In order to study the effectiveness of Choreito in the removal of ureteral stones, 7.5g/day of Choreito was administered to 52 patients who had been diagnosed as having ureteral stones. For stones of a diameter less than 4mm, 63.2% were passed within two weeks, and 78.9% within four weeks. The rates for stones between 4 and 10mm was 10% in two weeks and 33.3% in four weeks. For the 52 cases overall, the rate of stone excretion was 28.8% within two weeks and 50% within four weeks.
There were no side effects observed in conjunction with Choreito administration.

A shortage of physicians in rural areas has become a serious problem of the new residency training program in Japan. To address this problem, we propose a model for attracting physicians to rural areas by improving residency training programs and by evaluating a curriculum introduced to Kainan Hospital, a community hospital. In this second paper, we describe the middle-term curriculum evaluation and present our model.1) Interviews of program directors revealed 8 items necessary to improve residency training programs.2) After the residents finish their training, they remain at the same hospital, and the number of the number of physicians at the hospital increases, if the fellowship programs are well-organized.3) Because universities are interested in hospitals at which many residents and fellows work, attracting attending physicians to these hospitals is easier.4) Although attracting enough physicians by improving residency training programs requires 3 to 5 years, achieving this goal by increasing the larger number of medical students would take even longer.

The purpose of this survey is to determine the effect of balneotherapy at the Sukawa hot Spring. The spring provides hot water baths and a special kind of natural steam baths of volcanic origin. The spring water contains alum and green vitriol and shows strong acidity. The steam which blows up from the ground is used for the steam bath. The spring is situated in a alpine plateau, about 1200m. above the sea level, of Kurikoma volcanoes. In summer the climate is mild and the average August temperature is 17.9°C.
Since 1925 studies have been carried out by the staffs of our medical school and Some results were published. In 1935, Miyasaka et al. showed that the most bathers of the spring were the patients with respiratory diseases. It was noted, however, that recently the quality of the bathers seemd to have changed gradually, which led us to reexamine the effect of the balneotherapy on these new population of the bathers.
One hundred and thirty six bathers who stayed more than 2 weeks in the spring and took hot water bath twice daily and stream bath twice daily were used as a material, They were questioned twice by means of the CMI card method, first at the time of their arrival at the spring and the second at the time of departure.
The results are summarized as follows.
In 1935 the patients with respiratory diseases, especially with pulmonary tuberculosis occupied 37 per cent of all the bathers and the patients with gastrointestinal symptomes occupied only 16 per cent. Whereas in 1964 the ratio of the patients with G. I. symptomes increased to 34.7 per cent of all the bathers, most of them with the functional gastrointestinal disorders. The reason of the decrease in the ratio of patients with respiratory diseases may be explained by the fact that during the last 20 years the sanatorium therapy as the treatment of pulmonary tuberculosis has been replaced by the effective chemotherapy and by the increase of patients with functional disorders of the gastrointestinal tract, particularly on psychosomatic bases, which have probably due to “stress” elements spreading into our social life.
The balneotherapy was found to be effective in patients with functional disorders of the G. I. tract including psychosomatic diseases of the G. I. tract, which have characterized by soft stool, diarrhea, constipation, epigastri distress or fullness and abdominal dulla ches. Fifty five per cent of these patients, classified in the 3 rd and 4th area of CMI card or as a neurosis group improved after balneotherapy. Recently such psychosomatic diseases are increasing rapidly. In view of the fact that there is no effective treatment available for such diseases except for psychotherapy, the promissing results in our study suggest that the balneotherapy including sanatorium mood in fine circumstances may be a good indication for such diseases.

The present studies on gallstones, made by macroscopic morphology and infrared absorption spectra, were carried out in order to clarify recent features of cholelithiasis in rural district. One hundred and sixty-one stones obtained from 152 patients who had cholelithiasis, and who were operated-on at our clinics during the past 10 years, were used for this study.
The average age of the patients was 62 years, and about half of them were over 65 years of age. The patients included 100 women and 52 men. The types and frequency of gallstones are classified as follows: cholesterol stones, 50.9%; pigment stones, 40.4%(black stones, 7.5%; bilirubin stones, 32. 9%) and rare stones, 8.7%. Considerin sexual differences, the frequency of cholesterol stones was nearly 2 times greater in women than in men; on the other hand, that of pigment stones was nearly 2 times higher in men than in women. Regarding the age groups of the patients, although the incidence of cholesterol stones was greater in the group under 64 years of age than in the 65-year-old group, the incidence of bilirubin stones was 4 or more times higher in the latter group than in the former.
From the above observations it is suspected that one of the major reasons for the low incidence of cholesterol stones in rural districts, is because of the high percentage of elderly patients with cholelithasis in these areas. The incidence of black stones was not significantly greater in rural districts.

Kanehiro Takaki, the founder of The Jikei University School of Medicine suggested that a nutritional factor was important for preventing beri-beri, which was a common disease in the Meiji era in Japan and Southeast Asia. He improved the rations fed to crews of the Imperial Japanese Navy to include wheat and meat. The rations he devised effectively prevented beri-beri. Some 30 years later, vitamin B₁ was discovered, and a deficiency of vitamin B₁ was found to be the cause of beri-beri. Takaki believed that nutrition and exercise were important for keeping our bodies fit. He often gave lectures on how people could keep fit to prevent diseases. Thus, his activities are considered to be the beginning of preventive medicine in Japan. The contributions of Takaki to the physical fitness of the Japanese people have been continued by the graduates of The Jikei University School of Medicine. Some of the graduates became professors of The Jikei University School of Medicine and Tokyo University of Education (now, Tsukuba University). Thus, both universities have the common basis and tradition for research and education in the fields of physical fitness and sports medicine, and have collaborated with each other in these fields. In this article, we provide a brief overview of the history of the development of research regarding physical fitness and sports medicine in Japan. We discuss the contribution of various persons including our graduates, to the health and physical fitness of the Japanese people.

1) We report here the introduction of graduate entry programmes (GEP) of medical education curriculum in Ireland. Shortness of the doctors stimulated the introduction of GEP in Ireland.Two of the five medical schools introduced GEP and one is planning to introduce, while the other two do not have any idea to introduce it at present.
2) GEP can grow doctors of diverse abilities and is evaluated by Irish medical educators

1) Simulation-based learning is well organized in Universities of Dundee and Glasgow.Medical students use skills centre to brush up their clinical skills frequently.
2) University of Glasgow developed clinical final OSCE using 50 stations.In the United Kingdom, where national board examination is not necessary to be a doctor, OSCE using 50 stations is organized to foster good doctors.

Recently, basophil activation test (BAT) has been applied to the diagnosis of drug allergy. We performed BAT for various Kampo medicines taken by 12 cooperators to evaluate the concentration which arouse nonspecific reaction during incubation in BAT. When whole blood of each was incubated for 24 hours with each Kampo medicine, false positive results were frequently observed. After 1-hour incubation with Kampo medicine at high concentration (1/312.5), false positive results were sometimes observed. These results suggest that in the diagnosis of Kampo-medicine adverse reactions, BAT should be performed in the condition of 1-hour incubation with lower concentration (1/1250 or lower).

A 47-year-old woman visited our clinic, and thereafter she had taken various Kampo medicines until she turned 58 years old. She took each medicine, containing 1-3.5 g/day of glycyrrhiza, for one or two months. Hypertension or edema was not observed in those days. From the age of 60, she took 7.5 g of tokishigyakukagoshuyushokyoto, containing 2 g of glycyrrhiza, day after day. Hypertension or edema was not observed for 35 months. However, when she was 63 years old, pseudoaldosteronism with headache, hypertension, edema,and hypopotassemia was observed for the first time. This case suggests that administration period or patient's age influences the development of pseudoaldosteronism.