Abstract
Objective : We investigated the usefulness of providing medical students with demonstrations and education for commonly used medical devices focusing on medical and nursing care for the elderly. Educational materials were also distributed, in addition to the input from the participation of paramedic assistants as various strategies for providing instruction, prior to formal on-site practical training at our clinic.
Methods : Forty-two 5th year medical students undertook a questionnaire survey regarding the education provided prior to on-site practical training, and which was performed after training was completed at our clinic.
Results : All students responded that demonstrations of medical devices were “easy to understand”, while 81% responded that the distribution of materials was “necessary” and 97.6% responded that explanations from paramedics were either “important” or “necessary”. In addition, 95.2% reported that the explanations given prior to training “enhanced” their understanding of nursing care insurance facilities. In respect of medical procedures such as percutaneous endoscopic gastrostomy (PEG) tube management, while 97.6% of students reported that “the explanations given prior to practical training were adequate”, nevertheless 50% reported that “they still did not feel comfortable in actual practice even though the explanations given prior to training were adequate” .
Conclusion : The approaches used at our clinic for education given prior to on-site practical training, were considered beneficial for medical students. However, some of them did not feel comfortable performing medical procedures even though adequate explanations had been provided, indicating the need to create a program that promotes greater confidence in performing practical procedures among medical students in the future.

Introduction: Recently, we reported on the effectiveness of short-term educational programs in clinic-based clinical clerkships that focus on medical care for elderly patients. To evaluate the need for providing a preliminary explanation of the medical care system and the medical equipment related to our programs, we assess the basic knowledge indispensable for all medical students for clinic-based training.
Methods: Before the training, we distributed a questionnaire related to our programs to medical students of Oita University who had participated in clinical clerkships.
Results: The analysis of the questionnaire data revealed that only 11.4% of the students knew the difference between the numbers of beds in a clinic and a hospital. In addition, 24.3% and 35.7% of the students did not know that vaccinations and medical examinations, respectively, are not approved for health insurance coverage in Japan. Of the students, 31.4% could not see the inappropriateness of addressing elderly female patients as “Grandma”. Furthermore, 28.1% of them did not know the sizes of needles and catheters, and only 18.6% of them knew the difference between a normal syringe and a catheter-tip syringe. In regard to the long-term care insurance system, 62.9% of them did not know of the concept of daily-life group care for elderly dementia patients.
Conclusion: These results suggest that preliminary explanations of the medical care system and the medical equipment related to our programs must be provided at the beginning of the training.

The School of Medicine, University of Tsukuba, was founded in 1974 and had graduated 1, 561 students by 1994. From 1980 through 1987, 44% to 73% of graduates became hospital staff, 16% to 40% became university staff, and 0% to 8% became general practitioners. More than 80% of graduates did a 2-year residency (sotsugo-kenshu) at our university hospital and 40% completed a 6-year residency. Almost 10 years of postgraduate training was required to become an established medical practitioner. This length of time indicates that postgraduate training is the most important part of the medical career. About 80% of graduates earned doctor of philosophy (Ph. D.) degrees, whereas 93% became registered specialists, indicating that graduates tended to become specialists rather than to pursue Ph. D. degrees. This difference is more evident among female graduates: 85% became specialists whereas only 53% received a Ph. D. Most graduates considered the School of Medicine to have a good curriculum, but some younger graduates had complaints. The graduates chose their career specialties on the basis of their own interests and aptitudes. We should take these data into account to prepare a system of life-long education and learning.

ABSTRACT: A case of infectious mononucleosis (IM) in a previously healthy 43-year-old male is presented. The patient complained of fever and a sore throat of 3 weeks' duration. Although blood tests showed a marked increase in atypical lymphocytes, tests for Epstein-Barr virus (EBV) and cytomegalovirus (CMV) were negative. Human immunodeficiency virus type 1 (HIV-1) antibody was positive on enzymelinked immunosorbent assay (ELISA), and the HIV-1 viral load was 6.4×10⁴copies/mL. Western blot (WB) analysis did not initially confirm HIV-1 infection ; however, HIV-1 infection was confirmed one month after presentation. Although several pathogens can cause infections presenting as IM, in Japan there have been few reports of acute retroviral syndrome presenting as IM. This case is being reported to stress the importance of the early diagnosis of acute retroviral syndrome.

Objective:Express a human anti-HBsAg single chain antibody fragment(scFv)-consensus interferon (cIFN) fusion protein by bacterial expression system and analyse the function of the fusion protein.Methods:Human anti-HBsAg single chain monoclonal antibody cDNA encoding the variable regions of immunoglobulin from PBMC of Hepatitis B patient. Consensus interferon gene was produced by overlap PCR.A plasmid for production of cIFN-scFV fusion protein was constructed, then the expression vector pRA cIFN-scFV transformed with the E.coli strain BL21(DE3). The gene product was analysed SDS-PAGE and Western blotting, then was solubilized by guanidine hydyochloride, refolded by conventional dilution method, and purified using metal-chelating chromatography. The immune and functional analysis of the resulting fusion protein have been studied by ELISA,FACS(Flow cytometry),MTS assay and hemaglutination inhibition test.Results:The authors isolated and characterized the human anti-HBsAg single chain antibody fragment(scFv)-consensus interferon (cIFN) fusion protein. The resulting human anti-HBsAg scFv-cIFN fusion protein was bound to react with HBsAg and cIFN, this react show that highly specific and bioactivity.Conclusion:A human anti-HBsAg single chain antibody fragment(scFv)-consensus interferon (cIFN) fusion protein was produced by bacterial expression system in this study. This genetically engineered human anti-HBsAg scFv-cIFN fusion protein promises to be an important reagent for hepatitis B immunotherapy.