In C1–C2 posterior fixation, the C1 lateral mass and C2 pedicle/translaminar screw insertion under spine navigation have been used frequently. To avoid the risk of neurovascular damage in atlantoaxial stabilization, we assessed the safety and effectiveness of a preoperative computed tomography (CT) image-based navigation system with intraoperative independent C1 and C2 vertebral registration. It is ideal when a reference frame can be linked directly to the C1 posterior arch for C1-direct-captured navigation, but there is a mechanical challenge. A new spine clamp-tracker system was implemented recently, which allows reliable C1- and C2- direct-captured navigation in nine patients with traumatic C2 fractures. In this way, there was no misalignment of C1–C2 screws. C1 lateral mass screws were used except for one case, and translaminar screws were primarily used as an anchor for C2. The C1 lateral mass screw locations, which are 19 mm laterally from the C1 posterior arch’s center, are taken to be constant. However, there is one unusual circumstance in which using a C1 laminar hook instead of a C1 lateral mass screw appears to be a beneficial substitute. The increase of surgical accuracy for posterior C1–C2 screw fixation without cost constraints is significantly facilitated by intraoperative C1- and C2-direct-captured navigation with preoperative computed CT images.

Tohoku Medical and Pharmaceutical University, Japan, offers “Early Exposure to Medical Practice” in the first semester for first-year medical students to learn about patient-centered care as well as the real-world conditions and issues faced in community medical practice. Owing to the COVID-19 pandemic during the past two years, we planned and implemented online training, including some disability simulations, which mostly aimed to prevent the spread of infection. The students who completed these training courses reported that the online training had certain advantages over hands-on training ; the two activities implemented were not only effective in preventing infection but also had other benefits that only an online environment could provide. Herein, we report the results and some of the merits of these practices in 2021.

The Japan-Korea Primary Care Exchange Programme, which is an international project held by the Japan Primary Care Association and Korean Academy of Family Medicine, provides young family physicians opportunities to visit annual conferences and training programs each year. This article reports the history and several topics that Japanese delegates in 2018 learned about in Korea regarding family medicine: "Outpatient Department" "Health Information Systems" "Healthcare System for the Rapidly Aging Population," and "The Current Situation and Issues in Long-term Care Insurance."

BACKGROUND/AIMS: Tofacitinib is an oral, small-molecule Janus kinase inhibitor being investigated for ulcerative colitis (UC). In OCTAVE Induction 1 and 2, patients with moderately to severely active UC received placebo or tofacitinib 10 mg twice daily (BID) for 8 weeks. Clinical responders in OCTAVE Induction were re-randomized to 52 weeks' therapy with placebo, tofacitinib 5 mg BID, or tofacitinib 10 mg BID. METHODS: We conducted post-hoc efficacy and safety analyses of East Asian patients in OCTAVE Induction 1 and 2 and OCTAVE Sustain. RESULTS: A total of 121 East Asian (Japan, Korea, and Taiwan) patients were randomized in OCTAVE Induction 1 and 2 (placebo, n=26; tofacitinib 10 mg BID, n=95), and 63 in OCTAVE Sustain (placebo, n=20; tofacitinib 5 mg BID, n=22; tofacitinib 10 mg BID, n=21). At week 8 of OCTAVE Induction 1 and 2, 18.9% of patients (18/95) achieved remission with tofacitinib 10 mg BID versus 3.8% (1/26) with placebo. In OCTAVE Sustain, the week 52 remission rates were 45.5% (10/22), 47.6% (10/21), and 15.0% (3/20) with 5 mg BID, 10 mg BID, and placebo, respectively. Adverse event rates were similar between groups in OCTAVE Induction and numerically higher with tofacitinib in OCTAVE Sustain. Serious adverse event rates were similar across groups in all studies. Infections were numerically more frequent with tofacitinib than placebo. Increases in serum lipid levels were observed with tofacitinib. CONCLUSIONS: In East Asian patients with UC, tofacitinib demonstrated numerically greater efficacy versus placebo as induction and maintenance therapy, with a safety profile consistent with the global study population. ClinicalTrials.gov: NCT01465763; NCT01458951; NCT01458574.
Asian Continental Ancestry Group* ; Colitis, Ulcerative* ; Humans ; Korea ; Phosphotransferases ; Ulcer*

Objective: An evaluation index for drug release was measured in 25 currently used non‐steroidal anti‐inflammatory drugs (NSAIDs) for external use (4 components: indomethacin, diclofenac sodium, ketoprofen, and suprofen).Methods: All release tests were performed using the Franz diffusion cell with phosphate buffered saline (PBS) as the receptor phase and an artificial membrane to maintain uniform measurement conditions.　The receptor phase was collected over time and measured using high performance liquid chromatography (HPLC) to calculate the release rate.　The measurement time points were set over 0-4 h based on clinical use.　Furthermore, the additives were compared among the products.Results: The release profile of diclofenac sodium was similar among all 8 products.　On the other hand, the release rate of IN‐E (15.0% after 4 h) from indomethacin was higher than that from the other 6 products (6.2-9.1% after 4 h).　The release rate of KE‐D (39.2% after 4 h) from ketoprofen was higher than that from the cream, KE‐C (30.6 % after 4 h).　For suprofen, the release rate of SU‐E from the cream (18.1% after 4 h) was 1.6-1.7‐times higher than that of the other 2 products (10.9-11.3 %).　No release was detected from 3 suprofen ointments.Conclusion: Differences in the additives may have been a cause of the observed differences in release over 0-4 h.　This study may serve as a useful index for pharmacists to propose and select appropriate drugs.

The authors regret an error in the reporting of Inflammatory Bowel Disease Questionnaire (IBDQ) patient-reported outcome data in the manuscript. A data extraction error resulted in incorrect IBDQ data being presented in the publication. The error does not affect the overall conclusions regarding IBDQ as the difference between the corrected and erroneous numbers is, in general, small. The error was specific to IBDQ data; all other data have been reviewed and are correct as originally reported.
Asian Continental Ancestry Group* ; Colitis, Ulcerative* ; Humans ; Inflammatory Bowel Diseases ; Publications ; Ulcer*

Objectives: Despite the fact that the total energy intake of Japanese people has decreased, the percentage of obese people has increased.This suggests that the timing of meals is related to obesity.
The purpose of the study was to investigate the relationship between the timing of meals and obesity, based on analyses of physical measurements, serum biochemical markers, nutrient intake, and lifestyle factors in the context of Chrononutrition.
Participants and Methods: We analyzed data derived from 766 residents of Toon City (286 males and 480 females) aged 30 to 79 years who underwent detailed medical examinations between 2011 and 2013. These medical examinations included. (1) physical measurements (waist circumference, blood pressure, etc.); (2) serum biochemical markers (total cholesterol, etc.); (3) a detailed questionnaire concerning lifestyle factors such as family structure and daily habits (22 issues), exercise and eating habits (28 issues), alcohol intake and smoking habits; (4) a food frequency questionnaire based on food groups (FFQg);and (5) a questionnaire concerning the times at which meals and snacks are consumed.
Results: The values for body mass index (BMI) and waist circumference were higher for participants who ate dinner less than three hours before bedtime (<3-h group) than those who ate more than three hours before bedtime (>3-h group). The Chi-square test showed that there was a significant difference in eating habits, e.g., eating snacks, eating snacks at night, having dinner after 8 p.m., and having dinner after 9 p.m., between the <3-h group and the >3-h group.
Multiple linear regression analysis showed that skipping breakfast significantly influenced both waist circumference (β = 5.271) and BMI (β = 1.440) and that eating dinner <3-h before going to bed only influenced BMI (β = 0.581).
Conclusion: Skipping breakfast had a greater influence on both waist circumference and BMI than eating dinner <3-h before going to bed.

Objective: Despite the fact that the total energy intake of Japanese peoplehas decreased, the percentage of obese people has increased. This suggests that the timingof meals is related to obesity. The purpose of the study was to investigate therelationship between the timing of meals and obesity, based on analyses of physicalmeasurements, serum biochemical markers, nutrient intake, and lifestyle factors in thecontext of Chrononutrition.
Participants and Methods: We analyzed data derived from 766 residents ofToon City (286 males and 480 females) aged 30 to 79 years who underwent detailed medicalexaminations between 2011 and 2013. These medical examinations included. (1) physicalmeasurements (waist circumference, blood pressure, etc.); (2) serum biochemical markers(total cholesterol, etc.); (3) a detailed questionnaire concerning lifestyle factors suchas family structure and daily habits (22 issues), exercise and eating habits (28 issues),alcohol intake and smoking habits; (4) a food frequency questionnaire based on food groups(FFQg); and (5) a questionnaire concerning the times at which meals and snacks areconsumed.
Results: The values for body mass index (BMI) and waist circumference werehigher for participants who ate dinner less than three hours before bedtime (<3-hgroup) than those who ate more than three hours before bedtime (>3-h group). TheChi-square test showed that there was a significant difference in eating habits, e.g.,eating snacks, eating snacks at night, having dinner after 8 p.m., and having dinner after9 p.m., between the <3-h group and the >3-h group. Multiple linear regressionanalysis showed that skipping breakfast significantly influenced both waist circumference(β = 5.271) and BMI (β = 1.440) and that eating dinner <3-h before going to bed onlyinfluenced BMI (β = 0.581).
Conclusion: Skipping breakfast had a greater influence on both waistcircumference and BMI than eating dinner <3-h before going to bed.

We conducted a questionnaire survey involving 270 interns in the year 2011 at the pharmaceutical department of Teikyo University, in order to clarify pre- to post-practical training changes in: 1) the degree of pre-clinical training’s usefulness, 2) desired workplace in the future, 3) degree of satisfaction, 4) confidence degree of practical training, etc. The degree of pre-clinical training’s usefulness exceeded 80% in all training periods. Regarding the desired workplace in the future, a large proportion of students answered that they want to become a pharmacist in a pharmacy or hospital, both before and after their practical training in all training periods. Also, it was estimated that students decide their career with reference to their practical training experience. In terms of the degree of satisfaction with practical training, the proportions of those who answered “Satisfied” or “Somewhat satisfied” were: 95.1% in the 1st, 95.6% in the 2nd, and 86.1% in the 3rd periods. The confidence degree significantly increased after practical training in all periods. Because the confidence degree showed a tendency to be higher before the 3rd period of training compared to the other two periods, it was considered that students’ experience of practical training led to increased confidence degree. Regarding communication abilities, the degrees of before-after confidence degree and pre-clinical training’s usefulness were low, and, hence, it was suggested that pre-clinical training needs to be further improved regarding these areas.

Objectives: The first objective of this study was to classify men aged 40-74 yrs with metabolic syndrome (MetS) according to daily rice intake, and the second was to investigate physical measurements, physiological examinations, blood biochemical assays, intake of food other than rice and lifestyle and environmental factors in the study group.
Methods: We analyzed data from 6095 men aged 40-74 yrs who had undergone full medical examinations. The men were classified into 3 age groups: (1) 40-49 yrs, (2) 50-59 yrs, and (3) 60-74 yrs. The men were classified further into 3 groups according to daily rice intake: group 1 (≤300 g), group 2 (300-450 g), and group 3 (≥450 g). The relationship between daily rice intake and the following factors was analyzed in the three age brackets: (1) physical measurements including waist circumference, (2) physiological measurements, (3) serum biochemical indices, (4) whether or not the person was taking medication for hypertension, diabetes mellitus or serum lipid abnormalities, (5) lifestyle, and (6) consumption of foods other than rice.
Results: Daily rice intake was related strongly to the occurrence of MetS in all three age brackets. Multiple logistic regression analysis showed (1) a significant increase in the odds ratio for MetS (1.461 times) for group 3 compared with group 1 in men aged 40-49 yrs and (2) a significant increase in the odds ratio for MetS (1.501 times) for group 3 compared with group 1 in men aged 50-59 yrs. However, there was no significant difference in the odds ratio for MetS among rice intake groups in the 60-74 age bracket.
Conclusion: In men aged 40-59 yrs, daily rice intake strongly influenced the incidence of MetS, whereas in men aged 60-74 yrs, there was no relationship between daily rice intake and MetS.