Objectives: To clarify differences in medical students’ emotional intelligence and empathy among 4 school years and sex.
Methods: A cross-sectional study of 370 medical students in years 1, 2, 4, and 6 was performed with Japanese versions of 2 self-reported questionnaires: the Trait Emotional Intelligence Questionnaire–Short Form （TEIQue-SF） and the Jefferson Scale of Physician Empathy–Student Version （JSPE-S）.
Results: Total scores of the TEIQue–SF tended to decrease in higher school years. However, the total score of the JSPE-S was significantly increased in year 6 but was decreased in year 4. Male students had higher TEIQue–SF scores, and female students had higher JSPE-S scores. Of the 4 factors of the TEIQue–SF compared （well-being, self-control, emotionality, and sociability）, only sociability was higher in males. No differences were found among school years. The scores of the TEIQue–SF and the JSPE-S showed a weak correlation. Of the factors of the TEIQue–SF, only self-control showed no correlation with the JSPE-S.
Discussion and Conclusion: These results suggest that the emotional intelligence of both male and female medical students tends to decline. The increase in JSPE-S scores in year 6 suggests that medical interview training is effective. Furthermore, training is important both to enhance emotional intelligence and to teach self-control skills.

1) We visited 5 Scottish universities (the Universities of Aberdeen, St Andrews, Dundee, Glasgow, and Edinburgh) to observe and learn about simulated-patient programs and communication-skills training.
2) Each medical school has developed its own approach for using simulated patients in training and for giving feedback to medical students.
3) In Scotland, where all medical schools adhere to“Tomorrow's Doctors”and“the Scottish Doctor Curriculum Outcomes, ”curriculum styles vary greatly, but the differences are celebrated.The simulated-patient programs are integrated into each program in a way unique to each school.

  Emotional intelligence and empathy are crucial in patient–physician relationships and clinical outcomes. It has been reported that both emotional intelligence and empathy decrease as students advance through medical school. This study aimed to validate Japanese versions of the Trait Emotional Intelligence Questionnaire–Short Form （TEIQue–SF）, developed by Petrides and Furnham （2001）, and the Jefferson Scale of Physician Empathy （JSPE）, developed by Hojat et al. （2001）.
1）The TEIQue–SF and JSPE were translated and administered to 370 medical students. Valid responses were obtained from 321 students（88%）.
2）Cronbach’s alpha for internal reliability was high for both the TEIQue–SF （0.87） and the JSPE （0.89）. All item total score correlations were positive for both the TEIQue–SF （range, 0.29 to 0.64） and the JSPE （range, 0.27 to 0.72）.
3）Cronbach’s alpha was smaller if an item was deleted than if all items were included for both the TEIQue–SF （0.84–0.85） and the JSPE （0.81–0.86）.
4）Factor analysis of both the TEIQue–SF and the JSPE revealed that the Japanese versions had some structural differences from the original versions. However, criterion–related analysis showed that the TEIQue–SF and the JSPE were highly correlated with the NEO–Five Factor Inventory, a measure of the Big Five personality traits.
5）These findings provide support for the construct validity and reliability of the Japanese versions of the TEIQue–SF and the JSPE when used for medical students. Further investigation is needed.

Adipose triglyceride lipase (ATGL) catalyzes the first step of triglyceride hydrolysis. The gene mutations cause neutral lipid storage disease with myopathy (NLSDM) and/or triglyceride deposit cardiomyovasculopathy (TGCV) . Here we give the first report on rehabilitation of a patient with NLSDM and TGCV. The 62-years-old patient was admitted to our hospital for rehabilitation for skeletal myopathy and rehabilitation for cardiac dysfunction (NYHA class Ⅲ , ejection fraction 20%) . He complaint of dyspnea during the activity of daily life and exercise torelance was low. Our rehabilitation program consisted of physical therapy, occupational therapy, nutrition and cardiac education. We had paid a special attention to the intensity of exercise (aerobic training and resistance training) due to the low cardiac function, energy dysfunction and myopathy. After rehabilitation for two months, muscle strength had increased and 6MWT, ATVO₂ had improved. Importantly, the reduction of dyspnea on exertion as well as the increase in exercise capacity are considered to have led to improvement of quality of life.

The Medical Education Development Center has organized seminars and workshops for medical education 30 times from 2000 through 2008 throughout Japan. The participants have numbered more than 3200 and have included educators, physicians, students, and simulated patients. The topics of seminars and workshops have included problem-based learning tutorial systems, medical interview skills, objective structured clinical examinations, evidence-based medicine, coaching technology, simulations, and community medicine in response to educational needs. A questionnaire survey of 1793 participants of the 11th to 30th seminars and workshops (response rate, 85.6%) showed a high degree of satisfaction (4.33±0.13 of 5 points). Invited lecturers and directors from throughout the country often organized these workshops. The results of workshops are reported in our annual monograph, "Trends in Medical Education."

  Committee for Information Infrastructure in the 16th term of JSME Board Members was newly created to edit Medical Education White Book issued every four years and to provide sooner and more comprehensive information infrastructure provision. MEAL was opened as a website for medical education information since August 2011. MEAL consists of glossary, articles, books and more resources using a system like Wiki or Blog on the Web. By such technological progress, not only one–way information provision from JSME but also bidirectional communication between JSME members and committees／board members became available. Internationally, similar websites are known, such as MedEdPORTAL by AAMC （Association of American Medical Colleges）, and expected to be new scholarly information added to journals.

Pancreatic cancer is the fifth leading cause of cancer-related death in Japan. Surgical treatment is the effective way to achieve a long survival. Because of the development of surgical procedure and perioperative management, pancreatic surgery becomes safer. However, it still includes a certain number of morbidities and mortalities. It is important to perform safe operation for long survival. We herein introduce our operative procedure for pancreatic surgery including pancreaticoduodenectomy (PD) and distal pancreatectomy. In patients undergoing PD, leakage from the pancreatic anastomosis remains an important cause of morbidity and contributes to prolonged hospitalization and mortality. Recently, a new end-to-end pancreatojejunostomy technique without the use of any stitches through the pancreatic texture or pancreatic duct has been developed. In this novel anastomosis technique, the pancreatic stump is first sunk into deeply and tightened with a purse string in the bowel serosa. We modified this method in an end-to-side manner to complete the insertion of the pancreatic stump into the jejunum, independent of the size of the pancreas or the jejunum. Since April 2013, we have performed this new anastomosis technique in 36 patients. The breakdown of preoperative diagnosis of 36 patients were 13 pancreatic cancers, 8 extrahepatic bile duct cancers, 7 intraductal papillary mucinous neoplasms and so on. Of 36 PD, 32 were subtotal stomach preserving PD (SSPPD), and the rest were SSPPD combined with left hemihepatectomy or distal pancreatectomy, and middle pancreatectomy. The concentration of amylase in discharged fluid through an abdominal drain decreased day by day. According to the ISGPF definition, pancreatic fistula (PF) was observed in 4 patients (11%). Of 4, only 1 case had grade C PF. This case had a hemorrhage from pancreatic cut end. This occurred probably because the pancreatic cut end was not compressed by the intestinal wall with this technique. This case had reoperation and the hemostasis of pancreatic cut end was secured. The other severe complications were not observed. This new method can be performed safely and is expected to reduce the occurrence of leakage from PD. The development of PF following distal pancreatectomy is an unsolved problem. We introduce a simple technique, the parallel suturing technique, which prevents severe PF by hand-sewn closure of the pancreatic stump. After standard distal pancreatectomy in the described cases, the main pancreatic duct was secured. The stump of the pancreatic remnant was closed with three nonabsorbable monofilament sutures. The three sutures were positioned about 3 mm proximal to the cut end of the pancreas and tied parallel to the pancreatic stump. Ascites fluid was collected through a drain tube, and its concentration of amylase was measured on days 1, 2, 3, and 4 postoperatively. PF was diagnosed according to the ISGPF classification. On postoperative day 4, three patients were categorized as having grade A PF, six were diagnosed with no PF, and the drain tubes of the remaining three were removed on day 3. This simple technique may effectively lighten the severity of PF following distal pancreatectomy. It may have a particular advantage in patients with a wide pancreatic stump.

We examined pharyngeal nerve courses in paraffin-embedded sagittal sections from 10 human fetuses, at 25-35 weeks of gestation, by using S100 protein immunohistochemical analysis. After diverging from the glossopharyngeal and vagus nerves at the level of the hyoid bone, the pharyngeal nerves entered the constrictor pharyngis medius muscle, then turned upward and ran superiorly and medially through the constrictor pharyngis superior muscle, to reach either the levator veli palatini muscle or the palatopharyngeus muscle. None of the nerves showed a tendency to run along the posterior surface of the pharyngeal muscles. Therefore, the pharyngeal nerve plexus in adults may become established by exposure of the fetal intramuscular nerves to the posterior aspect of the pharyngeal wall because of muscle degeneration and the subsequent rearrangement of the topographical relationship between the muscles that occurs after birth.
Adult ; Fetus ; Glossopharyngeal Nerve ; Humans ; Hyoid Bone ; Muscles ; Parturition ; Pharyngeal Muscles ; Pregnancy ; Vagus Nerve

  In 2008, Japanese Society of Drug Informatics (JASDI) organized the Future Vision Committee (the Committee) to propose the essential focus of drug informatics.  To explore a future vision about the drug information sciences, it was necessary to collect a variety of opinions widely from researchers.  Therefore, at the 11^th annual meeting of JASDI in July 5-6, 2008, the Committee convened a workshop to extract problems in the researches of drug informatics by using KJ method and evaluated the contents.  The major problems raised were “the field of drug informatics is too broad” and “there is no definition and/or no system of the drug informatics”.  Related problems raised are the shortness of the history and lack of originality in the study.  From different viewpoints, it was also pointed out that the methodology of the research is not well established and no systematic education is provided.  Taken together, major problems in drug informatics are concluded to be the lack of definition and the lack of systematizations, and will be solved to a certain extent by defining the outcome of the researches in drug informatics.

Medical students at Kurume University begin practical training in clinical skills in their fourth year. At that time, students use the skills laboratory to improve their clinical skills. Medical education resources in the skills laboratory include simulators for emergency resuscitation and heart diseases, wireless stethoscopes, and videotapes. All students use the skills laboratory for 2 months, and its usefulness was evaluated with questionnaires after practical training. More than 50 % of students approved of their practice in the skills laboratory. However, some students were unsatisfied because they were unable to make effective use of the simulators. In the future, an improved skills laboratory will be necessary to improve practical training in the clinical skills for medical students.