Objective: In the differential diagnosis between uterine fibroids and uterine sarcomas, realworld magnetic resonance imaging (MRI) diagnostic information is scarce; furthermore, high diagnostic sensitivity is important in clinical practice. We previously developed a diagnostic algorithm to detect uterine sarcoma with high sensitivity using simple MRI images and serum lactate dehydrogenase (LDH) levels. In this multicenter study, we investigated the preoperative diagnosis of sarcoma in the real world and further validated the usefulness of our diagnostic algorithm. Methods: Of 154 uterine sarcomas and 154 uterine fibroids treated at 15 centers between January 2006 and December 2020, 139 sarcomas (16 smooth muscle tumors of uncertain malignant potential) and 141 fibroids with diffusion-weighted imaging information were included in the analysis. The diagnostic algorithm was validated by 3 radiologists who were blinded to the clinical information and pathologic diagnoses and who read the MRIs. Results: The sensitivity/specificity of preoperative diagnosis was 77.7%/92.9% for the preoperative report; 92.1%/72.3% for algorithm A; and 82.0%/85.8% for algorithm B (McNemar’s test p<0.05). Comparison of overall survival rates among 3 groups (Group 1: negative A, Group 2: positive A and negative B; Group 3: positive B) using algorithms A and B showed p=0.012. On multivariate analysis, stage, and serum LDH level were independent prognostic factors. Conclusion MRI is useful for preoperative diagnosis of uterine sarcoma, and the sarcoma diagnostic algorithm presented in this study is an option for diagnosing sarcoma with greater sensitivity. This information should be shared with patients.

Background: The anti-programmed death 1 (PD-1) antibody has led to durable clinical responses in a wide variety of human tumors. We have previously developed the caninized anti-canine PD-1 antibody (ca-4F12-E6) and evaluated its therapeutic properties in dogs with advance-staged oral malignant melanoma (OMM), however, their therapeutic effects on other types of canine tumors remain unclear. Objective: The present clinical study was carried out to evaluate the safety profile and clinical efficacy of ca-4F12-E6 in dogs with advanced solid tumors except for OMM. Methods: Thirty-eight dogs with non-OMM solid tumors were enrolled prospectively and treated with ca-4F12-E6 at 3 mg/kg every 2 weeks of each 10-week treatment cycle. Adverse events (AEs) and treatment efficacy were graded based on the criteria established by the Veterinary Cooperative Oncology Group. Results: One dog was withdrawn, and thirty-seven dogs were evaluated for the safety and efficacy of ca-4F12-E6. Treatment-related AEs of any grade occurred in 13 out of 37 cases (35.1%).Two dogs with sterile nodular panniculitis and one with myasthenia gravis and hypothyroidism were suspected of immune-related AEs. In 30 out of 37 dogs that had target tumor lesions, the overall response and clinical benefit rates were 6.9% and 27.6%, respectively. The median progression-free survival and overall survival time were 70 days and 215 days, respectively. Conclusions The present study demonstrated that ca-4F12-E6 was well-tolerated in nonOMM dogs, with a small number of cases showing objective responses. This provides evidence supporting large-scale clinical trials of anti-PD-1 antibody therapy in dogs.

The mandibular third molars are usually located near the inferior alveolar nerve, and surgical extraction may damage this nerve causing dysesthesia. Recently, cone-beam computed tomography (CBCT) has become more widespread, facilitating the diagnosis of various diseases of the oral maxillofacial region. This study investigated dysesthesia of the inferior alveolar nerve following mandibular third molar extraction and the relationship between this complication and preoperative imaging findings. A total of 401 mandibular third molars were extracted from 345 patients with a mean age 33.9 ± 14.6 years (range, 16-81 years). All patients were evaluated by panoramic radiography, and 89 mandibular third molars were evaluated by CBCT. We classified the shape of the mandibular canal into 4 types based on its shape at the point closest to the mandibular third molars. The rate of dysesthesia after mandibular third molar extraction was 5.7% among patients considered to be at high risk who underwent CBCT, and 0.64% among patients considered to be at low risk. The mandibular third molars were not in contact with the inferior alveolar nerve in 51 of the patients who underwent CBCT. These results suggest that deformation of the mandibular canal may lead to dysesthesia following mandibular third molar extraction and that CBCT was useful for predicting the risk of this complication.

The purpose of this study was to examine epidemiology of injury in a male collegiate volleyball team in Japan during 2019 season. Thirty-six collegiate male volleyball players were followed during 2019 season. Injuries that required more than 24 hours to recover were classified as Time Loss (TL) injury, and those that required less than 24 hours were classified as Non-Time Loss (NTL) injury. Exposure was calculated by total number of players and hours of participation. Then, we computed injury rate per 1000 Player Hour (PH) and 1000 Athlete Exposure (AE) as outcome measures. A chi-square test was utilized to statistically compare. Eighteen injuries occurred and the overall injury rate was 1.28/1000PH and 2.05/1000AE, respectively. Of which, 11 cases were NTL injuries (0.78/1000PH, 1.26/1000AE) and 7 cases were TL injuries (0.50/1000PH, 0.80/1000AE). Within the 7 TL injuries, 5 (0.36/1000PH, 0.57/1000AE) were of minor severity. Most TL injury were classified as chronic in nature (n=5, 0.36/1000PH, 0.57/1000AE). There was no statistically significant difference between injury rate of match (n=2, 1.33/1000PH, 2.88/1000AE) and training (n=16, 1.27/1000PH, 1.98/1000AE). The most frequently injured body part in training was lower back (n=7, 0.56/1000PH, 0.87/1000AE). In match, highest injury rate was observed in ankle (n=2, 1.33/1000PH, 2.88/1000AE). In conclusion, our results showed relatively low injury rate, and majority of reported injuries were categorized as minor severity. Our study also demonstrated injury characteristics of Japanese male collegiate players that lower back injuries were prevalent in training, and acute ankle injury rate was highest in match.

This article is a short report on the third Japan-UK Primary Care Exchange Programme. Japanese delegates visited Scotland in September of 2015. They watched GP surgeries and attended the Royal College of General Practitioners (RCGP) Annual Primary Care Conference. The following topics are covered as some of the most insightful experiences: NHS Cancer screening programmes, support for people with cancer and their families, working conditions for GPs, and the Half-Day Release Programme for GP specialist training. In addition, the delegates reflected on their experiences.

Objective: The Hyogo Hospital Pharmaceutical Society has been conducting an original pharmacy postgraduate education program, “lifelong learning program (to nurture pharmacy specialists)”, since 2002 using the Internet.  To understand the status of using this program, this study employed a questionnaire survey involving all registered members.
Methods: Subjects were all members (1,870) of the society.  Questionnaires were distributed and collected by mail.
Results: Only 20.1% of the members had experience of using the program, and the frequency of using it was less than once per 6-12 months in 60% of the members.  Their level of awareness concerning the acquisition of credits for lifelong learning was 36.9%.  The program category they wished to take was an infection-related program in 26.1% of the members, which was the highest.
Conclusion: As reasons for only a small number of members using the program, the following are considered: loss of user’s ID and password required to login, and lack of awareness concerning the acquisition of credits for lifelong learning offered by the Japanese Society of Hospital Pharmacists.  As future issues, we must encourage members to obtain a new password and be proactively involved in preparing new program categories that the members wish to take, in order to promote the continuous use of the program.

  On July 7, 2010, a 74-year-old man came to our hospital, complaining that he had a nagging pain in his chest that started the preceding day. After performing electrocardiography, blood tests and electrocardiography, we diagnosed the case as acute myocardial infarction. At first, it was thought that blood flow could be restored in due course of time, antiplatelet and anticoagulant agents were used. Intracardiac catheterization was not included in our initial treatment plan. Three days after the initiation of the treatment, the patient had pain in his left inguinocrural region. Computed tomography and magnetic resonance imaging reveled hematoma in his left iliopsoas muscle. We stopped administering antiplatelet and anticoagulant agents to him. But anemia progressed from Hb14.1g/dL to 9.8 g/dL, so blood transfusions had to be given. After that, the patient underwent a rest cure. With the passage of time, the pain and swelling of the left iliopsoas muscle went down. Regarding the cardiac condition, however, the pain in the chest did not abate even when he was taking a rest. The antiplatelet therapy was resumed, with one type of agent given at first and then with another type added. Examinations using a coronary CT and a cadiac catheter found 90% stenosis at the proximal left anterior descending coronary artery. So, a bare metal stent was placed in the near-closed artery. Ever since, there has been no recrudescence of chest pain and no recurrence of iliopsoas muscle hematoma. The extravascated blood mass seemed to be dissolved spontaneously.

A rare case of benign fibrous histiocytoma arising in the upper lip in a 76-year-old female is presented. A well-defined tumor measuring 1 cm existed in the submucosal area of the right side of the upper lip. With the patient under local anesthesia, the tumor was excised. Microscopically, the excised tumor was diagnosed as a benign fibrous histiocytoma. There has been no evidence of tumor recurrence after the operation.

Two cases of intramuscular lipoma occurring in the cheek of a 39-year-old and of a 55-year-old Japanese males are presented. These were excised by the intraoral approach. Histopathologically, these lesions were composed of the adipose cell-like tumor cells infiltrating in the striated muscles. There has been no evidence of tumor recurrence after operation.

Two cases of intramuscular lipoma occurring in the cheek of a 39-year-old and of a 55-year-old Japanese males are presented. These were excised by the intraoral approach. Histopathologically, these lesions were composed of the adipose cell-like tumor cells infiltrating in the striated muscles. There has been no evidence of tumor recurrence after operation.