This study examined the association of physical activity (PA) and sedentary behavior (SB) with chronic low back pain (CLBP) in older adults. Cross-sectional data were collected from 715 elders aged 65 years and over living in Dazaifu, Japan. CLBP was defined as pain that sustains more than 1-3 months within the past year. PA and SB were objectively measured using a triaxial accelerometer (Omron Healthcare, Active style Pro (HJA 350IT)). Participants were categorized into four groups (2 groups of PA×2 groups of SB) according to their levels of PA and SB (divided into 2 levels; low and high levels around the median). Logistic regression analysis was used to examine effect of PA/SB with CLBP. In the analyses, sex, age, body mass index, smoking, educational attainment, falls, handgrip strength, knee pain and non-locomotive activities were treated as potential confounders. The prevalence of CLBP was 35%. After adjustment of confounding factors, significantly higher risk of CLBP was shown only in Low PA/High SB group (odds ratio : 1.66, 95% confidence interval : 1.02-2.70), compared with that of the reference group (High PA/Low SB group). These results suggest that the combination of low PA and high SB might be the risk of CLBP. Future studies should try to clarify whether CLBP is a cause or a consequence of inactivity.

  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.

Background: Masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) is a relatively newly identified clinical condition that manifests as trismus with a square-shaped mandible. Herein, we report a case of MMATH that was initially misdiagnosed for polymyositis due to trismus and simultaneous lower limb pain, with literature review.Case presentation A 30-year-old woman had a history of lower limb pain after exertion for 2 years. Initial physical examination had been performed at the Department of General Medicine in our hospital. There was also redness in the hands and fingers. Although polymyositis was suspected, it was denied. The patient visited our department for right maxillary wisdom tooth extraction.Clinical examination revealed that the patient had a square-shaped mandible. The maximal mouth opening was 22 mm. There was no temporomandibular joint pain at the time of opening. Furthermore, there was awareness of clenching while working. Panoramic radiography revealed developed square mandibular angles with flattened con‑ dyles. Computed tomography showed enlarged masseter muscles with high-density areas around the anterior and lateral fascia. Magnetic resonance imaging also showed thickened tendons and aponeuroses on the anterior surface and inside bilateral masseter muscles. Finally, the patient was diagnosed with MMTAH. Bilateral aponeurectomy of the masseter muscles with coronoidectomy and masseter muscle myotomy was performed under general anesthesia.The maximum opening during surgery was 48 mm. Mouth opening training was started on day 3 after surgery. Histo‑ pathological examination of the surgical specimen showed that the muscle fibers were enlarged to 60 μm. Immuno‑ histochemistry testing for calcineurin, which was associated with muscle hypertrophy due to overload in some case reports, showed positive results. Twelve months after surgery, the mouth self-opening and forced opening were over 35 mm and 44 mm, respectively. Conclusions Herein, we report a case of MMATH. Lower limb pain due to prolonged standing at work and overload due to clenching were considered risk factors for symptoms onset of MMATH.

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.