子宮内避妊器具装着歴のない放線菌感染による骨盤内膿瘍の1例

放線菌症は慢性化膿性肉芽腫性感染症で，悪性腫瘍との鑑別がしばしば問題となる．骨盤内放線菌症は子宮内避妊器具装着（IUD）例がほとんどだが，我々は子宮内避妊器具非装着例で病理診断にて卵巣放線菌膿瘍と診断した1例を経験した．症例は73歳，女性．発熱，意識障害で救急搬送され，Computed Tomographyにて内部不均一で境界不明瞭な右卵巣腫瘤および右水腎症を認めた．閉塞性腎盂腎炎による敗血症のため，集中治療を要した．付属器膿瘍や卵巣境界悪性腫瘍を疑い待機的に手術を施行し，病理診断で卵巣放線菌膿瘍と診断した．術後6か月間のアモキシシリン1g／日内服にて，感染の再燃なく経過した．放線菌は培養検査で検出されにくく，病理学的に証明される例が多い．特に子宮内避妊器具非装着例では鑑別に挙がりにくいが，長期抗菌薬治療により再発を予防できることから，積極的に探索・診断するべき疾患である．局所浸潤傾向の強い骨盤内腫瘤を認める場合には，子宮内避妊器具非装着例においても放線菌症の可能性を念頭に置き，培養陰性例では早期に外科的介入を考慮する必要がある

昭和女子大学大学院修了生の臨床心理士としての自己研鑽-臨床歴からみた身につけたい力とその取り組み-

We investigated the continuing learning of clinical psychologists that graduated Showa Women\u27s University. The results were as follows: (1) Of the alumni, 85.3% were working as part-time employees, with more than half working in educational institutions and rest in hospitals. (2) They desired extra skills as clinical psychologists, including assessment skills, test data interpretation and feedback, and skills facilitating interactions between different jobs. They considered these skills to be important, regardless of the field of occupation and the number of years of working as a clinical psychologist. (3) They usually obtained these skills by reading related books and articles and through counseling sessions with work colleagues. Nevertheless, they desired their supervision and opportunities to attend seminars on the practice of helping professions

高齢者の生への価値観と死に対する態度

A questionnaire package consisting of the Purpose-In-Life Test (PIL), Death Attitude Profile (DAP) that includes four dimensions: Fear of Death/Dying, Approach-Oriented Death Acceptance, Neutral Acceptance, and Escape-Oriented Death Acceptance, as well as the Satisfaction with Life Scale (SWLS) was administered to examine the relationship between the value of life and attitudes towards the death of elderly people. Valid data were obtained from 100 males and 100 females over 65 years of age. The results were as follows: (1) Fear of Death and Dying in the high PIL group was significantly higher than in the mid and low PIL groups. (2) The score of Approach-Oriented Death Acceptance in females was significantly higher than in males. (3) There were no significant differences in Neutral Acceptance. (4) In regard to Escape-Oriented Death Acceptance score, the highest was the low PIL group and the lowest was the high PIL group. These findings show a relationship between the value of life and attitudes towards the death of elderly people