Objective: The purpose of the present study was to clarify the efficacy of alendronate and raloxifene for preventing bone loss in patients with hip fracture by monitoring bone mineral densities (BMDs) and biochemical markers during the 9-month period after fracture. Patients and Methods: Eighty-two female hip fracture patients from 50 to 99 years old (mean ± SD: 81.6 ± 9.5) were randomly divided into two groups; there were 46 patients in the alendronate-treated group (group ALN) and 36 patients in the raloxifene-treated group (group RLX). Drugs were administered to patients six weeks after their operations. Lumbar spine BMD and neck, trochanter, Ward's and total BMDs of the contralateral proximal femur, serum intact osteocalcin (intact OC), bone-specific alkaline phosphatase (BAP) and urinary N-terminal telopeptide of type I collagen (NTX) were measured just before the start of drug administration and at 9 months thereafter. Results: Twenty-two out of 46 patients in group ALN and 23 out of 36 patients in group RLX completed the study. The most common reason for dropping out was the patient's failure to visit the outpatient clinic. Trochanter BMD in group ALN tended to increase by 8.4% compared with the baseline, and total hip BMD in group RLX showed a significant increase (5.7%), although neck BMD in both groups decreased during the 9 months of treatment (–8.7% for group ALN and –4.2% for group RLX compared with the baseline). Spine BMD did not change significantly in eithr group. Serum BAP and urinary NTX decreased significantly in both groups. Serum intact OC did not change significantly. Conclusions: Both alendronate and raloxifene have a favorable effect on trochanter and total BMDs of the contralateral proximal femur in the short period after hip fracture. However, both drugs could not prevent bone loss in the femoral neck during the 9 months of treatment.

At the Niigata University School of Medicine, objective structured clinical examinations (OSCEs) were performed for the first time in 2001 for 92 fourth-year medical students. The average evaluation scores students received from instructors were summarized, and the differences between scores given by different instructors were examined. We found that practice methods for the medical interview and physical examination before OSCE and the question topics and evaluation methods of OSCE were appropriate, but scores on some items were extremely low. The standardization and objectivity of the evaluation were satisfactory, perhaps because one explanatory conference and two training conferences were held for instructors before OSCE. However, some questions tended to produce differences between instructors, as did some topics, especially in the medical interview. The scores with standardized patients and those by teachers were strongly correlated, but those with the former were lower than those by the latter.

1) The Medical (Dental) Education Eligibility Test was developed as the medical school admission test in Korea and was administered for the first time on August 29, 2004. The test evaluates reasoning abilities in language, natural sciences, and spatial relationships.
2) The language section assesses cognitive and communication abilities. The natural science section assesses cognitive ability on the basis of academic knowledge in the field, whereas the spatial relationships section evaluates aptitude expected of dentists in their clinical examinations.
3) Because entrance examinations have traditionally placed too much emphasis on academic knowledge and achievement, assessment of other kinds of aptitudes, such as ethics, cooperativeness, and communication skills, has recently become increasingly important. It remains to be seen how these aptitudes and interpersonal skills can be measured and scaled with admission tests.

1) The faculty development at each medical school from 2003 through 2005 was analysed.
2) The major themes in faculty development were problem based learning, tutorial, computer based testing, and clinical training.
3) Faculty development is considered an effective way to enhance the contributions of faculty members to medical education.

1) A program entitled Doc MMC was broadcast on FM Mie, a local FM radio station.“The Doc MMC Declaration”was performed on this program by residents.
2) The declarations were classified into six groups: “Affection, ”“Contribution to Community Medicine, ”“Knowledge and Skill, ”“Special Training Course Selection or Self-Activation, ”and “Others.”
3) This kind of broadcasting may enhance the motivation of residents and facilitate the understanding of medical issues by the community.

This study aimed to review the historical transition of rectal cancer surgery and recent evidence regarding transanal total mesorectal excision (TaTME). Additionally, it outlined the anatomical landmarks and technical considerations essential for successful TaTME. Anatomical studies and surgical techniques were analyzed to identify key landmarks and procedural steps crucial for TaTME. TaTME offers improved visibility and maneuverability even in the deep and narrow pelvis and is expected to contribute to tumor radical cure rates. By securing the circumferential resection margin and distal margin while preserving pelvic autonomic nerve function, TaTME holds promise for maintaining postoperative urinary and sexual functions. Key anatomical landmarks include the endopelvic fascia posteriorly, the S4-pelvic splanchnic nerve laterally, and the prostate or posterior vaginal wall anteriorly. Selecting the appropriate dissection layer based on tumor depth and ensuring precise incision of the tendinous arch of the pelvic fascia contributes to successful TaTME outcomes. TaTME represents a significant advancement in rectal cancer surgery, offering improved outcomes through meticulous attention to anatomical detail and precise dissection techniques. Understanding the historical context of rectal cancer surgery alongside recent evidence on TaTME is essential for optimizing patient outcomes and expanding the safe implementation of this innovative approach.

This study aimed to review the historical transition of rectal cancer surgery and recent evidence regarding transanal total mesorectal excision (TaTME). Additionally, it outlined the anatomical landmarks and technical considerations essential for successful TaTME. Anatomical studies and surgical techniques were analyzed to identify key landmarks and procedural steps crucial for TaTME. TaTME offers improved visibility and maneuverability even in the deep and narrow pelvis and is expected to contribute to tumor radical cure rates. By securing the circumferential resection margin and distal margin while preserving pelvic autonomic nerve function, TaTME holds promise for maintaining postoperative urinary and sexual functions. Key anatomical landmarks include the endopelvic fascia posteriorly, the S4-pelvic splanchnic nerve laterally, and the prostate or posterior vaginal wall anteriorly. Selecting the appropriate dissection layer based on tumor depth and ensuring precise incision of the tendinous arch of the pelvic fascia contributes to successful TaTME outcomes. TaTME represents a significant advancement in rectal cancer surgery, offering improved outcomes through meticulous attention to anatomical detail and precise dissection techniques. Understanding the historical context of rectal cancer surgery alongside recent evidence on TaTME is essential for optimizing patient outcomes and expanding the safe implementation of this innovative approach.

Complications after colorectal surgery remain inevitable, and anastomotic leakage is one of the most severe and potentially fatal complications. Generally, anastomotic leakage is associated with severe peritonitis, the need for emergency reoperation, and an increased mortality rate. Additionally, particularly after rectal cancer surgery, it has a negative impact on long-term outcomes, including postoperative anorectal function, local recurrence, and survival. To prevent anastomotic leakage, understanding the characteristics of each anastomotic technique and establishing a stable anastomotic procedure are important. Transanal total mesorectal excision (TaTME) is a relatively new advanced surgical access technique for pelvic dissection and facilitates different anastomotic techniques without the need for transabdominal rectal transection. Especially, stapled anastomosis in TaTME, also known as double purse-string circular stapled anastomosis or the single stapling technique (SST), has gained much attention as an alternative to the conventional double stapling technique (DST). In this article, we describe the DST, SST, and hand-sewn anastomosis as anastomotic techniques after rectal surgery, focusing mainly on the differences between conventional anastomotic techniques and SST in TaTME. Furthermore, the blood flow evaluation method for the reconstructive colon before anastomosis, which is extremely important in anastomotic leakage prevention regardless of the anastomotic type, is also described.

This study aimed to review the historical transition of rectal cancer surgery and recent evidence regarding transanal total mesorectal excision (TaTME). Additionally, it outlined the anatomical landmarks and technical considerations essential for successful TaTME. Anatomical studies and surgical techniques were analyzed to identify key landmarks and procedural steps crucial for TaTME. TaTME offers improved visibility and maneuverability even in the deep and narrow pelvis and is expected to contribute to tumor radical cure rates. By securing the circumferential resection margin and distal margin while preserving pelvic autonomic nerve function, TaTME holds promise for maintaining postoperative urinary and sexual functions. Key anatomical landmarks include the endopelvic fascia posteriorly, the S4-pelvic splanchnic nerve laterally, and the prostate or posterior vaginal wall anteriorly. Selecting the appropriate dissection layer based on tumor depth and ensuring precise incision of the tendinous arch of the pelvic fascia contributes to successful TaTME outcomes. TaTME represents a significant advancement in rectal cancer surgery, offering improved outcomes through meticulous attention to anatomical detail and precise dissection techniques. Understanding the historical context of rectal cancer surgery alongside recent evidence on TaTME is essential for optimizing patient outcomes and expanding the safe implementation of this innovative approach.

This study aimed to review the historical transition of rectal cancer surgery and recent evidence regarding transanal total mesorectal excision (TaTME). Additionally, it outlined the anatomical landmarks and technical considerations essential for successful TaTME. Anatomical studies and surgical techniques were analyzed to identify key landmarks and procedural steps crucial for TaTME. TaTME offers improved visibility and maneuverability even in the deep and narrow pelvis and is expected to contribute to tumor radical cure rates. By securing the circumferential resection margin and distal margin while preserving pelvic autonomic nerve function, TaTME holds promise for maintaining postoperative urinary and sexual functions. Key anatomical landmarks include the endopelvic fascia posteriorly, the S4-pelvic splanchnic nerve laterally, and the prostate or posterior vaginal wall anteriorly. Selecting the appropriate dissection layer based on tumor depth and ensuring precise incision of the tendinous arch of the pelvic fascia contributes to successful TaTME outcomes. TaTME represents a significant advancement in rectal cancer surgery, offering improved outcomes through meticulous attention to anatomical detail and precise dissection techniques. Understanding the historical context of rectal cancer surgery alongside recent evidence on TaTME is essential for optimizing patient outcomes and expanding the safe implementation of this innovative approach.