Early Intake of Radiocesium by Residents Living Near the Tepco Fukushima Dai-ichi Nuclear Power Plant After the Accident. Part 2: Relationship Between Internal Dose and Evacuation Behavior in Individuals

The Tokyo Electric Power Company's Fukushima Dai-ichi Nuclear Power Plant (FDNPP) accident exposed members of the public to radiation. This study analyses the relation between personal behavior data obtained from 112 out of 174 subjects who underwent whole-body measurements by the National Institute of Radiological Sciences (NIRS) during the period from 27 June to 28 July 2011 and their committed effective doses (CEDs) from Cs and Cs. The whereabouts of the 112 persons living in municipalities near the FDNPP (mainly, Namie town) on several days in March 2011 are graphed on maps. It was confirmed that most subjects started evacuation promptly and had left the 20-km-radius of the FDNPP by the end of 12 March. The individual CEDs were poorly correlated with the person's distances from the FDNPP at any day in March. Meanwhile, the percentage of persons remaining within the 20-km radius of the FDNPP was 100% at 16:00 on 12 March and 42.9% at 0:00 on 15 March for those with CEDs > 0.1 mSv, whereas the corresponding values were much lower for those with CEDs ≤ 0.1 mSv. This suggests that the time of evacuation would be one of the crucial factors for the early intake; however, more personal behavior data are needed to be analyzed to clarify the relevance to the individual internal dose

An Attempt at Curriculum Improvement through an Evaluation by External Experienced Childcare Workers

　本論は，保育現場における園のカリキュラム・マネジメントを活性化させるために，園外の保育経験者にカリキュラムの外部評価を依頼し，その評価内容と一連の評価方法について検討するものである。具体的には，地方政令市にあるA 保育園のカリキュラムを取り上げ，保育所保育士経験者及び幼稚園教諭経験者によって構成させる７名の外部評価者から，カリキュラムの評価を得た。その結果，外部評価者の勤務経験の違いを反映した，幅広い観点から，カリキュラムの評価できる点や問題点を確認することができた。カリキュラム改善の観点としては，「表記・表現の統一と分かりやすい様式の採用」「園の独自性や子どもの実態に即した計画の作成」「保健計画の作成」「PDCA サイクルによる再編成」「職員間での確認」の項目を明示することができた。カリキュラム改善の一方策として，保育経験者による外部評価に一定の有効性を確認した。　We commissioned external seven childcare workers with experience of early childhood education and care to evaluate the curriculum of a nursery school. Evaluation results reflected wide points of view based on the experiences of each evaluator. It was possible to specify the items of "unification of transcription and expression, and adoption of the plain style," "making of a plan in conformity with originality in facilities and the reality of the child," "making of a preservation of health plan," "reorganization by the PDCA cycle," and "confirmation between the staff" as factors related to curriculum improvement. The validity of the external evaluation by the childcare workers with experience was confirmed as a policy of curriculum improvement

ヒドウジョウミャク オ オンゾン シタ ヒオンゾン ビソクスイ セツジョジュツ ショウカカン ニュウセン シュジュツゴ ノ ヒゾウ ノ タイセキ ヘンカ

Aim: There is a paucity of information about changes in splenic volume after surgery. The aim of this study was to investigate postoperative changes in splenic volume（SV）and the factors influencing SV after spleen-preserving distal pancreatectomy（SPDP）with conservation of the splenic artery and vein （CSAV）, and after surgery of the digestive tract and breast.Methods: We investigated 113 patients who underwent SPDP with CSAV（n=7）, breast surgery （n=24）, colorectal surgery（n=45）, distal gastrectomy（n=27）and total gastrectomy（n=10）. SV changes were determined for three years after surgery using volumetry based on computed tomographic imaging, and splenic vein diameter changes after SPDP with CSAV were also determined.Results: Splenic vein diameter after SPDP with CSAV did not change during 3 years. SV did not change significantly during 3 years after SPDP with CSAV and distal gastrectomy. After breast and colorectal surgery, and total gastrectomy, SV was decreased.Conclusions: Postoperative SV changes differed according to the type of surgery. SV did not change significantly during 3 years after SPDP with CSAV

Symptomatic periesophageal vagal nerve injury by different energy sources during atrial fibrillation ablation

BackgroundSymptomatic gastric hypomotility (SGH) is a rare but major complication of atrial fibrillation (AF) ablation, but data on this are scarce.ObjectiveWe compared the clinical course of SGH occurring with different energy sources.MethodsThis multicenter study retrospectively collected the characteristics and clinical outcomes of patients with SGH after AF ablation.ResultsThe data of 93 patients (67.0 ± 11.2 years, 68 men, 52 paroxysmal AF) with SGH after AF ablation were collected from 23 cardiovascular centers. Left atrial (LA) ablation sets included pulmonary vein isolation (PVI) alone, a PVI plus a roof-line, and an LA posterior wall isolation in 42 (45.2%), 11 (11.8%), and 40 (43.0%) patients, respectively. LA ablation was performed by radiofrequency ablation, cryoballoon ablation, or both in 38 (40.8%), 38 (40.8%), and 17 (18.3%) patients, respectively. SGH diagnoses were confirmed at 2 (1–4) days post-procedure, and 28 (30.1%) patients required re-hospitalizations. Fasting was required in 81 (92.0%) patients for 4 (2.5–5) days; the total hospitalization duration was 11 [7–19.8] days. After conservative treatment, symptoms disappeared in 22.3% of patients at 1 month, 48.9% at 2 months, 57.6% at 3 months, 84.6% at 6 months, and 89.7% at 12 months, however, one patient required surgery after radiofrequency ablation. Symptoms persisted for >1-year post-procedure in 7 patients. The outcomes were similar regardless of the energy source and LA lesion set.ConclusionsThe clinical course of SGH was similar regardless of the energy source. The diagnosis was often delayed, and most recovered within 6 months, yet could persist for over 1 year in 10%