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Introduction:The Suwa Onbashira Festival is held every six years and draws approximately one million spectators from across Japan. Men ride the Onbashira pillars (logs) down steep slopes.At each festival, several people are crushed under the heavy log. During the 2004 festival, for the first time, a medical care system that coordinated a medical team, an emergency medical service, related agencies, and local hospitals was constructed.Objective:The aims of this study were to characterize the spectrum of injuries and illness and to evaluate the medical care system of this festival.Methods:The festival was held 02 April–10 May 2004. The medical records of all of the patients who presented to an on-site medical tent or who were treated at the scene and transported to hospitals over a 12-day period were reviewed.The following items were evaluated: (1) the emergency medical system at the festival; (2) the environmental circumstances; and (3) patient data.Results:All medical usage rates are reported as patients per 10,000 attendees (PPTT). A total 1.8 million spectators attended the festival during the 12-day study period; a total of 237 patients presented to the medical tent (1.32 PPTT), and 63 (27%) were transferred to hospitals (0.35 PPTT). Of the total, 135 (57%) suffered from trauma—two were severely injured with pelvic and cervical spine fractures; and 102 (43%) had medical problems including heat-related illness.Conclusions:Comprehensive medical care is essential for similar mass gatherings. The appropriate triage of patients can lead to efficient medical coverage.

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Primary dedifferentiated liposarcoma originating in the mediastinum is extremely uncommon. Here, we report a case of mediastinal dedifferentiated liposarcoma. A 74-year-old man was admitted to our hospital with a left intrathoracic tumor ∼10 cm in diameter. Computed tomography that was taken in another hospital 2 years before the initial visit to our hospital had shown a lipomatous tumor ∼3 cm in diameter adjacent to the left lower pulmonary vein. The tumor was resected by left lateral thoracotomy with video-assisted thoracoscopic surgery. Pathological examination revealed primary mediastinal dedifferentiated liposarcoma. No evidence of recurrence has been seen as of 8 months postoperatively.