Effect of communication skills training on nurses' detection of patients' distress and related factors after cancer diagnosis: a randomized study

Background: A randomized study was performed to investigate whether a communication skill (CS) training program can improve nurse's ability to detect the distress of patients who have just been informed of cancer diagnosis. Methods: Nurses were randomly assigned to the experimental or control group, and those in the former group had undergone CS training program. Nurses in both groups were then requested to support patients informed of their cancer diagnosis. Intervention consisted of one‐on‐one nurse interviews 3 times (on the day, 1 week, and 1 month after diagnosis). Patient's self‐reported distress according to the Hospital Anxiety and Depression Scale and nurse's ratings of patient distress by Visual Analog Scale were assessed 3 times (1 week, 1 month, and 3 months after diagnosis). These two scales were compared between the nurses of the two groups to assess the impact of CS training. Results: The nurses in the experimental and control groups supported 42 and 47 patients, respectively. The analysis using mixed‐effects modeling revealed no significant differences in the nurse's ability to detect patient's distress between the two groups. However, when the nurse's ratings of patient's distress and patient's self‐reported distress were compared, these two scores were significantly correlated only with the nurses in the experimental group, suggesting that the nurse's ability to become aware of patient's distress had been improved in that group. Conclusions: CS training for health professionals is useful in oncology practice to improve nurse's ability to recognize the distress of patients diagnosed with cancer. Copyright © 2009 John Wiley & Sons, Ltd.     

Rapid and accurate method for delineating cancer lesions in laparoscopic colectomy using activated carbon injection

The aim of our study was to evaluate the clinical efficacy of preoperative injection of activated carbon in delineation of cancer location in laparoscopic colectomy. Activated carbon particles were injected during endoscopy into the normal colonic wall surrounding cancer lesions in five cases of early colon cancer, prior to laparoscopic surgery. The carbon-stained area was clearly recognizable as a blackened patch on the serosal surface of the colon. Using the carbon-stained area as a reference point, partial colectomies were successfully performed on all five patients. The preoperative injection of activated carbon assisted in the intraoperative delineation of early colonic cancer lesions. This method is recommended for the rapid and accurate delineation of early colonic cancers in laparoscopic surgery. © 1995 Wiley-Liss, Inc.     

Angiospermic Changes of Coronary Aneurysms in Kawasaki Disease

The fate of coronary aneurysms in Kawasaki disease or MCLS was examined by follow-up studies on 9 patients with multiple bilateral aneurysms in the coronary arteries demonstrated by coronary arteriography. Their ages at the time if first examination ranged from 0.3 to 11 years (mean, 4.1 years). The mean interval between the onset of acute illness and the initial examination was 15.8 months, and the mean interval between the first and second examination was 17.9 months. Eight of the nine patients received anticoagulants between examinations. The second coronary arteriogram showed morphologic changes of the aneueysm from the time of the first examination: changes were seen in the right coronary artery area in 8 patients (89%) and in the left coronary artery area in 7 patients. These morphologuic changes seemed to be mainly secondary to thrombus formation, calcification, stenosis and/or obstruction of the aneuryms. Thus, coronary aneuryms in Kawasaki disease were transformed despite the use of anticoagulants. It is considered that multiple large coronary aneurysms will not healed or disappear, but are simply transformed as a result of their thrombosis and/or calcification.     

Chemosensitivity test for unresectable non-small cell lung cancer

To choose the optimal chemotherapy regimens, we have employed a new chemosensitivity testing method, the collagen gel droplet embedded culture drug sensitivity test (CDDST) for patients with non-small cell lung cancer (NSCLC). This method requires fewer cancer cells(1 x 10(5) cells in 2 specimens biopsied by bronchoscopy) than conventional chemosensitivity tests and can be also used to assess cases of malignant effusion. Correlations between the in vitro and in vivo responses were: true positive ratio, 75.0% (21/28 patients); true negative ratio 85.0% (17/20 patients); and accuracy 79.2%. The median survival time (MST) of patients (n = 11) with unresectable NSCLC who were given optimal chemotherapy based on the results of the CDDST was 15.8 months and the MST of those (n = 16) who did not receive a sensitive agent was 5.6 months. There was a significant difference between these two groups (p = 0.0048, log-rank test). These results suggest that the CDDST is an effective method for chemosensitivity testing in unresectable NSCLC.     

Establishment of clonal colony-forming assay system for pancreatic stem/progenitor cells

Pluripotent stem cells found in a number of organs are usually in small cell populations. However, under adaptive stimulation, they enter the stage of growth and differentiation to compensate for the loss of differentiated cells. To analyze stem cell potential precisely, the exclusion of other differentiated cells and a clonal assay system are strongly required. In this study, we established a colony-forming assay system for pancreatic stem/progenitor cells in vitro. In this culture condition, they received signals for growth and differentiation, and formed clonal colonies including pancreatic endocrine-lineage cells, such as alpha and beta cells. By combining this culture system with flow cytometric cell sorting, pancreatic stem/progenitor cells will be enriched, and their potential can be analyzed precisely in single cell-based experiments.     

Role of neurosecretory cells in the photoperiodic induction of pupal diapause of the tobacco hornworm Manduca sexta

In the tobacco hornworm, Manduca sexta, pupal diapause can be induced by exposure of fifth-instar larvae to a short-day photoperiod. We studied the effect of surgical ablation of tissues containing the neurosecretory cells of the brain of fifth-instar larvae on the photoperiodic induction of pupal diapause. At the end of the experiments, we immunostained the neurosecretory cells to determine the success of the ablations. Under long-day conditions (LD 16:8 at 22 degrees C), all intact larvae, most of the sham-operated larvae, and control-operated larvae developed into nondiapausing pupae. Under short-day conditions (LD 10:14 at 22 degrees C), most intact, sham-operated, and control-operated larvae developed into diapausing pupae. Removal of type-II cells did not interfere with the photoperiodic response. Under long-day conditions, elimination of type-Ia(1) cells did not affect the incidence of nondiapausing pupae. When type-Ia(1) cells were removed under short-day conditions, however, the incidence of nondiapausing pupae was higher (51%, n = 41) than that of the intact (16%, n = 75), sham-operated (24%, n = 88), control-operated larvae (5%, n = 40), and larvae with type-II cells removed (11%, n = 27). Thus, removal of type-Ia(1) cells can impede induction of diapause. These results indicate that the type-Ia(1) neurosecretory cells have an important role in the induction of pupal diapause.     

A case of acid burn of the penis

A 27-year-old man presented to our hospital complaining of multiple mild injuries sustained in an attack of violence at the workplace. He had received chemical burns to the penis induced by hydrochloric acid and had developed severe phimosis. He complained of pain on erection and ballooning during urination. The foreskin was partially resected with foreskin grafting for the stricture. The postoperative outcome was favorable and his symptoms were relieved.     

Clinical statistics of the operations during a 20-year period at the Department of Urology,Nissei Hospital: 1982-2001

A clinical statistics survey of the operations was performed at the Department of Urology, Nissei Hospital during a 20-year period from 1982 to 2001. The total number of operations was 3,164, and the number of extracorporeal shock wave lithotripsy procedures was 143. Operations for urogenital malignancies urolithiasis and prostatic hyperplasia numbered 893 (28.2%), 328 (10.4%), and 767 (24.2%), respectively. The total number of operations has been decreasing owing to the development of new diagnostic and therapeutic modalities.     

A case report of Fournier's gangrene in a diabetic patient induced by transrectal prostate biopsy (TRPB)

A 70-year-old man with poorly controlled diabetes mellitus, and an elevated serum prostatic specific antigen, underwent transrectal prostate biopsy. He received one dose of cefotium before, and three doses of cefotium (1.0 gram every 12 hours intravenously) after prostatic biopsy. He was doing well until postbiopsy day 1, when he developed high fever, dysuria and lower abdominal pain. His perineal area exhibited black-purpish discoloration. On postbiopsy day 3, laboratory data showed leukopenia and DIC. Operative findings during laparotomy on the same day, included malodorous cloudy fluid and tissue edema involving the perivesical space. Intraoperative tissue cultures as well as postoperative cultures of blood and drainage revealed Escherichia coli, serotype O-6. Despite maximal supportive therapy, the patient developed multiorgan failure and died on the tenth postbiopsy day. This patient's history and hospitalization course suggests that transrectal prostatic biopsy induced Fournier's gangrene.