Search

The clinical outcome of laparoscopic radical prostatectomy (LRP) was retrospectively investigated taking into consideration the surgeon's position during the procedure. The study cohort included 184 consecutive patients who had undergone LRP performed by a single surgeon from February 2013 to July 2018. During the study period,the surgeon stood alternately on either the left or right side of the patient. The D'Amico risk classification was low,intermediate and high in 26 (14.1%),45 (24.5%) and 113 (61.4%) patients,respectively. Mean surgical duration was 203.5 minutes and mean estimated blood loss was 437.6 ml. Nerve sparing (NS) was implemented in 82 (44. 6%) patients. The mean period of having an indwelling urethral catheter was 5. 0 days. Perioperative Clavien-Dindo degree ≥IIIa complications occurred in three (1.6%) patients. Except for cases with presurgical hormonal treatment,surgical margins were positive in 41 (22.3%) patients,among whom 23 (17.4%) had pT2 disease. The 5-year biochemical recurrence-free survival rate was 81.4%,and 84.8% of patients regained urinary continence at 12 months after surgery. Where the surgeon stood during LRP was not associated with significant differences in any parameter. However,the margin positive rate was higher on the side away from where the surgeon stood than the side closer to the surgeon (70.7% vs 29.3%). In conclusion,the position of the surgeon during LRP does not influence the outcome.

Additional fees for ward pharmacists' services have been valued for hospitals in Japan. However, the calculation period for services provided to inpatients in the psychiatric ward is limited to 8 weeks. This study aimed to reveal the need for the services of pharmacists in the hospital ward for inpatients hospitalized for >8 weeks in the psychiatric ward. Patients who were hospitalized in the psychiatric ward from September 2016 to February 2017 were analyzed retrospectively. The pharmacists suggested prescriptions for inpatients admitted for >8 weeks, similar to those admitted for <9 weeks, and this supported pharmacotherapy without exacerbating patient outcomes. Moreover, significant decreases in benzodiazepine doses were found between the prior and post prescription suggestions of the pharmacist for inpatients >8 weeks of admission. Healthcare expenditures were also reduced. These results suggest that the prescriptions suggested by pharmacists for inpatients admitted for >8 weeks in the psychiatric ward were useful. In conclusion, our findings show that ward pharmacists' services were necessary not only for the inpatients hospitalized for <9 weeks, but also for those hospitalized for >8 weeks.

Cutaneous infiltration by breast cancer significantly reduces patient quality of life(QOL)due to bleeding, exudate, and pain. We report a case of combined treatment using Mohs' paste and neoadjuvant chemotherapy for locally advanced breast cancer. Mohs' paste decreased bleeding and exudate from the tumor and neoadjuvant chemotherapy combined with bevacizumab down-staged a large tumor to a volume that permitted mastectomy. Good local control using Mohs' paste and neoadjuvant chemotherapy can improve patient QOL and reduce the physical burden.

Atypical teratoid/rhabdoid tumor(AT/RT)is a rare and lethal childhood cancer. Although radiation therapy in children less than three years of age is generally deferred because of its neural toxicity, recent studies have shown that multimodal therapies, including radiation therapy, are effective in pediatric patients with AT/RT less than three years of age. We treated four infant AT/RT patients and investigated the impact of radiation therapy and genetic classification on the prognosis. The mean age at the time of the operation was 9.3 months and all patients were female. All patients underwent surgical resection. Of the four patients, two received combined irradiation and chemotherapy. Specifically, one patient received conformal craniospinal radiation therapy and the other received craniospinal irradiation with proton beams. Immunohistochemical analyses of tumor specimens revealed that the two patients were positive for ASCL1, a regulator of Notch signaling. Patients who received radiation therapy and exhibited ASCL1-positive tumors had a better prognosis. We conclude that radiation therapy may prolong survival in AT/RT patients who are less than 3 years of age. However, further study is required to evaluate long-term functional outcomes.

Background: More than 20%of breast cancer patients who undergo myelosuppressive chemotherapy involving FEC(100) or TC experience febrile neutropenia(FN), and pegfilgrastim is commonly recommended as the primary prophylaxis. Delays and/or dose-reductions in chemotherapy should be avoided as much as possible to maximize the clinical benefits of these adjuvant chemotherapies., Purpose: This study assessed the relative dose intensity(RDI), efficacy, and safety of pegfilgrastim in patients with breast cancer. The incidence of FN was also evaluated., Methods: Twenty-six patients with breast cancer undergoing FEC(100)or TC were included in this retrospective study., Results: Of the 26 patients, 19 patients who underwent FEC(100)and 7 patients who underwent TC received 3.6 mg of pegfilgrastim 24 hours after administration of the myelosuppressive chemotherapy. Four and 14 patients who underwent FEC(100)achieved 85-99% and 100% RDI, respectively. All 7 patients who underwent TC achieved 100% RDI. Grade 3 and 4 adverse events, as assessed using the CTCAE, were observed in 11 patients who underwent FEC(100): 2 patients experienced leukocytopenia, 7 experienced neutropenia, 1 experienced thrombocytopenia, and 1 experienced FN. Four patients who underwent TC experienced Grade 3 and 4 adverse events: 1 patient each experienced bone pain, neutropenia, anemia, and FN., Conclusions: Pegfilgrastim can reduce the incidence of FN and maintain RDI in patients with breast cancer undergoing myelosuppressive chemotherapy.

Among secondary hyperlipidemia, dyslipidemia due to diabetes is common and important. Hyperlipidemia due to diabetes is divided into hypertriglyceridemia due to diabetic ketoacidosis (diabetic lipemia) and dyslipidemia due to relative insulin deficiency/insulin resistance in type 2 diabetes (diabetic dyslipidemia). Elevation of chylomicron due to the inactivation of lipoprotein lipase (LPL) induced by insulin deficiency is characteristic of diabetic lipemia, which is promptly ameliorated by insulin therapy. The characteristic lipo- protein profile for diabetic dyslipidemia involves elevations of VLDL, IDL, and small dense LDL and a reduc- tion of HDL. Relative insulin deficiency or insulin resistance induces the activation of hormone-sensitive lipase, reduced degradation of apoB100, increased microsomal triglyceride (TG) transfer protein, and inactivation of LPL and activation of hepatic TG lipase, which induce diabetic dyslipidemia. Diabetic dyslipidemia is a markedly ath- erogenic state, which should be carefully managed. [Review].

A 52-year-old woman was admitted to our hospital with right upper quadrant pain with gallbladder wall thickening and multiple liver tumors. Endoscopic ultrasound-guided biopsy revealed small cell carcinomas of both the gallbladder and liver. After 10 cycles of chemotherapy with etoposide and cisplatin, marked shrinkage of the tumors was evident on computed tomography. The patient subsequently underwent hepatectomy and resection of the extrahepatic bile duct and gallbladder with curative intent. Although no viable tumor cells were found in the resected specimens, we confirmed phagocytosis of tumor cells killed by chemotherapy in the resected liver specimen. Therefore, we suspected that the patient had primary small cell carcinoma of the liver that had been successfully treated. This is a rare case of primary small cell carcinoma of the liver that showed pathological complete response to chemotherapy with etoposide and cisplatin.

Objective and Methods: We analyzed the clinical effects of treatment for Mycobacterium tuberculosis infection for 1 year in our specialized hospital in 2011. Two hundred and ninety-six (296) patients were admitted and received treatment., Results: Two hundred and fifty-six patients (86.5%) were started on the standard treatment with 3 drugs (isoniazid [INH, rifampicin [RFP], and ethambutol [EB] or streptomycin [SM]) or 4 drugs (INH, RFP, EB or SM, and pyrazinamide [PZA]). One hundred and seventy-one patients (66.8%) continued receiving the standard treatment during the admission period. Of 160 cases who could continue 4 drugs, under 80 year-old patients were 127 cases (76.0%), but over 80 year-old patients were 33 cases (49.3%). The mean duration for negative conversion of sputum culture was 40.6 days. Liver dysfunction due to 4 drugs (INH, RFP, EB, and PZA) was noted in 8.5% of patients. Eighteen of the 296 patients had multi-drug resistant tuberculosis (MDR-TB). Each MDR-TB patient received individualized treatment. Moreover, 7 of the MDR-TB cases were treated surgically., Discussion: Treatment of TB had taken long time, and some patients could not continue the treatment owing to the adverse effects of drugs. Hence, it is important to monitor adverse effects of drugs in each patient.

We report 3 cases of long-term control achieved via S-1 monotherapy in elderly patients with advanced non-small-cell lung cancer. In case 1, a 75-year-old man clinically diagnosed with stage IIIA lung adenocarcinoma received S-1 as fourthline chemotherapy. PR was achieved, and PFS was 8 months. In case 2, a 78-year-old woman clinically diagnosed with stage IV lung squamous cell carcinoma received S-1 as third-line chemotherapy. A PR was achieved, and PFS was 14 months. In case 3, an 83-year-old man clinically diagnosed with stage IV lung squamous cell carcinoma received CBDCA plus PTX, followed by S-1 on alternate days. Although tumor size was not reduced, SD was maintained for 11 months.

Objective and Methods: In our hospital, we analyzed the clinical factors of pulmonary tuberculosis (TB) diagnosed in non-TB wards and the incidence of TB infection among contact patients and healthcare workers (HCWs) using QuantiFERON-TB GOLD (QFT) testing., Material: This study included 16 patients who were diagnosed with pulmonary TB in non-TB wards in our hospital from January 2008 to May 2011. Eight contact patients and 120 HCWs were also enrolled., Results: The 16 TB patients comprised 11 men (77.7 years) and 5 women (74.4 years). Among them, only 9 patients exhibited positive results for Mycobacterium tuberculosis after the first acid-fast bacterial examination; the other 7 patients presented positive results only after the second or third examinations. Moreover, there were 3 cases of positive Mycobacterium avium samples in the first acid-fast bacterial examination. Among 16 pulmonary Mycobacterium tuberculosis cases, 8 were sputum smear and culture positive, 7 were sputum smear negative and culture positive, and 1 was sputum smear and culture negative. Moreover, 17 days had elapsed from the time of admission to the non-TB ward to diagnosis. TB contact examination revealed that QFT results for 2 HCWs changed from negative to positive., Discussion: We suspected pulmonary aspergillosis or old TB when presented with cases with a history of TB. Moreover, we believe that the periods from admission to diagnosis were delayed when the first acid-fast bacterial sputum examination was negative or showed non-tuberculous mycobacteria.

Objective: The QuantiFERON-TB (QFT) blood test is the major tool for the diagnosis of Mycobacterium tuberculosis (TB) infection among healthcare workers (HCWs). We used QFT tests to estimate the prevalence of TB infection among HCWs in our hospital., Material and Methods: Between 2003 and 2010, a total of 733 HCWs were enrolled in this study, and the prevalence of TB infection was analyzed according to the HCWs' jobs and work place., Results: Among the 152 men and 581 women who were evaluated, 3 female HCWs had a history of TB. Fifty-eight HCWs (8 men and 50 women with a mean age of 56.3 years and 48.4 years, respectively) demonstrated positive QFT tests. The positive rate was 7.9% for all staff members throughout the study period. The QFT test was positive for 1 HCW who was treated for TB in 1998, and negative and inconclusive for 2 other HCWs treated for TB in 2002. The positive rate for QFT was 16.0% in the TB ward (12/75, 95% confidence interval [CI]: 7.7-24.3%), 9.9% in the other wards (22/222, 95% CI: 7.9-11.9), and 1.1% in the outpatient department (1/91, 95% CI: 0-2.2). According to the job category, the QFT positive rates were as follows: doctors, 4.3% (3/70, 95% CI: 1.9-6.7); nurses, 10.3 (4/35, 95% CI: 6.0-16.8). The positive rate among doctors working in the TB ward was 10.0%, and that for nurses was 24.3%. This indicates that the prevalence of infection among HCWs in the TB ward was significantly higher than that in other work places. A comparison of the results from 2003 through 2007 revealed that for a total of 307 workers, 90.6% and 5.2% remained negative and positive, respectively, while 1.6% converted from negative to positive, and 2.6% from positive to negative., Conclusion: The positive rate among HCWs in the TB ward was higher than that in other wards. This is especially remarkable for doctors and nurses working in the TB ward.

Synovial sarcomas compromise between 5 to 10% of all soft tissue sarcomas in adults. Synovial sarcoma commonly occurs in the vicinity of the large joints and cranial metastasis is rare. Here, we describe a case with intracranial metastases of a synovial sarcoma. A 41-year-old woman was admitted to our department with sensory aphasia. She had a history of a left inguinal synovial sarcoma and underwent surgery and chemotherapy for primary and metastatic lesions. Head MRI revealed three gadolinium-enhancing lesions in the left frontal, parietal and parietotemporal lobe. Gross total resection was achieved in the left parietotemporal lesion and pathological diagnosis was synovial sarcoma. Two weeks after surgery, she received cyber-knife radiosurgery and her neurological deficit was almost completely resolved. Intracranial metastatic synovial sarcoma is rare. Surgical resection and stereotaxic radiosurgery was very effective in the present case.

Objectives: The purpose of this study is to analyze the influence of sensitivity to cold or hiesho in pregnant Japanese women and to examine the relationship between hiesho and premature labor., Methods: In this retrospective cohort study in Japanese women after delivery, information for the approximately 12 months between October 19, 2009 and October 8, 2010 was obtained using questionnaire surveys and medical records at 6 hospitals with obstetric and pediatric departments in the Greater Tokyo Metropolitan Area. Further, in this analysis, confounding factors were adjusted by performing analysis of covariance and stratified analysis using propensity scores. The Research Ethics Review Committee of St. Luke's College of Nursing (09-057) approved this study., Results: Analysis of data from 2,810 women was performed. Regarding the correlation between hiesho and premature labor, the incidence of premature labor was 3.38 times higher (analysis of covariance) or 3.47 times higher (stratified analysis) among pregnant women with hiesho than among those without hiesho (P < 0.001). The results of this study proved the existing discussions that there is a correlation between hiesho, Conclusion: during the latter stages of pregnancy and incidence of premature labor.

The activation of innate immune responses by nucleic acids is critical to host responses against pathogens, such as viruses; however, nucleic acids can also trigger the development and/or exacerbation of pathogenic responses such as autoimmunity. We previously demonstrated that the selective activation of nucleic acid-sensing cytosolic and Toll-like receptors is contingent on the promiscuous sensing of nucleic acids by high-mobility group box proteins (HMGBs). Basides these findings, we also found that nonimmunogenic nucleotide with high-affinity HMGB binding, termed ISM ODN, functions as suppressing agent for nucleic acid-activated innate immune responses. In this review, we aim to summerize this novel feature of HMGB proteins in nucleic acid-mediated innate immune responses. In addition, we will discuss the inhibitory effect of nonimmunogenic oligodeoxynucleotides (ni-ODNs) targeting HMGB proteins.

Purpose: The purpose of this study was to develop "a professional identity scale for public health nurses (PISP)" and to discover factors related to professional identity for use in studies to improve public health nurse (PHN) activities., Method: Questionnaires including a tentative PISP together with "ego identity' "self-esteem', and "nurse identity' scales were sent to PHNs working in the Kanto region. Out of 986 questionnaires sent, 739 were be collected, and the data were statistically analysed for reliability,validity, and identify-related factors., Results: 1) A tentative PISP consisting of 7 factors and 52 items was developed. Item analysis and exploratory factor analysis (Promax rotation) of the scale showed that 37 of the PISP items had a 5-factor structure. Theses factors were interpreted as "confidence in working as a public health nurse," "identification of the profession with life," "feedback from others and self-esteem," "adaptation to and certainty about career," and "integration of life and career." 2) A significant, positive correlation was found between the total score of PISP and the "ego identity' and "self-esteem' scales. 3) A significant, positive correlation was found between the total score of PISP and the "nurse identity' scale. 4) The Cronbach's alpha coefficient for the total PISP was 0.96. 5) Significant, positive correlations were also found between the total score of PISP and age and years of experience. 6) Significantly higher scores of PISP were found for those having a partner or housemate, living with a partner or children, and holding a higher position 7) Multiple regression analysis showed that the factors significantly related to the total PISP score were having faith in his or her duties, having high motivation, being of a higher age, and having a satisfying role as a PHN., Conclusion: The PISP developed in this research demonstrates considerably high reliability and validity. It also showed the necessity to improve the working environment and enhance the positive behavior and motivation of PHNs, for facilitating their development of a professional identity.

Excess adiposity has been shown to play a crucial role in the development of the metabolic syndrome. Characteristics for dyslipidemia in the metabolic syndrome are elevated fasting and postprandial triglyceride (TG) and decreased high-density lipoprotein-cholesterol (HDL-C). Diacylglycerol(DAG) has been suggested to suppress postprandial hyperlipidemia and promote negative caloric balance by increasing energy expenditure, due to intestinal physiochemical dynamics that differ from triacylglycerol (TAG). Our study (Study 1) demonstrated that DAG suppressed postprandial increase in TG-rich lipoprotein, very low density lipoprotein (VLDL), and insulin as compared with TAG in young male individuals. Further, our another study using the apolipoprotein C-II deficient subject demonstrated that DAG suppressed postprandial increase in VLDL-cholesterol and remnant-like particle-cholesterol compared with TAG, suggesting that DAG suppress postprandial TG-rich lipoprotein independent of lipoprotein lipase. Study 1 also showed that DAG significantly increased plasma serotonin, which is mostly present in intestine and mediates thermogenesis, proposing a possible mechanism for a postprandial increase in energy expenditure by DAG. Our studies presented DAG-mediated amelioration in postprandial TG-rich lipoprotein, insulin, and energy metabolism, indicating the therapeutic application of DAG for the metabolic syndrome.

A 58-year-old man of unresectable gastric cancer was treated with S-1 (120 mg/body/day) after gastrojejunostomy. After 5 courses of orally administration of S-1 for 4 weeks and withdrawal for 2 weeks, partial response (PR) was obtained clinically and distal gastrectomy was performed. The histological diagnosis showed no residue of carcinoma with both HE and immunohistochemical staining. The patient has been in good health and no recurrence has occurred for about 4 years and 4 months after resection.

A 74-year-old man was referred to our hospital with positive fecal occult blood test. Colonoscopic examination revealed a 7-mm 0-Is type polyp in the sigmoid colon. Endoscopic mucosal resection for this lesion completely removed the lesion and the histologic diagnosis was well differentiated adenocarcinoma. Cancer cells invaded the submucosa to a depth of 900 microm, and vascular invasion was found. Therefore, the patient underwent additional surgical resection with lymph node dissection. During follow-up, however, serum CEA increased beyond the normal limit 18 months after surgical operation, and a 15-mm single liver metastasis was found through enhanced CT scan abdominal imaging, the FDG-PET scan, and ultrasonography. We have to pay attention to metachronous liver metastasis especially when the vascular invasion is suspected in the resected sample, even if the lesion is completely removed.

Objectives: To discuss the optimal TB control system in health care facilities for the elderly where the periodic TB screening is currently not obligatory., Methods: A study was conducted in three health care facilities for the elderly in Tokyo during the period from 2002 to 2004, and 212 admitted elderly persons were enrolled in this study. Medical charts were analyzed to identify informations about mental and physical conditions and TB risk factors. Questionnaire-based interviews were conducted in 58 residents who had no dementia or no serious conditions. TB mass screening was carried out with a mobile vehicle equipped with computed radiography, financially supported by the Tokyo Metropolitan Government. Since this mobile vehicle is equipped with a special wheelchair for chest X-ray examination, most elderly persons were able to receive chest X-ray examination. Medical chart review and interview were conducted at around the time of TB mass screening. The screening results of 183 elderly residents who received X-ray examination were reviewed., Results: Of the 212 persons admitted to the facilities, 73.1% were women. The mean ages of men and women were 80.7 and 84.2 years, respectively. Mental disorders were observed in 42.9% and dysfunction of extremities in 54.7%. At the time of admission, chest X-ray records were submitted by the attending doctors in 73.1% of the residents, but this proportion differed among facilities. From these records, old TB was found in 12.3%; however this proportion was 20.8% according to the TB mass screening results. A history of TB was more prevalent in the group interviewed than in the non-interview group (24.1% vs. 6.5%; p < 0.001). Two facilities had conducted TB screening for three consecutive years and comparative reading of chest X-ray films could be done in 35.8%. The remaining facility conducted TB screening for the first time, and comparative reading was not possible. The proportion of cases requiring further investigations was higher in the facility where TB screening was conducted for the first time (2.8% vs. 13.0%; p = 0.008). No active TB patient was detected in this study., Conclusion: From the viewpoint of risk management for tuberculosis, it is important to establish a system of early case finding for the aged persons admitted to health care facilities for the elderly. Therefore, the information on risk factors should be collected properly at the time of admission, and careful attention should be paid to the residents with risk factors, for the possible development to active disease. X-ray records submitted by the attending doctors or by screening would provide useful informations for early diagnosis, when abnormal shadows are found on chest X-ray films.

Recently, the presence of Epstein-Barr virus(EBV) in almost 7% of gastric carcinoma lesions was reported. From our observation, EBV-associated gastric carcinomas located mainly in the gastric body, and moderate to poorly differentiated adenocarcinoma with lymphoid infiltration, as currently reported. Macroscopically, there were mainly thick and ulcerated lesions, EBV-associated gastric carcinomas had close relation with intestinal metaplasia, and EBV could be suspected to provide the immortalized epithelial cells.

In the therapy for early gastric cancer, Endoscopic diagnosis is essential. When early gastric cancer is diagnosed within certain range, it is possible to be cured without surgery only endoscopic therapy. Indication for now endoscopic therapy is limited lesion which is well differentiated adenocarcinoma not more than 2 cm in size with mucosal infiltration but no ulceration. In the endoscopic therapy, it is important to detect serial multiple occurrence of early gastric cancer and recurrence of residual cancerous lesion. For these problems, annual endoscopic examination is needed.

The purpose of this study was to clarify the significance of immunohistological staining for PCNA/cyclin in human colorectal lesions. Our results: The PCNA-positive cells existed at the bottom of colonic tubuli in the normal and hyperplastic conditions. In the neoplastic lesions, however, the positive cells were existed at the relatively surface of the mucosa (chi 2: P less than 0.01) and distributed irregularly from the bottom to the top of carcinoma tissue. These results suggested that immunohistological staining for PCNA would specifically detect the cell proliferation and be beneficial for practical use and clinical application of the diagnosis of the colorectal lesions.

The strategy for peptic ulcer therapy has been changing with the clinical application of the gastric proton pump inhibitor (PPI). In Japan, Miyoshi et al and Takemoto et al reported an earlier reepithelialization of peptic ulcer with omeprazole (OME) or lansoprazole (LAN) than famotidine (FAM). Miyoshi et al also reported that there was no significant difference between OME and FAM in ulcer relapse rate during a one year follow-up period. Therefore, there were two problems. One is application of PPI for prevention of ulcer relapse, and the other is the more accurate diagnosis of ulcer healing. Application of PPI for maintenance therapy is not yet realized in Japan, but, Lauritsen et al had already reported on the efficacy and safety of OME, 20 mg, three days a week and 10 mg, daily in prevention of duodenal ulcer relapse. Reepithelialization (red scar) is already established as a starting point of maintenance therapy, and from Miyake's report, a white scar is believed a favorable (non relapsing) end point.

The purpose of the present study is to investigate the concurrent validity of a new type of personality inventory (NPI) which has been constructed by the present authors. For this purpose, we conducted three kinds of studies. The first one was to find the relationship of the 13 scales of the NPI with the 12 scales of YG personality inventory. Factor analysis and canonical correlation analysis were employed for the study. It was found that the NPI measured relatively wider area of personality traits as compared with the YG inventory. The second and the third studies were concerned with the concurrent validity of the NPI. The inventory was applied to both six hundred company workers and two hundred university students, and they were classified into adjusted and maladjusted groups respectively according to their responses to a questionnaire aimed at measuring the adaptability to jobs or to majors. Results showed that the 13 scales of the NPI had a strong predictive power in the sense of the concurrent validity. Further studies are needed in order to measure the predictive validity of all the scales of the present personality inventory.

Structures of Cornell Medical Index and Medical Data Index were examined by factor analysis. Both of the translated questionnaires were self-administered by six hundred male employees. Questions of low response rate less than 5 and 6% were excluded, and 117 and 70 questions were analysed finally by the method of varimax rotation for CMI and MDI respectively. Ten factors were extracted. Cummulated contribution ratio of them amounted to 72.0 and 84.1% for CMI and MDI respectively. The first two factors were common for the both questionaires and had pronounced contribution ratio amounting to 36.7 and 29.3% for CMI and MDI respectively. The first factors was composed of questions related to autonomic inbalance, gastrointesinal symptom and fatigue, so it was named a tendency of many physical complaints. This factor was considered to be characteristic and representative one in such general health questionnaires, which was closely related to response set of the respondent. The second factor of the questionnaires was named mental instability. The two major factors would correspond to the first and the second component of the Subjective Fatigue Complaint Test (1970) by Japan Association of Industrial Health. Not also CMI but MDI were found to have a poor scalability except for the two major factors.

The geographical relationships between cancer mortality and food consumption were analyzed by means of extensive uses of correlation coefficiencies, factor analysis, multiple regression analysis, cluster analysis and path analysis. The results for the countries in the world varied broadly due to selection of the countries analyzed. The results for prefectures in Japan showed differences between males and females especially with regard to stomach cancer. The present study shows the importance of careful selection of geographical and other variables when making correlation studies.

It is obvious that surgical resection is a superior therapy for gastric cancer. In this sense, endoscopic therapy could be regarded as an orphan in this field. However, in the combination of endoscopic therapy and ultrasonic endoscopy, endoscopic therapy for gastric cancer should be acknowledged to be equal to surgical therapy. We have treated early gastric cancer by means of endoscopical photocoagulation using a Nd-YAG laser, particularly in inoperable cases due to other complication or old age. Forty-seven lesions found in 41 patients have so far been photocoagulation and followed up. By this treatment, cancer cells disappeared in 42 out of 47 lesions, although 2 cases died of other diseases and recurrence was experienced in 3 cases. In addition to photocoagulation therapy using a laser, we have recently developed a large-biopsy technique called strip biopsy in order to get sufficient tissue for diagnosis in comparison with bite biopsy. By this method, we are able to resect the full thickness of the mucosa including the submucosal layer up to a size of about 4 cm, without any severe complication such as hemorrhage and perforation. We succeeded in resecting the early gastric cancer in 34 lesion in 31 patients. The combination therapy of endoscopical photocoagulation and strip biopsy seems to be reasonable for the therapy of early gastric cancer.

Strip biopsy is carried out in accordance with the principle of endoscopic injection and polypectomy. By using strip biopsy, the full thickness of the mucosa is removed, including the submucosal layer, largely without risk, even in cases of depressed or flat lesions. We have applied this procedure to the therapy of early gastric cancer. Its most valuable aspect is that the resected tissue is collected and the efficacy of the therapy can be evaluated from both macroscopic findings and histological sections. We have applied strip biopsy in 133 cases involving 137 lesions of 8 early gastric cancer, of which 65.0% were totally resected using only the strip biopsy technique. Other cases were treated surgically or subjected to additional endoscopic therapy. sixteen cases were confirmed to have been perfected resected by stomach surgery. Another 71 patients who were not candidates for surgery because of their physical condition have been followed endoscopically for 2 to 48 months, but there has not been any recurrence. On the basis of this study, we believe that the strip biopsy therapy of early gastric cancer should be evaluated in addition to surgical therapy, especially in cases of small lesions localized only in the mucosa.

The purpose of the paper is to construct a personality inventory which measures broader dimensions regarding multiple traits of personality common to normal people by means of extensive use of factor analysis. For the purpose, we prepared 300 items which are supposed to reflect the hypothetical 20 personality traits. Out of the 300 items, 240 items were selected on the basis of means and standard deviations of the items. We applied the oblique Promax rotation method in factor analysis and repeated it several times by changing the number of items and the number of factors. Finally, 12 factors were extracted from the 120 items, in each of which the 10 items having more than 0.4 factor loadings. Basing upon the result, we constructed a new personality inventory consisting of 13 scales (including a lie scale). The constructed scales demonstrated high test-retest reliabilities ranging from 0.880 to 0.950.

An inventory form for the personality description based on the principle of the three traits theory for the work curve of the Uchida-Kraepelin psychodiagnostic test was investigated from the factor-analytic point of view. Three kinds of analyses were performed. First of all, the 66 items of the present form were administrated and a tentative orthogonal factor solution was obtained. Secondly, the 20 items for a simplified pattern in the sense of "simple structure" were selected based on the result of the first factor rotation, and the further orthogonal factor rotation was applied to the data based on the selected items so that the assumption for the three traits, primacy (A), variability (B), and, recency (C) were confirmed factor-analytically. Finally, in order to increase the number of items for providing an extended form for academic and practical use, more 10 items were added to the 20 items of the second analysis after applying the third orthogonal factor rotation so that the new form consisting of 30 items was obtained. Some relationships between the present work and the one of Eysenck and Eysenck (1968) were discussed.