As part of an occupational health curriculum, 3rd-year medical students were taught about sexual harassment so that they can treat victims in an appropriate way. A lecture presented basic information: the definition of sexual harassment, its history, legal aspects, specific features, effects on victims' physical and psychological health, and appropriate approaches of doctors to victims. Students then played roles of both a patient and an occupational health doctor. A patient profile was created on the basis of a legal case.
Students were extremely interested in the course and judged it highly. Role play helped students develop a sincere interest in the problem of sexual harassment and an empathic understanding of its victims. The relevance of sexual harassment to medical education is discussed.

We present a rare case of stent graft infection. A 69-year-old man, who had undergone endovascular repair of an abdominal aortic aneurysm with an Inoue stent graft 5 years previously, was admitted with high-grade fever. An abscess around an abdominal aortic aneurysm was found on abdominal computed tomography (CT) and he was given a diagnosis of stent graft infection. The stent graft was removed and vascular reconstruction was performed using a Gelweave graft bonded with rifampicin. The graft was then covered with the greater omentum, and he was discharged on the 27th postoperative day.

Objective: The present study aimed to investigate the identification codes of tablets used in clinical practice, and to clarify the influence of these codes on the differentiation of drugs brought in by patients, and those that have been dispensed as one-dose packages at Tottori University Hospital.
Methods: We obtained the identification codes of tablets, which were released on the market before December 2013, based on their package inserts.  Concerning drugs without identification codes, we conducted a questionnaire survey involving companies releasing these drugs in order to clarify the reasons for the absence of these codes.  Among the drugs brought to the Hospital by patients who were hospitalized in 2013, we investigated the identification codes of tablets dispensed as one-dose packages, and the accuracy of the differentiation of these tablets.
Results: We investigated a total of 5,797 tablets. Among the tablets in which the identification codes imprinted on one side of these tablets were the same, the other side did not have codes for 65 tablets (28 pairs), and had different codes for 1,836 tablets (198 pairs).  A total of 244 tablets did not have identification codes.  The most common reason for releasing drugs without such codes was the cost.  Investigation of the drugs brought in by patients hospitalized revealed that some pharmacists mistook Grinolart®50 mg for Glucobay®50 mg due to them having the same code.
Conclusion: To prevent the misidentification of drugs brought in by patients, hospital pharmacists need to cooperate with other hospitals and health insurance pharmacies, and dispense drugs while regarding their distinguishability as of major importance.  In addition, to increase the distinguishability, identification codes need to be imprinted on both sides of tablets, and there is a need to avoid manufacturing drugs whose identification codes are the same.

Occupational health was taught to 3rd-year medical students using simulated patients and role playing. Patient profiles were created to enable students to consider psychosocial aspects, such as work environment and lifestyles, involved in occupational health. Simulated patients were used, later, students acted as patients and each student played the role of an occupational health doctor. The aim of the exercise was for students, through their own actions and observations, to learn communication skills and approaches to occupational health, such as prevention, health promotion, and the importance of health education, which are based on a biopsychosocial model.
Students were extremely interested and found the course valuable. This result shows the effectiveness and current shortage of active learning methods as well as the need for acquiring communication skills.
Although learning communication skills is most relevant to clinical medicine, active learning and communication training is also important for occupational health education because the latter should be based not on the traditional doctor-patient relationship but on the biopsychosocial model.

To examine personal space perception, a method of identifying joint position was determined by having the subject equally bisect the joint angle, by producing a minimum increment in change of position and by selecting a threshold for two-point discrimination using the metacarpophalangeal joint of digits 2-5.
Eight healthy adults (6 males and 2 females) were used as subjects. The subjects' eyes were covered at all times to prevent any visual feedback.
Each metacarpophalangeal joint of digits 2-5 was extended, flexed and pointed to the bisection position in 6 sec (about 2 sec in each position) . The difference in the bisection position selected using the index finger with the shoulder, elbow and hand in variety of positions was determined. The deviation from the mid-bisection point and the standard deviation were less when the hand was positioned most comfortably and near the face (“natural and near”) than when the hand was positioned in the more uncomfortable position and further from the face (“unnatural and further”) .
In a second test, the index finger was moved from full extension to the full flexion in increments as small as possible at a rate of one change in position per second. Again, the effect of arm position was determined.
In case of“the natural and near”position, each increment in joint position was smaller than in“the unnatural and further”position.
In“the natural and near”position, the two point threshold was smallest of all. It was measured at the thumb side of right palm in the proximo-distal direction.
These results suggest that personal space perception of metacarpophalangeal joint is affected by the position of adjoining limb segments.

To examine the personal space perception, measurements were conducted on both arms in 227 young men and women. Each subject, with his eyes closed, was instructed to stop the horizontal swing motion of his arm at the point he considered to be the middle of the range of possible motion on the horizontal plane, and this was repeated ten times.
Mean values of bisected angles were deviated from the middle points in the direction of the horizontal adduction, although there were large differences between the individuals. The deviation was larger in the right arms than that in the left, and it increased with the increasing range of motion of the horizontal abduction.
It was suggested that the gain of the personal space perception is higher in front of the body than in the side on the horizontal plane of the human shoulder.

To examine personal space perception, a method of identifying joint position was determined by having the subject equally bisect the joint angle, by producing a minimum increment in change of position and by selecting a threshold for two-point discrimination using the metacarpophalangeal joint of digits 2-5.
Eight healthy adults (6 males and 2 females) were used as subjects. The subjects' eyes were covered at all times to prevent any visual feedback.
Each metacarpophalangeal joint of digits 2-5 was extended, flexed and pointed to the bisection position in 6 sec (about 2 sec in each position) . The difference in the bisection position selected using the index finger with the shoulder, elbow and hand in variety of positions was determined. The deviation from the mid-bisection point and the standard deviation were less when the hand was positioned most comfortably and near the face (“natural and near”) than when the hand was positioned in the more uncomfortable position and further from the face (“unnatural and further”) .
In a second test, the index finger was moved from full extension to the full flexion in increments as small as possible at a rate of one change in position per second. Again, the effect of arm position was determined.
In case of“the natural and near”position, each increment in joint position was smaller than in“the unnatural and further”position.
In“the natural and near”position, the two point threshold was smallest of all. It was measured at the thumb side of right palm in the proximo-distal direction.
These results suggest that personal space perception of metacarpophalangeal joint is affected by the position of adjoining limb segments.

A number of investigators have been concerned with the anthropometric as well as physical characteristics of sumo wrestlers during the past several decades. However, none have attempted to determine body density and percent body fat by the most accurate technique of hydrostatic or underwater weighings. Thus, a precise quantification of body density and percent body fat for the wrestlers has not yet been obtained. Ogawa et al. (1972) have predicted the body composition of sumo wrestlers from a formula which added the triceps and subscapular skinfold thicknesses. As the regression equation used in this instance was based on samples of normal young men, it may not have great predictive accuracy when used on the exceptional population of very stout athletes.
The purposes of this study were : (1) to assess the validity of percent body fat estimation by skinfold thickness measurement when compared to the hydrostatic weighing criterion method ; (2) to determine the interrelationships between anthropometric variables for use in the clear assessment of the physical characteristics of ‘Shindeshi’ sumo wrestlers ; and (3) to thereby develop a formula that would reliably predict percent body fat using skinfold thicknesses and/or anthropometric measurements in this exceptional population. The interrelationships between anthropometric and body composition variables were investigated using 35 Shindeshi sumo wrestlers, aged 15-20 years (X=16.5±1.5) .
The results of the present study can be summarized as follows.
1. The Shindeshi in the present study possessed physiques more developed than those tested in the past, as evidenced by Rohrer's and Ponderal Indices which were approximately 180 and 26.2, respectively. The development of body weight was particularly notable (i.e., over 100kg) .
2. Percent body fat for the Shindeshi was remarkably higher than that of a normal population of the same age, with approximately seventy percent of the Shindeshi possessing more than 20% body fat and less than 1.05000 body density.
3. Body density and height correlated negatively and insignificantly with almost all the variables. In contrast, correlations of body weight, circumferences, and all other variables were, in most cases, high and positive, with body weight correlating least with height. The skinfold measurement correlating best with % body fat was that taken at the thigh site (r=0.898) . The circumference measurements correlating best with % body fat were obtained at the thigh (r=0.888 and 0.831) and the abdomen (r=0 885) parts.
4. Of the six formulae for estimating % body fat, Sloan's correlated best with % body fat as determined by densitometry, and best approximated the mean value of 24.5%. However, all of the equations underestimated the measured % body fat of the Shindeshi.
5. When an exceptional population is being investigated, estimation of % body fat should be done with a population specific equation to ensure predictive accuracy. The following multiple regression equation (r=0.963) should, therefore, be utilized for estimation of % body fat in sumo wrestlers.
Y=0.2488x₁+0.6172x₂-14.3962 where x₁ and x₂ are abdomen circumference and skinfold thickness at thigh, respectively.

Endoventricular circular patch plasty (the Dor procedure) has been demonstrated to improve outcome in patients with ischemic cardiomyopathy. However, in some of them congestive heart failure (CHF) occurred during follow-up. This study examined the effects of the Dor procedure on the long-term survival and predictors of CHF after this procedure. Hemodynamic and clinical results were analyzed and predictors of CHF were examined. Postoperative ESVI in the CHF group was larger than that in the non-CHF group. The delayed MR rate was greater following the CHF group (82.4%) compared to the non-CHF group (19.2%). Despite mitral valve repair (N=8), 3 patients had delayed MR. All of them were greater than MR³. Hemodynamic and clinical results were improved by the Dor procedure. However, cardiac events were usually occurred during the follow-up. The predictor of CHF was delayed MR. Therefore, patients with preoperative MR should be treated. If preoperative MR is greater than 3, there will be MR recurrence cases after MVP only. Therefore, patients with preoperative MR (3 or 4) should be treated by alternative surgical procedures.

To improve the long-term clinical results of coronary artery bypass grafting, we evaluated our graft selections and the designs that were used, in relation to the quality of the anastomoses and patient backgrounds. We retrospectively reviewed the records of 505 patients who underwent isolated coronary artery bypass grafting involving more than 3 vessel reconstructions between May 1999 and March 2007. Neither the selection of a saphenous vein graft nor that of an internal thoracic artery graft was a statistically significant cardiac event factor. The cardiac event-free rates (at 1 and 5 years) according to anastomotic site were as follows : a) 92.9% and 76.6% for a radial artery graft and 93.2% and 83.9% for a saphenous vein graft at the right coronary artery ; b) 93.0% and 70.3% for a radial artery graft and 95.1% and 80.4% for a saphenous vein graft at the distal right coronary artery ; c) 94.5% and 77.8% for a left internal thoracic artery graft and 93.0% and available for a right internal thoracic artery graft at the left anterior descending artery ; d) 96.5% and 79.8% for a radial artery graft, 93.0% and 78.0% for a saphenous vein graft, and 91.3% and 75.6% for an internal thoracic artery graft at the left circumflex artery. Significant cardiac event factors were dialysis (risk ratio, 5.28 ; p<0.001), the use of a right gastroepiploic artery graft as the inflow blood vessel of a radial artery graft (risk ratio, 5.75 ; p=0.02), and off-pump coronary artery bypass grafting (risk ratio, 1.62 ; p=0.03). As a tendency toward more frequent early-stage cardiac events among patients with radial artery grafts was confirmed, careful follow-up is important for this group of patients. Right gastroepiploic artery grafts should be chosen carefully with full consideration of the anastomotic site quality and the flow demand, as the blood supply capability of such grafts is limited. For dialysis patients, although the mid-term clinical results are still being evaluated, a saphenous vein grafts have bwer early-stage of cardiac events. In younger patients, off-pump bypass is not the only treatment method available, and revascularization with extracorporeal circulation can reliably achieve good long-term results. To improve the long-term clinical results for coronary artery bypass grafts, graft selection and design should be carefully considered on a case-by-case basis. The quality of the anastomotic site and the patient background are important factors, especially with regard to the selection of a saphenous vein graft or a right gastroepiploic artery graft. A radial artery graft should be selected for use in relatively young patients because of its superior patency. Off-pump bypass may not necessarily be the treatment of choice in some cases because revascularization using extracorporeal circulation can reliably achieve better long-term results.