Male mice of dd-strain, at 4 and 8 week-ages were used at the start of the trained. The trained continued for successive during 4 to 34 week-ages and 8 to 70 week-ages. The trained group was exercised on a treadmill, and the untrained group used as control under normal laboratry condition. The skin of the right dorsum near the tail was sampled and its collagen content was examined by means of concentration of hydroxyproline. The collagen content in the skin of the trained group is lower than in that of the untrained one at each week-age, 14-18, 27-34 and 63-70 week-ages. The trained group was depressed hydroxyproline concentration of defatted skin, compared with untrained one at each weekage. The continuous exercise reduced the accumulation of collagen in the skin of mice.

Male mice of dd-strain, at 4 weeks of age were used in the present study. The materials were divided into four groups; namely, mildly, moderately, severely trained and untrained. The treadmill exercise program for mildly, moderately and severely trained groups consisted of running at speeds of 6 m/min, 10m/min and running up a 10% grade at a speed of 12m/min for 10 min 5 times a week, respectively. The collagen content of the skin was measured by means of concentration of hydroxyproline. Moreover, the proportion of neutral salt-soluble (NSC), acetic acid-soluble (ASC) and insoluble collagen (ISC) in the skin was isolated. We attempted to study about the effects of physical activity on the metabolism of collagen by aging. Hydroxyproline concentration of the skin in untrained group increased rapidly until 6 weeks of age. Maximum hydroxyproline concentration was observed at 7 weeks of age in untrianed group. In three trained groups, maximum hydroxyproline concentration was observed at 9 weeks of age. The collagen content of the skin in the three groups was higher than that in untrained group at 9 and 11 weeks of age. The proportion of NSC, ASC and ISC of the skin varied with age in four groups. In the untrained group, the proportion of ISC increased with age and was recognized to reach 81.9% at 15 weeks of age. The proportion of NSC and ASC in both the moderately and severely trained groups indicated approximately 20% increase compared with that in the untrained group. This fact suggests that the degree of maturation of collagen is influenced by physical activity, especially, moderately and severely training. The authors conclude that continuous exercise training control the formation of intramolecular and intermolecular cross-links in skin collagen.

A survey was performed to examine residents' awareness of patient safety. Sixty-two residents who had just finished their first year of residency participated in the study. Of the 62 residents, 30 were training at Yokohama City University Hospital and 32 were training at other hospitals. Although all residents knew about the serious medical mishap ( “surgical mix-up” ) that had occurred at Yokohama City University Hospital in 1999, only 53% knew about the judicial verdict in this case. The residents most often believed that the mishap was the fault of the hospital and its system (82%), followed by nurses (73%), supervising doctors (62%), and residents (45%). Seventy percent of the residents knew about the “Incident Reporting System, ” but only 20% had written an incident report. Incidents experienced or observed by residents were most often medication-related. No significant differences in the results of the survey were found between residents of Yokohama City University Hospital and those of other hospitals. In conclusion, although residents recognize the importance of patient safety at the end of the first year of their residency program, they still cannot deal properly with incidents.

Male mice of dd-strain, at 3 weeks of age were used at the start of the exercise training. The exercise training continued successively throughout the 3 to 7 weeks of age. The trained group was divided groups ; namely, light-, middle- and heavy-trained groups, which were exercised on a treadmill. The treadmill exercise program for light-, middle- and heavy-trained groups consisted of running at speeds of 6 m/min, 10 m/min and running up a 10% grade at a speed of 12 m/min for 10 min 5 times a week, respectively. The untrained group was used as control under normal laboratory condition. The skin and Achilles tendon of the four groups were sampled and their collagen content were examined by means of concentration of hydroxyproline. The collagen content in the skin of growing mice did not recognize significant difference among the four groups. On the other hand, the collagen content in the Achilles tendon of growing mice clearly recognized significant difference between the middle-trained and untrained groups and/or between the middle-trained and light-trained groups. However, middle-exercise training reduced the accumulation of collagen in the Achilles tendon of grow. ing mice.

Integrated lecture programs for high school students involving university teaching staff have recently become popular. Here, we report on such a program involving lectures on tumor pathology attended by 110 high school students at the Yokohama City University School of Medicine. Two weeks before the lectures at our university, the students were given a 45-minute introductory lecture by a teacher at their school. The 1-day course at our university comprised an overview lecture by the author (40 minutes), light-microscopic observation of histologic specimens of normal and tumor tissues (50 minutes), and a summary with an introduction to diagnostic pathology (20 minutes). During light-microscopic observation, medical students served as teaching assistants. The high school students were given handouts of microscopic

Since the publication of To Err is Human in 1999, medical schools around the worldhave been discussing ways to teach medical students about patient safety. To deepen the understanding of patient-safety curriculums used in the United States, Dr. Matthew Weinger, director of the San Diego Center for Patient Safety and a professor at the University of California, San Diego, School of Medicine (UCSD), was invited to participate in around-table discussion on “Patient Safety Curriculum for Medical Students” held at Yokohama City University. Althoughthere have been active discussions in journals and within medical school faculties, no discernable consensus has emerged in the United States, other than that patient safety should become part of the educational system. The patient-safety curriculum used at UCSD and the curriculums promoted by the Department of Veterans' Affairs National Center for Patient Safety are introduced.

In autumn 2005, a 15-hour patient-safety education program was incorporated into the core curriculum for fourth-year medical students at the Yokohama City University School of Medicine. Sixty students took part in the program. The goals of the curriculum are for students to understand the prevalence and origins of medical errors and to increase awareness of the physician's responsibility for patient safety. Because typical learning methods, such as didactic lectures, might not be effective, we developed an experimental or case-based learning method. Educational modalities included small-group discussion of medical errors, role-playing of medical error disclosure, and experience operating infusion pumps. In addition, to bridge the gap between educational systems and hospital systems, we collaborated with other healthcare workers, such as nurses and hospital pharmacists. Students evaluated the program favorably; most recommended continuing the curriculum for future medical student classes.

Objectives: The aim of this study was to explore the first-year medical students’ perception of their learning from a lecture about sexual minorities.
Methods: In September 2012, a physician and a gynecologist first lectured about sex differences, reproductive medicine, and sexually transmitted infections. Next, the representative of a support group for a sexual minority talked about the prejudice and discrimination toward sexual minorities. He showed a video about a high school student who had publicity revealed his sexual orientation. We analyzed the students’ reports by the qualitative data analysis method Step Coding and Theorization. The students’ descriptions were extracted, coded by contents, and then grouped into several categories.
Results: Many students were surprised at the percentage of persons belonging to a sexual minority. By watching the DVD they came to realize that homosexuals are just like other persons in most ways. They mentioned the need for correct knowledge about sexual minorities.
Conclusion: We believe that the educational session about sexual minorities is meaningful for and valued by medical students, and medical care for sexual minorities should be taught to medical students.

Objective: We investigated the relation between fasting insulin (FI) and risk of cerebral infarction in a Japanese general population. Methods: The subjects were 2,610 men and women without past history of stroke or myocardial infarction and under treatment for diabetes, examined between 1992 and 1995 as part of the Jichi Medical School Cohort Study. The FI level was measured once at the baseline. Subjects were divided into quintiles by FI levels, and Cox’s proportional hazard model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for cerebral infarction. Results: During an average of 11.1 years of follow-up, 87 participants developed cerebral infarction. Crude incidence rates of FI quintiles 1-5 were 4.69, 2.35, 1.85, 2.77 and 3.30 per 1,000 person-years, respectively. The multivariate-adjusted HRs for cerebral infarction were 2.33 (95% CI, 1.10 – 4.96) in quintile 1 (Q1), 1.25 (95% CI, 0.55 – 2.84) in Q2, 1.68 (95% CI, 0.76 – 3.70) in Q4 and 2.06 (95% CI, 0.94 – 4.47) in Q5, using Q3 as the reference. Conclusions: The lowest FI level was associated with increased risk of cerebral infarction and the association between FI and risk of cerebral infarction appeared to be a U-shaped relationship.

1)Professionalism should be explicitly introduced as a fundamental content into curricula/programs of undergraduate medical education, postgraduate clinical training, and of continuing medical education provided by professional societies and the Japan Medical Association.
2)We need to enhance our research activities on goals and objectives which should be accomplished through professionalism education, effective learning strategies, appropriate assessment methods, as well as the impact of informal and hidden curricula.
3)We propose that the medical profession should collaboratively develop various activities to win the trust of the general society in tandem with the introduction of professionalism education.