We conducted an anonymous questionnaire survey to examine the results of regularly drinking FFC beverage. Over 70% of participants reported a positive reaction through consumption. By contrast, few negative reactions were recorded (0.7%). These would suggest its effectiveness as a health drink. Positive reactions were significantly related to the amount of FFC beverage consumed each day, the reason for starting to drink FFC beverage, participant’s age, the amount of FFC beverage consumed each time, and the no use of the other functional foods.

We report a childhood case of localization-related epilepsy manifesting frequent gelastic seizures, which were successfully treated with topiramate (TPM) monotherapy. The seizures were not associated with feelings of mirth. High-resolution three-tesla magnetic resonance imaging revealed no structural abnormality. Interictal 18F-fluorodeoxyglucose positron emission tomography showed hypometabolism over the entire right hemisphere. Single-photon emission computed tomography imaging, both ictal and interictal, demonstrated no significant findings. Interictal electroencephalography (EEG) showed paroxysms in the right frontal region. Ictal video EEG demonstrated diffuse attenuation, followed by fast activities and spike-wave complexes predominantly over the right hemisphere. At the ictal EEG onset, low amplitude paroxysmal fast activity was recorded over the F8-T4 region. The seizures were considered to have originated from the right frontal lobe. TPM monotherapy resulted in complete cessation of the seizure. We suggest that TPM should be considered as a valuable tool for treating childhood intractable gelastic seizures, which are not due to hypothalamic hamartoma.

Hybrid techniques to enable endovascular treatment of complex aortic pathology have been previously described. A staged endograft repair of a complex, chronic Stanford type B aortic dissection with atherosclerotic occlusion of bilateral iliac arteries is reported in a 66-year-old man. The patient also had chronic obstructive lung disease as well as chronic renal dysfunction. The aneurysmal portion of the dissection extended from the distal arch to the entire thoracic aorta. Bilateral femoral arteries were bypassed from the abdominal aorta using open techniques. Then, total arch replacement with a frozen elephant trunk was performed through median sternotomy. Finally, the aneurysmal portion was completely covered with an endograft from the frozen elephant trunk to the upper abdominal aorta, just proximal to the celiac trunk. The patient had no neurologic complications. This case report illustrates the feasibility of the hybrid technique in selected high-risk patients when confronted with complex aortic pathology.

A certain period of time has passed since the transition to the General Medicine residency system under the Japanese Medical Specialty Board and Family Medicine specialist training system by the Japan Primary Care Association. We have summarized the needs of residents identified in the survey, and detailed the activities to date and prospects of the Japanese Association of Family Physician Trainees, a self-help support organization, which is an official subcommittee of the Japan Primary Care Association, from the viewpoint of the residents. We believe that this paper will serve as a resource for the training of residents, help guide them under the new system, and help to improve the training system, considering evidence suggesting that information may not be reaching residents who need support.

Purpose: We assessed the efficacy of a palliative care team (PCT) in improving quality of life (QOL) among Japanese cancer patients. Patients and methods: This prospective study involved adult patients treated in the Division of Respiratory Medicine and Medical Oncology/Hematology at Kobe University Hospital between November 1, 2009 and March 30, 2010. Every patient had requested intervention by the PCT. Patients were asked to complete the EORTC QLQ-C15-PAL questionnaire at baseline and 1 and 4 weeks after initiation of the PCT intervention. Result: Of the 35 patients enrolled, 26 patients and 15 patients completed the assessments at 1 and 4 weeks after starting the intervention, respectively. Pain subscale (PA) was improved at 1 week after starting the intervention (p<0.05). Dyspnea subscale (DY) and PA were improved at 4 weeks after starting the intervention (p<0.05). Conclusion: We prospectively showed that QOL of cancer patients was improved with the intervention of the PCT, using the Japanese version of the EORTC QLQ-C15-PAL. Even if the PCT can only provide short-term care for cancer patients, this intervention appears worthwhile to improve QOL of cancer patients.

Objective: To investigate the effect on early mobilization in patients undergoing extra-corporeal membrane oxygenation (ECMO) and acute blood purification therapy in the intensive care unit (ICU). Methods: We conducted this multicenter retrospective cohort study by collecting data from six ICUs in Japan. Consecutive patients who were admitted to the ICU, aged ≥18 years, and received mechanical ventilation for >48 hours were eligible. The analyzed were divided into two groups: ECMO/blood purification or control group. Clinical outcomes; time to first mobilization, number of total ICU rehabilitations, mean and highest ICU mobility scale (IMS); and daily barrier changes were also investigated. Results: A total of 204 patients were included in the analysis, 43 in the ECMO/blood purification group and 161 in the control group. In comparison of clinical outcome, the ECMO/blood purification group had a significantly longer time to first mobilization: ECMO/blood purification group 6 vs. control group 4 (p=0.003), higher number of total ICU rehabilitations: 6 vs. 5 (p=0.042), lower mean: 0 vs. 1 (p=0.043) and highest IMS: 2 vs. 3 (p=0.039) during ICU stay. Circulatory factor were most frequently described as barriers to early mobilization on days 1 (51%), 2 (47%), and 3 (26%). On days 4 to 7, the most frequently described barrier was consciousness factors (21%, 16%, 19%, and 21%, respectively) Conclusion The results of this study comparing the ECMO/blood purification group and the untreated group in the ICU showed that the ECMO/blood purification group had significantly longer days to mobilization and significantly lower mean and highest IMS.

Objective: The control of myocardial temperature is very important in myocardial protection methods. We investigated the validity of myocardial protection methods at our institution using noninvasive thermography as a means of determining the effectiveness of myocardial protection, with the aim of confirming that myocardial protection solution is correctly infused. Methods: Of 52 extracorporeal circulation cases with cardiac arrest from May 2020 to June 2022, 10 cases with cardiac arrest by progressive myocardial protection with Microplegia, a blood myocardial protection, were included. Infusion was performed at an infusion temperature of 20℃, with an intracircuit pressure of less than 300 mmHg and a flow rate of 250-350 ml/min maintained in a progressive manner. Myocardial temperature in the anterior region of the heart was measured using a thermographic camera at a distance of 80 cm from the heart. Results: The cardiac surface temperature before the start of myocardial protection was 32.5±1.0℃. After the start of infusion, the cardiac surface temperature at the time cardiac arrest was obtained was 27.4±1.3℃. In all cases, the cardiac surface temperature at the time of cardiac arrest was visually heterogeneous. Further infusion was continued, and the average time to reach the lowest visually uniform surface temperature was 342±23 s. The mean cardiac surface temperature at the end of myocardial protection was 22.4±1.3℃. At the start of myocardial protection solution infusion, the myocardial surface cooled faster in muscle than in visible fat, in the order aorta>myocardium from the apex>cardiac base. The postoperative course was generally good in all cases with respect to EF, CKMB, catecholamine use, extubation time, postoperartive hospital stay, and outcomes. Conclusion: It was found that a time of about 360 s is needed to uniformly cool the myocardial temperature during infusion of myocardial protection solution. Furthermore, by confirming the cooling of the base of the heart, it is suggested that it is inferred that the whole is cooled. To avoid problems caused by inadequate myocardial protection, it is suggested that measuring myocardial temperature using a non-invasive, simple thermal imaging camera can assist in determining the effectiveness of myocardial protection, and is expected to establish the safety of further myocardial protection.

Bilateral shoulder joint disorders caused by rheumatoid arthritis significantly impair daily functioning owing to a lack of contralateral compensation. In Japan, reverse shoulder joint prostheses were approved in 2014. This was expected to improve the surgical outcomes of rheumatoid shoulder arthroplasty. We report two patients with rheumatoid arthritis who underwent bilateral reverse shoulder arthroplasty. This study aims to evaluate their postoperative clinical outcomes and activities of daily living. The patients were women in their 70s with stage III class 2 rheumatoid arthritis. Their treatment and postoperative activities of daily living were retrospectively reviewed. The first patient underwent the inlay type and experienced a residual limitation of external rotation postoperatively; therefore, she was restricted to dress with front-open clothes. However, she was able to undress after the lining of the garment was changed to a slippery material. The second patient underwent the onlay type and showed almost no limitations in postoperative activities of daily living. She was able to undress with an external rotation of 40–50°. Bilateral reverse shoulder arthroplasty improved range of motion, the Japanese Orthopaedic Association shoulder score, and functional outcomes. Only a few difficulties were encountered in the activities of daily living.