1) Although maternity leave can facilitate the professional success of female students.The extent to which maternity leave is implemented remains unknown.A cross-sectional questionnaire survey of all Japanese medical schools and postgraduate schools in medicine (N=81) was performed.Responses were received from 55 medical schools and postgraduate medical schools (response rate=67.9%).The results showed that no school had formally established a maternity leave policy for students.
2) We found that medical educators had reorganized clinical clerkship programs to accommodate the pregnancies of students but expressed confusion about how to manage such situations.
3) We also found that many female postgraduate students drop out because of pregnancy or child-care responsibilities. Medical schools and postgraduate schools should recognize the importance of maternity leave and should not close their doors to pregnant students who are contending with both motherhood and academic achievement.

We investigated, for the consecutive two years of 1964 and 1965, into the incidence and the percentage of hospitalization, etc. of cases of mental diseases in one city and four towns under the jurisdiction of the Fukuyama Health Center in Hiroshima Prefecture, including Fukuyama-shi Kannabe-cho Kamo-cho, Nnmakuma-cho and Utsumi-cho (total population of 219, 781 as of October 1, 1945). The results of sludy are as summarized below:
1) The reported cases-reported through the established procedure of flling and information, examined cases and hospitalized cases were, respectively, 72 cases, 62 cases and 58 cases (93.5%) in 1964, and 86 cases, 83 cases and 76 cases (90.6%) in 1965. The frequency of such reporting in 1965 was highest in May and July.
2) The total cases of mental diseases treated in hospitals during the years 1950 324 or 1.47 percent of the total population.
3) Of these 324 cases, schizophrenic cases held a majority of 252 cases (77.7%), and those that ranked second were alcoholic psychoses and senile psychoses both numbering 14 cases (4.3%).
4) The analysis of such 324 in-patients by age resulted in: 90 cases (27.7%) in the 25-34 age bracket, 83 cases (25.6%) in the 35-44 age bracket and only 1 cases under 14 years of age.
5) The classiflcation of the same cases by the sources of sustenance indicated: 115 cases (35.4%) sustained under Article 29 of the Mental Hygiene Law, 107 cases (33.0%) assisted under the Livelihood Protection Law, 37 cases (11.4%) paid under the National Health Insurance Law, 60 cases (18.5%) under the Health Insurance Law and 5 cases (1.5%) sustained from other sources.
6) Of these 234, the number of cases hospitalized with the public fund under the application of Article 29 of the Mental Hygiene Law and the Livelihood Protection Law was 222, the 126 cases (56.7%) of which were unmarried.And 94 (87.8%) of the 107 patients paid under the Livelihood Protection Law were also the heads of the households.
7) According to the survey conducted as of March 31, 1966, out of such 324 patients 72 cases (22.2%) were discharged within 3 years of hospitalization, and 83 cases (25.6%) had been hospitalized already more than 5 years.
8) According to the 1964 survey, the capacity of mental hospitals per 100, 000 population was 168.3 in Hiroshima Prefecture as a whole, but 127.8 within the jurisdiction of the Fukuyama Health Center, considerably short of the need.

Cardiac surgery in patients aged 90 years or older is not common. We report 2 successful cases in nonagenarians. A 90-year-old man underwent the Bentall operation for aortic root aneurysm with moderate aortic valve regurgitation. A 91-year-old man underwent aortic valve replacement and single CABG (LITA to LCX) for severe aortic valve stenosis with single coronary artery disease. Their postoperative courses were uneventful. We emphasize that cardiac surgery in nonagenarians should not be withheld on the basis of age alone, but should be based on careful assessments of the relative medical risks and benefits, as well as the wishes of the patient and family.

Gait disturbance is a serious problem in Parkinson's disease (PD). Exercise therapy is used to alleviate this complaint. We investigated the effects of a videotaped arm swinging-based home exercise program on gait in PD patients. The subjects included 25 outpatients aged between 55 and 77 years (average age 68.9 years) with PD in Hoehn and Yahr stages II-IV. We prepared a master video tape in which a trainer was shown to be performing an arm swinging exercise or steps in synchrony with a metronome. The exercise menu consisted of 4 parts : arm swinging in a seated position, arm swinging in an upright position without stepping, arm swinging with stepping, and walking on the floor or taking a walk. The patients performed the arm swinging exercise while watching a video tape everyday for a period of 3.4 weeks. Of the 25 patients, 22 completed the exercise program. Following the program, these patients showed significant improvements in their walking times for a 20m walk (10 m, return, 10 m) (before/after=29.6/24.3 sec, p=0.002) and in the step length (before/after=43.7/50.1 cm, p<0.001). Frozen gait was a negative factor to complete the programs. Improvement of gait speed after the exercise was related with less frequency of cadence. Loss of arm swinging in PD may be associated with a disturbance in the internal rhythm formation process. Arm swinging exercises are one of the exercise methods that use rhythmic cues. This study suggests that a videotaped arm swinging-based home exercise therapy is effective in such patients.

A 13-year-old girl with asplenia syndrome who previously had undergone left subclavian-to-pulmonary artery shunt after removal of a cavopulmonary shunt with interposition of a short segment of the left superior vena cava was admitted for congestive heart failure. Angiography revealed aneurysmal dilatation of the left superior vena cava. Percutaneous coil embolization of the shunt was successfully performed and the venous aneurysm was diminished. Interposition of a venous component in systemic-to-pulmonary artery shunt should be avoided even after removing a cavopulmonary shunt.

OBJECTIVE: We implemented automatic online medical consultation software. It infers disease of patients with knowledge about symptoms and the epidemiologic data. And we compared its performance of inference with that of human doctors. METHODS: This software accepts information about users' age, sex, and symptoms, lists up diseases compatible with these information, and sorts diseases by probability. We implement this software with Ruby and C. RESULTS: We compared diseases listed up by this software with those that by two human doctors, and found that 1) 90% of confirmed diagnoses was included in the list this software inferred, and 2) more than 50% of diseases in the list this software inferred are same diseases as ones both of two human doctors inferred. CONCLUSION: This software can not determine final diagnosis. But this software lists up probable diseases only by interview. Then we believe this software will be useful for patients when they want to check themselves before consulting their doctor. We believe that this software will be useful for patients to check their health status.
Diagnosis ; Humans

No abstract available.
Diagnosis* ; Echocardiography* ; Heart*

No abstract available.
Diagnosis* ; Echocardiography* ; Heart*

Correction of fetal malpresentation such as knee-chest positioning and external cephalic version, has long been performed in cases of breech presentation. The reliability and safety of such treatment, however, remains unclear. We performed moxibustion on three acupoints, namely, Saninko, Shiin, and Yusen to correct the condition.
We studied a total of 28 women, 22 of whom were observed until delivery, and six who had not reached full term by the end of the study. Cephalic presentation was achieved in 25 (89.3%), All but one of the fetuses that were corrected to cephalic presentation had full term vaginal delivery. The remaining one underwent premature delivery due to premature rupture of the membrane at 35 weeks 6 days. None of the babies showed any abnormalities. Correction could not be achieved in three women by the time of delivery. One of these three had dicornate uterus and underwent caesarian section due to premature rupture of the membrane. The other two had full term vaginal delivery of live babies. These results indicate that the correction of breech presentation by moxibustion is a safe method which cause no adverse effects on the mother or baby.