Fish sausage is a common food in Japan. It is mainly made from surimi, which contains a high amount of fish protein. Although it has been reported that the administration of fish protein reduces blood total cholesterol, LDL-cholesterol, and triglycerides in experimental animals, it has not been studied whether the intake of fish protein improves blood cholesterol profiles in humans. In the present study, male subjects (n = 20) with fasting blood LDL-cholesterol (140–179 mg/dL) were enrolled. Subjects consumed a total of 225 g of fish sausage daily for 8 weeks, and the total ingestion dose of fish protein was 13.5 g/day. Blood total cholesterol, LDL-cholesterol, and atherogenic index were significantly reduced (p < 0.01, p < 0.05, and p < 0.01, respectively), and HDL-cholesterol was significantly increased (p < 0.01) by fish sausage intake after 4 and/or 8 weeks of intervention without side effects. These results imply that the short-term intake of fish protein achieved by the eating of fish sausage improves cholesterol profiles in hypercholesterolemia subjects.

Introduction: In Japan, the number of female physicians is increasing rapidly. Therefore, surveying female physicians about their current working status, especially about their continuing to work, is important.
Methods: In September 2009, we sent a questionnaire regarding working status to 1403 female physicians who had graduated from Okayama University Medical School or who were working at university-affiliated hospitals or facilities at the time of investigation.
Results: Of the 420 female physicians who responded （response rate, 29.9％）, 46.6％ （n＝191） had left their jobs at some time, and 92.4％ （n＝171） of them had done so within 10 years after medical school graduation. The most common reason for leaving their jobs was childbirth／childcare, and the second most common was their husband’s job transfer. Of those who had ever left their job, 82％ （n＝151） wished to return to work at the time of their leaving. Only 27.2％ （n＝74） took childcare leave.
Discussion: Female physicians have trouble continuing their clinical work and developing their careers while caring for children. A system should be developed to support physicians who wish to continue their clinical work during life events, such as childcare. In particular, career support during the first 10 years after graduation from medical school is extremely important.

Introduction: In Japan, the number of female physicians is increasing rapidly. The importance of education focused on career development and the work-life balance is increasingly being recognized.

Methods: In February 2008, we sent a questionnaire regarding the working status and life events to 1,374 female physicians who graduated from Okayama University Medical School or who were working at university-affiliated hospitals and facilities at the time of the investigation.

Results: Of the 376 respondents (26.8% response rate), we analyzed 360 respondents whose specialty is clinical medicine. Among them, 75.9% (n=269) of female physicians have partners, 70.2% (n=233) have children, and most of the female physicians experience these life events from age of 25-29 years. Although 82.1% (n=216) regarded the timing of their marriage as appropriate, 65.2% (n=144) regarded it as appropriate about having first child. Of the 174 respondents who returned to clinical work, 32.2% (n=56) returned to the same position as a full-time worker, and 27.6% (n=48) changed their position from full-time to part-time. Important factors to return to work easily, 〈understanding from their supervisors〉, 〈support from their family〉, and an appropriate amount of work were the top three reasons.

Discussion: It is important to educate medical students about career development based on the life stage and work-life balance for gender equality in medicine.

Introduction: We started the gender-specific clinic for women to provide sufficient treatment for female patients. The purpose of this study was to clarify the characteristics of patients using the gender-specific clinic for women, and to assess the association among depression, physical and mental subjective symptoms.Methods: This observational study included female patients aged 16-84 years who visited our clinic between June 2012 and December 2015 (N=97). In addition to general attributes, we collected data on physical and mental symptoms, and depression status using the Cornell Medical Index (CMI) and Self-rating Depression Scale (SDS), respectively, at the first visit. We conducted analyses to assess patient characteristics and the association between subjective symptoms and depression, and between physical and mental symptoms by estimating odds ratios (ORs) and 95% confidence intervals (CIs).Results: The average age of subjects was 50.4 years. The average CMI score was 42.7 points and 55.9% of the subjects were suggested to be neurotic. The average SDS score was 45.0 points and 64.0% of them were suggested to be depressed. The association with depression by SDS was observed in subjective symptoms of CMI such as fatigue (OR [95%CI]: 7.66 [2.26-25.99], p-value: 0.001) and anxiety (OR [95%CI]: 11.73 [1.80-∞], p-value: 0.006). Physical symptoms in the cardiovascular system were positively association with some mental symptoms such as tension.Conclusion: As female patients often have mental symptoms, it is essential for doctors engaging in gender-specific medicine for women to approach patients while considering psychological and mental aspects.

　　This study investigated data on cardiopulmonary exercise testing (CPX) indices in order to estimate exercise intensity and ramp load from maximum walking speed (MWS) in elderly hospitalized patients with acute coronary syndrome (ACS). Subjects were 66 male patients hospitalized with ACS (49 young-old patients and 17 old-old patients). We measured exercise intensity by CPX using a cycle ergometer and MWS over 10 m, and examined the patients’ clinical characteristics. Stepwise multiple regression analysis was performed to identify variables that most closely predicted exercise intensity. We then estimated the ramp load from the relationship between exercise load at anaerobic threshold and MWS. The results indicated that MWS was an independent predictor of exercise intensity in old-old patients (adjusted R²=0.278, p=0.037) but not in young-old patients. The regression formula predicted the proper ramp load to be 5 and 10 watts as MWS was less than 1.5m/s or more than 1.5m/s, respectively. MWS was related to exercise intensity and could be used to consider the ramp load in CPX in old-old male patients with ACS.

Purpose: To compare the effects of aging in patients with acute myocardial infarction (AMI) on their clinical background and hospitalization progress, and to examine the relationships between age and these factors.
Subject: One hundred and fifty-three patients who experienced cardiac rehabilitation after percutaneous coronary intervention (PCI) (63.8±11.1 y.o, 126 men, 27 women).
Method: The patients were divided into the middle aged group (<65 y.o, n=84), young old group (65 to 74 y.o, n=44), and old group (75 y.o≥ n=25). The differences between groups were examined in respect of 13 items about clinical backgrounds (responsibility coronary arteries, CKmax, LVEF, residual stenosis, hypertension, diabetes, hyperlipemia, smoking, and BMI) and hospitalization progress (cardiac complications, locomotorium disabilities, abnormality as 200mECG, and duration of hospitalization).
Results: Left veticular ejection fraction (LVEF) was significantly lower in the old group than in the young old group. The old group had a high rate of residual stenosis. In the coronary risk factors, all of the groups had hypertension at a high rate of 54.5% or over. The middle aged group and young old group had diabetes at about 38%. The middle aged group was prone to hyperlipemia, and had significantly a high smoking rate. Body mass index (BMI) was significantly higher in the middle aged group than in the old group. In hospitalization progress, the old group had a high rate of cardiac complications and locomotorium disability. The duration of hospitalization was significantly longer in the old group than in the other groups.
Conclusion: It would be necessary to give middle-aged persons educational guidance for the improvement of the coronary risk factors, and to provide the old persons with the suitable rehabilitation programs considering various complications.