This research aims to construct an optimal practice system by investigation into satisfaction levels in physical therapy clinical practice. In this study, the results of an unsigned post-practice survey that targeted students who had undergone five years of physical therapy clinical practice from 2013 to 2017 were analyzed. Original surveys drafted by the university were utilized, and investigations were made into changes in self-confidence before and after the clinical practice （10 items）; mid-practice anxieties and corresponding resolution methods （6 items）; practice institutions, leaders, and leadership matters （9 items）; and consistency between learning environments and university lecture （3 items）. The results showed that practice satisfaction level was 95％. In Comprehensive Clinical Practice Ⅱ, which involved a greater amount of practice compared to evaluation practice, the confidence regarding evaluation-related knowledge, choices, and implementation was significantly high, as was that concerning problem extraction and risk management. However, students who felt unsatisfied with clinical practice had a significantly low self-confidence regarding evaluations, goal establishment, treatment, orientation, and risk management （p＜0.05）. On the other hand, there was strong satisfaction regarding grades, practice facilities as well as the learning methods utilized by practice leaders among students who felt satisfied with clinical practice. To conclude, the construction of a practice system that provides for a successful clinical experience can result in increased self-confidence concerning evaluations and techniques, and it appears to be linked to improving student satisfaction levels and growth.

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Ameloblastoma originates from the odontogenic epithelium in the jawbone, but may rarely originate from the oral mucosal epithelium or gingival remnants, in which case it is called extraosseous or peripheral ameloblastoma. Here, we report a case of peripheral ameloblastoma of the lower gingiva with bone resorption. The patient was a 49-year-old man who had noticed a mass in his lower right gingiva one month earlier. He gradually became aware of increases mass size and contact pain as a subjective symptom. A local dentist referred him to our department in April 2014. At the first medical examination, a hard elastic mass with a well-defined boundary was found in the gingiva of the right lower first premolar area. The surface mucosa of the tumor was slightly coarse and white, and tenderness was noted on palpation. Dental radiographs and panoramic radiographs showed translucent shadows with an indefinite and slightly unclear margin at the mesial part in the area of the right lower first premolar. In January 2015, the tumor was removed under local anesthesia as a single mass, including the periosteum. Intraoperative observation revealed bone resorption of the mandible in contact with the tumor. Histopathologically, epithelial components and mucus-like matrix with stromal components of fibrous connective tissue were observed. Enamel epithelium-like cells proliferating in a plexiform manner were found in the stroma, and an enamel-like reticular array was found inside. The tumor was localized to the gingiva with no intramaxillary lesions, and the definitive diagnosis of peripheral ameloblastoma was made. Currently, 4 years have passed since the operation, and the patient’s course has been good without recurrence.

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Most ectopic pregnancies （EP） are Fallopian tube pregnancies, which cause acute and strong lower abdominal pain due to rupture and intraperitoneal bleeding. However, we encountered a case of non-ruptured EP following frozen embryo transfer presenting acute abdominal pain. Preoperative transvaginal ultrasonography revealed a gestational sac （GS） near the right Fallopian tube but no fluid collection in the abdominal cavity. EP was suspected but Fallopian tube pregnancy itself was not considered to be the cause of the symptom. We performed laparoscopic surgery and noticed that the right Fallopian tube was dark red, swollen and twisted 900 degrees. It was considered that the blood was trapped in the Fallopian tube and it had become rapidly enlarged because of the co-existence of the obstruction. Furthermore, the swollen Fallopian tube was twisted and caused the abdominal pain. Transvaginal ultrasonography showed a ground-glass mass appearance in the Douglas fossa reflecting bleeding in the Fallopian tube, which appeared as an ovarian endometriotic cyst. Similar cases may be encountered due to the increase in assisted reproductive technology. It is necessary to be aware of the mechanism of occurrence of such acute abdominal pain.

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Patients with an isolated bone fragment in the maxillary sinus usually remain asymptomatic, and for this reason, in most cases these bone fragments are incidentally detected through an X-Ray or during maxillary sinus surgery. We report a case of successful diagnosis of isolated bone fragments in the maxillary sinus by using panoramic x-ray and dental cone beam computed tomography （CBCT）. A 25-year-old woman visited our hospital with a chief complaint of an uncomfortable feeling in the right wing of her nose. Panoramic x-ray images showed opaque lesions in the right maxillary sinus, and dental CBCT depicted two discrete fragments of bone-like tissue. A diagnosis of isolated bone fragments in the maxillary sinus was made, and bone fragment removal was performed under general anesthesia. Histopathological study revealed that the two surgically removed fragments corresponded to free bone fragments. After surgery, the uncomfortable feeling in the right wing of her nose disappeared, and she is making satisfactory progress.

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