[Objective]In clinical practice, it is important that patients experience symptomatic improvement or at least gain a certain level of satisfaction early on during a series of treatments. Most patients decide whether or not to return to the clinic based on these factors. At our school, students are trained in protocols from three different treatment styles:modern acupuncture, meridian acupuncture (based on classic acupuncture) and traditional Chinese medicine. In this study, we investigated the characteristics of each style, such as the presence of immediate effects and the types of sensations perceived by patients.
[Methods]Questionnaires were given before and after treatment to 177 patients who came to the clinic associated with our teacher training course for acupuncture, moxibustion and massage. We received valid responses from 169 patients. The practitioners surveyed were second-year students who had treated the surveyed patients 1.2 times on average prior to answering the questionnaire. Before treatment, patients were asked about their main complaints and symptoms, and afterward about changes in their symptoms, satisfaction level and other sensations. The resulting data was subjected to statistical analysis.
[Results]The style chosen by most practitioners was modern acupuncture, followed by meridian acupuncture, and then traditional Chinese acupuncture. Most lower back, leg and joint pain was treated with modern acupuncture protocols, while internal disorders were more often treated with meridian acupuncture or traditional Chinese acupuncture. All three styles were able to alleviate symptoms and achieve patient satisfaction with no statisticallysignificant differences among the three groups.
[Discussion]The results demonstrated that training practitioners in these three styles for one year helped them achieve positive and immediate effects. While there are many different styles of acupuncture, in actual clinical practice, the style is less important than how much a patient feels the effect of the treatment.
[Conclusion]All three styles, modern acupuncture, meridian acupuncture and traditional Chinese acupuncture, were able to alleviate symptoms and achieve patient satisfaction with no statistically significant differences among them.

The Consensus of this Committee is:

1) To change the name of the present committee from "Premedical Education Committee" to "Committee on Behavioral and Social Science" ; accordingly to discuss theoretical foundations, clinical application, learning objectives and outcomes of behavioral and social science in Japanese medical schools.

2) To collect actual case studies of teaching behavioral and social sciences in Japanese medical schools and create a database for such practices.

3) To develop behavioral and social science curriculum content in Japanese medical schools.

4) To organize training courses for teaching methods for behavioral and social science curricula and develop standardized teaching methods and materials.

During the perioperative period after total hip arthroplasty (THA), much attention has been recently paid to deep venous thrombosis, yet there are few reports concerning stroke after THA and there is no such data at all in Japan at present. The purpose of this retrospective study was to elucidate the occurrence rate and the characteristics of stroke cases during the THA perioperative period. A total of 1,551 primary THAs performed between January 1999 and December 2008 were investigated. Cerebral infarction occurred in three patients (0.19%) during three weeks after THA. Concerning the related factors, one male had foramen ovale, one female had untreated diabetes and atrial fibrillation, and one female had severe stenosis of the internal carotid artery. Cerebral infarction occurred at Day 1 in one male, at Day 2 in one female, and at Day 5 in the other female, and they underwent anticoagulant therapy just after their diagnosis. In all three patients, motor paralysis fully improved and they came back to the THA rehabilitation program within Day 9. One male was discharged at 4 weeks, and another two females were discharged at 8 weeks. Because many people eating a more European diet are now getting older in Japan, prophylaxis for not only DVT but also stroke after THA should be emphasized.

A 77-year-old man was hospitalized for a proximal anastomotic aneurysm 9 years after surgery for an abdominal aortic aneurysm. The aneurysm was located 3cm distal to the renal artery. The maximum diameter was 55mm. His medical history included a reoperation for the proximal anastomotic aneurysm and cerebral infarction. Endovascular stent grafting was performed because it was possible anatomically. Postoperatively, no endoleak nor migration were found. At present, the patient is being followed up regularly in the outpatient department. Endovascular stent graft placement can be an effective method for reoperation cases of an abdominal aortic aneurysm, and if it is possible anatomically, it should be attempted.

A 67-year-old man was referred to our department for surgical treatment of ischemic cardiomyopathy. Chest X-ray showed cardiomegaly with a cardiothoracic ratio of 62% and pulmonary congestion. CAG revealed multiple obstructive lesions in the left coronary artery system. LVG and UCG showed ventricular dilatation and dysfunction. ECG showed complete left bundle branch block with a QRS duration of 180ms. He underwent autologous bone marrow cell implantation and biventricular pacing concomitant with coronary artery bypass grafting. He is doing well after 15 months without any complications. Combination with therapeutic angiogenesis and cardiac resynchronization therapy may contribute to the development of new regenerative strategy for patients with severe ischemic cardiomyopathy.