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Introduction
At the end of FY2017, all the full-time radiation oncologists in the Department of Radiation Oncology at Kanagawa Cancer Center retired. Although the mass retirement of physicians is often a social problem, the clinical and/or research performance status of a department after such a mass retirement is unclear. Five years have passed since the mass retirement in FY2017 in this center. Thus, this study retrospectively analyzed the clinical and research performance in the radiation oncology department.
Materials and methods
The number of full-time radiation oncologists, actual number of patients receiving radio-therapy, number of conference presentations, and number of publications in English from FY2013 to FY2022 were investigated using the department database and the Kanagawa Cancer Center Annual Report. Differences between the 5-year period from FY2013 to FY2017 (before the mass retirement) and the 5-year period from FY2018 to FY2022 (after the mass retirement) were compared using the Mann-Whitney U-test.
Results
The mean [95% confidence interval (CI)] numbers of full-time radiation oncologists before and after the mass retirement were 5.2 (3.16-7.24) and 6.6 (4.03-7.17), respectively, with no significant difference (p=0.1351). The mean (95% CI) overall actual numbers of patients before and after mass retirement were 1063.4 (847.4-1279.3) and 1656.2 (1330.7-1981.7), respectively. The number of patients significantly increased after the mass retirement (p=0.0163). No significant differences in the number of conference presentations or publi-cations were observed.
Conclusions
This study investigated and compared the clinical and research performance of the radiation oncology department before and after the mass retirement. Although the number of full-time radiation oncologists and research results were not significantly different, the number of actual patients increased significantly after the mass retirement.

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本研究は、緩和ケア病棟に勤務する看護師を対象に、エンゼルケアに対する考えを明らかにすることを目的に実施した。研究方法は自由記載を含むアンケート調査であり、単純集計と質的分析を行った。　第一回目のアンケートでは、メイク道具への不満、エンゼルメイクの仕上がりへの不満、エンゼルメイクへの自信のなさやメイク時の困難感が明らかとなった。そこで、改善策としてメイク道具の補充、納棺士による講義と実演、外部講師によるメイクアップ講習会を行い、第二回目のアンケート調査を実施した。その結果、道具に対する満足度は上がり、新しい知識を吸収できたという結果を得ることはできたが、エンゼルメイクに対する自信に繋がっている人がまだ多くはなかった。　新しい道具を揃え、エンゼルメイクに関する知識・技術を学ぶだけでも満足度は高まるが、それを用いて経験を重ね、さらに自分自身の能力を高めるための研鑽を続けていくことが看護師の自信につながっていくことが明らかとなった。

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　症例は60歳女性。主訴は心窩部痛。胃X線および内視鏡で胃角部後壁にⅡc＋Ⅲ様進行癌を疑わせる病変を認めたが，生検（前医および当院第1回目）ではGroup Ⅱであった。当院第2回目の生検組織診ではGroup Ⅳ，adenocarcinoma，tub₁と診断され，1992年2月17日胃亜全摘が施行された。切除標本の病理組織学的診断では，多彩な組織像を示した胃腺扁平上皮癌であった。病変中央の潰瘍底（Ul Ⅱ）に中分化型扁平上皮癌が認められ，腺癌に関しては分化度が高く，細胞異型と構造異型に乏しく，高好酸性細胞や食道腺導管様多列円柱上皮が粘膜筋板を越えて存在した。さらに多量の粘液を含有した細胞や印環細胞が腺癌と扁平上皮癌辺縁で混在する領域が認められ，腺癌成分と扁平上皮癌成分の移行帯を示唆する所見と思われた。

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A 57-year-old woman was diagnosed with acute myeloid leukemia (AML, M5a) with MLL rearrangement in August 2006. Cord blood transplantation (CBT) conditioned with a reduced-intensity regimen was carried out during second complete remission in March 2007. Marrow study on day 28 confirmed complete chimera and disappearance of minimal residual disease by RT-PCR. She complained of left chest pain around day 120. CT scan on day 127 showed left pleural effusion, tumors of the upper mediastinum and spleen, and pericardial effusion. She suddenly died of cardiogenic shock on day 129. Postmortem examination revealed systemic granulocytic sarcomas and infiltration of leukemic cells into the right atrium and epicardium without recurrence of leukemia in blood and marrow.

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