A 75-year-oldm an with an aortocaval fistula as a complication of aortoiliac aneurysm visited our hospital. He complained of shortness of breath and melena. Physical examination revealed a pulsating abdominal mass with thrill and continuous murmur. Chest X ray showed cardiomegaly with pulmonary congestion. CT scan showed infrarenal aortoiliac aneurysm and echo Doppler scan revealed aortocaval communication at the inferior caval bifurcation. Aortoiliac bifurcated graft and patch reconstruction of IVC were performed. The postoperative course was uneventful, and his congestive heart failure and hepatorenal dysfunction immediately improved.

The present study investigated the effect of moxibustion for 4 weeks on insulin resistance in Otsuka-Long-Evans Tokushima Fatty (OLETF) rats, a model of spontaneous noninsulin-dependent diabetes mellitus (NIDDM). Glucose infusion rate (GIR) in the moxibustion group was higher than that in the control group. This finding suggests that moxibustion may be effective for insulin resistance.

Kinki University School of Medicine introduced clerkships for undergraduate clinical training in 1999. Clinical clerkships are performed for the first 8 weeks of the sixth academic year. In 1999 and 2000 we conducted questionnaire surveys asking students about this system. The teaching staff encourages students to participate extensively in clinical situations, which reflects the consensus about this system. We also performed similar surveys of nurses and teaching staff. Clinical clerkships did not increase the incidence of problems between patients and medical staff. Many students felt their motivation to be a physician was increased. Although the findings of these questionnaire surveys indicate that our clerkship system works successfully, they also revealed some problems for sixth-year students. Although we recognize the significance of this system for undergraduate clinical training, further improvement is required.