How are the educational goals stated by comedical schools such as “Education in Rich Humanity” and “Personnel who can coordinate with the various fields of Medicine, Health and Welfare” reflected in their curricula? I investigated the curricula and syllabi of 178 comedical schools around the nation and attempted to determine the position of welfare education therein. Welfare education was defined as a combination of learning through practical experience and programs in human rights and social welfare. The aim of such learning was found to be education in human understanding, the ability to solve problems, the foundation of cooperative social coexistence, and the awareness of self. However, I conclude that the content of the welfare education does not help students undergo meaningful personal development. Thus, this failing should be of immediate concern to comedical educators as they consider their role in medicine for the 21st century.

Introduction: We report a case of acute-phase reaction of denosumab which was difficult to exclude aggravation of original cancer pain. Case: A 65 year-old man with severe pain from right back to upper abdomen due to mid thoracic vertebral metastases of small cell lung cancer was consulted to palliative care team. Denosumab 120 mg was administered subcutaneously three times every four weeks. On the next day of first administration, pyrexia occurred. At all three administrations, pain worsened for four days after the next day of administration. The pain was worsened from numerical rating scale 2 to 6. Same phenomenon was observed each time denosumab was administered for three consecutive times. Although the area of pain overlapped with that of original vertebral metastases, the repetition of the pain exacerbation soon after the denosumab administration suggested acute-phase reaction. Conclusion: Pain aggravation caused by acute phase reaction of denosumab might be overlooked in patients with cancer pain. More investigation is needed for details of acute-phase reaction caused by denosumab.

Approximately 40% of women during the course of their menstrual cycles suffer from premenstrual syndrome (PMS). The cause of this syndrome is unknown, furthermore diagnostic criteria and treatments have not been established. Kampo medicines were applied using Kami-shoyo-san as a first choice, and several other alternative Kampo medicines, to 33 PMS patient cases. To evaluate the effectiveness of this therapy, PMS scores were recorded prior to treatment. Patients' scores were recorded as; score 0 (symptomless), score 1 (endurable), score 2 (unbearable without medicine), as well as the five major characteristics of PMS, 1) psychiatric symptoms, 2) headache, 3) breast pain, 4) swelling, 5) lower abdominal pain or lumbago. The scores were verified subsequent to two menstrual cycles. Kampo medicine was found to be effective in 24 cases, with scores declining in average from 4.4 to 1.5. Further treatments were requested in 4 cases, moreover, 5 cases were discounted altogether. Thus Kampo medicine proved to be a very useful method for patients suffering from PMS.

Welwalk WW-1000® (WW-1000®) is a gait exercise-assisted robot. Suitable assistance was provided to the patients with hemiplegic legs in both stance and swing phases. In addition，this robot offers various forms of feedback to patients during exercise. We present the case of a patient with multiple sclerosis and left hemiplegia who underwent WW-1000® gait exercise.The 73-year-old patient required maximum assistance with metal ankle foot orthotics (AFO) and a quadruped cane prior to robot-based rehabilitation. The aims of gait exercise with the WW-1000® were as follows；① maintain the verticality of the trunk during the entire gait cycle；②shifting the center of gravity during stance phase on the nonparalytic limb；③stabilizing the swing phase on the paralytic limb, and enhancing support during the stance phase on the paralytic limb. Each aim was modified depending on level of achievement. Assistance with the WW-1000® activated the trunk and Nonparalytic limb (visual feedback was utilized in exercises). On day 9, the patient could walk using a plastic AFO and T-cane supervised by a therapist.The multifunctional WW-1000® is useful for subdividing gait goals, exercise and set stepwise aims consistent with the patient's abilities. Gait exercises using the WW-1000® may efficiently improve gait and helps adapt to changes in conditions in the subacute phase.