Background: Sarcopenia negatively affects the short-term prognosis of hospitalized older adults. However, no evidence currently supports a direct relationship between sarcopenia and readmission among individuals who have experienced an acute stroke. Therefore, we investigated whether sarcopenia is associated with readmission after discharge. Methods: This retrospective cohort study included patients who had experienced acute stroke. Sarcopenia was defined as the coexistence of low skeletal muscle mass index (SMI) and grip strength. We applied the log-rank test and Cox proportional hazards regression analysis to analyze whether sarcopenia, low SMI, and low grip strength were associated with readmission within 6 months. Results: Among 228 included patients (mean age, 72.8 years; 146 males), the prevalence of sarcopenia was 24.6% (n=56; male 17.8%; female 36.6%). Cox proportional hazards regression analysis using the propensity score as a covariate revealed that sarcopenia (hazard ratio [HR]=7.21; 95% confidence interval [CI] 1.45–35.8; p=0.016) and low skeletal muscle mass (HR=7.40; 95% CI 1.14–48.1; p=0.036), but not low grip strength (HR=1.42; 95% CI 0.281–7.21; p=0.670), were significantly associated with readmission for stroke within 6 months. Conclusions Sarcopenia was negatively associated with readmission within 6 months of stroke onset in patients in Japan who had experienced an acute stroke. These findings suggest that the identification of sarcopenia may facilitate prognostic prediction from the acute stage and intervention(s) to prevent rehospitalization.

Objectives: Although a few studies have investigated the relationship between kidney and oral function (number of remaining teeth), their results remain inconclusive. Therefore, this study aimed to investigate the relationship between kidney function and oral health in community-dwelling healthy elderlies and examine the factors associated with kidney function. Materials and Methods: We used cross-sectional data from the Shimane prefecture cohort recruited by the Center for Community-Based Health Research and Education in 2019. We collected clinical data on dental status, background factors and kidney function (estimated glomerular filtration rate [eGFR], mL/min/1.73 m2 and creatinine levels, mg/dL). Results: The study enrolled 481 participants, whose mean age was 66.7±7.4 years, and 223 (46.4%) participants were men. Multivariate analysis revealed significant correlations between eGFR (B=0.17, P=0.04), creatinine (B=–0.54, P<0.01), and the number of remaining teeth. The number of remaining teeth was associated with creatinine and eGFR, which are indicators of kidney function. Conclusion This study suggests that preserving the teeth may prevent decline in kidney function. Dental professionals should provide instructions and professional care to reduce the risk of systemic diseases such as kidney dysfunction.

In the U-40 column, we conducted a questionnaire survey of the U-40 generation on the theme of the specialist system for cardiovascular surgery and reported on the present condition and problems in obtaining certification. With the introduction of a new system, off the job training and participatory training using extracorporeal circulation techniques were newly mandated. In this article, we report the results and discussion of the questionnaire survey regarding the present condition of extracorporeal circulation training for the U-40 generation and the pros and cons of training programs.

The U-40 generation of surgeons are practicing through trial and error, and form various careers. At the 51st Annual Meeting of the Japanese Society of Cardiovascular Surgery, U-40 Special Project, we looked back on the U-40 generation and more senior doctors to see what kind of future visions, problems and careers they have had. We conducted a questionnaire for the purpose of visualizing the future prospects of the U-40 generation. In this article, we report the results.

The reform of the way physicians work was started from April 2024. Restrictions on doctors' working hours is expected to be difficult to achieve the level required by the government. U40 Kyushu-Okinawa Branch conducted a questionnaire survey of young cardiovascular surgeons nationwide on their working conditions. While some institutions have taken measures such as streamlining doctors' work and shifting tasks, others seem to have made a few change to their previous work content. The reform of work styles of cardiovascular surgeons requires not only individual improvement of work styles, but also efforts by cardiovascular surgeons as a one team, including department heads and facility directors, and requires the involvement of academic societies and governments.

  In 2008, Japanese Society of Drug Informatics (JASDI) organized the Future Vision Committee (the Committee) to propose the essential focus of drug informatics.  To explore a future vision about the drug information sciences, it was necessary to collect a variety of opinions widely from researchers.  Therefore, at the 11^th annual meeting of JASDI in July 5-6, 2008, the Committee convened a workshop to extract problems in the researches of drug informatics by using KJ method and evaluated the contents.  The major problems raised were “the field of drug informatics is too broad” and “there is no definition and/or no system of the drug informatics”.  Related problems raised are the shortness of the history and lack of originality in the study.  From different viewpoints, it was also pointed out that the methodology of the research is not well established and no systematic education is provided.  Taken together, major problems in drug informatics are concluded to be the lack of definition and the lack of systematizations, and will be solved to a certain extent by defining the outcome of the researches in drug informatics.

We investigated how cardiovascular surgeons get a day off.

A 65-year-old man with a history of severe aortic valve regurgitation had undergone aortic valve replacement (AVR) via partial upper hemisternotomy at the age of 50 years. At that time, bioprosthetic valve was implanted. Fifteen years after the valve implantation, he presented with palpitations and chest tightness. Examination revealed bioprosthetic valve failure with consequent severe aortic valve regurgitation. Redo AVR via right anterior mini-thoracotomy was decided as the treatment strategy, and the procedure was successfully completed without complications. The patient underwent extubation on the day of the operation. His postoperative course was unremarkable, and he was discharged 13 days postoperatively. In this case, the patient had previously undergone partial upper hemisternotomy (classified as a minimally invasive cardiac surgery [MICS]) and showed only few adhesions in the pericardium, suggesting that MICS could be beneficial in cases involving re-operation.

A 73-year-old woman presented with epigastric discomfort and lightheadedness. She was admitted to another hospital with congestive heart failure due to severe aortic and mitral regurgitation. However, her heart failure was refractory to medical treatment, necessitating transfer to our hospital for surgical treatment. Emergency surgery was performed for worsening heart failure after admission to our hospital. Intraoperative findings showed aneurysms of the ascending aorta and aortic root and avulsion of the aortic valve commissure between the right coronary and non-coronary cusps. Replacement of the ascending aorta and aortic root replacement using the Florida sleeve method as well as double valve replacement (mitral and aortic) were performed with a favorable outcome. Histopathological examination showed myxomatous degeneration, which suggested that it could have contributed to avulsion of the aortic valve commissure.

Since students who would like to study Kampo medicine more have no opportunity to communicate each other in Northern Japanese Universities, we newly started joint study conferences held by medical students in 2013. The objectives of this paper are to report on these annually held student-based Kampo study conferences in the Hokkaido and Tohoku areas, and the ways each university studies Kampo medicine. In the conference, the students reported on their club activities. Then they studied the history of Kampo medicine and simulation of abdominal diagnosis, and performed group work on case reports together. The number of student participants in these conferences has tripled over 3 years from 18 to 58 (for a total of 111 participants). All members were satisfied with the content. And this reflects medical students' need for a wider perception of Kampo medicine, rather than a limited one gained in their university club activities. We hope this conference will play a major role in other nationwide student-based Kampo study conferences in the years to come.