Introduction: We investigated the improvement in and the priorities of patient education training in community pharmacy from the student’s point of view to improve long-term practical training.
Method: We conducted a questionnaire survey to assess student satisfaction and the acquisition of behavioral objectives and analyzed the results with customer satisfaction analysis. Questionnaires were distributed to 32 students who had taken part in long-term practical training in the first year.
Results: Customer satisfaction analysis showed that 4 factors-“the frequency of patient education,” “the period of patient education,” “the aggressiveness of the student,” and “the facilitation by pharmacists on question-asking by the student”-were preferentially improved. In addition, we found that the level of acquisition varied according to the specific behavioral objectives.
Discussion: These results suggest that universities and community pharmacies must work together to organize the training system to increase the frequency of patient education and to improve students’ attitudes about patient education in community pharmacy.

The purpose of this study was to determine the effects of supine floating on rectal temperature and cardiac autonomic nervous system activity after exercise. Seven healthy males volunteered for this study. Subjects performed supine position for 30 minutes in both control condition (C-condition) and water condition (W-condition) after exercise with a cycle ergometer for 15 minutes. Exercise intensity was high (80%VO₂max) and moderate (60%VO₂max). Water temperature was 30 degrees Celsius. Rectal temperature of post exercise showed no significant differences under the W-condition, as compared to the C-condition. Delta rectal temperature (point 0-0 was end of exercise) was significantly reduced (p<0.05) under the W-condition, as compared to the C-condition. Log HF was significantly increased (p<0.05) under the W-condition, as compared to the C-condition. These data suggested that supine floating after high and moderate intensity exercise could promote recovery of rectal temperature and increased in cardiac parasympathetic nervous system activity.

　　Along with the accumulation of evidence to support the use of an oral rehydration solution before surgery, there is a strong tendency for the period of fasting before the induction of general anesthesia to become shorter and shorter. In this study, we compared hunger, thirst, psychology and onset of pneumonia as a sequela in between two groups of surgical patients-one with preoperative rehydration and the other without. The results showed that stress did not build up in the patients given a preoperative oral rehydration solution even after they returned to their rooms and did not have an intravenous drip. No one in either group developed pneumonia after surgery.

A rare case of atlantoaxial rotatory subluxation occurred after pediatric cervical spine surgery performed to remove a dumbbell-shaped meningioma at the level of the C1/C2 vertebrae. This case is classified as a post-surgical atlantoaxial rotatory subluxation, but has a very rare morphology that has not previously been reported. Although there are several reports about post-surgical atlantoaxial rotatory subluxation, an important point of this case is that it might be directly related to the spinal cord surgery in C1/C2 level. On day 6 after surgery, the patient presented with the Cock Robin position, and a computed tomography scan revealed a normal type of atlantoaxial rotatory subluxation. Manual reduction was performed followed by external fixation with a neck collar. About 7 months after the first surgery, the subluxation became severe, irreducible, and assumed an atypical form where the anterior tubercle of C1 migrated to a cranial position, and the posterior tubercle of C1 and the occipital bone leaned in a caudal direction. The pathogenic process suggested deformity of the occipital condyle and bilateral C2 superior facets with atlantooccipital subluxation. A second operation for reduction and fixation was performed, and the subluxation was stabilized by posterior fixation. We encountered an unusual case of a refractory subluxation that was associated with an atypical deformity of the upper spine. The case was successfully managed by posterior fixation.
Congenital Abnormalities ; Humans ; Meningioma ; Neck ; Occipital Bone ; Songbirds ; Spinal Cord ; Spine

STUDY DESIGN: The strength effects of a pedicle screw-rod system supplemented with a novel cross-link configuration were biomechanically evaluated in porcine spines. PURPOSE: To assess the biomechanical differences between a conventional cross-link pedicle screw-rod system versus a novel cross-link instrumentation, and to determine the effect of the cross-links. OVERVIEW OF LITERATURE: Transverse cross-link systems affect torsional rigidity, but are thought to have little impact on the sagittal motion of spinal constructs. We tested the strength effects in pullout and flexion-compression tests of novel cross-link pedicle screw constructs using porcine thoracic and lumbar vertebrae. METHODS: Five matched thoracic and lumbar vertebral segments from 15 porcine spines were instrumented with 5.0-mm pedicle screws, which were then connected with 6.0-mm rods after partial corpectomy in the middle vertebral body. The forces required for construct failure in pullout and flexion-compression tests were examined in a randomized manner for three different cross-link configurations: un-cross-link control, conventional cross-link, and cross-link passing through the base of the spinous process. Statistical comparisons of strength data were analyzed using Student's t-tests. RESULTS: The spinous process group required a significantly greater pullout force for construct failure than the control group (p=0.036). No difference was found between the control and cross-link groups, or the cross-link and spinous process groups in pullout testing. In flexion-compression testing, the spinous processes group required significantly greater forces for construct failure than the control and cross-link groups (p<0.001 and p=0.003, respectively). However, there was no difference between the control and cross-link groups. CONCLUSIONS: A novel cross-link configuration that features cross-link devices passing through the base of the spinous processes increased the mechanical resistance in pullout and flexion-compression testing compared to un-cross-link constructs. This configuration provided more resistance to middle-column damage under flexion-compression testing than conventional cross-link configuration.
Lumbar Vertebrae ; Pedicle Screws ; Spinal Fusion ; Spine

Spinal cord stimulation (SCS) has been reported to be effective for complex regional pain syndrome (CRPS). This is a case report of a patient with CRPS who was successfully treated with a combination of temporary SCS lead placement and physical therapy. A 19-year-old man presented with severe pain for a few months since receiving plaster cast fixation as treatment for an ankle sprain injury at the previous hospital. At his first visit to our pain center, he could not walk without crutches because of severe pain accompanied by symptoms such as allodynia, decreased skin temperature, redness, edema, muscle weakness, and changes in the appearance of the affected area. The symptoms met the diagnostic criteria for CRPS. Temporary SCS lead placement was performed to alleviate the pain and peripheral circulatory disorder, along with physiotherapy to improve the flexibility and restore the normal appearance of the affected limb. The interdisciplinary treatment effectively improved our patient's leg edema and walking ability, which consequently led to pain relief.

Spinal cord stimulation (SCS) has been reported to be effective for complex regional pain syndrome (CRPS). This is a case report of a patient with CRPS who was successfully treated with a combination of temporary SCS lead placement and physical therapy. A 19-year-old man presented with severe pain for a few months since receiving plaster cast fixation as treatment for an ankle sprain injury at the previous hospital. At his first visit to our pain center, he could not walk without crutches because of severe pain accompanied by symptoms such as allodynia, decreased skin temperature, redness, edema, muscle weakness, and changes in the appearance of the affected area. The symptoms met the diagnostic criteria for CRPS. Temporary SCS lead placement was performed to alleviate the pain and peripheral circulatory disorder, along with physiotherapy to improve the flexibility and restore the normal appearance of the affected limb. The interdisciplinary treatment effectively improved our patient's leg edema and walking ability, which consequently led to pain relief.