Objective: We investigated the incidence of side effects related to contrast medium employed in our hospital based on monitoring materials to improve the safety of contrast-enhanced examinations.  Furthermore, we compared the incidence of side effects between the original product and generic drugs to confirm the safety of each preparation.
Methods: The survey period was from April 2007 until March 2011.  Based on the number of patients who underwent contrast-enhanced examinations and that of patients with side effects, we calculated the incidence of side effects in our hospital, and confirmed its annual changes.  Subsequently, we again collected the incidence of side effects per each manufacturer’s preparation employed, and confirmed the state of side effects of individual preparations.  Furthermore, we evaluated the symptoms as side effects, interval until appearance, and treatment for side effects during the data collection period, as well as the subsequent state, symptoms as side effects, and interval until appearance.  The chi square independence test was employed to compare the results among groups.  p<0.05 was regarded as significant (paired test).
Results: There were no changes in the annual incidence of side effects.  There were also no significant differences in the annual incidence of side effects among the preparations.  Furthermore, there were no marked differences in the symptoms, interval until appearance, treatment for side effects, or subsequent state among the preparations.
Conclusion: We investigated the appearance of side effects regarding contrast-enhanced examinations for 4 years.  We confirmed that there were no differences in the incidence of side effects among the preparations.

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乳がん術後女性のブラジャーと補整パッドの不具合解決にむけた指針を得ることを目的に研究を行った．被験者は，胸部形状に左右差のある乳がん術後女性12名（右全摘4名，左全摘4名，温存4名）である．実験1では適合したブラジャー(My ブラ)と補整パッド(My パッド)を，実験2ではMy ブラに同一型で重量の異なる補整パッド（トライアングル型シリコンパッド）6 種を試料とした． 実験1：全摘の被験者は，肩がこる，左右のバランスが気になる，全体的な圧迫感があると，半数以上が訴えた．パッドを装着しない時の重心は，多くの事例で術側にあったが，パッドを装着すると健側方向に変位した．実験2：全体の衣服圧はパッドの重量増加で高くなったが，特に術側の衣服圧が増加した．また，被験者はパッドが重いと感じ，肩がこる，全体の圧迫感がある，左右のバランスが気になるとした．術側の負担を軽減するためには，被験者ごとに補整パッドの重さを再検討する必要がある．

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乳がん術後女性のブラジャーとパッドの不具合解決にむけた指針を得ることを目的に研究を行った．被験者は胸部形状に左右差のある乳がん術後女性10名(乳房全摘5名，乳房温存5名)である．3次元形状計測ならびに健側10点，術側10点の衣服圧測定を，被験者が最もフィットして着心地が良いとしたブラジャー(試料I)と，試料Iよりもフィット性は悪いと感じているが着用しているブラジャー(試料Ⅱ)で実施した．測定は2種の試料に補整パッドを装着した場合としない場合で行った．
試料Iと試料Ⅱの違いは，圧力のアンバランス，特に術側へ負荷される衣服圧の大きさであると思われた．各試料にパッドを装着しないと，衣服圧は健側の方に高くかかった．パッドを装着すると，健側と術側の形状のアンバランスは解消された．しかし，全体にかかる衣服圧は高くなり，術側に偏った衣服圧のかかり方をする傾向となり，その傾向は全摘の被験者で顕著となった．

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要　旨

本研究の目的は，初発乳がん患者が告知を受けてから小学生の子どもに罹患に伴う情報を伝えることを決断するまでのプロセスを可視化し，子どもに伝える時の看護支援の在り方を検討することである．小学生の子どもを持つ初発乳がん患者14 名に半構造化面接を行い，修正版グラウンデッド・セオリー・アプローチを用いて質的帰納的分析を行った．伝える決断のプロセスは，がん患者ががん診断による衝撃を受けながらも，子どもの唯一無二の母親であるという意識のもと，母親役割を遂行するために子どもに罹患に伴う情報を伝えることに至る体験であり，母親役割の強化・停滞要因が影響していた．子育ての経験を活かした，これまで通りのコミュニケーションスタイルをとることで，子どもに情報を伝えることを可能にしていた．患者が母親役割を果たす強化要因を早期に把握し，強化要因を強化する支援が必要である．また，母親の存在意義を認め，子どもが持つがんのイメージを理解し，自信をもって子どもに罹患に伴う情報を伝えるための看護システム構築の必要が示唆された．

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 After the Great Hanshin Awaji Earthquake, the establishment of a regional medical system and a preparation of disaster medical system that is the establishment of the disaster base hospital. Medical facilities are needed to be actuating when the disaster occurs, and varieties of standards and guidelines of architecture and facilities has been established. To enforce medical services smooth enough when the disaster occurs, we need improvement projects that assume disaster medical services beforehand.
 But, at a large scale earthquake such as the Great East Japan earthquake, a case which sufficient medical service was difficult to enforce because of the shortage such as water and fuel due to long-term passage of the lifeline in addition to the damage of building equipment and medical equipment even in disaster base hospital has been reported.
 About the facility requirements that is based on the correspondence of the disaster, it is determined comprehensively based on expenses among the minimum capacity that is prescribed by Building Standard Act/the Fire Services Act and the capacity that is demanded from the activity assumption, but at the time of disaster there are many cases that caused restriction of medical services because of the restriction on use of medical equipment and the capacity lack of the private power generator, so it doesn’t mean that it is always decided appropriately.
 Therefore in this study, we will grasp about the priority of the disaster medical service in the disaster base hospital and the necessary medical equipment and make a survey and analyze about electricity consumption accompanying with it, to estimate the appropriate capacity of a private power generator becoming necessary for correspondence at hospitals at the time of disaster. This study is intended to contribute to the development of the hospital plan which can carry out the medical service at the time of disasters smoothly, by calculating electric power load that is based on the medical policy at the time of a disaster assumed on every hospital.
 In this study, we grasped about the priority of the disaster medical service of 14 disaster base hospitals and the necessary medical equipment and make a survey and analyze about electricity consumption accompanying with it, to estimate the appropriate capacity of a private power generator becoming necessary for correspondence at hospitals at the time of disaster. The obtained knowledge is shown below.
 1. The ratio of the private power generator to the contract demand of the 14 hospitals that the answer to the questionnaire was provided was from 43% to 155%, and considering the margin of the contract demand, most hospitals hold private power generators that has generation capacity of 60% degree of ordinary time.
 2. As a result of the medical equipment load that is assumed by each medical service contents at the time of the disaster calculated by per unit floor space, electricity consumption of emergency patient correspondence and the image diagnosis inspection were big , and the average electricity consumption of 5 hospitals were from 18.95 W/m² to 22.40 W/m².
 3. From the results of estimating the medical equipment load corresponding to the priority of medical services, we found that the medical equipment load account for 51.8% to 120.4% of the capacity of private power generator and 44.5% to 86.3% of the contract demand, even performing duties only that has have the medical services also be always performed at the time of disaster.

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We conducted a questionnaire survey on 344 females who suffered from breast cancer to investigate their problems with clothing after breast cancer surgery. In this study, we focused on the use of brassieres and the inconveniences they caused.The results obtained were as follows:1) More than half the participants felt there were difficulties and inconveniences associated with their brassieres, such as an imbalance of the two breasts, crawling up of the cups, and a humid sensation inside the bra cups, all of which were more often found amongst the participants who had undergone a mastectomy.Difficulties and inconveniences of bras, such as tightness under the bust, slipping down of the shoulder straps, and pain from abrasion were more often found in the participants who had undergone a breast conserving surgery. The first step we should take in solving these problems is to sort out the relationship between the inconveniences of bras and the diversity of the deformity and wounds in the breast area.2) We examined the connection of the inconveniences of bras with the physical symptoms and side effects of breast surgery. The results suggest an urgent need to provide patients with not only better bras but also other clothes ranging from innerwear to outerwear.3) The bras used were classified into three types: exclusive bras for breast cancer patients, ordinary bras different to the ones used before surgery, and the same bras as those used before surgery. The exclusive bras were shown to be easy on the body and were highly ranked except for moisture and hotness inside the bra cup. We believe this result was achieved through the use of silicon pads. The results for bras different to the ones used before surgery tended to show the greatest inconveniences, suggesting a need for more information in order to improve the comfort of bras after surgery.

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Aim: The aim of this work was to evaluate the coincidence between light and X-ray field width in air. Background: Light fields are often used for confirmation of irradiation position to superficial tumors and final confirmation of the patient’s irradiation position. To guarantee collation by the light field, the light and X-ray fields must coincide. Currently, the light field width is determined mainly by visual evaluation using manual methods, such as use of graph paper and rulers. The light field width is difficult to visually recognize a definite position at the edge of the light field. Materials and Methods: We quantified the width of light fields emitted from a linear accelerator using a light probe detector and compared the results with those of X-ray fields. In-air measurements were conducted at the same position in the light field with the light probe detector and X-ray field using an ionization chamber installed in an emptied three-dimensional water phantom. Results: The radiation field in air was approximately 2 mm larger than the light field, and we found some influence of transmission and scattered rays on the penumbra region. Before and after exchanging crosshair sheets, the fields also exhibited differences in uniformity. Conclusions: The proposed method quantifies the light field using a photodetector and can be used to compare the light field with the X-ray field, conforming a useful tool for evaluating the accuracy of treatment devices in an objective and systematic manner.

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強度変調放射線治療（IMRT）は頭頸部癌に対し有用な治療法である。治療計画にはCT画像上での輪郭設定と線量分布計算のCT値が必要であるが，歯科金属アーチファクトはCT画像やCT値を不明瞭にする。今回IMRT前に歯科金属除去を行った症例について報告した。
頭頸部癌患者5名が歯科用金属除去のため当科を受診した。原発部位は中咽頭2例，舌，喉頭，下咽頭が各々1例で，CT画像で舌，耳下腺，中咽頭，上頸部にメタルアーチファクトが生じていた。金属除去した歯は12～19本，除去期間は6～13日（通院回数2～5回）であった。歯科金属除去後はレジン充填やテンポラリークラウンを装着した。その後，CT画像でメタルアーチファクトは消え，CT値は正常となった。咀嚼機能障害はなかった。歯科金属除去は，IMRTにおいて有用であると思われる。

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 Isolation Hospitals are one of the important hospitals in modern Japan, but there are many things that are unidentified about buildings form because there are few old buildings and reference documents. This paper tries to clarify the conditions for the planning of early Isolation Hospital by analyzing the contents of 21 practical books for infectious disease control (written by health official instead of architect) published from the Meiji era to the Taisho era.

 The summary of the conclusion is as follows:

 1) Conditions of planning early Isolation Hospital could be classified into building site (9 items), block planning (4 items), plan of hospital room (11 items). 2) In terms of building site, convenience for transportation was more important than quarantine at the late Meiji era. 3) The site was partitioned into clean area and contaminated area in the late Meiji era. Management in the hospital was strengthened by establishing a traffic disinfection station at the boundary between these two areas. 4) The ward plan of pavilion type appeared at in the Taisho era. 5) Open spaces, gardens and playgrounds for the patients were recommended. 6) Beds on wooden floor were recommended not to reduce the work burdens of a medical staff, but to keep the hospital rooms clean. 7) The main circulation of isolation wards was located on the south side of the hospital rooms and sub circulation for nursing and care was located on the north side of the hospital rooms. At the end of the Meiji era, glass was used at Shoji (sliding door) on the south side of the hospital rooms.

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The present study aimed to prepare a small acute-phase cerebral infarction phantom made of gelatin and sucrose to simulate brain parenchymal cells, and a phantom made of collagen peptides and sucrose to simulate cerebral infarction for diffusion-weighted imaging (DWI). During the preparation of gelatin and sucrose mixture (17.0 wt% gelatin, 20.0 wt% sucrose), a cylindrical wooden bar was placed in the center of the phantom and covered with a heat-shrinkable film to ensure space remained after gelling. A mixed solution composed of collagen peptide and sucrose (16.0 wt% collagen peptide, 27.5 wt% sucrose) was then enclosed within the space. The T₂ relaxation time and apparent diffusion coefficient (ADC) of the phantom were set equal to those observed in actual patients with acute-phase cerebral infarction. The mixture was selected based on the signal intensity of both the healthy brain tissue and that subjected to acute cerebral infarction, such that no contrast was observed during T₂-weighted imaging (T₂WI). T₂WI and DWI were performed using a 1.5 T scanner. Although contrast between the mixed gel and mixed solution was obscure on T₂WI, cerebral infarction was clearly visible on DWI. However, the phantom exhibited mono-exponential changes in the ADC value at b values of 0 and 1,000 (s/mm²), and was affected by the proton density and T₁ value depending on the imaging condition.

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本稿では、中国・内モンゴルにおける伝統医療の一つであるモンゴル医療を取り上げ、モンゴル医師たちのインタビューを通して、彼らのモンゴル医療と自らの地位に対する認識の特徴を考察した。医師たちの語りからは、伝統医療としてのモンゴル医療の役割を確立させ、西洋医療には代替され得ないあり方を理想としていることが見受けられた。また、彼らの中では、西洋医療とモンゴル医療はそれぞれ独立した医療体系として位置づけられていた。医師たちはプライドを持ってモンゴル医療に従事しており、また当該医療のあり方は、地域社会の人々の慣習、生活スタイルと密接に結びついていることを示した。

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本研究は，地域で生活を継続する統合失調症を持つ者の回復とはどのような経験であるかを明らかにすることを目的とした．Giorgiが提唱する現象学的アプローチを参考に，統合失調症を持つ者5名を対象に分析した．

結果，統合失調症を持つ者の回復の経験とは『他者の理解の中だけにある未知の自分の存在を認知する』であり，未知の自分に対し，過去から現在までの連続の中で自分が認識できている既知の自分を見定めながら『未知の自分と既知の自分を共存させる』ことであった．未知の自分と既知の自分を共存させ続けるためには『既知の自分を維持・強化し続ける』ことが必要であった．統合失調症を持つ者の回復の経験は，未知の自分とそれに対応する既知の自分との因縁の不可分な関係によって生じ続け，今も持続的に経験されていた．

既知の自分を蓄積することは，自己同一性の再構築であると考えられ，今も継続しているものであると推察された．

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本研究は，精神科看護職者の看護実践能力を評価する尺度を作成し信頼性と妥当性を検討することを目的とした．文献的統合により53項目，5件法からなる質問紙原案を作成した．4つの施設に勤務する看護職者206名を対象に質問紙を配布し，有効回答は150部であった．項目分析により3項目を削除し，最尤法（Promax回転）による探索的因子分析を行った結果，13項目が削除され，全37項目，5因子が抽出された．第1因子「患者－看護師関係を形成する力」，第2因子「専門知識を活用する力」，第3因子「患者の主体性を引き出す力」，第4因子「安全なケアを意識する力」，第5因子「自己研鑽を続ける力」と命名した．全体のCronbachのα係数は0.95（下位尺度は0.76～0.91）であった．以上から，精神科看護職者の看護実践能力評価尺度として信頼性と妥当性を確認し，看護職者の自己評価や教育への活用可能性が示唆された．

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