1) In problem-based learning (PBL) tutorials during the2nd year, general symptoms (fatigue, weight change, bleeding, fever, pain, and edema) were chosen as subjects.Changes in the students'way of thinking about how to learn were evaluated before and after PBL tutorials.
2) After tutorials students were significantly more likely to believe that their participation in tutorials was a more effective way of learning. The students'views after tutorials on listening to lectures differed between2006and2007.
3) We conclude that PBL tutorials affect medical students'views about learning.

Takushato is a Kampo formula used for the treatment of dizziness and vertigo. Signs and symptoms suggestive of fluid retention have been regarded as clinical indications for takushato administration, but it is not clear if improvement of these signs and symptoms is related to the clinical efficacy of takushato, so we analyzed the correlation among these factors. Twenty patients who suffered from dizziness and vertigo were treated with takushato for 4 weeks. Before and after treatment, subjective symptoms and objective data including vestibular function tests were assessed, and correlation among the factors was analyzed. Improvement of patients' total symptoms was significantly correlated with improvement of fluid retention scores. Furthermore, improvement in vestibular function tests showed a trend toward correlation with that of fluid retention scores.These results suggest that improvement in the signs and symptoms of fluid retention is related to the clinical efficacy of takushato. We conclude that the presence of fluid retention is a reasonable clinical indication for takushato administration.

Objective: The feasibility of peri-orbital electrodes, which are not invasive and do not induce pain, as a supplemental electrode for detection of ictal discharges in medial temporal lobe epilepsy (MTLE) was examined. Methods: Patients with MTLE, who underwent video-EEG monitoring with simultaneous peri-orbital and sphenoidal electrodes and obtained good outcome following standard anterior temporal lobectomy, were subjects in this study. Initial ictal discharge amplitudes were compared between sphenoidal (Sp1/ 2), standard anterior temporal in 10-20 system (F7/ 8), peri-orbital (superior orbital lateral: SOL, inferior orbital medial: IOM), frontopolar (Fp1/ 2), frontal (F3/4) and ear (A1/ 2) electrodes. Results: A total of 34 consecutive seizures from 20 patients were analyzed, with a maximum amplitude observed at Sp1/2 (57.57±5.59), followed by F7/8 (54.89±5.59), SOL (50.97±5.59), IOM (46.95±5.59), A1/2 (45.07±5.69), Fp1/2 (44.78±5.62), and F3/4 (37.75±5.66) (mean±standard error, μV). There was no statistical difference between Sp1/2, F7/8, SOL, and IOM values. When the sphenoidal electrode was omitted, 13 seizures (13/34, 38.2%) resulted in the highest amplitude at peri-orbital electrodes and 10 seizures (10/ 34, 29.4%) at F7/8. Conclusions: Peri-orbital electrodes could detect ictal discharges in MTLE as well as sphenoidal and standard anterior temporal electrodes in 10-20 system and are useful for supplemental recording for detecting ictal epileptiform discharges in MTLE.

OBJECTIVESSumo wrestling is one of the most popular sports in Japan. Injuries are not uncommon as this is a vigorous contact sport. Sumo wrestlers have little in the way of protective clothing; their main garb is the mawashi, making them prone to exposure to any microorganisms in the dohyo. The bacterial flora of the dohyo has received little attention. If the constituent flora is identified, then appropriate treatment or prevention of any bacterial lesions or infections incurred by the wrestlers is possible.

METHODSThe Vitek AMS system used in this study was developed by McDonnell Douglas Corporation. In this system, the physiological and biochemical properties of Gram-positive and negative bacilli, Gram-positive and-negative cocci, and fungi isolated from clinical materials and environments are examined using test cards specifically for each microorganism group, and the results are automatically read by a computer and encoded. Obtained codes are compared with a built-in database, and bacterial species of test strains are identified.

RESULTSIn this study, using the automatic identification kit VITEK or ATB, we describe the aerobic bacterial flora found in the dohyo over the four seasons of the year. We also investigated the effect of salt on the bacterial flora as sumo wrestlers toss salt on the dohyo before each match. We show the relationship between salinity changes and variations in the flora observed upon the addition of salt. Without salt, at the beginning of a match, Gram-negative bacteria predominate. When salt is added, there is a transient decrease in the incidence of flora followed by an increase in the incidence Grampositive cocci.

CONCLUSIONSSixteen bacterial genera were identified using the bacterial identification systems in dohyo soil samples during the year. The number of identified bacterial species was 32. Even in the presence of salt, there is a measurable amount of bacterial flora in dohyo soil; salt does not act as an antibacterial agent.