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In recent years, discussions about anti-natalism have been activated in various areas. This movement has been started with David Benatar’s controversial book, Better Never to Have Been: The Harms of Coming into Existence, published in 2006. The purpose of this article is to examine what the type of questions has been raised in the movement, especially into pedagogy. Firstly, we survey historical genealogy of anti-natalism, as well as Benatar’s discussion. History of anti-natalism has been long both in the East and the West, and Benatar adds new insights to the genealogy using the method of analytic philosophy. Secondly, we clarify social conditions under which anti-natalism has been widely accepted today. Particularly we focus on contemporary topic such as reproductive ethics, various gaps in society, environmental problems. Then, we suggest there are three issues within recent anti-natalism, and consider the questions brought by each issue.

In another paper I pointed out that Henri Bergson (1859-1941), a French philosopher, in his early years argues on <sensibility> from a similar viewpoint to his contemporaries’. In this paper I aim to examine his notion of <sensibility> in his later years, focusing on The Two Sources of Morality and Religion (1932). Although rarely pointed out, in The Two Sources Bergson argues on <sensibility> from his particular point of view. He proposes “a psychology which accords so extensive and so handsome a place to sensibility,” where emotion gains an advantage over intellect and volition. When we compare The Two Sources with Technical and Critical Vocabulary of the Philosophy, a French encyclopedia published in 1926, we see that Bergson has his conception in common with his contemporaries to some extent, but that on the other hand he is outstanding among his contemporaries especially for his paying attention to the <superior component> of <sensibility>, which is characterized by activity and unity, in contrast to the <inferior component>, which is characterized by passivity and multiplicity.

『葉隠』の武士道において、有事の「武篇」と平時の「奉公」とは、いかにして統一されるか。「武篇」における死の覚悟と実践を一つに貫く「無分別」なありようを、「奉公」にもあてはめることは、果たして可能か。両者の間にある矛盾は、まずもって実践の側にある。「武篇」と「奉公」の実践は、「死」と「生」という基調の色合いにおいて、また時間的な長さと質において、大きく異なるからである。この矛盾は「奉公」の内部において、主君のために死する覚悟が、逆に長きにわたる生の実践を疵なきものにする、という齟齬をもたらすかに見える。しかし「奉公」における死の覚悟は、主君から浪人切腹を命ぜられるのが今日でも将来でもあり得る、という意味で、実はこれも、時間的に大きな振幅をもつものであった。また「奉公」における実践は、現実的にどれだけ長く継続されようとも、理念的には、戦闘の果てに死するという道のりを意味した。「奉公」における覚悟と実践の間に齟齬はなく、さらにその全体は、「武篇」における理想的な戦闘のあり方と通底している。「武篇」と「奉公」の違いは、"戦闘"がもつ時間的な射程とその質のみにあった。しかし、まさにその時間的な射程の長さゆえ、平時の「奉公」における武勇の実践は、有事の「武篇」にあっては認めにくい矛盾をなお、内に抱えている。武士としてその場にふさわしい言葉を出す、という例において顕著なように、「奉公」の実践は、入念な事前の準備と事後の反省とを、不可欠な前提とする。当座の働きは、両者に挟まれてはじめて継続され、磨かれもしたのである。すぐれて反省的で持続的な吟味と、それを「無分別」に棄て去り、超越した地点ではじめて立ち現れる当座の実践は、いかにしてつながるのか。この点をさらに追究することが、今後の課題である。

To minimize the impact of the COVID-19 pandemic, the Japanese government regulated the mobility of international visitors including students. Before March 2020, international students could enter Japan without restriction. During October and November 2020, a limited number of international students entered Japan with expensive air fares and a 14-day quarantine. However, except these months, many students, especially newly enrolled ones, could not enter Japan.

ダイアモンド・ブラックファン貧血 (Diamond–Blackfan anemia : DBA) は, リボゾーム蛋白異常によって生じる赤芽球癆で, 新生児期の貧血および一部で身体奇形を合併する. 臨床的特徴が多様で, 原因となるリボゾーム蛋白遺伝子も多数存在するため, 新生児期にDBAと確定診断し, 適切な治療を行うことが困難である. 本研究では, 全エクソーム解析 (whole-exome sequencing; WES) を用いて最終診断した3組の母子例について報告する. 貧血の重症度や治療反応性は各母子間で異なり, 低身長, 翼状頸, 母指球形成不全などの特徴的な身体奇形を認めた症例は, 母1名のみだった. この母はRPL11 (exon 2, c.58_59del) のフレームシフト変異があり, 子は一過性の新生児貧血を認めたがリボゾーム蛋白遺伝子の変異はなかった. 他の2組の母子では, それぞれRPS19 (exon 4, c.185G>A) のミスセンス変異とRPS7のスプライシング変異 (exon 3, c.76-1G>T) を同定した. それぞれの変異と別に, 貧血を来し得る遺伝子変異はなかった. 本研究は, WESがヒトリボゾーム病の迅速かつ正確な診断を得るために有用であることを示唆した.

We will discuss how a household determines the budget allocation to consumption goods and decides consumption and savings. Microeconomics explain that a consumer maximizes utility under budget constraint. However, in reality, a consumer first determines the budget for each consumption item such as food and clothing and then determines individual consumption goods to buy.

A 38-year-old woman was referred to our hospital with a complaint of left buttock pain. Contrast-enhanced computed tomography and magnetic resonance imaging showed a 7cm smooth mass on the anterior sacrum adjacent to the small intestine and mesentery. The mass was suspected to be a gastrointestinal stromal tumor of the small intestine;however, a definitive diagnosis from radiological and clinical findings was impossible. Laparoscopic visualization revealed that there was no lesion in the small intestine;the mass situated in the retroperitoneally, in contact with the anterior sacrum around the aortic bifurcation. With a diagnosis of retroperitoneal tumor, laparoscopic resection was performed simultaneously. An incision was made in sigmoid mesentery, and the tumor was detached and resected preserving the anterior fascia of the hypogastric nerve. Intraoperatively the surface of the tumor was confirmed to be smooth, and there was no infiltration around the tumor, which facilitated handling and manipulation of the tumor for resection. The patient was discharged without any complications and the pathological diagnosis was benign schwannoma. Anterior sacral retroperitoneal schwannomas are rare and difficult to diagnose preoperatively. In this case, successfully management was achieved via simultaneous laparoscopic observation and resection.

A 52-year-old-man visited hospital with right lower abdominal pain. We diagnosed acute appendicitis and intraperitoneal abscess. We decided to perform interval appendectomy and started antibacterial treatment. Antibacterial treatment was successful and the patient was discharged. Laparoscopic appendectomy was performed six month later. Only thickening of appendix mucosa was found in the specimen, but postoperative pathological diagnosis revealed goblet cell adenocarcinoma(GCA)of appendix. There was a risk factor associated with invasion depth T4, we performed ileocecal resection(D3)one month after the first surgery. The postoperative pathological examination result was pT4aN0M0 pStageⅡ.Recurrence has not been observed 18 months later. This case was an appendiceal GCA which was accidentally found in a specimen after interval appendectomy and treated by additional surgery. Infrequently, there are some reports of acute appendicitis associated with appendiceal tumor. In clinical practice, it is difficult to perform interval appendectomy for all appendicitis cases after conservative treatment, but it is suggested that for complicated appendicitis, we should perform interval appendectomy in consideration of age, ADL, and social background.

Abdominal incisional hernia is a frequent complication of open abdominal surgery. We herein report a rare case in which the left lateral segment of the liver prolapsed as the contents of an abdominal incisional hernia.The patient was a woman in her 80s whose chief complaint was abdominal protrusions. She had undergone abdominal surgery for gallstones 30 years ago. Computed tomography revealed abdominal incisional hernias in the upper abdomen, from which the left lateral segment of the liver and the transverse colon had prolapsed. Laparoscopic hernia repair surgery was performed under general anesthesia. The intraoperative findings showed the adhesion of the round ligament of the liver to the abdominal wall and transverse mesocolon. The prolapsed left lateral segment of the liver appeared as if being pulled upward by the round ligament of the liver and the poor formation of the triangle ligament. Two hernia orifices were repaired using two meshes. Recently, laparoscopic hernia repair surgery is increasing. Laparoscopic hernia repair surgery is useful to observe the abdominal cavity, details of hernia orifice and content, and the check of repair’s completion.

We have developed ACTce‑CCM̶ Analysis and Coordination Tools of Clinical Ethics in Critical Care Medicine. The preparation process was carried out in four stages:construct setting and prototype creation, application of prototype version to fictitious cases, clarification of the construct based on focus group interviews, and a fact-finding survey on ethical issues and ethical adjustment. The completed version of ACTce-CCM consists of information organization and assessment frameworks, problem analysis and integration, problem lists, goals, care practices, and ethical adjustment. There are six frameworks for information organization and assessment:pathology and treatment, QOL and QOD, patient intention, family psychosocial situation, medical team situation, and the surrounding situation. The problem lists include those related to the patient, the family, and the medical staff. Goals include those of the medical team and the expected outcomes for the patient/family. Care practices and ethical adjustment consist of three aspects: direct patient care, direct family care, and medical team adjustment.

This study aimed to clarify outcome of the public health nursing practice conducted under the influence of COVID-19. A self-administered anonymous questionnaire survey was performed for 4th grader students at University from 2018 through 2020. The investigation items consisted of basic attributes, impression of public health nurse activity, learning motivation and learning target items. We compared shortened clinical practice and online practice enforced in 2020 and before. For 217 effective answers,＂A public health nurse was involved in practice sufficiently＂ was significantly low. In top learning achievement scores of 2020 included many of the items from the the learning target＂Process of public health nursing activity＂ and ＂Role and function of public health center and municipalities. In 2018 and 2019, learning achievement degrees were over 80% in 94.3% of 53 items while on the other hand it was only 32.1% in 2020. Learning achievement degrees were less than 60% in no items in 2018 and 2019 while it was 15.1% in 2020. For the techniques of health service and health practice for which the learning achievement degree were low in 2020, it is necessary to support students so that they can acquire them as a public health nursing practice ability.