We performed a statistical analysis to find characteristic elements or moments which may make old people feel life worth living in rural areas in Japan, using the results of a questionnaire survey we reported in 1996 wiht the title “Aging of the Rural Population and Effective Measures to Respond to the Trend.”
In the analytical procedure, we used a multiple regression analysis with a logistic model. The dependent variable was the question “Is your present life worth your while to live?” As the independent variables, 168 questions were used covering various aspects of everyday life-farm work, activity in the community, environment, health, medication, aging, death, etc.
The number of subjects responded to the survey totaled 1, 373 men and women at age 55 and over living in 7 prefectures in Japan. The purpose of the analysis was to obtain items of questions with statistically significant coefficients in the logistic regression equation for the dependent variable. A total of 28 items of questions of statistic significance were obtained and most of the answers to these questions had a positively directed nature in order. Some of the items are as follows:
“Principles in life, ”“High hopes on agriculture, ”“Family with plural generations, ”“Satisfaction with domestic conditions, ”“Positive (healthy) ADL-markers, ”“Liking for harmony, ”“Participation in neighborhood activity, ”“Medication up to the terminal stage, ”“Willingness to leave one's body to medicine or donate for organ transplantation, ” etc.
Further, we discussed the comparison of items of unique characteristics between prefectures, healthy and unhealthy groups, sexes, age groups, and farmers and non-farmers.

There is a great diversity of manner in agricultural daily work compared to other industrial works. Therefore, at the estimation and comparison of farmers' subjective symptoms caused by the work, it should be known the relative grade of the work load of the day compared to those of other working days.
From this viewpoint, in this study, seventy three farmers who had been surveyed the subjective symptoms after daily work 10-16 months before were shown the working record of the day and were made to recall and estimate the grade of the work load and fatigue at that time by five steps rating method. The obtained data were referred to their fatigue symptoms.

Objective: Pharmacy students are considered to experience various forms of stress during long-term practical training in the 6-year pharmacy education.  This study examined relationships between psychological stress responses and self-efficacy involving 77 subjects who consented to join this study in practical training conducted at Teikyo University Hospital (2010-2011FY).
Methods: This study used the Profile of Mood States (POMS) for evaluating the psychological response, and an assessment form consisted of 20 items including interpersonal relationships, contents of practical training and health/life/stress coping for self-efficacy before, during, and after the training.
Results: In the POMS, only the state of ‘vigor’ showed a significant difference in a comparison among before, during, and after the training; however, no significant change was observed in other mood states.  These results suggested that the students were under mild stress during the training.  Their self-efficacy was increased after the training in all 20 items except “contacting university instructors during the training”.  The results also showed that there was an association between self-efficacy and psychological stress responses.
Conclusions: It is considered important that instructors and pharmacy technicians involved in pharmacy practice should understand the levels of individual stress responses or interpersonal communication skills to utilize them for coaching and maintaining students’ mental health.

A 75-year-old man with severe mitral valve regurgitation and 80% stenosis of the right internal carotid artery was referred to us for surgical treatment. He had a history of ipsilateral cerebral artery thrombosis 28 months previously. Although preoperative percutaneous transluminal carotid angioplasty with stenting (PTCAS) was performed, 60% stenosis of the artery still remained. He underwent mitral valve repair 2 months after PTCAS due to cardiac symptom progression. Intraaortic balloon pumping was used to maintain higher pressure during the extracorporeal circulation of the heart surgery. He recovered uneventfully and without any cerebral complications.

Health problems of the farmers were surveyed in two districts where progressed mechanization, green hause culture or other improved management systems were introduced.
The following results were obtained:
1. Long daily working hours remain as before, therefore, sleeping hours and hausehold hours in female are shortened in busy seasons.
2. By introduction of joint management or cooperative manegement working hours of female farmers were shortened in some cases, but not enough.
3. New health hazards as noise, vibration, toxic chemicals, continuing of forced posture, forced repetitive motion of hands and arms are being marked.
4. High incidence of subjective symptoms relating to their acute or chronic fatigue were obserbed in most type of agriculture, which were considered to indicate that modernization of agricultural production had been promoted in lacking of consideration for farmer's health.

Objective: In previously reported comparisons of aminoglycoside antimicrobials administered once daily versus multiple administration, toxicity was found to be equal or lower while efficiency remained high.  However, there are few reports on the clinical condition of targeted elderly persons.  The objective of this study was to evaluate the once-daily dosing regimen of 400 mg of AMK involving elderly pneumonia patients aged 75 years or older with regard to clinical evaluation including the efficacy and toxicity.
Methods: A survey to clinically evaluate the efficacy and toxicity of 400 mg AMK administered once daily for 30 min at 24 h intervals was carried out.  One hundred twenty-seven patients with pneumonia and who were 75 years or older at Funabashi General Hospital were targeted, with the aim of an expected clinical effect of C_max/MIC≥ 8-10.  Serum concentration monitoring was carried out after administration began.
Results: There were 121 patients (95.3%) of controlled AMK concentration with a trough serum concentration of <10 μg/mL, which is a safe concentration range.  There were 6 patients (4.7%) where trough serum concentration in the toxic range >10 μg/mL, with an average at 15.1±5.0 μg/mL, and the average administration days were 7.5 ± 3.3 days.  Moreover, before/after AMK administration, there were 3 patients (2.4%) where CRE values increased more than a 150% over the previous values, and were evaluated as renal dysfunction.  Average trough serum concentration at that time was 3.6 ± 1.1 μg/mL, and average number of days of administration were 13 ± 1.4 days.  Patients of trough serum concentration in the toxic range >10 μg/mL were not included.  The average peak serum concentration calculated by Winter’s pharmacokinetic parameter and the 1-compartment model was 35.3 ± 8.0 μg/mL, and the average C_max/MIC which correlates with the AMK effect was 9.9 ± 2.2.  The treatment was effective for 83 (65.4%) of the 127 patients.
Conclusion: By once-daily administration of AMK 400 mg to aged persons 75 years or older, change in trough serum concentration into a safe range and C_max/MIC≥ 8-10, the level at which clinical effectivity can be expected, could be achieved.  This administration method is shown to be useful in maintaining AMK in the target serum concentration range for aged persons.

We conducted a questionnaire survey involving 270 interns in the year 2011 at the pharmaceutical department of Teikyo University, in order to clarify pre- to post-practical training changes in: 1) the degree of pre-clinical training’s usefulness, 2) desired workplace in the future, 3) degree of satisfaction, 4) confidence degree of practical training, etc. The degree of pre-clinical training’s usefulness exceeded 80% in all training periods. Regarding the desired workplace in the future, a large proportion of students answered that they want to become a pharmacist in a pharmacy or hospital, both before and after their practical training in all training periods. Also, it was estimated that students decide their career with reference to their practical training experience. In terms of the degree of satisfaction with practical training, the proportions of those who answered “Satisfied” or “Somewhat satisfied” were: 95.1% in the 1st, 95.6% in the 2nd, and 86.1% in the 3rd periods. The confidence degree significantly increased after practical training in all periods. Because the confidence degree showed a tendency to be higher before the 3rd period of training compared to the other two periods, it was considered that students’ experience of practical training led to increased confidence degree. Regarding communication abilities, the degrees of before-after confidence degree and pre-clinical training’s usefulness were low, and, hence, it was suggested that pre-clinical training needs to be further improved regarding these areas.

  We require our students in the 4th grade to take an on-site pediatric outpatient clinic course at the Teikyo University Hospital as part of a 4-week on-site training program.  This year, 64 trainees divided into groups of 3 or 4 students took the course between June and August.  In the morning, trainees were asked to conduct clinical interviews with 287 patients’ guardians in the presence of trainers.  This was followed by the observation of consultation and treatment services provided to patients.  In the afternoon, students reported the findings obtained in medical interviews, participated in group discussions, and received supplementary lectures from trainers.  After completing the course, students were asked to fill in a questionnaire.  When asked whether they were satisfied with the course, 62.5% and 37.5% of students said “very satisfied” and “satisfied,” respectively, while 64.1%, 29.7%, and 6.2% of students said the observation of consultation and treatment services was “very good,” “good,” and “cannot say which,” respectively.  About the medical interviews, 64.1% and 34.4% said that it is “very good” and “good” to conduct them, while 1.5% said “cannot say which.”  All students said they could determine the problems faced by guardians regarding drugs in the medical interview.  The on-site pediatric outpatient care course was found to be “very useful” and “useful” by 62.5% and 35.9% of patients, respectively, while 1.6% said “cannot say which.”  In conclusion, most students were greatly satisfied with the medical interview with guardians using a questionnaire and said that it made it possible for them to closely communicate with guardians.  This result was thought to be attributable to the use of the techniques of the medical interview OSCE which the students learned prior to conducing medical interviews with guardians.

The external preparation Metronidazole (MTZ) is reported to be useful in controlling the malodor associated with advanced and recurrent breast cancer patients. We prepared two different MTZ external preparations, a 1% MTZ Hydrophilic Ointment and a 0.8% MTZ Carbopol Gel. These preparations were then used to control malodor associated with breast cancer and the results were clinically evaluated. Malodor disappeared within 1 week of administration of either preparation and no adverse reactions were observed. These MTZ external preparations were thus found to be useful in the elimination of malodor as part of the treatment of those patients with advanced and recurrent breast cancer.

Ischemic colitis following cardiac surgery is a rare but critical complication. We report two cases of ischemic colitis following cardiac surgery successfully treated with stenting of the stenotic celiac trunk. Case 1 was a 65-year-old man who developed perioperative myocardial infarction during off-pump coronary artery bypass grafting. He experienced abdominal pain and bloody stool on postoperative day 19. Severe ischemic changes in the sigmoid colon and descending colon were seen on colonoscopy, and CT scan revealed significant stenosis of the celiac trunk and occlusion of the inferior mesenteric artery and bilateral internal iliac arteries. Revascularization of the celiac trunk via stenting resulted in dramatic improvement in colonic ischemic changes. Case 2 was a 60-year-old woman who underwent a restoration procedure for a left ventricular aneurysm. She experienced gradual onset of postprandial pain beginning 9 days after surgery and massive bloody stool on postoperative day 33. Imaging revealed severe ischemic changes in the descending colon on colonoscopy and stenoses of the celiac trunk, superior mesenteric artery, inferior mesenteric artery, and bilateral common iliac arteries on CT angiogram. Stenting was performed to the celiac trunk on postoperative day 52. Her abdominal pain and bloody stool were completely resolved after treatment. Prior to the introduction of endovascular treatment of mesenteric ischemia in 1980, the standard treatment had been open surgical repair. Since then, endovascular repair has become widely accepted. In our experience, endovascular treatment of the mesenteric vessels may be an effective and less invasive approach to treating mesenteric ischemia in unstable patients after cardiac surgery.