Objectives: This study evaluates the relationship between the various words expressing pain and the efficacy of opioid analgesics, in order to provide information on the appropriate selection of analgesic drugs for cancer pain relief. A new and simplified evaluation list for the assessment of pain, including the common words used to express pain, was developed accordingly. Methods: The words expressing pain were classified into three categories based on the Guidelines for Drug Therapy in Cancer Pain. These words were grouped into clusters according to the efficacy of opioid drugs, as expressed by the patients. On the basis of these results, an evaluation list was developed, and its validity was assessed by clinical pharmacists and cancer patients experiencing pain. Results: On the basis of the classification of the words, their relationship with opioid efficacy was summarized, and the results of the cluster analysis were found to be helpful for the development of a new pain evaluation list. Conclusion: Patients use various words to express their pain. By classifying and clustering these words according to the guidelines and the efficacy of opioid drugs, we proposed a practical pain evaluation list for appropriate selection of analgesic drugs in patients with cancer.

Objective: To investigate frequency of adverse drug reactions (ADR) on HIGURD ®
, a switch OTC product of azelastine hydrochloride, in a three-year post-marketing surveillance study.
Methods: We conducted two surveys in this study a solicited survey with a questionnaire and a survey of spontaneous ADR reports.
Results: A total of 183 cases with 293 ADRs were reported in the solicited survey on 3,453 consumers and a total of 29 cases with 37 ADRs were reported from spontaneous sources.  No serious ADRs were reported.  Most frequently reported ADRs were somnolence, thirst, malaise, and dysgeusia, all of which are common on azelastine hydrochloride.  This study indicated that HIGURD ®
is well tolerated.
Conclusion: This study suggested that efficacy and safety of HIGURD ®
depend on how much consumers understand the contents of “Precautions for Use” section of package insert.  It is considered to be effective for safety assurance in an early post-marketing phase that pharmacists inform consumers about appropriate use of HIGURD ®
and ask for the occurrence of ADRs.

There are various problems associated with the surgical management of concomitant abdominal aortic aneurysm (AAA) and gastrointestinal malignancy. Our surgical strategy for the treatment of concomitant AAA and gastrointestinal malignant diseases, with the exception of colorectal diseases is basically a one-stage operation. This report reviews 6 cases involving concomitant AAA and gastrointestinal malignancy (colon cancer in 3 cases, gastric cancer in 2 and hepatoma in one). In 2 cases involving gastric cancer, we selected a one-stage operation for the coexistent AAA and gastrointestinal malignancy. The postoperative courses were uneventful. In a 69-yearold man with concomitant AAA, hepatoma and ischemic heart disease, a hepatectomy and coronary revascularization preceded AAA repair because the AAA diameter was too small. AAA repair was performed after 4 months when its diameter had been enlarged. In one of the 3 cases involving concomitant AAA and colon cancer, the malignancy was resected first and the patient died of recurrence 7 months after the operation and prior to the operation for AAA. In the second case of colon cancer, AAA repair preceded the resection of the malignancy. A right hemicolectomy was performed 53 days after the AAA operation. The third case had a one-stage operation for coexistent AAA and colon cancer. His postoperative course was uneventful. In this case, we took particular care to avoid graft infection. The 5 cases that underwent both operations have survived without major complications or evidence of recurrence during a follow-up period ranging from 2 months to 4 years.

A 7-year-old boy suffered from isolated interruption of the aortic arch without any other complications or cardiovascular malformations. Cardiac murmur, which had been apparent since one month of age, had been left untreated because of the absence of any symptoms of heart failure. Isolated interruption of the aortic arch was noted during a routine physical examination at school and the patient was referred to our hospital for a complete medical evaluation. Blood-pressure difference was recognized not only between the right side and the left side of the upper extremities but also between the upper and lower extremities. On the basis of the results obtained via magnetic resonance angiography (MRA) and aortography, a definitive diagnosis of isolated interruption of the aortic arch was made. Reconstruction of the aortic arch by synthetic implant was indicated. The blood-pressure difference disappeared and the postoperative course was satisfactory.

The projection region of the dome of the pleura to the surface of the anterior neck was investigated in 31 domes of 17 cadavers. The point “Tentotsu”, and a line connecting that point and the most lateral edge of the acromion were adopted for a basis of measurement of the projection region. The mean length of the Tentotsu-Acromion line was 185mm on either side of the body. Its upward angle to the horizontal plane was 22° and 23° in average on the right and left sides, respectively, while its backward angle to the frontal plane was 23° on the right and 25° on the left. The right pleural domes (17 cases) were included within a range 0-58mm lateral to the Tentotsu and lower than 44mm above, and on the left side (14 cases), these values were 5-58mm and 49mm, respectively. On the other hand, when adopting the Tentotsu-Acromion line as the basis, the pleural domes were located within the medial one-third of the line. Their summits lay on the point of its medial one-fourth in medio-lateral direction, and were situated at levels lower than about 35 (on the right) or 32mm (on the left) above the line.

Purpose: The aims of this study were to create a deep learning model to distinguish between nasopalatine duct cysts (NDCs), radicular cysts, and no-lesions (normal) in the midline region of the anterior maxilla on panoramic radiographs and to compare its performance with that of dental residents. Materials and Methods: One hundred patients with a confirmed diagnosis of NDC (53 men, 47 women; average age, 44.6±16.5 years), 100 with radicular cysts (49 men, 51 women; average age, 47.5±16.4 years), and 100 with normal groups (56 men, 44 women; average age, 34.4±14.6 years) were enrolled in this study. Cases were randomly assigned to the training datasets (80%) and the test dataset (20%). Then, 20% of the training data were randomly assigned as validation data. A learning model was created using a customized DetectNet built in Digits version 5.0 (NVIDIA, Santa Clara, USA). The performance of the deep learning system was assessed and compared with that of two dental residents. Results: The performance of the deep learning system was superior to that of the dental residents except for the recall of radicular cysts. The areas under the curve (AUCs) for NDCs and radicular cysts in the deep learning system were significantly higher than those of the dental residents. The results for the dental residents revealed a significant difference in AUC between NDCs and normal groups. Conclusion This study showed superior performance in detecting NDCs and radicular cysts and in distinguishing between these lesions and normal groups.

Purpose: The purpose of this study was to clarify the panoramic image differences of cleft alveolus patients with or without a cleft palate, with emphases on the visibility of the line formed by the junction between the nasal septum and nasal floor (the upper line) and the appearances of the maxillary lateral incisor. Materials and Methods: Panoramic radiographs of 238 patients with cleft alveolus were analyzed for the visibility of the upper line, including clear, obscure or invisible, and the appearances of the maxillary lateral incisor, regarding congenital absence, incomplete growth, delayed eruption and medial inclination. Differences in the distribution ratio of these visibility and appearances were verified between the patients with and without a cleft palate using the chi-square test. Results: There was a significant difference in the visibility distribution of the upper line between the patients with and without a cleft palate (p<0.05). In most of the patients with a cleft palate, the upper line was not observed. In the unilateral cleft alveolus patients, the medial inclination of the maxillary lateral incisor was more frequently observed in patients with a cleft palate than in patients without a cleft palate. Conclusion Two differences were identified in panoramic appearances. The first was the disappearance (invisible appearance) of the upper line in patients with a cleft palate, and the second was a change in the medial inclination on the affected side maxillary lateral incisor in unilateral cleft alveolus patients with a cleft palate.