Hyaline ring granuloma (HRG) is a comparatively rare inflammatory condition occurring mainly in the oral region, and is characterized by hyaline rings (HRs) formed in the granulation tissue. This study describes a case of HRG occurring in the mandibular periosteum of an 18-year-old male. Histopathologic, histochemical and electron microscopic studies were performed on surgically excised materials. Histopathologically, ovoid bodies (OBs) surrounded by thin hyaline walls and HRs showing pale-stained eosinophilic thick hyaline walls were both detected. Histochemical study revealed that the OBs contained many granules chiefly composed of starch. Ultrastructurally, the HRs presented a stratiform structure due to the accumulation of cross-banded collagen fibrils with a basement membrane-like lining containing cellulose microfilaments. These results suggest that HRs are formed as follows: the exogenous vegetable materials are encapsulated by collagen, then the component is gradually degraded; the residual cellulose fraction adheres to the inner surface of the collagenous capsules, and the continuous deposition of collagen at the outer surface of the capsules increases its thickness. Finally, thick hyaline walls of HRs are formed. The possible pathogenesis of this curious lesion is discussed for stomatologists.

The effect of bathing with NY-008 (3-octylphthalide, a newly synthesized vasodilative compound) on skin temperature was examined. The subjects were 28 healthy male adults (22±4 years old). The group bathed for 10min in 40°C water containing 3ppm of NY-008. On alternate days, the group bathed similarly but without NY-008 (control bathing). Skin temperature (Ts), blood pressure, and heart rate (HR) were then measured in a room in which the ambient temperature was maintained at 24°C and relative humidity at 60%. To eliminate any effect of diurnal fluctuations in skin temperature, each subject bathed at the same hour each day. Measurements were performed in random order by the double-blind method. The mean values of Ts after bathing were slightly higher after NY-008 bathing than after control bathing, and a significant difference was noted 10min after bathing (p<0.01). There was no significant difference in systolic blood pressure between NY-008 bathing and control bathing. Diastolic blood pressure was slightly lower after NY-008 bathing. Mean blood pressure, measured 5 min after bathing, was significantly lower after NY-008 bathing than after control bathing (p<0.05). No significant difference was found in HR. These findings suggest that NY-008 bathing increases skin blood flow through vasodilation of skin vessels and lower peripheral resistance, and may have longer lasting warming effects than ordinary bathing.

Introduction : To promote disease management in the community, general physicians should refer their patients to specialists in a timely and appropriate manner. In this study, we propose an indicator for evaluation of such referrals.
Methods : We analyzed all referrals in an urban clinic from September 1, 2011 to August 31, 2012. Symptoms and diagnoses documented by general physicians were collected from medical records, and the final diagnoses by specialists were collected from their reports. The symptoms and diagnoses were classified using the International Classification of Primary Care second edition (ICPC-2). Referral rates, hospitalization rates, and place of referral were analyzed.
Results : The average number of encounters in the candidate clinic was 1402 per month, and the mean number of referrals was 23 (1.6% of encounters). Of patients who received a referral, 6.75 (29.1%) were admitted to hospitals. The symptoms and diagnoses of the referred patients were distributed across all chapters (A to Z) of ICPC-2. Diagnoses of admitted patients included pneumonia (R81) (24%), urinary tract infection (U70 and U71) (9%), and acute gastroenteritis with dehydration (D73 with T11) (9%).
Conclusion : We identified the referral rates, hospitalization rates, and distribution of referral patients as indicators of the triage function of primary care physicians. These should be evaluated further as potential indicators of “the quality of medical care.”

The purpose of this study was to assess the negative effects of some factors on medicine-taking behavior. For the patients taking oral medication who visited a health insurance pharmacy, we enacted the actual situation of medication and conducted an attitude survey on the feeling of burden and resistance of taking the drugs. The survey also covered the factors that can influence medicine-taking behavior and the extent of the influence. For differences in each factor such as patient characteristics, lifestyle, and medication status, we used the 2 test to analyze the association with medicine-taking behavior. We found significant differences in age, dietary habits, occupation, periodic consultation with the pharmacy/doctor, and unpleasant experiences. In addition, in patients with multiple factors that cause noncompliance with medication, we observed a strong influence of age and occupation. From the factor analysis, we obtained data on time, quantity, and pharmaceutical factors (three factors called regular factors). These factors negatively influenced the use of medication by the patients. Next, in the covariance structure analysis, the influence of time and the quantity factor on medication-related stress was the observed to be the strongest, whereas the influence of the regular factors was not significant. Furthermore, there were differences in the influence of these factors depending on patient characteristics.

The effect of octylphthalide (OP) bathing was compared with placebo bathing on patients with rheumatoid arthritis (RA).
A liquid containing octylphthalide was dissolved in water of 40°C at a concentration of 10ppm. A liquid which has quite similar appearance and perfume to the above was used as a placebo. Double blind controlled study tests were performed.
Twenty patients (10 for OP bathing and 10 for placebo bathing) were tested by single bathing, 33 other patients (16 patients for OP bathing and 17 for placebo bathing), by serial bathing for 30 days (once a day).
After a single bathing, while grip strengths, tender joints scores, and 20m walking time improved significantly in the OP bathing group, only tender joint scores and 20m walking time improved significantly in the placebo bathing group.
After serial bathing for 30 days, tender joint scores improved significantly in the OP bathing group, but no improvement was observed in the placebo bathing group. The above results suggest that OP bathing may be beneficial for RA patients, but further study may be needed.