We are conducting research funded by a grant from the Ministry of Health, Labor and Welfare of Japan to create standardized, high-quality medical education content that incorporates video, images, and sound files, to develop a system that can be widely used by everyone from medical students to clinicians, and to create CBT-enabled examination questions for the future CBT National Medical Licensing Examination. The research aims to conduct trial examinations, study issues and measures to deal with them, and make proposals for their implementation.　With regard to the CBT system for the National Medical Licensing Examination, questions incorporating video, images and sound files were prepared based on the scope of the current national examination, and a trial examination was conducted with the cooperation of 10 universities nationwide using the CBT examination system via the internet. The trial was generally conducted smoothly, with smooth playback of videos, etc., and no system problems.　In conducting this research, we believe that it should not be considered as an extension of the previous national examination initiatives for doctors, nor should it be regarded merely as a technological initiative. In addition, as advances in AI-based diagnostic technology and patients’ medical literacy are foreseen to change significantly in 2040, the competence of doctors to cope with these changes will be questioned.　For this reason, it is fundamental to consider medical education content and examination questions for the CBT National Medical Licensing Examination with a view to the ideal image of doctors of the future.

The present study was attempted to examine whether the cold-induced vasodilation is affected by maturation and aging. Twelve prepubertal boys (10-11 yrs), 15 young men (18-26 yrs), and 8 older men (66-78 yrs) immersed their middle finger in ice-water for 15 min under air condition of 27°C and 40% RH. Before the immersion, no age-related differences were observed in skin temperature of middle finger (T_fin) . The time required for the first rise of T_fin after the immersion (TTR) was significantly longer in the older men than in the boys and young men. T_fin at the first rise after the immersion (TFR), highest value of Tfin after the first rise (HST) and the mean value of T_fin during the immersion (MST) were significantly lower in the boys than in the young men. The integral value of T_fin from the onset of cold-induced vasodilation to the end of the immersion (CIVD_index) was significantly lower in the boys and older men than in the young men. TTR, TFR, HST, MST, and CIVD_ifldex did not correlate significantly with maximal oxygen uptake, mean skinfold thicknesses at seven body sites, and length and girth of the middle finger. Oral temperature (Tor) did not change between before and after the immersion regardless of age, although the Tar in the boys was significantly higher than in the young and older men. There were no age differences in the relationship of thermal sensation or pain sensation and T_fin. These results suggest that boys and older men have inferior cold-induced vasodilation compared to young men, and that the mechanisms of inferior cold-induced vasodilation are different in these two groups.

In order to study whether there is any relation between the cause of anemia in rural women and environmental factor from the epidemiological standpoint, we have followed up the seasonal change of the blood properties (GB, Hb, Ht, R, Serum iron) of 3 groups of women in different working and living circumstances.
The results revealed a remarkable tendency to increase the values of the blood properties excluding serum iron in winter and to decrease in summer. The degree of seasonal change was found to be greater in rural women than that in factory workers. And among the factory workers, the married had more change than the unmarried, the rural residents than the urban. And among the rural women, only the establishmental gardeners who were especially busy in winter showed a tendency to decrease the values of the blood properties in winter.
From these data, we can see that the seasonal change of the burden of agricultural work and the change of dietary life actually have direct influence on the change of the blood properties.

We conducted an overseas mobile clinic in Lao PDR and examined the results of biochemical tests and blood examinations. For the biochemical tests, we used a method involving plasma skimming film and filter paper, called “plasma separation plate.” In this study, we report the usefulness of the plasma separation plate, which is a newly developed method for the screening of biochemical tests in Japan. We were able to apply this method in a mobile clinic in Lao PDR. The quantitative concentration of plasma from blood collected from pricked fingers was measured by this method. Using the plasma skimming film and filter paper, the non-cell components in the blood were separated, and a quantity of the plasma was adsorbed by filter paper. Neither elaborate equipment nor electricity was required. The results of our test data indicated that few inhabitants suffered from adult diseases for which we were screening. We concluded, therefore, that this method is suitable for use in mobile clinics in the rural areas of developing countries.

OBJECTIVETo investigate the genes involved in pulmonary metastasis of human fibrosarcoma HT1080 cells in nude mice.

METHODSHT1080 cells were injected into the tail vein of BALB/ C nude mice. RNA samples were extracted from pulmonary metastatic tissues and normal control lung tissues, purified using Atlas Pure Total RNA labeling System (Clonetech Laboratories). cDNA probes labeled with 32P were prepared and hybridized to a cDNA membrane constructed with spots of 1176 human cancer related genes and radioactivities on the membrane were measeured by BAS 5000. The mRNA expression of gene FN1 was determined by real time RT-PCR using TaqMan methods. Furthermore, cells with FN1 expression were localized and obtained in situ in pulmonary metastatic foci by laser captured microdissection, and the FN1 expression was quantitated by real time RT-PCR.

RESULTSOf the total 1176 genes, 27 genes (2. 3%) revealed to be apparently up-regulated and 4 genes (0. 3% ) down-regulated. Real time RT-PCR analysis verified significant up-regulation of gene FN1. Laser captured microdissection/ real time RT-PCR analysis demonstrated up-regulated gene FN1 not in stroma cells but in tumor cell nests.

CONCLUSIONGene FN1 expression in fibrosarcoma HT1080 cells may be involved in pulmonary metastasis.

Animals ; Cell Line, Tumor ; Fibronectins ; genetics ; Fibrosarcoma ; genetics ; pathology ; Gene Expression Profiling ; Gene Expression Regulation, Neoplastic ; Humans ; Lung ; chemistry ; Lung Neoplasms ; genetics ; secondary ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Transplantation ; Oligonucleotide Array Sequence Analysis ; RNA, Messenger ; genetics ; metabolism ; RNA, Neoplasm ; genetics ; isolation & purification ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Transplantation, Heterologous

BACKGROUND: Studies on the adverse effects of Asian dust (AD) on respiratory function in children are scarce. The objective of this study was to examine the association between AD and respiratory function by measuring peak expiratory flow rates (PEFRs) in asthmatic children. METHODS: The study was carried out from March to May from 2014 through 2016. One hundred ten children with bronchial asthma were recruited from four hospitals in the Goto Islands and south Nagasaki area in Nagasaki prefecture. The parents were asked to record their children's PEFRs every morning/evening and clinical symptoms in an asthma diary. AD was assessed from light detection and ranging data, and a linear mixed-effects model was used to estimate the effects of AD on daily PEFR. Time-stratified case-crossover analyses were performed to examine the association between AD and asthma attacks defined by reduction levels in PEFR. RESULTS: AD was detected on 11 days in the Goto Islands, and on 23 days in the south Nagasaki area. After adjusting for age, sex, temperature, and daily oxidants, we found a consistent association between AD and a 1.1% to 1.7% decrease in PEFR in the mornings and a 0.7% to 1.3% decrease in the evenings at a lag of 0 to 5 days. AD was not associated with the number of asthma attacks, respiratory symptoms, or other symptoms at any lag days examined. CONCLUSIONS Exposure to AD was associated with reduced PEFR, although the effects were not large enough to induce clinically apparent symptoms, in clinically well-controlled asthmatic children.

BACKGROUND: An increase in cardiovascular diseases has been reported following major disasters. Previous work has shown that ultrasonographic findings from ultrasound cardiography examination (UCG) increased until the 44th month after the tsunami caused by the Great East Japan Earthquake. The present study conducted UCG among victims in the tsunami disaster area and investigated the frequency of disaster-related cardiovascular diseases and changes over time until the 55th month after the disaster. METHODS: The subjects were residents of temporary housing complexes and neighboring housing in Watari-gun, Miyagi Prefecture, Japan. There were 207 subjects in the 18th month, 125 in the 30th month, 121 in the 44th month, and 106 in the 55th month after the disaster. Data were collected through UCG and self-report questionnaire. RESULTS: Significant changes were observed among subjects with clinical findings from the UCG, which increased over the study period-from 42.0 to 60.8, 72.7, and 73.6% beginning in the 18th month after the disaster (p < 0.0001). CONCLUSIONS: It is possible that the UCG can become a useful examination to visualize the potential impact of a major disaster on the cardiac function of victims. Victims with clinical findings continued increasing not only during the acute phase after a disaster but also in the long term. We therefore need to keep this in mind, and note that it is important to establish a support system to control cardiovascular diseases from the early stage of disaster. TRIAL REGISTRATION UMIN; ID000029802. R000034050 . 2 November 2017.
Aged ; Aged, 80 and over ; Cardiovascular Diseases ; diagnosis ; diagnostic imaging ; Case-Control Studies ; Disasters ; statistics & numerical data ; Earthquakes ; Female ; Health Behavior ; Humans ; Japan ; Male ; Middle Aged ; Tsunamis

In 1952, the Japanese Society for Hygiene had once passed a resolution at its 22nd symposium on population control, recommending the suppression of population growth based on the idea of cultivating a healthier population in the area of eugenics. Over half a century has now passed since this recommendation; Japan is witnessing an aging of the population (it is estimated that over 65-year-olds made up 27.7% of the population in 2017) and a decline in the birth rate (total fertility rate 1.43 births per woman in 2017) at a rate that is unparalleled in the world; Japan is faced with a "super-aging" society with low birth rate. In 2017, the Society passed a resolution to encourage all scientists to engage in academic researches to address the issue of the declining birth rate that Japan is currently facing. In this commentary, the Society hereby declares that the entire text of the 1952 proposal is revoked and the ideas relating to eugenics is rejected. Since the Society has set up a working group on the issue in 2016, there have been three symposiums, and working group committee members began publishing a series of articles in the Society's Japanese language journal. This commentary primarily provides an overview of the findings from the published articles, which will form the scientific basis for the Society's declaration. The areas we covered here included the following: (1) improving the social and work environment to balance between the personal and professional life; (2) proactive education on reproductive health; (3) children's health begins with nutritional management in women of reproductive age; (4) workplace environment and occupational health; (5) workplace measures to counter the declining birth rate; (6) research into the effect of environmental chemicals on sexual maturity, reproductive function, and the children of next generation; and (7) comprehensive research into the relationship among contemporary society, parental stress, and healthy child-rearing. Based on the seven topics, we will set out a declaration to address Japan's aging society with low birth rate.
Aging ; Birth Rate ; trends ; Child ; Child Health ; Environmental Exposure ; adverse effects ; prevention & control ; Female ; Health Planning Guidelines ; Humans ; Japan ; epidemiology ; Male ; Occupational Health ; Reproductive Health ; education ; Research Design ; standards ; Societies, Scientific ; organization & administration ; Stress, Psychological ; prevention & control ; Women's Health