The authors encountered 2 rare cases of adventitial cystic disease of the popliteal artery. Case 1 was a 51-year-old woman with dull pain in the lower limbs during walking. Case 2 was a 34-year-old man with numbness in the lower limbs on bending his knees. In both cases, angiography showed crescent stenosis, and computed tomography (CT) showed cyst-like lesions about the artery. Magnetic resonance imaging (MRI) indicated the lesions to have high density at T 2 imaging. With a diagnosis of adventitial cystic disease, cystectomy was conducted with satisfactory results. Adventitial cystic disease is rare and only 43 cases have so far been reported in this country. All of these were reviewed to clarify the characteristics of this disease. Its clinical symptoms often resemble those of arteriosclerosis obliterans (ASO) as intermittent claudication, but it differs from ASO in that it is usually achieved cure by cystectomy alone and seldomly required bypass operation. In the case of intermittent claudication in young patients, adventitial cystic disease should be diferrentiated from ASO.

The incidence of fluorosis, believed to arise from the burning of coal, has been frequently reported in the highlands in the southern part of China. With a lot of rain and a climate of low temperature, the hilly region produces coal and inhabitants use it as a fuel for cooking and heating. The fossil fuel used by them is mostly powdery. It is mixed with dirt and rolled up into bolls. In that way,the people make the briquettes that burn a long time.Ordinary houses have no chimneys to belch forth smoke, so that it stagnates indoors for a while. Soot and smoke, before flowing out via the openings in the roof shingle of the loft, spoils farm produce stored there. Because the smoke contains high concentrations of fluoride derived from coal and dirt, it is believed that eating farm produce exposed to the smoke is one of the major factors for fluoride poisoning. Many researchers have thus far analyzed farm products for fluoride content and confirmed that high levels of fluoride were contained in their samples.In the present study, we measured fluoride concentrations in some samples of corn and capsicum produced in a rural area of Sichuan, China on one hand and on the other examined the water-solubility of fluoride. Furthermore, screening tests for chronic endemic dental fluorosis were performed on students to survey the fluoride contamination in the past as compared with the present state.Incidentally, indoor air-borne fluoride concentrations in this area averaged out at0.047mg F/m3 (15 times as high as the mean in a community that was free of fluoride contamination). The fluoride content of the drinking water from a spring in the nearby hill, measured with use of a fluoride-specific electrode method,was within the range from 0.2 to 0.3μg/ml.
Fluorides ; Fluoride measurement ; China ; Coal ; Levels

Statistical analyses were made on a total of 242 clinical cases of skin disordersfrom agricultural chemicals in Japanese farmers, using data recorded by physicians on standard forms in 41 hospitals and other medical institutions during the 1982-89 period. The majority of the cases were acute dermatitis (72.3%), followed by chronic dermatitis (19.0%), chemical burns (7.4%) and photosensitive dermatitis (2.1%). Organophosporus insecticides were the most frequent inducer of occupational skin lesions (24.8%), followed by sulfur fungicides (20.7%), polyhaloalkylthio-fungicides (16.1%), and soil disinfectants (7.9%). Main factors contributing to the onset of skin lesions were insufficient clothing on the part of users (46.7%), carelessness (21.9%), unsuitable weather (strong wind) (9.9%) and so forth. Epidemiological features such as sex, age, season, complications, affected sites and prognoses were also analyzed and discussed.

A total of 630 clinical cases of occupational skin disorder from agricultural chemicals werestatistically analyzed in Japanese farmers who were recorded by physicians on a standard form from41 hospitals and other medical institutions during the 1972-81 period. The majority of the cases wereacute dermatitis (66.7%). This was followed by chronic dermatitis (24.3%), chemical burns (8.4%) andphotosensitive dermatitis (2.2%). By type to chemicals, the number one skin hazard was sulfurfungicides (32.2%), followed by organophosphorus insecticides (28.6%), polyhaloalkylthio-fungicides (11.4%), and copper fungicides (7.1%). Factors contributing to the onset of any disorder of the skinwere mainly defenseless on the part of users (41.3%), carelessness (20.2%), poor health condition(14.6%), and so forth. Other epidemiological features by sex, age, season, complications, sites of skindisorder, prognosis, etc. were also analyzed and discussed.

A China-Japan joint project was carried out to study the incidence of fluorosis caused by coal burning in China from 1995 to 1997.
The health survey covered a control area and two flourosis areas. In those research areas, drinking water was not polluted with fluorides. The survey was designed to analyze the health status of people exposed to fluorides and evaluate the relationships between the dose and incidence of fluorosis. The concentration of airborne pollutants in both indoor and outdoor air was measured. The concentration of fluoride in the urine was analyzed and definite diagnoses for dental fluorosis and skeletal fluorosis were determined.
As a result, the incidence of coal burning fluorosis was confirmed in studied areas. Moreover, the fluorosis was caused not only by the direct inhalation of the airbone fluorides in indoor air but also by the intake of cereals polluted with fluorides. Fluoride was contained in both coal and soil. Therefore the mixture of coal and soil used for the adjustment of fire energy contributed to the air pollution to a great extent. The typical polluted crops were red pepper, corn and potato. An extremely high concentration of fluoride in the urine of residents in the polluted areas was detected.

In the 2022 revision of the Model Core Curriculum, a new "Educational Strategies and Assessment" section was added as a further development in outcome-based education. By adding a chapter on strategies and evaluation, which is an important element of the curriculum, and linking it to qualities and abilities, we have devised a way for learners and instructors to make use of the Core Curriculum more easily. In addition, 11 example of strategy and assessment cases are included as Good Practice to encourage practical application. However, since these are only examples, we hope this chapter will be further developed as universities create strategies and evaluations that make the most of their unique characteristics.

BACKGROUND: The number of adults aged over 65 years is rapidly increasing in several Southeast Asian countries. Muscle mass decreases with age, leading to sarcopenia. The primary objective of this study was to determine whether differences exist in the body composition and physical strength, according to ethnicity, among community-dwelling Japanese and Thai older adults living in Chiang Mai Province, Thailand. METHODS: A survey was conducted in February and March 2019. Japanese and Thai adults aged ≥ 60 years living in Chiang Mai Province were recruited through community clubs. Participants completed a self-administered questionnaire that enabled collection of data on age, sex, educational background, marital status, annual income, current medical conditions, smoking and alcohol consumption, and exercise habits. Measurements were collected on height, weight, body composition, blood pressure, hand grip, and walking speed for 6 m. Body composition was measured using a standing-posture 8-electrode multifrequency bioimpedance analysis analyzer. Hand grip of each hand was measured with the patient in the standing position using a digital grip dynamometer. Multivariable logistic regression was used to determine factors associated with skeletal muscle mass index (SMI). RESULTS: Of the total 119 participants, 47 were Japanese (26 men, 21 women) and 72 were Thai (16 men, 56 women). The prevalence of a low SMI was 3/26 (12%), 1/21 (5%), 6/16 (38%), and 5/56 (9%) among Japanese men, Japanese women, Thai men, and Thai women, respectively. The prevalence of low muscle strength was 2/26 (8%), 2/21 (10%), 3/16 (19%), and 13/56 (23%) among Japanese men, Japanese women, Thai men, and Thai women, respectively. There were significant differences between ethnic groups in body mass index for both sexes, percentage body fat in women, SMI in men, and average grip strength in men. Ethnic group, sex, age, and body mass index were independent predictors of SMI. CONCLUSIONS Ethnicity had a clinically important effect on body composition and physical strength among older Japanese and Thai adults living in a similar environment.
Aged ; Aging/physiology* ; Asians/ethnology* ; Body Composition ; Body Mass Index ; Cross-Sectional Studies ; Electric Impedance ; Ethnicity ; Female ; Hand Strength ; Humans ; Independent Living ; Male ; Middle Aged ; Muscle Strength ; Thailand/ethnology* ; Walking Speed

Following the revision of the structure and content of the Model Core Curriculum for Medical Education to be more outcome-based and the legal status of the medical practice performed by medical students in the clinical clerkship, we have revised the Guideline for Participatory Clinical Clerkship. The following items were revised or newly described : significance of enhancing the participatory clinical clerkship, scope of medical practice, confidentiality, patient consent, patient consultation and support service, objectives of the clinical clerkship, simulation education, departments where the clinical clerkship is conducted, assessment in the clinical practice setting, CC-EPOC, and entrustable professional activities. A foundation has been established to promote seamless undergraduate and postgraduate medical education. However, future work is needed to examine the specific level of performance expected at the end of the clinical clerkship and department-specific clinical practice goals and educational strategies.