A 55-year old man was admitted to our hospital owing to endograft collapse after TEVAR. He had undergone total arch replacement for acute aortic type A dissection at age 39, and undergone thoracic endovascular aortic repair (TEVAR) for chronic aortic type B dissection at age 54. TEVAR was successfully performed and the false lumen was shrunk. However, one year after TEVAR, computed tomography showed endograft collapse. Technical success was not achieved by the balloon technique to treat endograft collapse, so we performed additional TEVAR. After this procedure, endograft collapse was repaired. The postoperative course was uneventful.

Many patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) complain of respiratory distress, chest pain, and arthralgia even after their recovery. We tried to give saibokuto to a 61-year-old man who has suffered from those symptoms as after effects of COVID-19 for more than 2 months. We report that after administration of saibokuto, almost all symptoms have disappeared within 3 weeks.

Introduction: The aim of this study is to explore career perceptions of male and female medical students.
Methods: Semi-structured interviews to 16 medical students (9males, 7 females) were undertaken.
Results: Qualitative data analysis showed that development of their career perceptions were affected by “gender view”, “interests in medicine” as well as their “perceptions of family”. Specifically, female students in the lower grades felt difficulty in making decisions on career choices due to the conflict between carrying out family responsibilities (e.g., housework and childcare) and interests in medicine. After clinical clerkships, their perceptions of a career were formed in one of two ways: giving priority to family responsibilities or interest in medicine. On the other hand, male students in lower and higher grades consistently gave priority to their interests in medicine for their career choices.
Conclusion: Differing career perceptions between male and female medical students emerged from this study, and supports the need for undergraduate education on gender-equality in society.

 The increase of female physicians and its undeveloped supporting system can be one of the causes of physicians' shortage. Although physicians' marriage/family perceptions and their influences on career choices have been extensively studied, those of medical students are not fully understood. An anonymous questionnaire survey was conducted involving male/female medical students in years 2 and 5 at Gifu University School of Medicine. The results showed that many male/female students hoped to get married, have children, and continue to work in the future, but different perceptions were demonstrated between the sexes with regards to the partners' occupation, working style, and influences of family/marriage perceptions on students' specialty choice. The results suggest the presence of sex-related differences in perceptions among medical students. The survey indicates the necessity of early undergraduate education for a better mutual understanding of gender issues.

Continuing medical education for the general practitioners has been activery performed. The former committee for continuing medical education of the Japan Society for Medical Education reported the objectives of continuing medical education for general practitioners. The present committee proposed learning strategies for continuing medical education for general practitioners in accordance with specific behavioral objectives of the curriculum.
It was postulated that appropriate learning strategies are necessary for physicians to provide holistic medical care in their communities, in addition to improving their medical knowledge and skills.
Learning strategies in the curriculum were also coordinated with the continuing medical education system of the Japan Medical Association.

The aim of this study is to clarify the definition and recognition on continuing medical education for administrators (or leaders for residents) of 80 university hospitals and 266 clinical training hospitals as designated by the Ministry of Health and Welfare, using the questionaire consited of 5 main questions, as following:
1) On the curriculum (program) of continuing medical education in their hospitals.
2) On the continuing medical education system of Japan Medical Association.
3) On the continuing medical education activity of the specified academic societies.
4) On guide of continuing medical education for the residents.
5) On definition of continuing medical education.
Answers to a questionaire were returned from 227 institutions (65.6%)
Analyzing the results, present situation of program curricula for continuing medical education in hospitals, participation to continuing medical education system of Japan Medical Association and Academic Societies, and consideration on continuing medical education as a hospital leader were comprehensible.

This study aimed to validate the usefulness of parent artery complex coil protection for the treatment of wide-neck, side-branched, and ruptured aneurysms. A microcatheter was first introduced into the aneurysmal sac, and another microcatheter was introduced into the parent artery or near the orifice of the branch artery. A framing coil was deployed partially from the first microcatheter, and a protection coil was deployed from the second microcatheter to prevent protrusion of the first framing coil to the parent artery and side branches. After the first framing coil insertion, the protection coil was withdrawn to confirm the stability of the framing coil and blood flow. The procedures with this technique were successful for 3 patients. Parent artery complex coil protection can be an effective and safe coil embolization technique for the preservation of parent and side branch arteries and an alternative method for emergent ruptured cases.

Background: The lack of clarity regarding the significance of engaging in research activities during a clinical career has been identified as a contributing factor to the trend of decreasing research involvement among young physicians.　Methods: A mixed-methods study was conducted within a clinical department of a private university to investigate physicians' perceptions of the correlation between research experience and clinical competency.　Results: Quantitative analysis of survey data indicated that physicians acknowledge the contribution of research activities to their clinical competency. Qualitative data revealed subjective perceptions among participants regarding these contributions.　Conclusions: This study highlights that physicians recognize research activities as an opportunity to enhance their clinical competency. Clarifying the relationship between research activity and clinical competency is expected to support the development of more effective research programs aiming at improving physicians' clinical competency.

The Saku Central Hospital classified muscular relaxants, potassium products and the like as “high-risk medicines”, but when it came to insulin, did not take any standardized measure against it to prevent accidents. Having organized a team of personnel from a wide variety of job, our hospital has recently carried out a campaign for improvements in medical care. With pharmacists playing a leading role, we grappled with measures for the prevention of errors in the administration of insulin using quality control (QC) methods. As a consequence, the campaign served to decrease the number of medical mistakes. As there still occur many incidents involving medication, the role played in risk management by pharmacists remains significant. In future, pharmacists will hopefully play a constructive role in risk management to prevent medical incidents involving medical supplies. That said, a campaign for improvements inmedical care through the practical use of QC methods seems likely to bring about favorable results.
Role ; Quality Control ; Analysis ; Avoidance ; ERROR

STUDY DESIGN: Retrospective chart review. PURPOSE: A comparison of mini open foraminotomy (MOF) for cervical radiculopathy using either large tubular (LT) or TrimLine (TL) retractors. OVERVIEW OF LITERATURE: Posterior foraminotomy relieves compression of the cervical nerve root in radiculopathy patients. However, invasion of the paravertebral muscle may cause major problems in these patients. To address these problems, we performed MOF. METHODS: Twenty cervical radiculopathy patients (16 male and 4 female) who underwent MOF between May 2004 and August 2011 were assigned to LT and TL groups. Each group contained 10 subjects. Surgical and clinical outcomes were compared. RESULTS: The average operating time in the TL group was significantly shorter than that in the LT group. The final follow-up mean neck disability indices significantly improved compared to the preoperative values (LT group, 12.0+/-7.8 vs. 28.0+/-9.4; TL group, 6.0+/-5.9 vs. 21.9+/-10). The final follow-up neck pain visual analog scale (VAS) scores also decreased significantly from the preoperative of 8.0+/-1.5 and 2.5+/-2.5 to the final follow-up values of 2.2+/-2.2 and 1.0+/-2.5 in the LT and TL groups, respectively. The recovery rate for the neck pain VAS score was 70.0+/-31.9 in the LT group and 87.0+/-32.0 in the TL group, thus suggesting no significant difference between the two groups. CONCLUSIONS: MOF with the TL retractor is an easy and safe procedure. Furthermore, the use of the TL retractor allows for a minimally invasive and effective surgical treatment of cervical radiculopathy patients.
Follow-Up Studies ; Foraminotomy* ; Humans ; Male ; Neck ; Neck Pain ; Radiculopathy* ; Retrospective Studies ; Visual Analog Scale