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Many healthy protective behaviors can be taken to prevent the spread of COVID-19. However, some people behave unreasonably and others seldom take preventive actions. To clarify such diff erences in behavior, the mechanism of behavior occurrence was examined from the perspective of a health belief model. As a result, behaviors in response to the threat to COVID-19 were divided into three categories. We found that gender and age infl uence preventive behaviors, unreasonable behavior is infl uenced by anxiety about infection and social threats, and poor protective behavior is related to acceptance of infection and the benefi ts of avoiding protective behaviors. In addition, those who had poor protective behaviors had a higher recognition of the probability of infection.

寄稿, Contributed Article

The purpose of this study was to develop a measurement for death attitude. This study was consisted of 3 researches. Research 1 was aimed for exploring factor structure of death attitude and item selection for constructing brief inventory. Research 2 and 3 were intended for test-retest procedure and validation of the Death Attitude Inventory (DAI). Exploratory factor analysis revealed that the scale had following seven factors: "Afterlife belief", "Death anxiety", "Death relief", "Death avoidance", "Life purpose", "Death concern" and "Supernatural belief." Stepwise exploratory factor analysis was conducted and it was found out that the scale had 27 items with best fitting. Test-retest reliability and internal consistency were obtained, and factor validity, concurrent validity and construct validity were confirmed. Thus, DAI has high reliability and validity and can be used briefly because it has only 27 items. It is expected that using DAI clarifies the structure of death attitude and several death-related issues.

A 44-year-old man visited a local urologist complaining of continuous pain and tumescence at penis persisting for 3 days. He was diagnosed with priapism. A caverno-glandular and caverno-saphenous shunt was performed. He presented to our hospital 3 days later, because the symptoms especially tumescence continued. We confirmed the diagnosis of low-flow priapism from cavernosography and intracavenal blood-gasometry and performed caverno-spongiosum shunt. Detumescence was finally achieved after the operation.

一側停留精巣を有する36歳の患者で, 対側の陰嚢内精巣に腫瘍が発生した症例を報告した.精巣腫瘍に対しては, 精巣摘除術を施行し, 後腹膜リンパ節転移巣に対して放射線療法を行い, CRを得た.停留精巣は摘除し, 現在, 定期的なテストステロン補充療法を行っている, A 36-year-old man visited the hospital complaining of painless swelling of the right scrotal contents. His left scrotal contents were absent in the scrotum. Right inguinal orchiectomy was performed on May 17, 1993 under the diagnosis of testicular tumor. The pathological diagnosis of the tumor was pure seminoma. Abdominal computed tomography (CT) and magnetic resonance imaging (MRI) revealed the enlargement of para-aortic lymph nodes and there was a soft tissue signal in the left inguinal region which seemed to be the left testis in MRI. His serum testosterone level was low and gonadotropin level was high. The left orchiopexy was performed on June 24, 1993, but the left testis was finally removed because of methicillin-resistant Staphylococcus aureus (MRSA) infections. Radiation therapy was done against the metastatic lesion in the retroperitoneal lymph nodes and complete remission was obtained. The left undescended testis pathologically showed atrophy of germ cells but there was no appearance of atypia of Leydig cells or germ cells.

A 7-year-old girl was hospitalized with urinary incontinence. Intravenous pyelography showed the dilatation of upper segment of the right kidney, in which slight radioisotopic accumulation was detected on renal scintigraphy with 99mTc-DMSA. On computerized tomographic (CT) scan, a cystic mass shadow occupied the retroperitoneal space. During surgery, the right kidney was found to be completely duplicated and the ectopic ureter opened in Vestibule vaginae accompanied with midureteral stricture. The ectopic ureter was incised above the strictural site and anastomosed with the ureter of the lower segment. Although approximately 700 cases of ectopic ureter have been reported in Japan, congenital midureteral stricture accompanying ectopic ureter is extremely rare.

This study was done to explore the appropriate procedure of retroperitoneal lymph node dissection (RLND) to preserve ejaculatory function. The relation between postoperative ejaculatory function and area dissected at RLND was investigated in 47 patients with testicular cancer. The patients were divided into 5 groups according to the retroperitoneal area dissected. Group 1 (38 patients) underwent bilateral RLND, group 2 (3 patients) and 3 (2 patients) right unilateral RLND, and group 4 (2 patients) and 5 (2 patients) left unilateral RLND. The vertical limits of the dissected area were similar in all groups, namely renal pedicle and bifurcation of common iliac artery. The lateral limits were bilateral ureters in group 1, right border of aorta and right ureter in group 2, left border of aorta and left ureter in group 4, and vena cava and left ureter in group 5. Group 3 was similar to group 2, but the paraaortic region at the root of inferior mesenteric artery was also dissected. All patients in group 1 had dry ejaculation. Thirty patients in this group were examined for seminal emission and none of them could demonstrate seminal emission. Normal antegrade ejaculation was seen in group 2 and 4 patients, but retrograde ejaculation was recognized in group 3. Inability of seminal emission ws confirmed in group 5 patients. When consideration is given to the function of retroperitoneal sympathetic nerves, our results suggest that unilateral RLND without impairing superior hypogastric plexus should be adopted to preserve ejaculatory function.