Background: Few medical education programs provide hands-on classes using electronic medical charts for a large number of students.
Methods: To simulate a medical interview, third- and sixth-year medical students viewed electronic medical chart samples on a screen, created by FileMaker, and discussed patient management. Following this, they underwent a questionnaire survey.
Results: A total of 63.1 and 76.3% of the third- and sixth-year students responded to the questionnaire, and 87.1 and 78.9% of the responders became interested in the class, respectively, because it focused on hands-on, practical training. A total of 5.6% of third-year students stated that the class was difficult to master but they hoped to continue learning.
Discussion: The adoption of a hands-on class using electronic medical charts interested even junior medical students.

From January 1979 through May 1982, 36 premature infants less than 2.5kg and less than 35 weeks of gestation, including 24 patients with respiratory distress syndrome, underwent ligation of patent ductus arteriosus (PDA) due to being unresponsive to medical treatment. Ten patients died postoperatively mainly from intracranial hemorrhage and necrotizing enterocolitis. Surviving 26 patients were examined for developmental sequelae based on questionnaire survey. One infant died of respiratory failure secondary to severe bronchopulmonary dysplasia 28th month after operation. We found no evidence of recurrent ductal patency following ligation during the follow-up period. Twenty four patients exhibited normal motor and mental development to attend the ordinary elementary school everyday, but one patient shows mental retardation. Most of patients suffered from the frequent upper respiratory infection in childhood to require rehospitalization. There are no patients with hoarseness, but 2 patients developed funnel chest and one required the operation. One third of the patients had ophthalmological handicap (myopia or strabismus). Surgical ligation of PDA in premature infants seems to reduce the duration of postoperative mechanical ventilation and the incidence of bronchopulmonary dysplasia. Analyzing long-term follow-up indicates that infants who undergo PDA ligation grow almost normally and do not appear to be at increased risk for sensorineural handicaps. Therefore we emphasize that surgical ligation of PDA is an effective and appropriate treatment of choice for significant PDA in premature infants.

A nationwide survey of Japanese teachers belonging to departments of medicine was conducted to investigate their opinions about: 1) expanding medical departments into medical schools and, 2) the required subjects and selection criteria for admitting students to the faculty of medicine. We found that responses to both questions depended largely on the specialty of the teachers. With regard to the medical school design, which will cause a dramatic change in medical education in Japan, 60% of the teachers were in favor of expanding departments into medical schools.

Clinical course and outcome of 34 patients with peripheral and visceral artery aneuryms, operated during 1975-1990, were analysed. There were 24 males and 10 females. Ages ranged from 14 to 87, with an average of 55 years. Peripheral aneurysms located most frequently in the lower extremity, and the incidence of various origin of the aneurysms were as follows: 14 in femoral, 5 in popliteal, 4 in internal iliac, 3 in subclavian, 2 in common iliac arteries, and 1 in each of vertebral, radial, splenic, renal and anterior tibial artery. Most common cause of aneurysm was arteriosclerosis. Multiple aneurysms were found in 59% of sclerotic type and in most of these with bilateral aneurysms in the iliac, femoral and popliteal. Ruptured aneurysms were seen in 26% of this series. Most of the aneurysms in the extremities were totally excised without difficulty, while the aneurysms in common iliac and internal iliac were opened with partial excision or obliterated with endoaneurysmorrhaphy. Arterial reconstruction was performed using saphenous vein graft or synthetic vascular graft, excepting that the internal iliac artery itself was not reconstructed. The early operative results were satisfactory, but late results showed two death and three complications of cardiovascular system. Therefore, careful follow up of the postoperative patients was recommended.

Introduction: The diagnosis of cancer-related neuropathic pain is often difficult for non-pain medicine specialists. We examined whether a Japanese version of a neuropathic pain screening questionnaire (Japan-Q), which was developed for chronic pain, is appropriate for screening cancer-related neuropathic pain. Methods: Our palliative care team screened 104 patients from May 2014 to December 2015 and compared total points of the Japan-Q with diagnosis of the type of cancer pain by specialized pain clinicians. Validity was evaluated using a receiver operating characteristic (ROC) curve. Results: The area under the ROC curve in terms of the total score, sensitivity, and specificity for the Japan Q was 0.82, which indicated a moderate level of diagnostic accuracy. A cut-off value of 3 points was shown to be best (sensitivity: 79%, specificity: 82%). When a cut-off value of 9 points was used as the diagnostic criterion for neuropathic pain, there was greatly reduced sensitivity (sensitivity: 40%, specificity: 97%). Conclusion: Although the Japan-Q shows moderate diagnostic accuracy related to cancer pain, the cut-off value for this tool is lower than that for chronic pain. Cancer-related neuropathic pain should be suspected with a total score of 3 or more in the Japan-Q.