The roles of behavioral science in current medical education are examined in terms of its origin and the deregulation of the university establishment standards. Based on modern disease structures, the basic elements of behavioral science education are summarized from the viewpoint of human relationships that support holistic medicine. Specific examples of learning attitudes using laboratory training are also examined.

The innovation of the University Chartering Standards Law in 1991 triggered changes in general education in almost all medical schools in Japan. These changes include: 1) frequent abolition of the department of general education; 2) an expansion in the offerings of specialty subject; and 3) increase in early exposure programs. The Model of general education has, in general, changed from the liberal arts model to the one that emphasizes the development of physicians. One remaining problem is that, although the system of general education has changed, the traditional pedagogy has generally persisted. These are at least two possible forms that general education can take in the future. The first one comes from the U.S., in which students enter medical schools after finishing their general college education. The other one stems from an European model in which high school provide students with part of their general education, and medical schools provide them with intensive basic and humanity education that is necessary for physicians. Medical schools in Japan now face three major challenges for the future: 1) seeking how to teach ways of thinking other than medical one; 2) establishing an education system corresponding with recent changes in young people; 3) establishing divisions which comprehensively organize and supervise general education.

We have been successful in preventing induced cavities in rats using acupuncture stimulation. In order to more profoundly understand one aspect of that preventative mechanism, we studied rises in natural antibody values and special antibody values using the Jerne method. In so doing, we proved that when D-phenylalanine (DPA) is administered 30 minutes proir to acupuncture stimulation the rise which occurrs in antibody counts with acupuncture is great and the duration of the period of increase is lengthened. Such reports about acupuncture effects on the living body are many. That acupuncture strengthens the stability of the living body is an unquestionable fact.
In an effort to study the preventative effects of acupuncture or acupuncture supplemented by DPA, we performed the following experiment. We planted Sarcoma-180, a homotransplantable tumor which often displays an immune resistant effect in mice and observed the immunity level rises produced by acupuncture and acupuncture supplemented by the administration DPA.
ICR mice (male, 3 weeks old) were divided into 5 groups: I-control grop, II-treatment with carboxymethyl cellulose sodium (CMC) III-treatment with CMC and DPA, IV-treatment with CMC and acupuncture, V-treatment with CMC, DPA and Acupuncture
Sarcoma-180 cells were administered to all the rats subcutanously in a ratio 10⁶ cells/0.1ml after which cells were administered every 3rd day for a total of 4 times. DPA combined with 1% CMC was administered into the abdominal cavity in a concentration of 250mg/kg.
All of the mice were sacrificed on the 13th following the cancer transplant and the weight of the cancer, the liver and the spleen measured. Upon examinig for significant differences it was found that sigificant differences were indicated between Groups I and III, and I and V with a 1% danger rate, and I and IV with a 5% rate of danger. No signicant differnce was obseved between I and II.
It can be said that in the mice which received the Sarcoma-180 transplants macrophage funcctional insufficiency occured in a relatively early stage with decreased T lymph corpuscle functions occuring in the later stages. It can be assumed that in the process of interference with the functional in sufficiency, a preventative effect comes into play. In future studies we'd like to investingate the meaning of acupuncture for resistance to infection, etc.

Background: Even for the emergency transportation of cancer patients in the terminal phase of the disease with a DNAR, all patients are transported while resuscitation is carried out. We examined how on-site rescue squads felt about this along with what was found therefrom. Methods: We conducted an anonymous questionnaire among 103 staff members involved in emergency activities in the area concerned. The contents included: Have you ever transported patients with a DNAR? If yes, what kind of activities did you carry out?; and If not bound by the Fire Services Act, what kind of activities would you have carried out? Results: Even if you express your DNAR order, they have no choice but to comply with the Fire Service Law. Even assuming that there is no Fire Service Law, about half of respondents responded to lifesaving treatment, but about half of them responded that they wanted to refuse transportation. Discussion: For rescue squads, a difference between resuscitation activities and transportation was observed. Lack of knowledge among those near the patient who request emergency transportation against the will of the patient is the major cause of transporting patients with a DNAR. In order to respect the will of patients, the permeation of advance care planning including decisions made by visiting physicians and the creation of advance directives and education of local residents are necessary.

Purpose: Patients who receive chemotherapy for colorectal cancer with the prophylactic dexamethasone (DEX) for antiemesis may experience an abnormal elevation in their casual blood glucose levels. The purpose of this study was to determine the frequency of such a DEX-induced elevation in patients with metastatic colorectal cancer, and to emphasize the importance of pharmaceutical care in improving the quality of life of patients. Methods: We retrospectively analyzed data from 50 patients who had received chemotherapy with or without DEX. Results: Of the 30 patients who received DEX, 8 exhibited abnormally high blood glucose levels (>200 mg/dl on more than 2 occasions); 3 of these patients also had diabetes mellitus. None of the 20 patients who did not receive DEX exhibited a remarkable elevation in the blood glucose levels. Conclusions: We confirm that patients receiving concomitant administration of DEX with chemotherapy may exhibit elevated blood glucose levels. Because an increase in the blood glucose levels may produce symptoms indicative of diabetes such as fatigue, appropriate pharmaceutical care for early detection of the abnormal elevation in the blood glucose levels may be important in preventing complications in such patients.

Objectives: This study evaluates the relationship between the various words expressing pain and the efficacy of opioid analgesics, in order to provide information on the appropriate selection of analgesic drugs for cancer pain relief. A new and simplified evaluation list for the assessment of pain, including the common words used to express pain, was developed accordingly. Methods: The words expressing pain were classified into three categories based on the Guidelines for Drug Therapy in Cancer Pain. These words were grouped into clusters according to the efficacy of opioid drugs, as expressed by the patients. On the basis of these results, an evaluation list was developed, and its validity was assessed by clinical pharmacists and cancer patients experiencing pain. Results: On the basis of the classification of the words, their relationship with opioid efficacy was summarized, and the results of the cluster analysis were found to be helpful for the development of a new pain evaluation list. Conclusion: Patients use various words to express their pain. By classifying and clustering these words according to the guidelines and the efficacy of opioid drugs, we proposed a practical pain evaluation list for appropriate selection of analgesic drugs in patients with cancer.

The Consensus of this Committee is:

1) To change the name of the present committee from "Premedical Education Committee" to "Committee on Behavioral and Social Science" ; accordingly to discuss theoretical foundations, clinical application, learning objectives and outcomes of behavioral and social science in Japanese medical schools.

2) To collect actual case studies of teaching behavioral and social sciences in Japanese medical schools and create a database for such practices.

3) To develop behavioral and social science curriculum content in Japanese medical schools.

4) To organize training courses for teaching methods for behavioral and social science curricula and develop standardized teaching methods and materials.