We studied the effect of Saiko-ka-ryukotsu-borei-to (crude extract powder for research purposes) on central monoamine-related substances in mice. The formulation was given in a dose of 50mg/kg or 400mg/kg and was administered once or repeatedly (twice a day for seven days). The brain was removed and segmented in the conventional method. The monoamine-related substances were measured by a method using HPLC-ECD. The main results were as follows. The single or repeated administration of 50mg/kg increased DOPAC and HVA contents in the cerebral cortex. In the hypothalamus, the single 50mg/kg treatment decreased NE, and the repeated 50mg/kg treatment decreased NE but increased DOPA. In the corpus striatum, the single 50mg/kg administration increased DA, DOPAC, HVA, and 5-HIAA while the repeated administration increased NE and MHPG as well. In this region, the single 400mg/kg treatment increased NE and 5-HIAA, and the repeated treatment increased NE. In the hyppocampus, the repeated 50mg/kg treatment increased MHPG, and the repeated 400mg/kg treatment decreased HVA. These results indicate that the effect of this formulation on murine brain monoamines is greater at 50mg/kg than at 400mg/kg and that the effect varies among the regions of the brain.

Purpose: This study investigated the current state of critical hemorrhage during home palliative care for terminally ill cancer patients. Methods: We conducted a retrospective medical chart review of 7 cancer patients (1.4%) who received home palliative care from our clinic and died of critical hemorrhage at home from October 2007 to December 2014. Results: Four patients were male, the mean age was 70±11 years, and underlying diseases were different. None of the patients were accompanied by medical staff at the onset of bleeding. Six patients died at home and one patient was admitted to hospital for hemostasis. Six patients had a pre-hemorrhage episode more than 24 hours before critical hemorrhage occurred from the same site. One patient was administered a hemostatic agent, hemostasis was attempted in one, and one was given sedation. Six patients wanted to die at home, and did die at home. Discussion: If terminally ill cancer patients have critical hemorrhage at home, our options are limited. The results of this study suggest the importance of hemorrhage risk assessment and advance care planning.

The 82 nd and 83 rd National Examination for Physicians' License, which were held in 1988 and 1989 respectively, were evaluated from question to question as well as in all the questions as a whole to set minimum pass scores and analysis “relevance” and “difficulty” in a matrix utilizing a modified Ebel's method.
The evaluators were teachers in different disciplines in nationwide medical schools and teaching hospitals and clinical trainees who had taken and passed the immediate past examinations.
Following data processing, the questionable and difficult questions were on the decrease compared with the preceding year, and it was tentatively concluded that the National Examinations have gradually improved year by year.