We report on the state of postgraduate anesthesiology training (3 months) at Fukui Medical School. This report was based on a questionnaire sent to 144 doctors who had undergone this training. The response rate was 68%.
Participants entered anesthesiology training at a mean of 1.9 ± 1.2 years after graduation. Seventyone trainees (91%) were actively involved in clinical anesthesiology, among which 48 trainees (63%) had experienced between 31 to 60 cases over a 3 month period. Twenty-four trainees (31%) indicated that the training period (3 months) was too short. After such training, 50 doctors (66%) practiced anesthesia, among which 29 encountered difficulties with endotracheal intubation. Sixty-nine trainees (93%) thought the training would be useful for resuscitation. We conclude that anesthesia training is effective at the end of a 2-year postgraduate training course, and recognize the need for improvement in the teaching of anesthesiology.

Relationship between serum OCT activity and nutrient intake pattern were investigated in 90 young adults. Applying multiple regression and factor analysis, we found the following results:
1) Multiple regression analysis showed that the variables which correlated best with the serum OCT activity were dietary intakes of the energy, fat and vitamin C.
2) In the factor analysis, no significant correlation was found between serum OCT and food intake pattern.

In this study, we showed the bioavailability of ubiquinol (QH) in the form of water-dispersive powder.Two groups of 5 healthy young subjects received single oral administration of 100 mg of QH in the form of a soft capsule containing QH dissolved in safflower oil or 40% water-dispersive powder in the fasting period, and changes in the plasma QH concentration were monitored over time.The water-dispersive powder form of QH exhibited superior bioavailability even when administered in the fasting period.

Cystadenoma is an uncommon benign epithelial neoplasm. Cystadenoma usually occurs on the palatal and buccal mucosa, but is less commonly found in the retromolar regions.A 43-year-old male patient noticed a swelling on his gingiva distal to the right mandibular second molar. Physical examination showed a diffuse poorly circumscribed swelling extending from the lingual gingiva distal to the right mandibular second molar to the floor of the mouth and pharynx. The tumor size was 20 x 27 mm. The surface mucosa was purply-blue in parts. About 4 ml of pale yellow serous fluid was aspirated. The tumor was surrounded by a capsule and was excised successfully above the periosteum, incorporating a 2 mm safety margin including the surface mucosa. The tumor consisted of a fibrous capsule with multiple cystic cavities of various sizes. The cysts were lined by a layer of columnar epithelium, with intracystic papillary proliferation in some areas. No cytologic atypia or invasion of the surrounding tissues were observed.There is no evidence of recurrence ten years after excision, suggesting that complete excision is sufficient treatment in such cases.

Two cases of secondary oral squamous cell carcinoma (SCC), which developed in recipients of hematopoietic stem cell transplantation (HSCT) for leukemia, are reported. The first patient underwent allogeneic HSCT for chronic myelogenous leukemia at 32 years of age. He suffered from chronic graft-versus-host-disease (GVHD) of the oral mucosa after HSCT, and has subsequently received immunosuppressive therapy. He experienced metachronous multiple SCCs in the maxillary gingiva and the dorsum of the tongue at 36 years and 40 years of age, respectively. The second patient received autologous HSCT for acute myelogenous leukemia at 22 years of age, and she did not experience GVHD after transplantation. SCC developed in the lateral border of the tongue at 27 years of age. PCR analysis detected both HPV16 and HPV18 in the tongue tumor of the first patient, and only HPV18 in that of the second patient, suggesting that the infection of high-risk HPVs was possibly involved in the development of post-HSCT oral cancers in these patients. Since risk factors for post-HSCT oral SCC are not yet well recognized, long-term close follow-up is necessary for the early detection of secondary oral cancers in all transplant recipients.

An 81-year-old patient, who had a postinfarction left ventricular aneurysm with thrombus underwent left ventricular aneurysmectomy with right coronary artery bypass grafting (CABG). Preoperative examination showed 99% stenosis of the left coronary artery (#7) and 90% stenosis of the right coronary artery (#3). The operation was performed because angina was not improved and formation of thrombus was suspected on the wall of the aneurysm. The operation was performed under cardiopulmonary bypass and by antegrade and continuous retrograde cardioplegia. The aneurysm was resected and a relatively fresh thrombus which was detected on the endocardium of the aneurysm was extracted. The left ventricle was closed by direct linear suture with felt reinforcement. Because the area of resection included part of the left anterior descending artery, only right CABG (#3) with a saphenous vein was done. Weaning from bypass was very easy and the postoperative course was uneventful.

The following analgesic effects have resulted from irradiating each finger joint (DIP, PIP, and MCP) of patients with rheumatoid arthritis for 20 seconds using the semiconductor laser, “uni-Laser” (10mw, 790nm) from ITO company.
1) Comparison of the post-exposure state with the pre-exposure state in the open test
i) Of 13 cases of joint pain, 7 cases showed improvement and 6 cases showed no change with no case showing aggravation.
ii) Duration of analgesic effect was less than 48 hours in 2 cases, less than 72 hours in 1 case, and more than 96 hours in 3 cases.
2) Comparison of the post-exposure state with the pre-exposure state in the single blind test on a total of 25 patients with rheumatoid arthritis. Twelve patients were exposed to the irradiation twice per week, 10 times a session (irradiated group) and 13 were exposed to the dummy of the above (control group).
i) The irradiated group improved considerably in the number of painful joints, frequency of joint pain, and grasping power. The rate of improvement was superior to that of the control group (P<0.05).
ii) No significant improvement in duration of morning stiffness was shown in either group.

Renal plasma flow (RPF) and glomerular filtration rate (GFR) are decreased in patients with heat stroke. Heat stroke after prolonged exercise under high temperatures is usually associated with hypotension and dehydration, leading to decreased RPF. However, whether renal blood flow (RBF), RPF, and GFR are increased or decreased during immersion in mild warm water remains unknown.
Para-aminohippurate clearance (C_PAH), sodium thiosulfate clearance (C_thio), and creatinine clearance (C_cr) were determined in 14 healthy men aged 19 to 27 years old (mean±SD, 22±2), 161 to 181cm (171.5±6.3) tall, and weighing 52 to 78kg (64.2±7.4) without immersion at about 25°C (room temperature) and during immersion in water at 41±0.5°C.
C_PAH, C_thio, and RBF significantly increased during immersion compared with those without immersion (P<0.0001, P<0.03, P<0.0001, respectively). C_cr did not change (P=0.108). The filtration fraction (FF) was significantly decreased (P<0.001). Levels of plasma atrial natriuretic peptide, aldosterone, anti-diuretic hormone and renin did not significantly differ between these two conditions.
This investigation suggests that daily immersion at 41°C is beneficial for renal function.

Coronary artery bypass surgery and abdominal aortic aneurysm repair were performed simultaneously during cardiopulmonary bypass in two patients with severe left ventricular dysfunction. Both patients underwent coronary artery bypass surgery first, followed by abdominal aortic aneurysm repair during cardiopulmonary bypass. Combined surgery is reasonable for patients with combined coronary artery disease and abdominal aortic aneurysm. Aortic aneurysm repair during cardiopulmonary bypass for patients with severe left ventricular dysfunction also appears safe and effective.

PREAVOID is pharmaceutical intervention that is utilized to illustrate pharmacists’ contributions to medical care.  Currently, there is a great need for pharmacists to provide good medical services to inpatients; as a result, many pharmacists conduct pharmaceutical management in hospital wards.  However, pharmacists who have limited experience in working in the ward do not know exactly what they should check with respect to pharmaceutical management.  To resolve this problem, we determined 16 pharmaceutical-management items based on PREAVOID that was conducted at Nagara Medical Center.  Moreover, we conducted a pre-questionnaire survey assessing whether pharmacists who had worked in the ward for fewer than 4 years attended to these 16 check items in their daily work prior to our introducing the list to them.  The results indicated that pharmacists who had fewer than 2 years of experience working in wards attended to the 16 check items less than those who had more than 2 years of experience, and approximately half of the pharmacists had not received adequate guidance before beginning work at the ward.  In addition, most pharmacists indicated that clear check points were useful for conducting pharmaceutical management and the 16 check items were useful for their daily work.  These results indicate that the 16 check items are a useful educational tool for enabling pharmacists to conduct high quality pharmaceutical management from the initial stage and that using the 16 check items is superior to pharmacists only gaining this ability via prolonged experience working in the ward.