1.Graduate schools of medicine in Japan: The status and problems of researcher training
Kouki INAI ; Atsushi HIRAIDE ; Isamu SAKURAI ; Kazuo SUGAMURA ; Tsuguya FUKUI ; Motokazu HORI ; Saburo HORIUCHI
Medical Education 2008;39(5):317-320
1) Common training for the introduction of research and the elective and individual guidance for research should be devised in a manner attractive to graduate students of medicine.
2) To train researchers, a graduate school of clinical medicine should be established as a professional school, separate from an ordinary graduate school.
3) To promote basic medical sciences, the capacity of graduate schools of basic medical sciences should be reduced despite the number of teachers and the bold plan for the financial support of students.
2.A Statistical study on Accidents Caused by Farm Machinery
Kimio Inoue ; Hisami Miyoshi ; Atsushi Tsukamoto ; Noboru Horiuchi ; Jun-etsu Saito
Journal of the Japanese Association of Rural Medicine 1975;24(4):620-632
In the insured of the agricultural cooperative life insurance program (12, 156, 022 cases), 12, 588 persons were involved in accidents in 1973 fiscal year. The following analysis was conducted on these 12, 588 persons with special reference to the 2, 218 persons who were involved in farm machine accidents.
1. There were 3, 945 cases of traffic accidents. Of them, there were 2, 499 deaths and the fatality ratio stood at as high as 63.3%. There were 57 cases of traffic accidents involving farm machines. Of them, there were 42 deaths and the fatality rate was evidently high with 73.6%
2. There were 54 deaths caused by farm machines excluding those caused by traffic accidents. Of them, 45 were caused by cultivators. The ratio was extremely high with 83.3%.
3. Of the 45 deaths caused by cultivators, 26 were the cases in which the operators were pressed by fallen cultivators. In 13 cases, the operators were caught in between the machine and tree or building.
4. There were the other 2, 164 cases of farm machine accidents in which the patients were later seized with sequelae. Of these cases, 564 cases (26.0%) were caused by cultivators, 379 cases (17.5%) by thrashing machines and 316 cases (14.6%) by reapers. The accidents caused by these three types of machines accounted for 1, 259 cases (58.1%).
5. In the overwhelmingly large portion of the cases of accidents, sequelae broke out in fingers. Thus, 89.6% of those who were involved in machine accidents suffered from sequelae in fingers.
6. There were 1, 939 cases of finger accidents, of which 1, 032 accidents were caused by machine belts and 441 by machine blades. The accidents caused by these two items accounted for 75.9%.
7. From the statistical analysis, it might be said that the correlation coefficients between the number of farm machines available in a given area and that of accidents are less significant for cultivators and reapers, and that the environmental and working conditions are just as important elements as the number of machines.
3.Combined Coronary Artery Bypass Grafting, Abdominal Aortic Repair and Aortic Valve Replacement in a Case with Porcelain Aorta.
Kanji Kawachi ; Tatsuhiro Nakata ; Yoshihiro Hamada ; Shinji Takano ; Nobuo Tsunooka ; Yoshitsugu Nakamura ; Atsushi Horiuchi ; Katsutoshi Miyauchi ; Yuuji Watanabe
Japanese Journal of Cardiovascular Surgery 2002;31(5):344-346
A 73-year-old woman was admitted to undergo three simultaneous operations: aortic valve replacement (AVR), coronary artery bypass grafting (CABG) and abdominal aortic aneurysm repair. She had previously undergone percutaneous catheter intervention in the left coronary anterior descending artery. Computed tomography revealed an abdominal aortic aneurysm 5cm in diameter. Aortic valve stenosis (AS) was shown with a pressure gradient of 60mmHg, and 90% stenosis of the distal right coronary artery was also shown. CT scan and aortography revealed porcelain ascending aorta. The patient underwent simultaneous operations because of severe AS, coronary artery disease and abdominal aortic aneurysm. An aortic cannula was placed in a position higher in the ascending aorta with no calcification. Cardiopulmonary bypass was started using a two-staged venous cannula through the right atrium. At first, AVR was performed with cardioplegic solution and ice slush. Because it was difficult to inject the cardioplegic solution into the coronary artery selectively due to the calcified orifice of coronary artery, we closed it immediately by removing the calcified intima of the porcelain aorta after completion of AVR. The second cardioplegic solution was injected through the ascending aorta. Next, CABG to RCA was performed using the right gastroepiploic artery without anastomosis to the ascending aorta. Cardiac surgery was first performed, followed by abdominal aortic aneurysm repair after discontinuation of cardiopulmonary bypass. The patient was extubated the next day and stayed for two days in the intensive care unit. She is very well now one year after the operation.
4.The current education program in all medical schools in Japan
Nobuo Nara ; Hiroshi Ito ; Masaaki Ito ; Miyuki Ino ; Yutaka Imai ; Masaru Kawasaki ; Keijiro Saku ; Toshiya Suzuki ; Mitsuru Seishima ; Takuzo Hano ; Saburo Horiuchi ; Masayuki Matsushita ; Atsushi Miyamoto ; Rika Moriya ; Masao Yamada ; Hitoshi Yokoyama
Medical Education 2016;47(6):363-366
The education program in all medical schools in Japan has been studied and analyzed every 2 years since 1974 by the curriculum committee of the Association of Japan Medical Colleges. Based on the most recent analysis in 2015, the marked innovation of medical education, such as an integrated curriculum, active learning, and clinical clerkship, was recognized.