Recently, varieties of medical instruments have been developed and improved upon rapidly along with the progress of medicine. However, the advent of many types of new devices sometimes creates confusion on the clinical scene. The central supply system of medical instruments may be effective in reducing medical troubles and accidents, through centralized maintenance, check and repair stuff education and enlightenment.
In our hospital, the central supply room of medical instruments was established in April 1993 to try to reduce the costs and troubles. We have somehow managed our system by trail and error for eight years. Recently, many people who have any relationship with us have come to rate our system highly. We will try to make a further effort to establish a better supply system.

The purpose of this study was to determine the influence of a 6-month unsupervised, flexible and fairly light intensity walking program on endurance fitness, strength, lipids and lipoproteins and bone health in a group of middle-aged sedentary women. Six pre-menopausal and 8 post-menopausal women, aged 54 yr, served as the walk training group (W) and 9 women (2 post-menopausal), aged 49yr, served as controls (C) . W walked an average of 10, 000 steps per day for 6 months, which included an average of 5, 000 steps of brisk walking for 30 min, 4 to 5 days per week. Workloads, heart rates and double-product break point (during incremental maximal ergometer exercise), body weight and %fat, serum lipids, leg strength and bone density (by ultrasound) and induces of bone metabolism were measured at baseline and after 3 and 6 months. Walk training in W resulted in a significant improvement in maximal workload during the exercise test compared with C. Double product break point in W during exercise significantly shifted towards higher workloads and resting heart rate was reduced. Isokinetic muscular strength of leg extensors and abdominal muscular endurance measured by situps were also significantly increased in W. Estimated calcaneal bone density showed a tendency to increase after 6 months of training in W. Indicators of bone resorption and growth remained unchanged. Changes in serum lipids and lipoproteins were also favorable, but not significant. In conclusion, these results show that a flexible and self-regulated walking program is sufficient to elicit improvements in cardiovascular endurance, aerobic capacity measured by DPBP and strength of leg and abdominal muscles. Bone strength and serum lipids were not clearly improved after 6 months with this walking program. If training time were extended to 12 months, significant improvements in these measures can be expected because tendencies toward improvements were observed.

Objective: In this study, we evaluated distinctive types of physical predisposition in patients with common side effects.
Method: We selected 500 and 1,200 individuals with and without a previous diagnosis of side effects, respectively, through web-based research.  Then, we conducted a decision tree analysis for investigating the status of 100 types of physical predisposition in these individuals.
Results and Conclusion: The individuals who had suffered from hepatic disorder and answered “relevant” for “predisposition to swelling” (likelihood ratio of a positive result [LR+] 2.17; p=0.004) and “very relevant” for “predisposition to skin dryness” (LR+ 3.52; p<0.001) enhanced the probability of extracting individuals who developed side effects.  The individuals who had suffered from skin disorder and answered “relevant” for “predisposition to eczema and inflammation” and “not relevant” for “predisposition to higher temperature” had an LR+ of 2.22 (p<0.001).  The individuals with “predisposition to worsening of physical condition on a rainy or high-humidity day” are more likely to develop side effects with the use of antibiotics and NSAIDs, compared to those without this predisposition (antibiotics: LR+ 2.33; NSAIDs: LR+ 2.51).  The results of this study indicate that we can identify patients with a high risk of side effects through an interview on predisposition.

Horseshoe kidney is an unusual abnormality occurring in 0.25% of the population. In surgery for AAA with horseshoe kidney, reconstruction of aberrant renal and preservation of renal isthmus is important. We report 3 cases of AAA with horseshoe kidney treated successfully without division of the isthmus.

Although there are a number of reported cases of increased cerebral blood flow during exercise, there are no reports on the relation between changes of blood flow during exercise and attentional function. The purpose of this study is to clarify the relation between changes of blood flow during exercise with AT intensity and attentional function, using near-infrared spectral analysis. The subjects were 10 healthy males. The research protocol was to conduct steady load exercise. We randomly conducted two invention trials: 1) an exercise/task trial in which a trail making test (TMT) was performed as an attentional assignment during steady load exercise, and 2) a rest/task trial in which TMT was performed during rest as a control. As a result, we observed the following: increase of oxy-Hb in the prefrontal cortex during AT exercise, the significant shortening of TMT during exercise from 69.1±10.2 seconds to63.2±7.2seconds, and, with further control, that the more oxy-Hb rises, the more TMT time is shortened. From these results, it is suggested that 10 minutes of exercise would improve attentional function, and furthermore, there is a possibility that increased cerebral blood flow may be involved with the improvement of attentional function.

Objective : There are two types of studies on the relationship between adverse events and genetic background and the relationship between constitution and genetic background.  To investigate the relationship between adverse events and constitution retrospectively, we first reviewed the appearance of the constitution responsible for the adverse events in the relevant sources of information.
Methods : Fifty two pharmaceutical interview sheets, 150 case reports and two manuals; “jyudaina fukusayou kaihi notameno fukuyaku sidou jyouhousyu”, “jyutoku fukusayou sikanbetu manual” were selected for review.
Results : Fourteen items about the constitution were found in the pharmaceutical interview sheets.  No items about the constitution were found in the case reports and manuals.
Conclusion : Rules for the preparation of pharmaceutical interview sheets and case reports to use the constitution information is necessary for retrospective analysis of this issue.

The working group to improve foreign language education in medical schools established in 1994 and chaired by K. Uemura, M.D. sent questionaire about their present curricula and future plans for teaching English to the deans of all 49 public and 31 private medical schools from January 9 to March 9, 1995, and collected the responses from 30 (61.2%) public, 24 (77.4%) private, in total 54 (67.5%) medical schools. The teaching of useful English includes English conversation in 37 (68.5%), medical English in 34 (63.0%), and structures of medical papers in 9 (16.7%) schools. Medical English is also taught as extracurricular and other activities in 40 (74.1%) schools. These figures have increased as compared with the ques-tionaire conducted two years previously. English conversation can be taught to junior (1st & 2nd yrs) students, for whom medical English can only be taught on general medical topics such as the medical care delivery system, bioethics, roles of physicians, and primay care. Therefore medical English is more and more taught to middle-class (3rd & 4th yrs) and senior (5th & 6th yrs) students. It seems necessary to annually conduct a workshop for medical English teachers to improve their strategies of teaching.

The working group to improve foreign language education in medical schools established in 1994 and chaired by K. Uemura, M.D. here proposes a model curriculum for teaching useful English in medical schools at three levels. The major objectives are listening, speaking, rapid reading, and sentence structuring including paragraphing for junior (1st & 2nd yrs) students, reading medical papers and charts in English, structures of medical scientific papers, and listening to medical English for middleclass (3rd & 4th yrs) students, and writing and orally presenting papers in English on given medical subjects are for senior (5th & 6th yrs) students.

The Working Group for the Improvement of Foreign Language Education in Medical Schools in Japan, organized in 1994 and chaired by Prof. K. Uemura, M.D. lists here English teaching materials for medical purposes. More than half of the materials listed are those that one of the group members, T. Ohki, has used or wants to use in his classes. The list has been enlarged due to the responses to the questionnare sent to those who participated in the first workshop held in 1995. The list is divided into 12 categories: listening & reading, writing, medical terminology, pronunciation, textbooks for training the four skills, essays on medicine, fictional stories about medicine & medical doctors, medical ethics and terminal care, handbooks for medical students and doctors, writing medical charts, self-teaching materials. and video materials.
It is hoped that the materials listed here will supplement a model curriculum for teaching ‘useful’ English in medical schools, as proposed by the working group.