Purpose: Pharmacists should play a positive role in palliative care. The pharmacy curriculum should also contain content promoting an appropriate attitude toward death. Hence, this study aims to gather fundamental information that can be used to understand the various death attitudes held by pharmacy students. Methods: We targeted 159 sixth-year students of the School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, in 2011. They studied "Up-to-date-Palliative-Care" (an elective subject). To investigate their overall perception of death, we used the Death Attitude Inventory (DAI), developed by Hirai and others (2000), and investigated their views of death on the basis of seven factors. We also classified students on the basis of type of death they had experienced, that is, the death of a household, relative, friend, or pet. We compared the scores obtained for each factor and conducted a logistic regression analysis. Results and Conclusion: We analyzed the data from 120 students (valid response rate: 75.5%). Students who had experienced the death of friend, had significantly higher scores on "Life Purpose" and "Death Concern" (p<0.05). Students who had experienced the death of household etc., statistical positive correlation with "Death Concern" and statistical negative correlation with "Death Anxiety" were recognized.

This study examined peculiarities in both muscle strength and cross-sectional area (CSA) among soccer players in comparison with those of archers as contrasting athletes. Subjects were 15 male soccer players and 9 male archers at N University. Measurement items were height, body weight (BW), isokinetic muscle strength (knee extension, knee flexion, hip extension, hip flexion) and CSA (psoas muscles). Isokinetic muscle strength (30, 120, 240°/sec.) was measured by Cybex6000 (Lumex Co.), and the psoas muscle CSA was determined using magnetic resonance imaging (Hitachi, Japan). Results were as follows : 1. There was no significant difference in isokinetic knee extension and flexion strength/BW at all angular velocities between soccer players and archers. 2. On isokinetic hip flexion strength/BW, the average values of soccer players were significantly higher at all angular velocities than those of archers. However, there was no significant difference in the average values of isokinetic hip extension strength at all angular velocities between the two groups. 3. The average value for the psoas muscle CSA in soccer players was significantly higher than that of archers. In this study, the biggest difference in muscle strength between soccer players and archers was hip flexion strength, and the CSA of the psoas muscle in soccer players, which is the main component of hip flexion, was significantly larger than that of archers. These findings showed the peculiarity of soccer players due to the constant demands of movements involved in ball kicking and running during practice and competition.

We report a 77-year-old woman who underwent mitral valve repair using leaflet folding plasty for mitral regurgitation due to bilatelal commissural prolapse. A Carpentier prosthetic ring was applied to remodel the annulus and to reinforce repair. Postoperative echocardiography revealed no regurgitation and good mitral valve opening. Leaflet folding plasty is considered to be a simple and effective technique to accomplish mitral valve repair for mitral regurgitation due to commissural prolapse.

We describe an unusual case of a chronic pulmonary thromboembolism with right atrial thrombus. A 56-year-old man suffering from chronic pulmonary thromboembolism for 5 years complained of increasing dyspnea. Computed tomography revealed massive emboli in bilateral pulmonary arteries and a thrombus in the right atrium. Massive tricuspid regurgitation and atrial fibrillation were also recognized. We performed pulmonary thromboendarterectomy using a Jamieson rigid long miniature sucker with a rounded tip and our original flexible sucker under deep hypothermic circulatory arrest. Right atrial thrombectomy, tricuspid annuloplasty and a Maze procedure were also performed during the cooling, recirculating, and warming period. His postoperative cause was uneventful, and he was able to return to an ordinary lifestyle without acquiring oxygen inhalation. Tricuspid annuloplasty and Maze operation during pulmonary thromboendarterectomy contributed to the maintenance of stable homodynamics during and after surgery.

A number of investigators have been concerned with the anthropometric as well as physical characteristics of sumo wrestlers during the past several decades. However, none have attempted to determine body density and percent body fat by the most accurate technique of hydrostatic or underwater weighings. Thus, a precise quantification of body density and percent body fat for the wrestlers has not yet been obtained. Ogawa et al. (1972) have predicted the body composition of sumo wrestlers from a formula which added the triceps and subscapular skinfold thicknesses. As the regression equation used in this instance was based on samples of normal young men, it may not have great predictive accuracy when used on the exceptional population of very stout athletes.
The purposes of this study were : (1) to assess the validity of percent body fat estimation by skinfold thickness measurement when compared to the hydrostatic weighing criterion method ; (2) to determine the interrelationships between anthropometric variables for use in the clear assessment of the physical characteristics of ‘Shindeshi’ sumo wrestlers ; and (3) to thereby develop a formula that would reliably predict percent body fat using skinfold thicknesses and/or anthropometric measurements in this exceptional population. The interrelationships between anthropometric and body composition variables were investigated using 35 Shindeshi sumo wrestlers, aged 15-20 years (X=16.5±1.5) .
The results of the present study can be summarized as follows.
1. The Shindeshi in the present study possessed physiques more developed than those tested in the past, as evidenced by Rohrer's and Ponderal Indices which were approximately 180 and 26.2, respectively. The development of body weight was particularly notable (i.e., over 100kg) .
2. Percent body fat for the Shindeshi was remarkably higher than that of a normal population of the same age, with approximately seventy percent of the Shindeshi possessing more than 20% body fat and less than 1.05000 body density.
3. Body density and height correlated negatively and insignificantly with almost all the variables. In contrast, correlations of body weight, circumferences, and all other variables were, in most cases, high and positive, with body weight correlating least with height. The skinfold measurement correlating best with % body fat was that taken at the thigh site (r=0.898) . The circumference measurements correlating best with % body fat were obtained at the thigh (r=0.888 and 0.831) and the abdomen (r=0 885) parts.
4. Of the six formulae for estimating % body fat, Sloan's correlated best with % body fat as determined by densitometry, and best approximated the mean value of 24.5%. However, all of the equations underestimated the measured % body fat of the Shindeshi.
5. When an exceptional population is being investigated, estimation of % body fat should be done with a population specific equation to ensure predictive accuracy. The following multiple regression equation (r=0.963) should, therefore, be utilized for estimation of % body fat in sumo wrestlers.
Y=0.2488x₁+0.6172x₂-14.3962 where x₁ and x₂ are abdomen circumference and skinfold thickness at thigh, respectively.

Background
The Pacific Islands is an area with one of the world's highest prevalence of obesity and diabetes. The Republic of the Marshall Islands (RMI) is an independent country of the Micronesian that extends along latitude 4 to 18 degrees north. In the past, several studies reported regarding the prevalence of diabetes among the people of the Pacific Islands. However, there is no report yet with respect to diabetes in Majuro, the capital of RMI. In RMI, diabetes and obesity are also recognized to be a serious problem, but the present state of affairs prevents an understanding of the situation.
Objectives
The purpose of the present study was to investigate the present situation and the prevalence of diabetes and obesity in Majuro.
Methods
The participants were Marshallese visited our thyroid cancer-screening program. Among those participants who undertook thyroid cancer screening, the Body Mass Index (BMI) and hemoglobinA1c (HbA1c) levels were taken of 850 participants. Participants with an HbA1c level of 6.5% or more were put into the diabetes group and participants with a BMI of 30 and over were the obese group. Prevalence was adjusted using the Majuro population based on 1999 national census and using world standard population of Segi.
Results
The age-adjusted prevalence of diabetes in aged 20 years and over in Majuro was 22.1%. After standardization, the prevalence was 31.0%.
Conclusion
The results suggest there is a high rate of diabetes in RMI similar to other pacific islands. It could be concluded, based on this research, that there is a crisis situation with regards to diabetes in the RMI. There is also a need for epidemiological research to be on a random sample of the population.

Purpose: Escitalopram has been inadequately evaluated in cancer patients. Here, we report two patients with advanced cancer who benefited from escitalopram for depression. Case 1: A man aged in his 50s had postoperative recurrence of rectal cancer. He was diagnosed with a major depressive episode according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). The score of the Hamilton Rating Scale for Depression (HAMD-17) was 20 points. He began treatment with 10 mg/day of escitalopram. His symptoms began to improve at about 14 days, and the HAMD-17 score was 4 points at 23 days, suggesting a marked improvement. Case 2: A woman aged in her 50s had cancer of the external auditory canal. She was diagnosed with a major depressive episode according to DSM-IV-TR. The score of HAMD-17 was 26 points. She began treatment with 10 mg/day of escitalopram. Her symptoms began to improve at 15 days, and the HAMD-17 score at 28 days was 13 points, suggesting a marked improvement. In both cases, serious side effects, clear exacerbation of depression, and withdrawal syndrome due to acute drug deprivation associated with worsening of the symptoms were not noted. Conclusion: Escitalopram is considered a useful drug for depression in patients with advanced cancer.