Background: Although problem–based learning （PBL） tutorials have widely been used in many medical schools, they are rarely used to enhance the effectiveness of clinical clerkships.
Methods: We used a questionnaire survey to evaluate the effectiveness of PBL tutorials during the clinical clerkships of 5th–year medical students.
Results: Of the 91 students, 90％ answered that PBL tutorials during clinical clerkships were considerably useful, and 94％ favored using PBL tutorials during clinical clerkships. All responses to the open–ended question regarding the usefulness of PBL tutorials stated that PBL tutorials were more useful during clinical clerkships than in the 2nd to 4th years. Many students felt that PBL tutorials helped them understand the processes of clinical reasoning and decision–making.
Conclusion: PBL tutorials increase the effectiveness of clinical clerkships, and, at the same time, the experiences of clinical clerkships increase the effectiveness of PBL tutorials.

Objective: To develop an effective and safe therapeutic strategy, we studied the effect of the clinical characteristics of patients with acute drug intoxication on the duration of hospitalization.
Subjects and Methods: The subjects were 89 patients hospitalized for acute drug intoxication. They were divided into two subgroups; the short hospitalization group (duration of hospitalization < 7 days) and the long hospitalization group (duration of hospitalization ≥ 7 days). We compared age, sex, vital signs, drugs, and therapy between the two groups.
Results: There were no significant differences in sex or severity of consciousness disturbance between the short- and long-hospitalization groups. Age in the latter group was higher than that in the former, and age was significantly and positively correlated with the duration of hospitalization. Prolongation of hospitalization in patients with Japan Coma Scale (JCS) I or II is associated with psychiatric disease, and in patients with JCSIII, with physical disease. We used direct hemoperfusion (DHP) to treat patients with severe acute drug intoxication. The duration of hospitalization in patients treated by DHP tended to be shorter than those not so treated.
Conclusions: The present results suggest that aging is associated with prolongation of hospitalization and the onset of physical disease among patients with acute drug intoxication. When elderly patients with acute drug intoxication are treated in a primary-care setting, the question of whether or not physical diseases are present as complications should be considered. The appropriate use of DHP for the treatment of patients with severe acute drug intoxication requires further study.