Purpose. To investigate deteriorating effects on systemic organs due to actute arterial occlusion of the lower extremities, ultrastructural changes of the heart and lung after temporal occlusion of the abdominal aorta for 24 hours were examined with transmission electron microscopy (TEM). Methods. Fifteen mongrel dogs, weighing 10 to 15kg, underwent temporal occlusion of the infrarenal aorta and lumbar arteries followed by release of occlusion and restoration of circulation 24 hours later. After three-hours' reperfusion, the heart and lungs were excised for pathological evaluation with TEM. Experimental groups were divided into three groups according to the maximum values of CPK (group I, max CPK≤10000; group II, 1000040000 (IU/L)), which had been measured during and after the reperfusion period. Results. TEM examination revealed the following findings in the myocardial tissue: slight cell edema of the myocytes, disruption of the myofibrils, swelling of the mitochondria, interstitial edema, type III bleb formation, cellular edema of endothelial cells and intravascular hemostasis. Pathological findings in the lung tissue included: pulmonary edema, congestive atelectasis, edema of Type I lung epithelial cells and increased neutrophils in the capillary. These findings were significantly remarkable in groups II and III as compared to group I. Conclusions. Elevation of CPK values after the reperfusion period correlated well with the degree of cell damage in the heart and lungs. Free radicals generated during the reperfusion period and their related pathways may play a significant role in the development of cardiac or pulmonary failure after acute arterial occlusion of the lower extremities.

The purpose of this study was to examine the health-related Quality of Life (QOL) of women and the effects of “fruits granola” on women’s health. It was based on an Internet questionnaire survey on QOL (using a QOL questionnaire for women that was prepared by LSTT Co., Ltd.) of 3,460 subjects who answered questions concerning physical and mental matters. It also had 165 subjects, 108 of whom had mild constipation and 57 of whom did not, consume fruits granola freely for a period of time and then compared their QOL before and after consumption.The results of the screening survey showed significantly higher scores in all categories among women who did not have constipation than women who did. Additionally, the mental QOL score was significantly higher among women who had the habit of eating fruits granola.Moreover, the overall QOL score significantly increased after consumption of fruits granola. These results suggest that consumption of fruits granola may be effective in improving women’s QOL.

To seek longitudinal changes in metacognitive processes through problem-based learning (PBL), we analysed the contents of all comments written reflectively by the third-year students after they finished discussions in each PBL session. After dividing their comments into meaningful units, we focused on two major thematic categories and five sub-categories to be analysed.
1) The number of units decreased significantly (chi-square: p=0.02).
2) Only the proportion of units categorised as “comprehension” in “individual learning” showed significant increase (Bonferroni: p<0.001).
3) Comments in this category stated that “I don't understand so-and-so.”
4) The increase of “comprehension” as they experienced more PBL suggested that students' knowledge of ignorance as metacognition was fostered through sessions in medical PBL.

We report a successful case of graft replacement for ascending and aortic arch aneurysm which developed 5 years after CABG. A 75-year-old woman, who underwent emergency CABG (LITA-LAD, SVG-RCA) 5 years previously, was admitted to our hospital due to an abnormal shadow on chest roentogenogram. Aortogram and coronary angiogram revealed ascending and aortic arch aneurysm and patent LITA and SVG. Graft replacement of the ascending and total aortic arch was carried out using four branched grafts (Gelweave 26/10/8/8^*8). Cardiopulmonary bypass was established with right axillary arterial perfusion and bicaval cannulation. Cardiac arrest was obtained with cold blood cardioplegia using both retrograde and antegrade techniques. Selective cerebral perfusion was used for brain protection. The patient was discharged without any complication on the 27th postoperative day.

In order to investigate the effects of fruits granola intake on defecation and quality of life (QOL), 20 females (mean age: 20.0 ± 1.1 y.o.) with frequency of defecation of less than 5 times per week were selected for this open study. Daily intake of 50 g of fruits granola was used as a substitute staple food for 2 weeks, and changes in defecation and QOL were compared before and after the procedure. The results showed that, compared with the pre-intake period, the frequency of defecation and the amount of defecation increased after fruits granola intake (p = 0.014, p = 0.024), and improvement of QOL (p = 0.011) was also observed. We conclude that, a continuous intake of fruits granola can improve defecation, and also improve quality of life.

A case of pseudoaneurysm of the external iliac artery after a total hip arthroplasty is reported. A 48-year-old man had undergone a total left hip arthroplasty 5 years previously. Acute arterial occlusion (AAO) of the left lower extremity occurred 3 times. AAO was due to pseudoaneurysm of the external iliac artery, which was detected by rotating digital subtraction angiography (DAS). Aneurysmectomy and reconstruction were carried out. Rotating DSA was useful for the diagnosis of this unusual case of pseudoaneurysm of the external iliac artery after a total hip arthroplasty is unusual.

The current study examined the antimicrobial resistance of Chlamydia Trachomatis (CT) genital infection during pregnancy in Japan. We requested 2,146 obstetrical facilities that are members of Japan Association of Obstetricians and Gynecologists to provide information of CT screening tests and antimicrobial resistance in pregnant women between April 2020 and March 2021. The prevalence of CT genital infection in Japan was 2.1%. The antimicrobial resistance was recognized in 2.0 and 2.4% of the cases using azithromycin and clarithromycin, respectively. There were no significant differences in the antimicrobial resistance rate between the 2 analogues (P = 0.28). In Japan, azithromycin and clarithromycin have effectively treated genital CT infections during pregnancy.

Problem-based learning (PBL) tutorials were introduced at our university in April 2001. Because a complete PBLbased curriculum could not be adopted, a transitional curriculum incorporating 3-hour PBL tutorial sessions into the traditional curriculum was introduced. More than 80% of students agreed that PBL is an effective way of learning problem solving at the bedside. Twenty percent to 40% of teachers felt that students who took PBL were more motivated for bedside learning and self-directed learning and had better at presentation than were students who did not take PBL. Because of 80% of the curriculum comprised didactic lectures, most students considered PBL tutorials a type of lecture. For this reason, motivating students to learn additional material originating from PBL tutorials was difficult. Although the combination of a traditional curriculum and PBL tutorials may appear to be a new curriculum, this type of PBL has limited value as a method for studying problem solving.

Folic acid contained in potato (Solanum tuberosum L.) tubers is concentrated in potato chips by dehydration during frying. It is a vitamin recommended to young women which helps protect fetus from congenital disease. Additionally, folic acid can lower plasma homocysteine concentrations, a known independent risk factor for cardiovascular disease. This study was designed to determine whether the dietary consumption of potato chips affect serum folic acid concentration and plasma homocysteine concentration in human subjects. Results showed a significant increase in serum concentrations of folate 1, 3, and 6 hours after ingestion. Vitamin B₆, on the other hand, increased significantly after 3 hours of intake. In contrast, plasma homocysteine concentration decreased significantly 6 hours after ingestion. These results suggest that potato chips would be a good dietary source of folic acid for humans.