Undergraduate medical students in their 5th year were given integrated lectures on two topics, “ The cerebellum ” and “Patient -centered medical care”. The results of a questionaire survey indicated that students had hoped for continuation and expansion of the lectures to include many other topics. A series of discussions among faculty however, disclosed two problems with regard to continuation and expansion, i. e., a lack of experts for integration and lack of adequate means to assess educational impact. Teaching personnel in integrated lectures need not necessarily be experts or professors, but persons who can be in close contact with one another for the purpose of integration. Setting aside rigid discussions on validity, small achievement tests may be useful in assessing the degree of student comprehension.

Increased carotid arterial stiffness is associated with a risk factor of congestive heart failure. Thus factors that affect carotid arterial stiffness are of both physiological and clinical interest. The purpose of the present study was to examine the effects of regular aerobic exercise and menstrual cycle on carotid arterial stiffness in young female. The carotid β-stiffness index, an index of carotid arterial stiffness, was assessed in eight young female athletes (20.5 ± 0.4 years) and ten young female control subjects (21.3 ± 0.7 years). The carotid β-stiffness index was determined using ultrasound images of the common carotid artery with simultaneous recording of carotid arterial blood pressure by applanation tonometry. There was no difference in carotid β-stiffness index between the control and the athlete group both at the early follicular and the pre-ovulation phase of the menstrual cycle. On the other hand, the carotid β-stiffness index decreased from the early follicular phase to the pre-ovulation phase both in the control and the athlete group. These results suggest that carotid arterial stiffness in young females is not affected by regular aerobic exercise, but changes with the menstrual cycle, irrespective of exercise status.

A case of isolated left coronary artery ostial stenosis treated successfully by the saphenous vein patch plasty is reported. A 49-year-old woman was referred for surgery because of unstable angina with subendcardial infarction on ECG. Coronary angiogram showed isolated severe stenosis of left coronary artery ostium without stenotic lesion in the periphery and right coronary artery. At surgery, the aorta was incised obliquely downward to the left coronary ostium and this incision was further extended 8mm distally in the main trunk. Atheromatous left coronary ostium was enlarged with the saphenous vein patch. Postoperatively, angina disappeared and aortic root angioram revealed a well dilated ostium. At 1 year follow-up, the patient remains asymptomatic.

A 68-year-old man was taken to our hospital by ambulance due to syncope. He was in shock with cardiac tamponade. Pericardial drainage was performed. Aortic valve regurgitation gradually increased and surgery was performed at 25 days after onset. Surgical finding showed that there was a detachment of the commissure between the right and non coronary cusps of the aortic valve. An intimal tear was detected in the same place and aortic root replacement was required. The patient had a good recovery and he was discharged 14 days after surgery.

No abstract available.
Pemphigus* ; Psoriasis*

Purpose: To report a case of successful treatment using gabapentin against hot flashes due to LH-RH agonist in a patient with advanced prostate cancer. Case summary: A male patient in his seventies with advanced prostate cancer had hot flashes due to LH-RH agonist therapy. The patient began to notice hot flashes within a few months after starting hormone treatment. Oral gabapentin was administered at a starting dose of 400mg/day and was gradually escalated to 1,200mg/day. Within 7 days of administration, the patient achieved a partial improvement of his symptoms. After 17 days of gabapentin therapy, the hot flashes significantly improved. While the patient was taking a maintenance dose of 1,200mg/day, he remained to be asymptomatic. Conclusion: There are only a few reports (none in Japan) that show effectiveness of gabapentin against hot flashes due to hormone treatment in male patients with prostate cancer. Although the mechanism of the hot flash-relieving effect of gabapentin is not fully understood, this case report indicates that gabapentin may help treating patients suffering from intractable hot flashes. Palliat Care Res 2009; 4(2): 334-338

Since the discovery of the first strain in 1961 in England, MRSA, the most notorious multidrug-resistant hospital pathogen, has spread all over the world. MRSA repeatedly turned down the challenges by number of chemotherapeutics, the fruits of modern organic chemistry. Now, we are in short of effective therapeutic agents against MRSA prevailing among immuno-compromised patients in the hospital. On top of this, we recently became aware of the rise of diverse clones of MRSA, some of which have increased pathogenic potential compared to the classical hospital-associated MRSA, and the others from veterinary sources. They increased rapidly in the community, and started menacing otherwise healthy individuals by causing unexpected acute infection. This review is intended to provide a whole picture of MRSA based on its genetic makeup as a versatile pathogen and our tenacious colonizer.
Adenosine ; Chemistry, Organic ; Chromatography, Micellar Electrokinetic Capillary ; Clone Cells ; Colon ; England ; Fruit ; Humans ; Methicillin ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Sprains and Strains ; Staphylococcus ; Staphylococcus aureus

A 78-year-old woman was referred to our hospital because of progressive exertional dyspnea due to nonrheumatic severe aortic valve stenosis and moderate mitral valve stenosis with mitral annular calcification. We subsequently performed aortic valve replacement and mitral anterior leaflet decalcification. During surgery, we found that the cause of mitral valve stenosis was calcification of A2 aortic curtain-medial trigon through aortic valve annulus and resected calcification with SONOPET. The postoperative echocardiography revealed good mitral valve motion with mild mitral valve stenosis.

Bovine abortion, diarrhea, and respiratory disease complexes, caused by infectious agents, result in high and significant economic losses for the cattle industry. These pathogens are likely transmitted by various vectors and reservoirs including insects, birds, and rodents. However, experimental data supporting this possibility are scarce. We collected 117 samples and screened them for 44 bovine abortive, diarrheal, and respiratory disease complex pathogens by using Dembo polymerase chain reaction (PCR), which is based on TaqMan real-time PCR. Fifty-seven samples were positive for at least one pathogen, including bovine viral diarrhea virus, bovine enterovirus, Salmonella enterica ser. Dublin, Salmonella enterica ser. Typhimurium, and Neospora caninum; some samples were positive for multiple pathogens. Bovine viral diarrhea virus and bovine enterovirus were the most frequently detected pathogens, especially in flies, suggesting an important role of flies in the transmission of these viruses. Additionally, we detected the N. caninum genome from a cockroach sample for the first time. Our data suggest that insects (particularly flies), birds, and rodents are potential vectors and reservoirs of abortion, diarrhea, and respiratory infectious agents, and that they may transmit more than one pathogen at the same time.
Animals ; Birds ; Cattle ; Cockroaches ; Diarrhea Viruses, Bovine Viral ; Diarrhea ; Diptera ; Disease Reservoirs ; Disease Vectors ; Enterovirus ; Enterovirus, Bovine ; Genome ; Insects ; Neospora ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction ; Rodentia ; Salmonella enterica ; Virulence Factors