The severity of mitral regurgitation (MR) and tricuspid regurgitation (TR) was evaluated semiquantitatively by Doppler color flow imaging. The maximum MR area/body surface area (MRA/BSA) correlated significantly to the severity of angiographyic changes (tau=0.897). The maximum TR area/body surface area (TRA/BSA) also correlated significantly to the severity in angiography (tau=0.874). The cutoff values were 0.5, 2, 4, and 8cm²/m² for MRA/BSA and 1, 2.5, 5, and 10cm²/m² for TRA/BSA. Fourteen children (mean age 4.2 years) underwent repair of partial atrioventricular septal defects (P-AVSD) from 1985 to 1992. The cleft in the anterior leaflet was closed in the mitral valve; other procedures such as annuloplasty were not performed. They have been followed for periods from 7 months to 7 years and 5 months (mean 4 years); they were examined by echo cardiography and the Holter electrical cardiogram at the end of the period. MR had reduced to grade 0-II in all cases. No patients were given any medication, and all remained in NYHA Functional Class I. Paroxysmal supraventricular tachycardia developed in only one patient. We concluded that no annuloplasty in mitral valve is needed in children suffering from P-AVSD.

[Objective]In recent years, communication skills have been recognized as an essential competence for acupuncturists. This study proposes to develop a scale for measuring the medical communication skills of acupuncturists.
[Materials and Methods]A questionnaire of 20 items was used to measure medical communication skills. These items were adopted from a concept analysis conducted in a previous study.
Cronbach's alpha was used to examine the scale's reliability. The scale's validity was examined by correlation analysis and multiple regression analysis comparisons with normal communication skills subscale scores (ENDCOREs, Encode, Decode, Control, Regulate) and a Japanese version of characteristic trait anxiety scores (STAI, State-Trait Anxiety Inventory).
[Results]Factor analysis, using a principal extraction method and promax rotation, was conducted on responses from 443students and therapists. As a result, the original 20 items were reduced to 16, and the following three factors were extracted:I. Acceptance of patients and self-control;II. Appropriate explanation to patients;and III. Understanding of patient's feelings. These three factors had high degrees of internal consistency (Cronbach's alpha =.872 -.892).
The scores of the three factors correlated significantly with the scores of the six factors of ENDCORE, and with the anxiety scores. Although the results of multiple regression analysis showed that each factor of ENDCORE explained the three factors, the anxiety scores did not influence medical communication skills. The scores for the three factors correlated significantly with self-evaluation scores of medical interview skill. In addition, these three factors were affected by the degree of clinical experience.
[Conclusion]These results suggest that this scale may be a reliable instrument for assessing medical communication skills among Japanese acupuncturists.

About 7, 000 workers migrated from Kochi Prefecture in 1965. Recently the number of patients with pneumoconiosis and vibration syndrome has increased among these persons who worked on constructing tunnels. To investigate the health status of these workers, we interviewed 73 of these workers with regard to history of migration, work situations, health condition and so on in Niyodo Village in Kochi Prefecture. Thirty workers were examined for pneumoconiosis and vibration syndrome. Geographical distribution of the areas from which these workers had migrated were also analysed by using the statistical data of Kochi Prefecture in 1965.
The results were as follows:
1) Numerous migrant workers come from the mountain villages along the Shikoku Mountains. In the middle-northern areas, included Niyodo Village, the number of migrant workers was large.
2) Their working conditions in the tunnel were poor and measures for prevention of pneumoconiosis, such as wearing of a dust respirator and drilling the rock with water, were poorly carried out. Vibrating tools were also used for long periods of time.
3) Of 73 workers, 40 have been given the compensation follwing a diagnosis of pneumoconiosis or vibration syndrome.
4) In 23 examinees, silicosis was detected in the chest X-ray examination. Classifications included 13 of type 1, 7 of type 2, and 3 of type 4. Also examinees had subjective symptoms and/or objective findings of vibration syndrome. Eighty seven percent were classified as Grade III according to the criteria of Andreeva-Galanina. Thus, most of migrant workers involved in tunnel construction work had complications of pneumoconsosis and vibration syndrome.

To assess the effectiveness of a problem-based learning tutorial system introduced at Gifu University School of Medicine in 1995, we conducted a questionnaire survey of medical knowledge, attitudes about learning, communication ability, and social behavior in sixth-year medical students. The questionnaire was given to instructors and attending physicians at community hospitals who were involved in clinical education. Many of the evaluators felt that students who trained with the tutorial system showed improved understanding, a more active attitude toward learning, and a better attitude toward patients than did students who received traditional, lecture-based education.

The Common Achievement Tests Organization performed the first nationwide trial of computer-based testing (CBT) used to assess students entering the clinical phase of medical education. Seventy-seven medical schools participated in the trial. We compared performance on the national CBT with performance on preclinical tests administered at Gifu University School of Medicine. Despite some methodologic differences between the national CBT and our system, the overall results correlated well. Students who did poorly on the national CBT also did poorly on Gifu University's preclinical test. Correlation of these two performance scales suggests that nationwide CBT could be used to accurately assess preclinical skills.

The purpose of this study was to develop the "Itamikei", a small machine which records the subjective level of pain between 0-10. In addition to testing it's ease of operation and usefulness in the clinical practice environment. The "Itamikei" is 23 cm x 6 cm x 2 cm. It weighs 160 grams. It has 11 buttons, relating to the 0-10 Numeric Rating Scale (NRS). Each time a button is pushed the level of pain is recorded, along with the time and date. Later, this data can be transferred to computer displayed graphically showing the patient's subjective level of pain. This research was a case study for using the "Itamikei". One in-patient at the university hospital who had cancer pain was asked to use the "Itamikei" for 14 days. A graph was printed out and given to both the patient and the medical staff.
The results suggest the following:
1. Using the 0-10 NRS the patient could easily express her level of pain.
2. Because the "Itamikei" was easy to operate, the patient found no difficulty in entering her level of pain.
3. In graph form the daily transition in pain levels can be easily analyzed, and a program for managing pain can be prepare.

Objective: The Pain Level Memory Device (PLMD) is an instrument which patients can use to record their subjective level of pain. The usefulness of the PLMD on both medical staffs in managing cancer pain and the independence of patients were examined in this study. Method: Ten participants, inpatients at Nagoya University Hospital prescribed opioid drugs for cancer pain, were selected and asked to input any change in their pain level into the PLMD for a 14 day period between February and April 2005. A graph of the resulting data was printed and given to both the patient and medical staffs. And a questionnaire evaluating their experience with the PLMD was developed and administered to both. Relationships between the frequency of use of the PLMD and item-scores on the questionnaire were investigated. Results: The median number of inputs into the PLMD was 4.5 (range: 0.5-11) per day. High usage of the PLMD and each high score for the questionnaire items "The PLMD helped assessment of pain (p<.05)" and "The patients satisfaction with pain control improved (p<.05)" were strongly correlated. Spearman's rank correlation coefficient showed a relationship between the median number of inputs and the questionnaire items, "I used the PLMD whenever I intended to (r=.80, p<.01)", ""I saw graphs (r=.78, p<.01)", "I discussed graphs with my doctor (r=.70, p<.05)", "I felt that I participated in my pain management (r=.82, p<.01)", and "I would recommend the PLMD to other patients (r=.80, p<.01)". Conclusion: These results suggested that the PLMD could assist medical staff in the control of cancer pain and support the independence of patients.

Effects of taurine on the functions of the body and metabolism with 3km running upon taking a diet, which is constituted of lowest possible amount of carbohydrate and highest possible amount of fat and protein, were investigated in 25 male and female subjects of age thirties by double blind test method. The results were as follows
1) Taurine administration (T. A.) proved to inhibit the degree of increase in heart rate and increase the maximal degree of pulse pressure in response to 3 km running.
2) T. A. proved to inhibit the degree of increase in serum creatine kinase isozyme MB (CK-MB) activities and CK-MB/CK ratio.
3) T. A. proved to inhibit the decrease of serum total protein values immediately before running and in the following morning. Similar trends in terms of the particuler times were observed, too, in the case of the degree of decrease of serum triglycerides values.
4) T. A. seemed to accelerate the utilization of saturated fatty acids especially.
5) Three kilometer running seemed to increase in serum taurine concentrations from several hours after running to the morning immediately after running.