1) Obstetrics medical education in Japan, Vietnam, Thailand was compared.The education differed according to the levels of knowledge and the techniques required for first-year doctors.In Japan and Vietnam, the importance of selfdirected learning was stressed in doctors' interviews.
2) The number of deliveries students attended was much higher among Vietnamese students than among Japanese students. Accordingly, Vietnamese students rated their obstetric knowledge and clinical skills more highly than did Japanese students.
3) The major challenges in Japanese medical education are to provide medical students with opportunities to participate in medical care as a member of a treatment team by introducing clinical clerkship training and to enable students to learn in a more self-directed manner.

BACKGROUND/AIMS: To determine the nutritional markers important for assessing the degree of pancreatic insufficiency due to chronic pancreatitis in routine clinical practice. METHODS: A total of 137 patients with chronic pancreatitis were followed up for more than 1 year. They were divided into two groups: a pancreatic diabetes mellitus (DM) group, consisting of 47 patients undergoing medical treatment for DM of pancreatic origin, and a nonpancreatic DM group, consisting of 90 other patients (including 86 patients without DM). Serum albumin, prealbumin, total cholesterol, cholinesterase, magnesium, and hemoglobin were compared between the two groups. RESULTS: The total cholesterol was significantly lower in the pancreatic than the nonpancreatic DM group (164 mg/dL vs 183 mg/dL, respectively; p=0.0028). Cholinesterase was significantly lower in the former group (263 U/L vs 291 U/L, respectively; p=0.016). Among the 37 patients with nonalcoholic pancreatitis, there was no difference in the cholinesterase levels between the pancreatic and nonpancreatic (296 U/L vs 304 U/L, respectively; p=0.752) DM groups, although cholesterol levels remained lower in the former (165 mg/dL vs 187 mg/dL, respectively; p=0.052). CONCLUSIONS: Cholinesterase levels are possibly affected by concomitant alcoholic liver injury. The total cholesterol level should be considered when assessing pancreatic insufficiency due to chronic pancreatitis.
Adult ; Aged ; Aged, 80 and over ; Cholesterol/*blood ; Cholinesterases/blood ; Diabetes Mellitus, Type 2/complications ; Exocrine Pancreatic Insufficiency/*blood/etiology ; Female ; Follow-Up Studies ; Humans ; Liver Cirrhosis, Alcoholic/blood ; Male ; Middle Aged ; Nutritional Status ; Pancreas/enzymology ; Pancreatitis, Alcoholic/blood/complications ; Pancreatitis, Chronic/blood/*complications ; Serum Albumin/analysis

We investigated the relationship between neonatal blood hemoglobin (Hb) and period of oxygen administration in 4 cases of fetomaternal transfusion syndrome at our hospital. The hematological parameters were as follows. Case 1: Hb 7.0 g/dL, reticulocyte count 177‰, no blood transfusion, and oxygen administration for 3 days. Case 2: Hb 4.7 g/dL, reticulocyte count 132‰, blood transfusion given, and oxygen administration for 7 days. Case 3: Hb 4.1 g/dL, reticulocyte count 202‰, blood transfusion given, and oxygen administration for 12 days. Case 4: Hb 3.6 g/dL, reticulocyte count 48‰, and blood transfusion given. In Case 4, we started artificial respiration and oxygen administration for treatment of neonatal asphyxia. Oxygen administration was stopped at 50 days of age. Artificial respiration was continued, and tracheostomy was attempted at 198 days of age. Case 4 was classified as having acute blood loss based on the reticulocyte count and had a poorer prognosis than Cases 1-3, which were classified as having chronic blood loss. In Cases 1-3, peripheral blood Hb level was inversely related to the period of oxygen administration.