Background The differences in gastric cancer between East and West have been frequently discussed. However, there are few studies that have compared Japan and China in Asia.
Methods Patient characteristics, surgical procedures and pathologic information were compared among gastric cancer patients who underwent curative-intent gastrectomy at two large volume cancer centers in China and Japan.
Results The median age of Japanese patients is 70 years, seven years older than those in China, and more than 25% of Japanese patients were older than 75. In China, the tumor was thicker, and lymph node metastasis was frequently observed. Total gastrectomy was more common in China (35.6% vs 21.9%). Distal gastrectomy rate was 56.0 percent in Japan, compared to 42.2 percent in China. The proportion of patients undergoing proximal gastrectomy was almost equal in China and Japan. Further analysis of the characteristics of patients undergoing total gastrectomy revealed that in China, more advanced gastric cancer patients with larger tumors and more lymph node metastasis underwent total gastrectomy, while in Japan, more early stage gastric cancer patients underwent total gastrectomy.
Conclusion There are some differences in gastric cancer between Japan and China. China needs to learn from Japan by establishing some screening programs for the diagnosis and treatment of early gastric cancer.
Background The present study aimed to determine whether total laparoscopic hysterectomy (TLH) is being implemented safely and appropriately compared with abdominal total hysterectomy (ATH) in our hospital.
Methods We retrospectively reviewed clinical records of 102 patients who underwent total hysterectomy for benign gynecological disease at Japanese Red Cross Yamaguchi Hospital from January 2017 to August 2018. We examined periods of hospital stay, operation time, blood loss, weight of the uterus, frequency of perioperative complications, and the duration from the first visit to the date of surgery. P < 0.05 was considered to be statistically significant indicated statistical significance.
Results TLH and ATH were performed in 55 (53%) and 47 (46%) cases, respectively. The TLH group had significantly longer total operation time [133 (82–205) min vs. 87 (57–155) min, P < 0.0001], lesser blood loss [5 (5–35) g vs. 100 (10–820) g, P < 0.0001], shorter hospital stay [7 (5–14) days vs. 10 (9–26) days, P < 0.0001], and lighter uterine weight [206 (27–658) g vs. 554 (79–2284) g, P < 0.0001] than the ATH group. The frequency of perioperative complications did not differ between the two groups (3.5% vs. 8.0%, P = 0.4103).
Conclusion TLH had a longer operation time and a lesser excised uterine weight, but it had less intraoperative blood loss, shorter hospital stay, and no difference in perioperative complication frequency when compared with ATH.
Background There will probably be an exponential increase in the number of seniors suffering from dementia, as aging is the greatest risk factor for this disease. Therefore, neuropsychological tests to assessing dementia are likely to play an increasingly important role for medical services in Japan. This study developed and evaluated the usefulness of a training program on neuropsychological tests aimed at promoting the understanding of testers with regard to the cognitive functions and communication required in the neuropsychological testing process.
Methods The subjects of this study comprised 20 individuals engaged in administrating neuropsychological tests at the Japan-Multidomain Intervention Trial for Prevention of Dementia in Older Adults with Diabetes. A four-hour training session was held. The first part of the training program focused on “cognitive functions and communication;” the second addressed “neuropsychological tests.” As the main evaluation criteria, a fidelity checklist was created with 14 items designed to measure success or failure with regard to important and easily mistakable aspects of implementing each neuropsychological test. They were conducted three times: before, immediately after, and six months after the training.
Results The main effect of time was significant for the “fidelity” score. The effect size was large at η2 = 0.69. A simple main effect test using the Bonferroni method revealed significant differences between the pre-training and post-training values and between the pre-training and six-month point values. However, no significant differences were found in self-efficacy scores before, immediately after, and six months after the training.
Conclusion This outcome indicates that the fidelity of the subjects to neuropsychological tests increased as a result of the training program, and that this improvement was maintained through the six-month period following the program. Moreover, the large effect size suggests that the training program may be effective in facilitating the mastery of neuropsychological tests in testers.
Background Hemodialysis treatment and the high stress brought about by the treatment are the circumstances which set the background for alexithymia. Alexithymic feelings basically emerge as restriction in the world of emotion and thought, and the inability to recognize physiological changes. Biomarkers that are indicators of physical change are influential in the stress lives of individuals. This research was carried out to discover the relationships between, and to determine the influence of urea, creatinine, sodium, potassium, hemoglobin, hematocrit, albumin, calcium, phosphorus and C-reactive protein biomarkers on stress and alexithymia in individuals, who are diagnosed with chronic renal failure and receive hemodialysis treatment.
Methods The research environment was formed of patients who underwent hemodialysis treatment in a hospital in Turkey. The subject group was comprised of 72 individuals. Demographic data form, biomarker list form, Hemodialysis Stressor Scale and Toronto Alexithymia Scale were used in the research.
Results It was found that the levels of perceived stress of individuals who participated in the research were high at all dimensions, and 59.7% were alexithymic. The means of the total scale scores of all patients were calculated as 87.81 ± 13.59 for Hemodialysis Stressor Scale and 62.46 ± 9.84 for Toronto Alexithymia Scale. The relationship between the Toronto Alexithymia Scale and Hemodialysis Stressor Scale and selected biomarkers were determined (P < 0.05).
Conclusion It was concluded that stress and alexithymic feelings were high in patients who received hemodialysis treatment, and that there is a relationship between C-reactive protein, creatinine, sodium, hemoglobin, hematocrit, potassium from the biomarkers and the scales and scale sub-dimensions. It is necessary to increase the awareness of nurses on the importance of the skills to communicate with individuals who have to cope with stress, manage emotions, and have high stress and emotional deprivation.
Background We examined factors influencing psychiatric nurses’ job satisfaction levels focusing on their frequency of experiencing negative emotions toward patients and support at their workplaces.
Methods An anonymous, self-administered questionnaire survey was conducted involving 1,097 psychiatric nurses working at 13 psychiatric hospitals in the Chugoku area to investigate their basic attributes, work-related factors, and scores from 3 scales: the Negative Feeling toward Patient Frequency scale, an original support-in-workplace scale, and the new Brief Job Stress Questionnaire (job stress and satisfaction). Correlations between basic attributes/work-related factors and scores from each scale, and the relationships among the study items were analyzed. Furthermore, logistic regression analysis was performed using the job satisfaction level.
Results The subjects were the 577 psychiatric nurses who returned valid responses without missing data (response rate: 60.4%, valid responses: 87.0%). The subjects were the 577 psychiatric nurses who returned valid responses without missing data (response rate: 60.4%, valid responses: 87.0%). To clarify the level of influence on the job satisfaction level of each variable, logistic regression analysis was performed adopting the stepwise method for all of the items that were correlated with the job satisfaction level as a dependent variable. Support (from supervisors) at the workplace (OR: 1.069), job stress (OR: 0.751), Negative Feeling toward Patient Frequency-Total scale scores (OR: 0.980) were found to influence the job satisfaction level.
Conclusion Support from supervisors may be indispensable, and working environments that reduce job stress and negative emotions toward patients may be required to increase the job satisfaction levels of psychiatric nurses. This survey suggested that the establishment and maintenance of favorable working environments and interpersonal relationships increase job satisfaction levels while reducing stress, thereby improving job retention among psychiatric nurses.
We report a rare case of a high-grade glioma masquerading as a small subcortical hemorrhage. A 71-year-old woman came to a local hospital with sudden right upper extremity numbness. Computed tomography revealed a small subcortical hemorrhage with faint perifocal edema in the left postcentral gyrus. Conservative treatment was initiated, and she was discharged from the hospital with no neurological deficits. Six months later after discharge, she suffered an acute partial seizure of the right upper extremity. Magnetic resonance imaging with gadolinium demonstrated a ring-enhancing mass surrounded by severe perifocal edema in the hemorrhagic scar. We performed complete resection of the tumor, and the histological diagnosis was anaplastic oligodendroglioma. The diagnosis of a high-grade glioma was delayed due to intratumoral hemorrhages mimicking a small subcortical hemorrhage; consequently, we suspected the hemorrhage was induced by cerebral amyloid angiopathy. It may be important to repeat radiological follow up, if necessary, and to maintain clinical observance of possible intracranial neoplasm, even when the hemorrhage is small, particularly when the cause of bleeding is unknown.