A 40-year old man with chest pain was admitted to our hospital. A three-dimensional CT revealed an unruptured left coronary sinus of Valsalva aneurysm and mild stenosis of the left main trunk. An echocardiogram revealed severe aortic regurgitation. He was operated on with an aortic root replacement procedure. Though the procedure was itself uneventful, he could not be weaned from cardiopulmonary bypass because of unexpected coronary events ; relative stenosis of the RCA and stretched LMT due to a huge aneurysm of the sinus of Valsalva. Additional CABG with LITA to LAD and SVG to RCA led to weaning from cardiopulmonary bypass. Left coronary sinus of Valsalva aneurysm is rare, and it requires early surgical intervention for an increase in the diameter of the aneurysm together with myocardial ischemia due to compression of the coronary artery.

An 80-year-old man felt a loss of strength and sharp pain in both lower limbs while playing gate-ball, consulted a nearby doctor, and was followed up. Because the sharp pains in both lower limbs became aggravated the next day, he was given a previously prescribed medication. Both femoral pulses were absent and acute arterial obstruction of the lower limbs was suspected. A contrast-enhanced CT scan showed a thrombosed infrarenal abdominal aortic aneurysm with a maximum transverse diameter of 37 mm, and both external iliac arteries were contrast imaged by collateral circulation pathways. We diagnosed acute thrombosis of an abdominal aortic aneurysm, and was urgently transported to our hospital. We classified his lower limbs as Balas grade III and TASC classification grade IIb and Rutherford classification grade IIb. He exhibited no abdominal symptoms and since we confirmed the blood flow of his lower limbs, we decided to perform revascularization. An extra-anatomical bypass (axillo-bifemoral bypass) was conducted because he had dementia, and was old. After the operation, myonephropathic metabolic syndrome (MNMS) did not develop, and the patient was discharged on foot on the 16th postoperative day. Acute thrombosis of an abdominal aortic aneurysm is a rare disease. Because the ischemic area widens, often causing serious MNMS after the revascularization, it has a poor prognosis. Here, we report a case in which one such patient was rescued.

Annual changes in age, age at onset, incidence of cases with steroiddependent intractable asthma, clinical asthma types and clinical efficacy rate were examined in 256 patients with chronic respiratory diseases, especially in 203 cases with bronchial asthma, admitted to Misasa Branch Hospital from 1982 to 1989.
1. A number of patients with respiratory diseases as well as asthmatics admitted each year, having spa therapy, increased from early year (1982) to later year (1989).
2. A number in cases with 40 year or over of age (also with 60 year or over of age) and cases with 40 year or over of age at onset showed a tendency to increase in later three years (1987-1989). A decreased frequency of cases with steroid-dependent asthma and of cases with type II (bronchiolar obstruction type) was observed in the later three years.
3. The clinical efficacy of spa therapy for bronchial asthma was Niger in the later three years than in early three years (1982-1984).

Although previous studies have investigated the relationship between agricultural work and health conditions in older adults, little attention has been paid to crop handling. In this study, we aimed to clarify the relationship between agricultural work, crop handling/sales, and health. A survey was conducted of older adults attending health examinations in Tosa Town, Kochi Prefecture. To clarify the relationship among comprehensive geriatric assessment items, the t-test was used for comparisons between two groups according to the presence or absence of agricultural work, and one-way analysis of variance with multiple comparisons was used for comparison among three groups according to the presence or absence of crop handling and agricultural work. The analyses were performed separately for men and women. The analysis results showed that male participants who were engaged in agricultural work had significantly better indicators of ability to walk and stand up as well as higher scores for social roles on the Tokyo Metropolitan Institute of Gerontology Index of Competence compared with those who were not engaged in agricultural work. No significant differences were found between the two groups of women. In three-group comparisons, the subjective well-being and social roles of men and women who did agricultural work and distributed their crops were significantly higher than those who did not do agricultural work and those who did agricultural work but did not distribute their crops.

Objective: Confirmation by pharmacists of brought-in drugs is not only limited to identification of drugs, but also requires prescription design and proposals based on the background of patients and evaluation of associated information. In this study, we analyzed the content of brought-in drugs related PreAVOID reports in our hospital according to the years of pharmacist experience in order to help educate pharmacist for better brought-in drugs confirmation.Method: Various interventions regarding brought-in drugs were compared between two groups: pharmacists with >6 years of experience (group H) and those with < 5 years of experience (group L). PreAVOID reports, which related to drugs brought in by patients admitted to the Ogaki Municipal Hospital between April 1, 2018 and March 31, 2019 were assessed.Result:The PreAVOID reporting rate for the number of brought-in drugs confirmed was higher in group H (1.56%) than in group L (1.12%) (odds ratio 1.399, p = 0.023). The PreAVOID reporting rate when reporting was based solely on prescription information did not differ between these two groups, but when patient background, including disease-related information, was included with prescription information, the rate was higher in group H (0.80%) than in group L (0.30%) (odds ratio 2.725, p < 0.001). Group H provided more reports related to unnecessary drugs.Conclusion: The involvement of pharmacists in the evaluation of brought-in drugs is important when reviewing subsequent medical treatments. Our findings suggest that to improve the quality of treatment, it is necessary to provide appropriate newcomer education, such as conducting case studies using PreAVOID cases.