The aim of this study was to understand the use of complementary and alternative medicine (CAM) in cancer patients in Japan. This study was part of the Japan Hospice and Palliative care Evaluation 2016 (J-HOPE2016) Study. A multicenter questionnaire survey was conducted on a sample of bereaved family members of cancer patients who died at palliative care units. Data suggest that 54% of cancer patients use CAM. In comparison with a previous study in 2005 in Japan, categories of CAM vary widely; CAM previously included supplements mostly, but now exercise and mind and body therapy are also used. Most cancer patients use CAM without any harmful influence on their household economy and cancer treatment; however, in some patients, CAM incurs a large expense and a delay in starting cancer treatment. Therefore, it is important for medical staff and patients to have an opportunity to discuss CAM use. Multiple logistic regression analysis shows that CAM use is significantly associated with younger patients and highly educated families; moreover, there is a possibility that family members who use CAM have a high level of psychological distress. We must pay attention to the physical and the psychological aspects of cancer patients who use CAM and their families. Further studies are needed to investigate the use of each category of CAM, and to understand patients who use CAM and who die at home or in hospitals other than palliative care units.

The purpose of this study was to confirm both the reproducibility of indices (NIRS slope, NT2, %NIRS fall) and the specificity obtained by analyzing the muscle oxygenation curve measured by near-infrared spectroscopy (NIRS) during ramp exercise. Ten healthy men participated in this study. The NIRS probe was placed on the vastus lateralis muscle. An increase in oxygenation was observed from rest to warm-up at 0 watts (Δ NIRS) . Oxygenation began to decrease lineally as the workload increased (NIRS slope) . In the latter phase of exercise, the oxygenation curve flattened out despite an increasing workload, and as a result, an inflection point was formed (NT2) . The minimum value of oxygenation during ramp exercise was indicated as“%NIRS fall.”
Protocol 1. After a warm-up period of 3 min at 0 watts, a ramp exercise (20 watt/min) test was performed until volitional fatigue. The test was performed for each subject twice (test-1, test-2) with a 1-week interval. Protocol 2. A test was performed with three consecutive ramp exercises (lOwatt/min·20watt/min·30watt/min) up to120watt each with sufficient rest between the exercises.
NT2 was observed in 7 of 10 subjects. Test-1 and test-2 mean values of ANIRS, NIRS slope, watts at NT2 (NT2) and %NIRS fall were not significantly different, and the correlations between test-1 and test-2 were highly significant (r=0.94, P<0.0001: ANIRS, r=0.99, P<0.0001: NIRS slope, r=0.91, P<0.002: NT2 and r=0.78, P<0.005 : %NIRS fall) . The regression lines obtained for correlations of results of test-1 and test-2 were y=-5.89+1.38X (Δ NIRS), y=0.02+ 1.03X (NIRS slope), y=31.52+0.83X (NT2), and y=19.91+0.61X (%NIRS fall) . No significant differences in both intercept and coefficient between the regression line and identity line were found in the NIRS slope and NT2. The rate of decrease in the oxygenation curve became steeper with an increase in work-load from 10 watts/min to 20 watts/min and to 30 watts/min. However, the mean values of the NIRS slope, modified by watts, were 0.29±0.06%/watt, 0.29±0.07%/watt and 0.29±0.07%/watt, respectively. There were no significant differences of the NIRS slopes among these exercises. The results indicate constancy of the rate of decrease in oxygenation per workload.
In conclusion, these findings demonstrate the reproducibility of the NIRS slope and the appearance of NT2 during ramp exercise, and the specific way in which the decrease in muscle oxygenation reflects workload. They suggest that analysis of the muscle oxygenation curve can be used to estimate muscular metabolism and indices of training effects.

The purpose of the present study was to examine the importance of the agonist muscle activity of the post-impact 30 ms phase during drop jump (DJ) for effective rebound performance by comparing those of sprint runners and swimmers. The eight sprint runners (SPRINT) and twelve swimmers (SWIM) were participated in this study. They performed DJ from a 0.3-m height box with maximal rebound efforts. Electromyograms (EMG) of the lower leg muscles (medial gastrocnemius [MG], soleus [SOL] and tibialis anterior [TA]), and vertical ground reaction force together with kinematic data were measured simultaneously during DJ. In addition, the onsets of fascicle stretching of the MG and SOL muscles were measured by using high-speed ultrasonography (521Hz) during DJ. The onsets of the fascicle stretching of SOL during DJ were not significantly different between SPRINT and SWIM (15 ± 7 ms and 16 ± 6 ms, respectively). During DJ, SPRINT showed onset of the SOL EMG before the ground contact (-26 ± 19 ms). Meanwhile, SWIM showed the onset of the SOL EMG after the ground contact of DJ (16 ± 19 ms). These results suggest that the SOL muscles for SWIM cannot be fully-activated during the braking phase. Consequently, the rate of force development during the braking phase of DJ and subsequently rebound height could be reduced in SWIM.

A kainic acid microinjection into unilateral occipital cortex induced an experimental model of occipital lobe epilepsy in cats and rats. Elicited focal seizures in the occipital cortex promptly propagated to the bilateral cortices and also to the subcortical structures. Behavioral and EEG observations were well correlated to the human occipital lobe epilepsy. Metabolic study using 14C-deoxyglucose autoradiography in rats demonstrated a rapid propagation of the hypermetabolic area in the parietal, frontal, temporal and contralateral occipital cortices and also to the thalamus, basal ganglia, MRF and lateral geniculate body. The result shows that not only Meyer’s loop but also subcortical fasciculus between occipital lobe and other lobules may have an important role in the mechanism of seizure evolution and propagation of the occipital lobe epilepsy

Objective: Many patients in Kagawa University Hospital are administered medicines prepared by the simple suspension method.  Pharmacists in charge of these patients receive inquiries from doctors and nurses regarding the suitability of medicines for the simple suspension method.  Answering these inquiries is complicated and time-consuming as multiple data sources need to be searched.  In order to simplify these complicated procedures, we herein attempted to develop a novel database to provide valuable information that could contribute to the safe performance of the simple suspension method, and evaluated its usefulness.
Method: The specifications of the database were determined by analyzing previously answered inquiries.  To evaluate the usefulness of the database, we used test prescriptions and compared the amount of time required to gather information using the database and the conventional method, i.e., using books alone.  We also analyzed previous prescriptions with the database in order to determine what kinds of problems could be detected.
Results: The investigation of previous prescriptions indicated that some medicines needed to be examined not only for their suitability for the simple suspension method, but also their incompatibility.  Therefore, we added a feature regarding the incompatibility of medicines to the database.  The time required to gather the information needed to answer the test prescription was shorter with our database than with the conventional method.  Furthermore, the database improved the detection of medicines that require particular attention for their properties including incompatibility.  An analysis of previous prescriptions using our database indicated the possibility of incompatibility in half of the previous prescriptions examined.
Conclusion: Our database could rapidly provide information related to the simple suspension method, including the incompatibility of medicines.

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.

Clinical training programs play an extremely important role in the new postgraduate clinical training system introduced in 2004 because facilities for clinical training now include various health-related institutions in addition to the university hospitals and special hospitals for clinical training used in the previous system. Although educational goals have been established by the Ministry of Health, Labour and Welfare, trainees may have difficulty achieving these goals, even under the guidance of staff at the various facilities. There are differences in the function and quality of health-related institutions in the community. For the practical and convenient application of educational goals, we have attempted develop a “model program” to supplement the objectives indicated by the learning goals with more specific objectives. These supplementary objectives can be modified by individual institutions. We hope that this “model program” contributes to the development of objectives for each institution and helps improve the quality of the postgraduate training system in Japan.

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.

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.