ガッコウ ゲンバ ノ ガッコウ キンキュウ シエン ニツイテノ ヨウボウ ニ カンスル チョウサ ケンキュウ : ガッコウ キンキュウ シエン マニュアル ト キット サクセイ ニ ムケテ

学校緊急支援のためのマニュアルとキットを作成するために、学校緊急支援についての要望について秋田県内すべての教育委員会、高等学校、中学校、小学校といくつかの幼稚園・保育園に対して、自作の質問紙による調査を行った。結果、527人(回収率51.7%)から回答を得た。回答者は、教頭、養護教諭が多かった。学校緊急支援については、75.9%の回答者が知っていた。学校緊急支援を必要とする事案は多様であるが、回答者は、「校内(敷地内)」「自殺」「死傷」という事案で多く必要性を感じていた。必要とする人材は、複数の臨床心理士、教育委員会職員などであり、2～3日から1週間程度の支援を望んでいた。希望する支援内容は、カウンセリング、心理的ダメージの評価、子供への接し方についての専門的アドバイスなどであった。For the purpose of making a School Crisis Intervention (SCI) manual and a kit, data on needs for SCI for school teachers were collected from all educational boards, high schools, junior high schools, elementary schools and some nursery schools in Akita prefecture through the use of a self‑evaluating questionnaire. As a result, we received data from 527 school teachers, a return rate of 51.7%. They were mainly from assistant principals and Yogo‑Teachers (nurse‑teachers.) 75.9% of them were familiar with SCI but said they needed SCI guidance in various situations especially situations such as "in school (on campus)," "suicide," "deaths or injuries." Regarding the human resources for SCI, they would need some assistance from clinical psychologists and members of the board of education from a few days up to a week. They also would expect counseling, assessment of psychological damage and advice from specialist dealing with such affected children

Ascending Colon Cancer Associated with Dermatomyositis Which Was Cured after Colon Resection

A 76-year-old woman with muscle ache, weakness of the extremities, and skin rash was diagnosed with dermatomyositis (DM). Upon the diagnosis of DM, a systemic survey of malignancy revealed an advanced carcinoma of the ascending colon. The patient underwent right hemicolectomy approximately 2 months after the onset of DM. The symptoms and signs of DM disappeared after the surgery without additional therapy. DM is an idiopathic systemic inflammatory disease characterized by muscle ache, muscle weakness, and skin rash. In some cases, DM develops as paraneoplastic syndrome, and it is assumed that 30% of DM patients have cancer. Symptoms and signs of DM can be attenuated by treatment of the malignancy, and they reappear if the malignancy recurs. It is essential to perform a systemic survey of malignancy in DM patients, and treatment of the malignancy has to precede treatment of DM

Two Patients with Large Colonic Lipomas for which Endoscopic Unroofing was Ineffective

Endoscopic unroofing is effective for treating large colonic lipomas. However, additional endoscopic resection is occasionally required when the outcomes of initial unroofing are incomplete. The colonoscopy of an 82-year-old woman with abdominal pain revealed a yellowish lipoma of about 20 mm in the transverse colon. The mass was treated by unroofing, but a follow-up colonoscopy 5 days later revealed residual lipoma. One month later, the regenerated surface had become covered with mucosa, and the status of the lipoma had returned to that before unroofing. The colonoscopy of a 74-year-old man with abdominal pain and melena revealed a 50-mm-wide protruding lipoma in the transverse colon. The mucosa of the upper third of the lipoma was excised using an electric knife and snare, which allowed the immediate partial drainage of adipose tissue. Unroofing proceeded, but 7 days later, the unroofed surface had become coated with a white substance, and the residual lipoma required additional endoscopic resection. Colonic lipomas are often asymptomatic. However, patients with abdominal pain and hemorrhage should be treated in consideration of complete resection, but not by unroofing, which could leave a residual tumor. Drainage should be confirmed after unroofing and any residual lipoma should be treated by additional resection

Unusual False-Positive Mesenteric Lymph Nodes Detected by PET/CT in a Metastatic Survey of Lung Cancer

Positron emission tomography/computed tomography (PET/CT) is a credible diagnostic modality for detecting primary and metastatic malignancy. PET/CT sometimes shows false positives and negatives, which make clinical diagnosis difficult. A 42-year-old man who had undergone right upper lobectomy for lung cancer 1 year previously had PET/CT for a metastatic survey of the lung. The lung cancer was stage IB (pT2N0M0) bronchioloalveolar carcinoma. PET/CT showed massive 18F-fluorodeoxyglucose (FDG) uptake in the mesenteric lymph nodes. Because the mesentery is an unusual site of metastasis, the patient was under watchful observation. Another PET/CT after 6 months still showed FDG uptake in the same location, with a slightly increased standard uptake value. A systemic survey was performed, but it did not reveal any malignancies or inflammatory diseases. Eventually, the patient underwent probing laparoscopic surgery. For complete resection of the lymph nodes, laparoscopic ileocecal resection was performed. Histologically, the resected lymph nodes showed reactive lymphadenitis. Glucose transporter 1 immunostainings of the lung cancer and the lymph node were positive and partially positive, respectively. Although PET/CT is a powerful diagnostic modality, clinical interpretation of unusual results is difficult