The optical networking system has been expected to be a part of the foundation of information communication in our daily life and commonly known as“Hikari no Michi”. A medical version of“Hikari no Michi”plan aims not just for improvement of the communication environment out of a hospital, but for the system as a basis of application of medical and engineering knowledge in a hospital, however, it has not been put into effect yet. This plan makes an improvement of the work effectiveness by ICT（information and communication technology）and（semi-）automation, and solves shortage of doctors and nurses in short term. Also, there are great hopes that the realization of these technologies；time synchronization and latency control in networking, scalability, bandwidth guarantee and methods for recovering from various kinds of networking error, results in making a medical network more efficient with medical and nursing service inside the hospital and whole community outside the hospital. To support this system, we take an earphone type vital signs monitor and automatic vocal recognition system as practical examples, and attempt to propose the significance of this plan in the medical-engineering and nursing-engineering cooperation fields and the specific direction toward the purpose.

When eating food, the hardness of food is reportedly related to the metabolic status such as type 2 diabetes and waist circumference, and to lower jaw development. Therefore, to take the hardness of food into account at meals has been considered beneficial for metabolic amelioration and sound jaw development. However, the system that can easily estimate the hardness of food when eating meals in daily life has not been offered yet, although the hardness of food itself can be measured. In this study we theorized to use lower jaw acceleration for estimation of food hardness during mastication. As a basic study, an ultra-small accelerometer was attached to the subject’s mentum, and 3-axes acceleration data was obtained when eating soft or hard sample. As a result, there were significant differences between soft and hard samples when RMS and RMSSD were calculated. These results imply that the monitoring lower jaw acceleration may applicable for the estimation of food hardness during mastication.

One aspect of preventive care for diabetic foot ulcers is the production of therapeutic footwear for diabetic patients. Some patients with diabetes do not have therapeutic footwear, even though it is recommended by health providers. Effective intervention is unknown because the production process is unclear. Therefore, the production process for therapeutic footwear for diabetic patients was investigated qualitatively. Twenty-two diabetic patients who visited the university hospital from April 2008 to November 2012 and for whom therapeutic footwear was recommended were recruited. A semistructured interview concerning the process from proposal of therapeutic footwear to its production and subsequent continuous use or, in contrast, its lack of production, was conducted. The core category was“value the design of shoes, and continue to not rely on therapeutic footwear”. The subjects who did not have therapeutic footwear valued the design of shoes, interpreted diabetic foot ulcer in their own way, and continued to not rely on therapeutic footwear given that non-ulcerative lesions do not develop into ulcers. Shared knowledge between patients and health providers that functionality of shoes is important and the development of well-designed footwear are needed.

Therapeutic drug monitoring（TDM）that can be performed near the patient is helpful for safe and effective pharmacotherapy. We aim to realize rapid TDM that does not require blood sampling and we investigate the potential of Raman spectroscopy of tear fluid with paper substrates. For this purpose, it should be shown that Raman spectroscopy can identify drugs in human tear fluid, and it is enough sensitive for TDM, and Raman spectroscopy with paper substrates is available for drug identification. In this study, we revealed that Raman spectroscopy could identify the therapeutic drug in artificial tears on silicon coated glass substrates, the sensitivity was enough to detect the drug in aqueous solution whose concentration was equivalent to real human tear fluid, and the drug absorbed in paper substrates was detectable by separating the spectra of drug from that of paper substrates.

Objective：We assessed the value of the skin color and morphology in the detection of lower extremity peripheral arterial disease（PAD）in diabetic subjects. Methods：Setting：A advanced treatment hospital in Japan. Participants：32 outpatients with diabetes mellitus. Measurements：The presence of PAD defined as combination with ankle brachial index and thermography. Lower extremity skin condition was evaluated by skin color and skin morphology. Results：The skin variables, a and b were significantly associated with lower extremity PAD. a showed the area under the receiver operating characteristic curve of 0.706. a＜2.80（sensitivity 78.6%, specificity 55.6%）had the large positive likelihood ratio. Conclusions：The skin color with lower extremity PAD in diabetic patients had dark red color skin.

The aim of the present study was to examine whether ultrasonography（US）can be used to assess the location of peripheral intravenous catheters（PIVCs）in the peripheral vein and surrounding tissues. A total of 30 adults with PIVCs inserted were examined in a prospective study. Transverse and longitudinal US images were used for analysis of the position of the PIVC tips, the strong adherence to vessel wall near the PIVC tips, the collapsed intravascular lumen in the PIVCs tips, the intravenous thrombus, the vessel wall thickness obtained with PIVCs, and the edema of the subcutaneous fat layer（subcutaneous edema）. We found that US identified the PIVC tips located in the inside of intravascular lumen in 26/30 patients, with an unknown location in four cases. US images of the intravascular lumen obtained with PIVCs were classified into three main patterns： the venous thrombus（thrombus type）in 8; the vessel wall thickness without the thrombus（wall thickness type）in 2; and the venous thrombus with vessel wall thickness（mixed type）in 8 and in the remaining 8 patients. These data suggest that US imaging is a useful technique for investigation of complications following PIVC placement.

The purpose of this study was to examine the possibility of new nursing observation method by evaluating 24h sleep quality, core body temperature, and respiration rate and heart rate in a bedridden elderly patient with disorder of consciousness. Polysomnography was performed for evaluating 24h sleep quality. Subsequently, abdominal temperature for 72h, respiration rate and heart rate for 24h were measured for evaluating vital signs. The 24h sleep efficiency was 98.0%. The core body temperature had 8h. cycle. The difference between day and night-time was not observed in the respiration rate and heart rate；this could be because the subject showed a fragmented sleep pattern throughout the day. It is possible that nursing care during daytime could result in a change in the sleep-wake rhythm and biological rhythm, because the number of awakenings during daytime is more than that during night-time. Future, it is necessary to clarify relationship between biological measurement indexes and nursing care.