A 55-year-old male on regular hemodialysis was referred to our department for evaluation of intermittent claudication. Abdominal aortography demonstrated occlusion of the abdominal aorta below the superior mesenteric artery. The patient underwent reconstruction of the abdominal aorta by Y-grafting. The occluded abdominal aorta was filled with a gelatin like tumor in which malignant cells were identified histopathologically. Immunohistochemical examination of the malignant cells showed negative results for factor VIII antigen but positive results for actin antigen, which suggested that the cells were of smooth muscle cell origin and the tumor was diagnosed as leiomyosarcoma. The patient's condition gradually deteriorated and he died at eleven months after the initial surgery because of generalized dissemination of the tumor.

The present study was aimed to investigate the physical ability of javelin throwers among uni-versity students using the magnetic resonance imaging (MRI), and Capacity Test, compared with other throwers.
The anatomical cross-sectional areas (ACCAs) of trunk muscles were determined using MRI. Capacity Test is composed of 30 m sprint, standing triple jump from a double-legged, backward over the head shot, forward over the head shot, sargent jump, snatch, and shoulder flexibility test with a javelin.
Results are as follows:
1. The male javelin throwers (MJT) group showed significant correlation between javelin throw records and ASCAs per body mass of body trunk extensor muscles (r=0.722, p<0.05) .
2. There was significant correlation between the forward over the head shot, and javelin throw in MJT group (r=0.800, p<0.01) . And the same tendency was also seen in female javelin throwers (FJT) group (r=0.735, p=0.055) .
3. The MJT group showed some correlation between javelin throw records and ASCAs per body mass of psoas major muscle (r=0.657, p=0.060) .
By the above-mentioned results, it was considered that the trunk extensors are important for male javelin throwers.

Two cases of intramuscular lipoma occurring in the cheek of a 39-year-old and of a 55-year-old Japanese males are presented. These were excised by the intraoral approach. Histopathologically, these lesions were composed of the adipose cell-like tumor cells infiltrating in the striated muscles. There has been no evidence of tumor recurrence after operation.

A rare case of benign fibrous histiocytoma arising in the upper lip in a 76-year-old female is presented. A well-defined tumor measuring 1 cm existed in the submucosal area of the right side of the upper lip. With the patient under local anesthesia, the tumor was excised. Microscopically, the excised tumor was diagnosed as a benign fibrous histiocytoma. There has been no evidence of tumor recurrence after the operation.

Two cases of intramuscular lipoma occurring in the cheek of a 39-year-old and of a 55-year-old Japanese males are presented. These were excised by the intraoral approach. Histopathologically, these lesions were composed of the adipose cell-like tumor cells infiltrating in the striated muscles. There has been no evidence of tumor recurrence after operation.

Objective: The Hyogo Hospital Pharmaceutical Society has been conducting an original pharmacy postgraduate education program, “lifelong learning program (to nurture pharmacy specialists)”, since 2002 using the Internet.  To understand the status of using this program, this study employed a questionnaire survey involving all registered members.
Methods: Subjects were all members (1,870) of the society.  Questionnaires were distributed and collected by mail.
Results: Only 20.1% of the members had experience of using the program, and the frequency of using it was less than once per 6-12 months in 60% of the members.  Their level of awareness concerning the acquisition of credits for lifelong learning was 36.9%.  The program category they wished to take was an infection-related program in 26.1% of the members, which was the highest.
Conclusion: As reasons for only a small number of members using the program, the following are considered: loss of user’s ID and password required to login, and lack of awareness concerning the acquisition of credits for lifelong learning offered by the Japanese Society of Hospital Pharmacists.  As future issues, we must encourage members to obtain a new password and be proactively involved in preparing new program categories that the members wish to take, in order to promote the continuous use of the program.

An increasing number of children who have ADHD are visiting pediatric clinics. In this study, we focused on the behavior of ADHD children in different situations.The behavior of ADHD children was evaluated with a specially designed checklist in a person-to-person situation in which the subject was face to face with the clinical psychologist at the counseling room and in a group situation in which the subject participated in an outdoor program organized by the Department of Pediatries of Enshu General Hospital.In the person-to-person context, all of the performance scores with respect to attention-deficit, impulsivity, hyperactivity and difficulty with communication were decreased after psychotherapy. This suggested the regular person-to-person therapy with medication could improve the behaviors and development of ADHD children. On the other hand, the hyperactivity score was increased in the group context because of a lot of stimulation. These findings suggested ADHD children’s behavior changes according to the situation, and that we should take care of them with this fact in mind.
Child ; Child attention deficit disorder ; Pulmonary evaluation ; seconds ; behavioral aspects

This article is a short report on the third Japan-UK Primary Care Exchange Programme. Japanese delegates visited Scotland in September of 2015. They watched GP surgeries and attended the Royal College of General Practitioners (RCGP) Annual Primary Care Conference. The following topics are covered as some of the most insightful experiences: NHS Cancer screening programmes, support for people with cancer and their families, working conditions for GPs, and the Half-Day Release Programme for GP specialist training. In addition, the delegates reflected on their experiences.

The aim of this study is to clarify the present situation of activities of continuing medical education (CME) for the primary care physicians to whom the leading hospitals, such as universities and clinical trainee hospitals perform CME in their regions. A questionaire was designed for main 4 parts, as following: 1) On the purpose of CME for the physicians. 2) On the organization (office) managing CME in the hospitals. 3) On the strategies of CME. 4) On the evaluation of CME. Answers to a questionaire were replied from 234 institutions (58.1%). Analyzing the results, we recognized that the leading hospitals actively carried out CME for the primary care physicians in the community. Furthermore, conversion to experiential learning from passive learning and establishment of evaluation methods should be promoted in CME.

  On July 7, 2010, a 74-year-old man came to our hospital, complaining that he had a nagging pain in his chest that started the preceding day. After performing electrocardiography, blood tests and electrocardiography, we diagnosed the case as acute myocardial infarction. At first, it was thought that blood flow could be restored in due course of time, antiplatelet and anticoagulant agents were used. Intracardiac catheterization was not included in our initial treatment plan. Three days after the initiation of the treatment, the patient had pain in his left inguinocrural region. Computed tomography and magnetic resonance imaging reveled hematoma in his left iliopsoas muscle. We stopped administering antiplatelet and anticoagulant agents to him. But anemia progressed from Hb14.1g/dL to 9.8 g/dL, so blood transfusions had to be given. After that, the patient underwent a rest cure. With the passage of time, the pain and swelling of the left iliopsoas muscle went down. Regarding the cardiac condition, however, the pain in the chest did not abate even when he was taking a rest. The antiplatelet therapy was resumed, with one type of agent given at first and then with another type added. Examinations using a coronary CT and a cadiac catheter found 90% stenosis at the proximal left anterior descending coronary artery. So, a bare metal stent was placed in the near-closed artery. Ever since, there has been no recrudescence of chest pain and no recurrence of iliopsoas muscle hematoma. The extravascated blood mass seemed to be dissolved spontaneously.