Acupuncturists should have clinical competency, including knowledge, skill and humanity, such as attitude.
In acupuncture and moxibustion educational institutions, educational objectives and strategies have been established to develop competency as a therapist. Therefore, an evaluation was performed in order to confirm the achievement of the learners, and whether the established initial objectives and strategies were appropriate or not.
As a matter of course, the National Examination for Acupuncture and Moxibustion Therapists is an evaluation standard which assesses the social competency oftherapists completing the educational course, namely they must have significance.
However, the current National Examination can only estimate the aspect of knowledge. Each educational in-stitution should, therefore, responsibly evaluate other acupuncturists' competency including skills and attitudes toward their competency insociety.
In the Objective Structured Clinical Examination (OSCE), an adequate method to evaluate clinicians has widely been introduced for medical education.
The OSCE was introduced to educational circles of acupuncture in Japan because OSCE can evaluate competency; i.e. the psychomotor and affective domain, that is difficult to measure using a paper test.
Various difficulties still remain using OSCE for the education of acupuncture students in the view of both its adequacy and objectivity.
In the present paper, the actual condition and difficulty in using OSCE in education of acupuncture students are reviewed based on the reports presented atthe educational session of the conference.

Background: We assessed the relationship between patient age and remifentanil dosing rate in patients managed under general anesthesia with spontaneous breathing using low-dose remifentanil in sevoflurane. Methods: The participants were patients with an American Society of Anesthesiologists Physical Status of 1 or 2 maintained under general anesthesia with low-dose remifentanil in 1.5-2.0% sevoflurane. The infusion rate of remifentanil was adjusted so that the spontaneous respiratory rate was half the rate prior to the induction of anesthesia, and γH 　(µg/kg/min) was defined as the infusion rate of remifentanil under stable conditions where the respiratory rate was half the rate prior to the induction of anesthesia for ≥ 15 minutes. The relationship between γH and patient age was analyzed statistically by Spearman's correlation analysis. Results: During dental treatment under general anesthesia using low-dose remifentanil in sevoflurane, a significant correlation was detected between γH and patient age. The regression line of y = − 0.00079 x + 0.066 (y-axis; γH , x-axis; patient's age) was provided. The values of γH provide 0.064 µg/kg/min at 2 years and 0.0186 µg/kg/min at 60 years. Therefore, as age increases, the dosing rate exhibits a declining trend. Furthermore, in the dosing rate of remifentanil when the patient's respiratory rate was reduced by half from the preanesthetic respiratory rate, the dosing rate provided was around 0.88 mL/h in all ages if the remifentanil was diluted as 0.1 mg/mL. EtCO2 showed 51.0 ± 5.7 mmHg, and SpO2 was controlled within the normal range by this method. In addition, all dental treatments were performed without major problems, such as awakening and body movement during general anesthesia, and the post-anesthetic recovery process was stable. Conclusion General anesthesia with spontaneous breathing provides various advantages, and the present method is appropriate for minimally invasive procedures.

AIMTo evaluate the occurrence and prevalence of microdeletions in the gamma chromosome of patients with azoospermia.

METHODSDNA from 29 men with idiopathic azoospermia was screened by polymerase chain reaction (PCR) analysis with a set of gamma chromosome specific sequence-tagged sites (STSs) to determine microdeletions in the gamma chromosome.

RESULTSDeletions in the DAZ (deleted in azoospermia) loci sgamma254 and sgamma255 were found in three patients with idiopathic azoospermia, resulting in an estimated frequency of deletions of 10.7% in idiopathic azoospermia men.

CONCLUSIONWe conclude that PCR analysis is useful for the diagnosis of microdeletions in the Y chromosome, which is important when deciding the suitability of a patient for assisted reproductive technology such as testicular sperm extracion-intracytoplasmic sperm injection (TESE-ICSI).

Adult ; Base Sequence ; Chromosomes, Human, Y ; DNA Primers ; Euchromatin ; genetics ; Follicle Stimulating Hormone ; blood ; Heterochromatin ; genetics ; Humans ; Luteinizing Hormone ; blood ; Male ; Oligospermia ; blood ; etiology ; genetics ; Polymerase Chain Reaction ; Prolactin ; blood ; Sequence Deletion ; genetics ; Sequence Tagged Sites ; Testosterone ; blood

OBJECTIVE: The aim of this study was to explore the factor structure of a novel, 10-item rating scale, the Targeted Inventory on Problems in Schizophrenia (TIP-Sz). Determining the factor structure will be useful in the brief evaluation of medication and non-medication treatment of the disease. METHODS: An exploratory factor analysis was performed on TIP-Sz scores obtained from 100 patients who met the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for schizophrenia. RESULTS: The factor analysis extracted four factors that were deemed clinically pertinent, which we labeled: disorganization, social cooperativeness, functional capacity, and emotional state. The items exhibited cross-loadings on the first three factors (i.e., some items loaded on more than one factor). In particular, the 'behavioral dyscontrol and disorganization,' 'insight and reality testing,' and 'overall prognostic impression' items had comparable cross-loadings on all of the first three factors. The emotional state factor was distinct from the other factors in that the items loading on it did not cross-load on other factors. CONCLUSION: The TIP-Sz scale comprises factors that are associated with the psychosocial functioning and emotional state of patients, which are important outcome parameters for successful treatment of the disease.
Anomie ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Schizophrenia

AIMChromosome 13 is one of the most frequently altered chromosomes in prostate cancer. The present study was undertaken to examine the role of human chromosome 13 in the progression of prostate cancer.

METHODSHuman chromosome 13 was introduced into highly metastatic rat prostate cancer cells via microcell-mediated chromosome transfer.

RESULTSMicrocell hybrid clones containing human chromosome 13 showed suppression of metastasis to the lung without any suppression of tumorigenicity, except for one clone, which contained the smallest sized human chromosome 13 and did not show any suppression on lung metastasis. Expression of two known tumor suppressor genes, BRCA2 and RB1, which map to chromosome 13, was examined by reverse transcription- polymerase chain reaction analysis. BRCA2 was expressed only in the metastasis-suppressed microcell-hybrid clones, whereas RB1 was expressed in all clones.

CONCLUSIONHuman chromosome 13 contains metastasis suppressor gene(s) for prostate cancer derived from rat. Furthermore, the RB1 gene is unlikely to be involved in the suppression of metastasis evident in this system.

Animals ; Animals, Genetically Modified ; Cell Division ; genetics ; Chromosome Aberrations ; Chromosome Mapping ; Chromosomes, Human, Pair 13 ; Disease Progression ; Genetic Markers ; Humans ; In Situ Hybridization, Fluorescence ; Kinetics ; Male ; Neoplasm Metastasis ; Prostatic Neoplasms ; genetics ; pathology ; prevention & control ; Rats ; genetics

AIMThe metastatic ability of a Dunning R-3327 rat prostate cancer subline (AT6.3) was suppressed by the introduction of human chromosome 10, when these hybrid cancer cells were injected subcutaneously into nude mice (Nihei et al., Genes Chromosomes Cancer 14:112-119, 1995). The present study was undertaken to clarify which step of metastasis was suppressed in the human chromosome 10-containing microcell hybrids (AT 6.3-10 clones).

METHODSGelatin zymography, an in vitro invasion assay using a Boyden chamber and an intravenous metastasis assay involving the injection of hybrid cells into nude mice were performed.

RESULTSGelatin zymography revealed that AT6.3-10 microcell hybrid clones expressed the 72 kD type IV collagenase (MMP-2) at an almost equal level as control microcell hybrid clones. Both the invasiveness as measured by the invasion assay and the number of lung metastases as measured by the intravenous metastasis assay of AT6.3-10 hybrid clones were significantly less than those of the AT6.3 parental clone.

CONCLUSIONThe human chromosome 10 suppresses both the local invasion and the metastatic process after entry into the blood circulation of rat prostate cancer. This decrease in local-invasive ability does not seem to require a decrease in MMP-2 activity.

Animals ; Animals, Genetically Modified ; Cell Division ; Chromosomes, Human, Pair 10 ; Gelatin ; analysis ; Humans ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Invasiveness ; Neoplasm Metastasis ; genetics ; Prostatic Neoplasms ; genetics ; pathology ; Rats ; Skin Neoplasms ; genetics ; pathology ; secondary ; Tumor Cells, Cultured

Androgens play a central role in prostate cancer pathogenesis, and hence most of the patients respond to androgen deprivation therapies. However, patients tend to relapse with aggressive prostate cancer, which has been termed as hormone refractory. To identify the proteins that mediate progression to the hormone-refractory state, we used protein-chip technology for mass profiling of patients' sera. This study included 16 patients with metastatic hormone-refractory prostate cancer who were initially treated with androgen deprivation therapy. Serum samples were collected from each patient at five time points: point A, pre-treatment; point B, at the nadir of the prostate-specific antigen (PSA) level; point C, PSA failure; point D, the early hormone-refractory phase; and point E, the late hormone-refractory phase. Using surface-enhanced laser desorption/ionization time-of-flight mass spectrometry, we performed protein mass profiling of the patients' sera and identified a 6 640-Da peak that increased with disease progression. Target proteins were partially purified, and by amino acid sequencing the peak was identified as a fragment of apolipoprotein C-I (ApoC-I). Serum ApoC-I protein levels increased with disease progression. On immunohistochemical analysis, the ApoC-I protein was found localized to the cytoplasm of the hormone-refractory cancer cells. In this study, we showed an increase in serum ApoC-I protein levels in prostate cancer patients during their progression to the hormone-refractory state, which suggests that ApoC-I protein is related to progression of prostate cancer. However, as the exact role of ApoC-I in prostate cancer pathogenesis is unclear, further research is required.
Aged ; Amino Acid Sequence ; Antineoplastic Agents, Hormonal ; therapeutic use ; Apolipoprotein C-I ; analysis ; blood ; isolation & purification ; Blotting, Western ; Cell Line ; Disease Progression ; Drug Resistance, Neoplasm ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Molecular Sequence Data ; Prognosis ; Prostatic Neoplasms ; drug therapy ; metabolism ; Protein Array Analysis ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

Aged ; Androgen Antagonists/adverse effects* ; Anticholesteremic Agents/therapeutic use* ; Cholesterol, HDL/blood* ; Cholesterol, LDL/blood* ; Humans ; Hypercholesterolemia/chemically induced* ; Lipids/blood* ; Male ; Middle Aged ; Prostatic Neoplasms/therapy* ; Retrospective Studies ; Testosterone/blood*

The final analysis of the phase 3 Targeted Investigational Treatment Analysis of Novel Anti-androgen (TITAN) trial showed improvement in overall survival (OS) and other efficacy endpoints with apalutamide plus androgen deprivation therapy (ADT) versus ADT alone in patients with metastatic castration-sensitive prostate cancer (mCSPC). As ethnicity and regional differences may affect treatment outcomes in advanced prostate cancer, a post hoc final analysis was conducted to assess the efficacy and safety of apalutamide in the Asian subpopulation. Event-driven endpoints were OS, and time from randomization to initiation of castration resistance, prostate-specific antigen (PSA) progression, and second progression-free survival (PFS2) on first subsequent therapy or death. Efficacy endpoints were assessed using the Kaplan-Meier method and Cox proportional-hazards models without formal statistical testing and adjustment for multiplicity. Participating Asian patients received once-daily apalutamide 240 mg ( n = 111) or placebo ( n = 110) plus ADT. After a median follow-up of 42.5 months and despite crossover of 47 placebo recipients to open-label apalutamide, apalutamide reduced the risk of death by 32% (hazard ratio [HR]: 0.68; 95% confidence interval [CI]: 0.42-1.13), risk of castration resistance by 69% (HR: 0.31; 95% CI: 0.21-0.46), PSA progression by 79% (HR: 0.21; 95% CI: 0.13-0.35) and PFS2 by 24% (HR: 0.76; 95% CI: 0.44-1.29) relative to placebo. The outcomes were comparable between subgroups with low- and high-volume disease at baseline. No new safety issues were identified. Apalutamide provides valuable clinical benefits to Asian patients with mCSPC, with an efficacy and safety profile consistent with that in the overall patient population.
Male ; Humans ; Prostatic Neoplasms/pathology* ; Androgen Antagonists/therapeutic use* ; Prostate-Specific Antigen ; Castration ; Prostatic Neoplasms, Castration-Resistant/drug therapy*