Tuberculous spondylitis, or so-called Pott's disease, seems to be overlooked because of a lack of severe inflammation in the insidious generating process and tends to cause non-specific symptoms, such as back pain, fever, weakness, and weight loss. Diagnostic delay is common and the results can be disastrous. Discriminating between Pott's disease and other diseases, such as malignancy and pyogenic infection, is difficult. However, the inflammatory process in Pott's disease tends to spare the disk space, while that of pyogenic infection typically affects the area. Herein, we present a patient with Pott's disease who showed the characteristic clinical and radiological findings.

A case of xenograft valve dysfunction presenting with musical cooing murmur is reported. The patient was a 47-year-old woman and had received mitral valve replacement with porcine xenograft (Carpentier-Edwards 31-M) 10 years before Preoperative echocardiogram showed vibration of a leaflet outside the stent of the bioprosthetic valve. Cardiac catheterization revealed stenosis as well as regurgitation of the bioprosthetic valve. The resected xenograft valve showed a tear which produced regurgitation and musical cooing murmur in one of three pliable leaflets and it also showed pannus formation which caused stenosis.

Various types of surgical techniques have been reported for the closure of complicated PDA, since Morrow first described an innovatory operative method. At our institute, extracorporeal circulation has been frequently used as a support measure for these operations to ensure the safety of the operation. Ten patients with complicated PDA were operated under extracorporeal circulation. All patients but one were adults. The reason for use of extracorporeal circulation included age, presence of atherosclerosis or calcification of the ductus, short neck ductus, ductal aneurysms, right sided descending aorta and recanalization after previous ligation. The ductus was approached through the left lateral thoracotomy in 8 patients and median sternotomy in 2. The Morrow procedure was performed in 2 patients. No hospital death occurred, although the mean duration of the hospital stay after the operation was longer in these cases than in cases with simple PDA. We conclude that the use of extracorporeal circulation is safe and effective for the closure of complicated PDA.

Alzheimer's disease (AD), the most common form of dementia among the elderly, is characterized by the progressive decline of cognitive function and has a detrimental impact worldwide. Despite intensive laboratory and clinical research over the last three decades, pharmacological options for the prevention and effective long-term treatment of AD are not currently available. Consequently, successful therapeutic and preventive treatments for AD are needed. When researching materials from natural resources having anti-dementia drug activity, we identified nobiletin, a polymethoxylated flavone from the peel of Citrus depressa. Nobiletin exhibited memory-improving effects in various animal models of dementia and exerted a wide range of beneficial effects against pathological features of AD including amyloid-beta (Abeta) pathology, tau hyperphosphorylation, oxidative stress, cholinergic neurodegeneration and dysfunction of synaptic plasticity-related signaling, suggesting this natural compound could become a novel drug for the treatment and prevention of AD.
Aged ; Alzheimer Disease ; Animals ; Citrus* ; Natural Resources ; Dementia ; Humans ; Memory ; Models, Animal ; Oxidative Stress ; Pathology

A Task Force team consisting of members from pharmaceutical companies --a central player to develop and implement RMP (Risk Management Plan)-- as well as health care professionals and members from academia was established in JSPE. The Task Force developed guidance for scientific approach to practical and ICH-E2E-compliant Pharmacovigilance Plan (PVP) stated in Japanese Risk Management Plan issued in April 2012 by the Ministry of Health, Labour and Welfare. The guidance contains the following topics.
1．Introduction: JSPE's activities and this task force's objectives for pharmacovigilance activities
2．How to select Safety Specification (SS) and describe its characteristics
・Selection of SS
・Characterization of SS
・Association with Research Questions (RQ)
3．How to define and describe RQ
・What is RQ ?
・RQ interpretation in other relevant guidelines
・Methodology to develop RQ for PVP with examples
・Best approach to integrating PVP for whole aspects of safety concern
4．How to optimize PVP for specific RQ
・Routine PVP or additional PVP ?
・Additional PVP design (RQ and study design, RQ structured with PICO or GPP's research objectives, specific aims, and rationale)
・Checklist to help develop PVP
5．Epilogue:
・What can/should be “Drug use investigation” in the context of ICH-E2E-compliant PVP.
・Significance of background incidence rate and needs for comparator group
・Infrastructure for the future PVP activities
6．Appendix: Checklist to help develop PVP activities in RMP
The task force team is hoping that this guidance help develop and conduct SS and PVP in accordance with ICH E2E, as stated in Japanese Risk Management Plan Guideline.

The purpose of this study was to determine whether improved physical fitness through a new exercise program intervention including elements of Tai Chi Chuan and Kung Fu gymnastics among elderly people who have lower physical. Eighty older adults with less physical strength aged 71-89 (mean age±SD=77.3±3.9), recruited from Tsurugaya area of Sendai, participated in a 3-month randomized controlled trial, with allocation to a new exercise program or well-accepted exercise program control. Physical performance measures included the timed up and go test (TUGT), the functional reach test, a 6 min continuous walking test, and the sit-and-reach test were conducted before and after the intervention. Data were analyzed through on-treatment-analysis of variance. After training, although no significant between-groups differences were observed for all the measures, TUGT, which is recommended as a simple screening tool to identify those at risk of falling was improved in both groups following the intervention (P<0.05). The findings revealed that the new exercise program including Tai Chi Chuan and Kung Fu gymnastics element could improve physical fitness to a similar level as the well-accepted exercise program.

To promote the stockpiling of regular medicines for disasters (SMD), we investigated SMD rates and clarified the relationship between SMD status (Yes or No) and the characteristics of patients with chronic diseases. A survey was provided to patients visiting the pharmacies in Hokkaido. SMD was defined as a patient having a supply of regular medicine for 7 days or more and replacing with new medicine within one year. Of a total of 537 participants (51.0% male; mean age 65.8 years), 61.1% had experienced a major disaster. The SMD rate was extremely low at 15.3%. The median score for a patient’s understanding of the regular medicine names (5-point scale: 1＝hardly understood, 5＝almost understood) was 2. The median number of monthly pharmacy visits was 0.8. 5.4% were recommended SMD by physicians or pharmacists. Results from multiple logistic regression analysis indicated that positive patient characteristics included age (OR＝1.154, 95%CI [1.026-1.298], P＝0.017), understanding of the regular medicine names (1.724, [1.039-2.859], P＝0.035), and recommendation of SMD by physicians or pharmacists (5.991, [2.616-13.722], P<0.001). A negative patient characteristic was the number of pharmacy visits (0.587, [0.383-0.899], P＝0.014). The most influential positive factor was the recommendation of SMD by physicians or pharmacists; however, only 5.4% of the participants had experienced this. The findings of this study indicated important that health care providers and the government to work together to devise easy-to-understand measures to inform local residents about the importance of SMD and how to them, conduct educational activities.

A 78-year-old woman who had a history of left deep venous thrombosis was referred to our hospital with a sudden hemoptysis. Thoracic computed tomography showed a solitary pulmonary nodule in the right lower lobe. Based on her medical history of deep venous thrombosis, she was tentatively diagnosed as having pulmonary embolism and successfully treated by inserting an inferior vena cava filter and anticoagulant therapy with warfarin [Please confirm whether previous sentence is correct]. However, the lung nodule on thoracic computed tomography was still depicted four months later. With suspicion of a malignant tumor, including possible lung cancer, a right segmentectomy was performed. Pathological assessment of the resected specimen showed the tumor was derived from the right bronchial wall, but was not ruptured into the intratracheal lumen, as well as coexistence with intraalveolar hemorrhage near the tumor. The lung nodule was diagnosed as bronchial schwannoma. Thus, the origin of the hemoptysis was found to be pulmonary embolism due to deep vein thrombosis, and not by bronchial schwannoma, which was also present in the lung.