Objectives: To examine in two tests the potential of kaki (persimmon) extract-containing diet (KE diet) to reduce malodorous volatile sulfur compounds (VSC), such as hydrogen sulfide (H₂S), methyl mercaptan (CH₃SH) and dimethyl sulfide (CH₃SCH₃), as well as on subjective fecal odor on healthy adults.
Methods: In the first test, 11 subjects were given garlic-containing soup. For a period of time, they were given a single dose of KE diet (150 mg as kaki extract) with water, and only water for the rest of the study period. Two hours after the administration, oral gas samples were collected from individual subjects and analyzed for VSC. In the second test, 14 subjects were given a single dose of KE diet for 7 days. Fecal samples were collected from individual subjects before and after the 7-day KE diet intervention. Levels of VSC were determined and the magnitude of subjective fecal odor was estimated based on ratings in the self-administered questionnaire.
Results: Levels of CH₃SCH₃ in oral gas were significantly lowered when subjects were on a KE diet. On the other hand, although decreases in the level of any VSC in feces before and after the 7-day KE diet intake did not reach a statistical significance, subjective fecal odor significantly improved by the KE diet intake.
Conclusion: KE diet appears to have a beneficial effect on VSC-associated oral malodor and subjective fecal odor.

We surveyed the involvement of hospice and palliative care staff in spiritual and life-and-death education at school. We sent a questionnaire to a total of 138 hospice and palliative care institutions, receiving 67 responses (response rate 49%). A variety of staff at 15 institutions (22%) practiced life-and-death education. Most often, they realized the necessity of such education when they observed children grieving from the death or dying of a family member. 6 institutions targeted their life-and-death education to primary schools, 8 to junior high schools, and 6 to senior high schools. The number of teaching sessions ranged from once to 97 times per year, with hours of class contact less than one hour in 2 institutions, and 1-3 hours in the other 12 institutions. Even those institutions not conducting school education almost all responded that school education on life and death by healthcare workers would be meaningful. Respondents concurred that children would be moved by both "life-and-death education" and "spiritual education." Further comments almost all noted the importance of life-and-death education, not only for children but also for adults. In this sense, the expertise and experiences of hospice and palliative care institutions will become valuable educational resources.

Secretory immunoglobulin A (s-IgA) in saliva constitutes the first-line barrier to the entry of pathogens into the body, implying its critical role in mucosal immunity.To examine the effect of a shark liver oil (SLO)-containing diet on salivary s-IgA concentration in healthy male and female adults, 42 subjects were assigned to either placebo or 6 weeks of a 2,400 mg SLO-containing diet (1,500 mg as SLO) and assessed in a randomized, double-blind, placebo-controlled, parallel group trial.Salivary s-IgA concentration significantly increased at week 6 in the SLO group (P = 0.033), but not in the placebo group.Moreover, there was a significant difference between groups in the magnitude of change from baseline to week 6.No intervention-related adverse event or abnormal changes of laboratory test parameters were observed throughout the study period.In conclusion, an SLO-containing diet increases salivary s-IgA in healthy adults.

　　Capnocytophaga canimorsus is a spindle-shaped facultatively anaerobic Gram-negative rod in the oral cavity of dogs and cats. C. canimorsus rarely infects humans through an animal bite or scratch. However, it leads to severe sepsis once infection occurs, and the fatality rate is estimated to be up to 30%. The patient was a 56-year-old man with fatigue and fever. Sepsis with thrombocytopenia was suspected from the blood examination results. We decided to conduct microscopic examination of a non-stained peripheral blood smear and identified bacteria; therefore, Gram stain was immediately performed and spindle-shaped Gram-negative bacilli were detected. Additionally, the patient had a history of a bite and scratch by his cat. We suspected C. canimorsus infection from the microscopic examination findings and history. Moreover, we determined early that the pathogenic bacterium was C. canimorsus by blood culture. With immediate and proper treatment based on these results, we could rescue this septic patient with disseminated intravascular coagulation. Microscopic examination of non-stained peripheral blood smear is helpful for the early diagnosis of C. canimorsus infection.

OBJECTIVE: Oocyte degeneration often occurs after intracytoplasmic sperm injection (ICSI), and the risk factor is low-quality oocytes. The follicular fluid (FF) provides a crucial microenvironment for oocyte development. We investigated the relationships between the FF volume aspirated from individual follicles and oocyte retrieval, oocyte maturity, oolemma stretchability, fertilization, and development. METHODS: This retrospective study included data obtained from 229 ICSI cycles. Ovarian stimulation was performed according to a gonadotropin-releasing hormone antagonist protocol. Each follicle was individually aspirated and divided into six groups according to FF volume (<1.0, 1.0 to <2.0, 2.0 to <3.0, 3.0 to <4.0, 4.0 to <5.0, and ≥5.0 mL). Oolemma stretchability during ICSI was evaluated using a mechanical stimulus for oolemma penetration, that is, the stretchability was assessed by oolemma penetration with aspiration (high stretchability) or without aspiration (low stretchability). RESULTS: Oocyte retrieval rates were significantly lower in the <1.0 mL group than in the ≥1.0 mL groups (46.0% [86/187] vs. 67.5%–74.3% [172/255 to 124/167], respectively; p<0.01). Low oolemma stretchability was significantly more common in the <1.0 mL group than in the ≥1.0 mL groups during ICSI (22.0% [13/59] vs. 5.8%–9.4% [6/104 to 13/139], respectively; p=0.018). There was a relationship between FF volume and oolemma stretchability. However, there were no significant differences in the rates of fertilization, cleavage, ≥7 cells at day 3, and blastocyst development among all groups. CONCLUSION: FF volume is potentially associated with the stretchability of metaphase II oolemma during ICSI. Regarding oolemma stretchability, ensuring a uniform follicular size during ovarian stimulation is crucial to obtain good-quality oocytes.
Blastocyst ; Clothing ; Female ; Fertilization ; Follicular Fluid* ; Gonadotropin-Releasing Hormone ; Humans* ; Infertility ; Membranes ; Metaphase ; Oocyte Retrieval ; Oocytes ; Ovarian Follicle ; Ovulation Induction ; Retrospective Studies ; Risk Factors ; Sperm Injections, Intracytoplasmic*

Following the revision of the structure and content of the Model Core Curriculum for Medical Education to be more outcome-based and the legal status of the medical practice performed by medical students in the clinical clerkship, we have revised the Guideline for Participatory Clinical Clerkship. The following items were revised or newly described : significance of enhancing the participatory clinical clerkship, scope of medical practice, confidentiality, patient consent, patient consultation and support service, objectives of the clinical clerkship, simulation education, departments where the clinical clerkship is conducted, assessment in the clinical practice setting, CC-EPOC, and entrustable professional activities. A foundation has been established to promote seamless undergraduate and postgraduate medical education. However, future work is needed to examine the specific level of performance expected at the end of the clinical clerkship and department-specific clinical practice goals and educational strategies.