Case: A 62-year-old woman underwent high anterior resection and partial lobectomy for colon cancer and lung metastasis, respectively, and postoperative chemotherapy. During the follow-up period, she visited the Department of Otolaryngology at our hospital, complaining of expectoration of a mass. Laryngeal fiberscopy showed no abnormality, but thoracic computed tomography revealed nodular lesions protruding into the bronchial lumen. Bronchoscopy confirmed the presence of multiple granular nodules protruding from the bronchial wall. The nodules had a polyp-like appearance and were easily dissected or detached. Anti-cancer drug therapy was initiated for endobronchial metastases from colorectal cancer diagnosed in transbronchial biopsy. Conclusion: This was a rare case of endobronchial metastases that were discovered after expectoration of tumor masses. Bronchoscopic findings were extremely unusual, showing multiple tumors that were easily detached because of their extremely weak connection to the bronchial wall. The findings suggest that it is important to consider endobronchial metastasis from colorectal cancer and perform early diagnostic imaging and bronchoscopy when patients present with recurrent expectoration of masses after surgery for colon cancer.

The usefulness of individual care of patients in the attitude education of undergraduates was evaluated with questionnaires completed by 4th-year medical students and patients. Ninety-eight percent of students finished performing patient care during a 2-week period. Seventy percent of patients completed questionnaires. The appearance, manner of greeting, and language of the students were considered good by 87% or more of the patients, and the students' consideration for the patients' safety, privacy, and communication was considered good by 86% or more of the patients. The practice was approved by 77% of the patients and was objected to by none. Ninety-nine percent of students completed questionnaires, and 79% of the respondents approved of the practice. Fourteen percent of the student respondents, many of whom had been treated as outpatients, objected to the practice. These results suggest that individual care of patients by medical students is useful for both patients and students.

We analyzed the scores of objective structured clinical examinations (OSCEs) and written examinations administered to fourth-year medical students after practical training in clinical skills and to fifth-year medical students after clinical training and scores of graduation examinations taken by sixth-year medical students. Correlations were analyzed among the scores of 96 students who had taken all 3 examinations during a 3-year period. Mean scores on examinations in the fourth, fifth, and sixth years were compared between sixth-year students who did or did not graduate and between graduating students who did or did not pass the national examination for medical practitioners in Japan. Significant correlations in the scores were found between 1) OSCEs and written examinations for fourth-year students versus those for the fifth-year students; 2) OSCE and written examinations for fourth-year students versus graduation examination scores for the sixth-year students; and 3) OSCE and written examinations for fifth-year students versus graduation examination scores for sixth-year students. In addition, the mean scores in the fourth and fifth years were significantly higher for sixth-year students who graduated and passed the national examination than for students who did not graduate or who graduated but failed the national examination. These results suggest that the practical training in clinical skills given to fourth-year students and the clinical training given to fifth-year students strongly affect the overall evaluation of the ability of sixth-year students and success on the national examination.