Purpose: We investigated the involvement of the pharmacy, as a health care resource that supports regional palliative care, in the treatment of patients who received continuous sedation during home-based care. Method: Of the home-based patients with end-stage diseases who received guidance for the management of home-based care between January 2011 and December 2012, this study involved 13 patients who were treated with sedation to relieve pain, and died at home. The survey items included the improvement of pain levels after the initiation of sedation, the number of prescriptions for sterile preparations, number of home visits made by physicians and pharmacists, and the change in the purpose of home visits made by pharmacists. Result: The improvement of pain levels was 76.9%. The number of prescriptions for sterile preparations and that of home visits made by physicians and pharmacists (per day) significantly increased after the initiation of sedation. Concerning the change in the purpose of home visits, an "emergency situation" became significantly more prevalent. Conclution: In the care of patients undergoing sedation at home, it is necessary to have physicians who can respond to emergency situations; thus, a similar system must be established for the pharmacy as a health care resource that supports regional care.

The present study was designed to examine the effects of aerobic exercise on the change of alpha wave component in electroencephalogram (EEG) and plasma β-endorphin. Exercise consisted of 30-min cycling on an ergometer with the load adjusted to elicit a heart rate rise of 50% between resting and predicted maximal value. The EEG signals and blood samples were obtained before and after 30-min exercise. The EEG signal was digitized at a sampling frequency of 64 Hz and analyzed by means of computer-aided decomposition algorithm and frequency power spectral analyses, respectively. The blood samples were immediately centrifuged for 15-min for quantitative analysis of β-endorphin by means of radioimmunoassay method. Results indicated that β-endorphin was significatly (p<.05) greater after exercise as compared to that of the resting contorol. It was also found that the larger the changes in β-endorphin following exercise, the higher the appearance rate of alpha wave in EEG. There was a positive and significant correlation (r=563, p<0.05) between the increase in alpha wave component and that of the plasma β-endorphin. These results suggest that traquilizer effects of aerobic exercise could be explained, at least in part, by the increase of alpha wave component and plasma β-endorphin which in turn bring about the relaxation effects upon the central nervous system.

The present study was designed to examine the effects of aerobic exercise on the change of alpha wave component in electroencephalogram (EEG) and plasma β-endorphin. Exercise consisted of 30-min cycling on an ergometer with the load adjusted to elicit a heart rate rise of 50% between resting and predicted maximal value. The EEG signals and blood samples were obtained before and after 30-min exercise. The EEG signal was digitized at a sampling frequency of 64 Hz and analyzed by means of computer-aided decomposition algorithm and frequency power spectral analyses, respectively. The blood samples were immediately centrifuged for 15-min for quantitative analysis of β-endorphin by means of radioimmunoassay method. Results indicated that β-endorphin was significatly (p<.05) greater after exercise as compared to that of the resting contorol. It was also found that the larger the changes in β-endorphin following exercise, the higher the appearance rate of alpha wave in EEG. There was a positive and significant correlation (r=563, p<0.05) between the increase in alpha wave component and that of the plasma β-endorphin. These results suggest that traquilizer effects of aerobic exercise could be explained, at least in part, by the increase of alpha wave component and plasma β-endorphin which in turn bring about the relaxation effects upon the central nervous system.

Methods: The medical records of patients with intervertebral TLIF from 2012 to 2018 were retrospectively examined. The patients were divided into those with fusion and those with pseudoarthrosis, and the following data were compared: age, sex, DISH, diabetes mellitus, smoking, drinking, albumin levels, body mass index ≥30 kg/m2, and L5/S fixation. Statistical analyses were performed using regression models. Results: In this study, 180 patients (78.6%) had fusion and 49 patients (21.4%) had pseudoarthrosis. The number of patients with DISH was significantly higher in the pseudoarthrosis group than in the fusion group (36.7% and 21.7%, respectively; univariate p=0.031, multivariate p =0.019). No significant differences in age, sex, diabetes mellitus, smoking, drinking, albumin levels, body mass index ≥30 kg/m2, and L5/S fixation were observed between the two groups. The risk factors for bone fusion were statistically analyzed in 57 patients with DISH. DISH with a caudal end below Th11 was an independent risk factor for pseudoarthrosis (univariate p=0.011, multivariate p=0.033). Conclusions DISH is an independent risk factor for pseudoarthrosis after one intervertebral TLIF, and DISH with a caudal end below Th11 is associated with a higher risk of pseudoarthrosis than DISH without a caudal end below Th11.

The purpose of this study was to consider the validity of measuring the Star Excursion Balance Test (SEBT), which has been used as a measure of balance ability in athletes, for community-dwelling elderly people. To achieve this purpose, we examined the relationship between the existing balance ability measures, leg strength, and the SEBT. The subjects were 36 elderly people (mean age: 71.1 years). We used the SEBT, functional reach test (FRT), timed up-and-go test (TUG), and Mini-BESTest to evaluate balance ability and the 30-second chair-stand test (CS-30) to assess leg strength; we also assessed the 10-m walk time. The correlation coefficient with the SEBT was calculated. The significant level was 5%. A significant positive correlation was observed between the total score of Mini-BESTest and the SEBT reach distance in the anterior direction (r = 0.364, p < 0.05) and the posteromedial direction (r = 0.407, p < 0.05). A significant positive correlation was observed between anticipatory postural control and the SEBT reach distance in the anterior directions (r = 0.403, p < 0.05), and postural responses and SEBT reach distance in the posterolateral direction (r = 0.360, p < 0.05), which were subsystem category of Mini-BESTest. No significant correlation was found in the other items. The correlation with Mini-BESTest indicates that SEBT might be a valid tool to evaluate the dynamic balance ability of community-dwelling elderly people. However, their correlation coefficient is not high, suggesting that SEBT can evaluate elements different from Mini-BESTest.

Methods: The outcomes of 72 patients who underwent BKP for VCFs between 2015 and 2021 were retrospectively investigated. Patients with DISH were assigned to group D (n=21), whereas those without DISH were assigned to group ND (n=51). Back pain, incidence of subsequent adjacent fractures, reoperation rates, and local kyphosis were statistically analyzed. Results: VCFs in group D occurred at the distal end or adjacent vertebra of the fused segments, and no fractures occurred in the midportion of the fused segment. Back pain improved in both groups, with no significant differences between them. Subsequent adjacent fractures were observed in three of the 21 patients in group D and 11 of the 51 patients in group ND, with no significant difference between them. Reoperation was performed in one patient each in groups D and ND, with no significant difference between the groups. Postoperatively, local kyphosis progressed significantly in group D. Conclusions Although local kyphosis is more advanced in patients with DISH, BKP is effective for VCFs at the distal end or adjacent vertebra of the fused segments and may be useful in older patients with high complication rates.

  We reviewed the clinical features and treatment outcome of 110 children with leukemia. Treatment was performed between 1980 and 2009 at our hospital. The mean age at onest was 5 years 6 months, the ratio of males to females was 1:0.72, and mean leukocyte count was 4.91×10⁴/μl. Subtypes of leukemia were acute lymphoblastic leukemia (ALL) in 79.1% of the patients, acute myeloid leukemia (AML) in 17.2%, and chronic leukemia in 3.6%. In all patients, the overall 30-year survival rate estimated by the Kaplan-Meier method was 67.4%. In the three decades from the 1980s, the overall 10-year survival rate has been improved significantly from 46.4% in the 1980s, 69.2% in the 1990s to 87.2% in the 2000s (P<0.01). The overall 10-year survival rate was 70.7% in all children with ALL, and 70.6% in all children with AML. But in the last decade, the 10-year survival rate was improved to 87.0% in children with ALL and 87.3% in children with AML. Twenty-four patients received hematopoietic stem-cell transplantation, and the 10-year survival rate was 58.6% after transplant. Second malignancies were detected in three patients, and six patients have long-term sequelae. In conclusionn, the treatment result of childhood leukemia has improved considerably, so that more intensive treatment for patients with poor prognosis and less toxic treatment for patients with good prognosis will be necessary in future.

In career education, devising ways to elicit proactive participation is vital, thus we conducted face-to-face workshops to drive learners’ participation. However, the COVID-19 pandemic forced us to teach classes online. Therefore, to motivate more than 100 students to participate actively in the online format, we conducted career education using Active Book Dialogue® where several students read a book together in a short period of time. Each student read a specific part of the book they were assigned and summarized it in collaboration with their group members. This enabled them to learn career theory. Additionally, the online format allowed several lectures to be held within a remote and interactive environment. We will reflect on this experience and report on how this can be applied in other schools.

We developed a virtual career thinking game and provided third-year medical students with workshop-type career instruction to identify "transition" in a career and their own values. The game is a group work activity based on the assumption that the virtual character will respond to a turning point during undergraduate school and after graduation, and experience the story of a doctor's life. After playing the game and sharing the story of each group, participants were asked to think about what they would do at a possible turning point. Although favorable response were observed in the first year, problems were found, and improvements were made in the second year, and further effects were observed. The results show that career education using games increases students' ability to respond to turning points and is an effective technique in career education.