients and Methods; Twenty-seven patients with urinary tract obstruction and 2 patients without obstruction underwent MRU. The urogram was reconstracted by means of maximum intensity projection method and multiplanar reformation method. As imaging examinations, intravenous urography (IVU) and retrograde pyelography (RP) were conducted in 22 and 11 patients, respectively. The quality of the images was subjectively classified into4grades (grade 0 to 3).
Results; In the comparison of IVU to MRU, 9 patients whose urinary tracts were not identifiable or slightly identifiable (grade 0 or 1) by IVU showed grade 2.5 in the average in MRU. The average grade obtained by MRU was 2.6 in the patients whose urinary tracts were not clearly shown by RP.
Conclusions; MRU provides an alternative to conventional imagings of urinary tract, especially in the cases in which only poor images are obtained by IVU. Although MRU cannot completely replace RP, it is useful to identify the location of the urinary tract disease, which is unidentifiable by RP.

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[in Japanese]

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　Writer's cramp is a writing specific movement disorder with hand muscle cramps when writing. It is classified as a focal dystonia. Treatments for the disease include medication and botulinum injection. However, there are some cases resistant to these non-surgical treatments. As surgical treatments, thalamotomy and deep brain stimulation have been used. In this study, we performed thalamotomy on two cases of writer's cramp. Both patients were completely cured following surgery. We introduce the surgical cases and summarize the treatments for writer's cramp with special emphasis on neurosurgical treatments.

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Background: The purpose of this study was to determine the application of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley−III) for Japanese infants.
Methods: Forty−two infants aged 12−month−olds and eighty−one infants aged 36−month−olds were assessed using the Bayley−III, BSID−II and Tsumori Test.
Results: Among Japanese 12−month−olds, the Bayley language score was lower than the United States norms. Among 36−month−olds, the fine motor score was higher than US controls. Bayley−III mean scores were approximately 6 to 11 points higher than those of BSID−II. There were strong correlations between BSID−II and Bayley−III. There are no problem in translation and the instructions of Bayley−III.
Conclusions: This study suggests the Bayley−III is available for evaluation method of development in 12−month−olds and 36−months−olds Japanese infants.

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　The purpose of this study was to examine the effectiveness of a depression prevention program for nursing students. The study design was a nonequivalent, three-group before-and-after test. The subjects were 34 randomly selected first to third year nursing students who consented to participate in the study, separated into a control group (first year students), intervention group (second year students), and conventional group (third year students). A Center for Epidemiologic Studies Depression Scale (CES−D) was used for an outcome indicator, and the Sense of Coherence scale (SOC−13) and the Spirituality Rating Scale (SRS−A) were used as covariates. The results of a multiple regression analysis with CES−D as a dependent variable conducted before the program was implemented showed that SOC−13 and SRS−A were inhibitory factors (R2=.54, p<.001, n=102). A comparison of mean CES−D values before and after the program showed a significant decrease in the intervention group only (95%CI=－.87～－5.1,p=.007). The results of an analysis of covariance and multiple comparison test with CES−D as the dependent variable conducted after the program showed that the intervention group was significantly lower than the other two groups(intervention group < conventional group: 95%CI=－7.41～－.81, p=.009) (intervention group < control group: 95%CI=－7.54～－.97, p=.006). The effect of this program in inhibiting depression was confirmed from the above.

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　We have performed limb-salvage procedures with Pasteur-treatment in two cases of femoral osteosarcoma (Case 1: 15-year-old male; Case 2: 21-year-old male). The tumor was removed at curative wide margin (Case 1), or marginal margin (Case 2). After the Pasteur−treatment (60℃−30 min or 70℃−15 min) for the local bone, we returned it back where it was, and reconstructed the femoral bone. These patients have completely cured without recurrence or metastasis.

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[in Japanese]

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　A joint meeting for international collaborative studies on social determinants of health and policy implications was held in Kyoto on October 15, 2011. The collaborative meetings have been periodically held since late 1990’s. Researchers from Britain (the Whitehall II study), Finland (the Helsinki Health Study), and Japan (the Japanese civil servant study) shared findings from our previous studies and discussed future directions of the international collaborative study. Researchers from Japan reported that there were health inequalities among socioeconomic status groups and such social inequalities in health were explained by work stress, workfamily conflicts and job satisfaction. Researcher from Britain reported that there were the links between early life factors and adult health inequalities from research findings on life course epidemiology. Researchers from Finland reported as to how health inequalities among occupations are generated. The similarities and differences in the above findings and their potential reasons were discussed. Researchers reached agreements on the future research topics in the international comparisons, and concluded that our international comparative studies provide more useful evidence for further understanding of social determinants of health.

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