Objective : To analyze and reveal the contents of medical questionnaires distributed to nationwide general practice outpatients prior to their initial medical consultations.
Method : An observational study was conducted, based on questionnaire format. Sample questionnaires were collected from 85 hospitals registered with the Japan Primary Care Association.
Results : No standard format was found among the samples. A4 size forms (210 mm×297 mm) averaging 19.7 questions were in the majority, accounting for 68%. The distribution frequency of questionnaires reported by research cooperation centers listed 28 items (31.8%) concerning medical history, 19 items (21.6%) related to lifestyle, and 7 items (8.0%) referring to social and reproductive status.
Conclusion : This research assessed the qualitative value of medical questionnaires used in General Practice Clinics in Japan. The results indicate the nature of the medical information required by physicians prior to medical consultation.

Effects of 5 km running upon taking a low-carbohydrate, high-fat and protein diet on the body, in fourteen healthy young males and three healthy young females, all being affected by taurine inducement, were investigated by double blind test method. The results obtained were as follows ;
1) As to the degree of in heart rate upon 5 km running, in males, there were no differences between taurine administration group (M-group) and placebo administration group (P-group) . But in females, recordings in P-group were much larger than those of M-group.
2) As to the degree of increase in systolic blood pressure upon 5 km running, in males, no differences between both groups were observed, but in females, recordings in P-group were larger than those of M-group.
3) Both serum creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) activities did not recover to pre-exercise levels during 3 days after 5 km running in both groups of both sexes.
4) In the rate of CK-MB against CK, not only P-group of females had extraordinary high levels immediately after 5 km running, but also P-group of both sexes had higher levels on 3rd and 5th day after 5 km runnning than M-group.
5) In both sexes P-group was larger than M-group in the degree of increase in blood lactate and serum triglyceride levels.
6) As to the changes in serum total protein levels, in males, no differences between both groups were observed, but in females, P-group had extraordinary low levels on 1st day after 5 km running and maintained low levels during 5 days recovery.
7) As to the changes in both serum total fatty acids levels and the rate of unsaturated fatty acids against total fatty acids, no differences were observed between both groups of both sexes.
8) As to the degree of increase in plasma noradrenalin and adrenalin levels, in males, no differences between both groups were observed, but in females, recordings in M-group were larger than those of P-group.

OBJECTIVE: Oocyte degeneration often occurs after intracytoplasmic sperm injection (ICSI), and the risk factor is low-quality oocytes. The follicular fluid (FF) provides a crucial microenvironment for oocyte development. We investigated the relationships between the FF volume aspirated from individual follicles and oocyte retrieval, oocyte maturity, oolemma stretchability, fertilization, and development. METHODS: This retrospective study included data obtained from 229 ICSI cycles. Ovarian stimulation was performed according to a gonadotropin-releasing hormone antagonist protocol. Each follicle was individually aspirated and divided into six groups according to FF volume (<1.0, 1.0 to <2.0, 2.0 to <3.0, 3.0 to <4.0, 4.0 to <5.0, and ≥5.0 mL). Oolemma stretchability during ICSI was evaluated using a mechanical stimulus for oolemma penetration, that is, the stretchability was assessed by oolemma penetration with aspiration (high stretchability) or without aspiration (low stretchability). RESULTS: Oocyte retrieval rates were significantly lower in the <1.0 mL group than in the ≥1.0 mL groups (46.0% [86/187] vs. 67.5%–74.3% [172/255 to 124/167], respectively; p<0.01). Low oolemma stretchability was significantly more common in the <1.0 mL group than in the ≥1.0 mL groups during ICSI (22.0% [13/59] vs. 5.8%–9.4% [6/104 to 13/139], respectively; p=0.018). There was a relationship between FF volume and oolemma stretchability. However, there were no significant differences in the rates of fertilization, cleavage, ≥7 cells at day 3, and blastocyst development among all groups. CONCLUSION: FF volume is potentially associated with the stretchability of metaphase II oolemma during ICSI. Regarding oolemma stretchability, ensuring a uniform follicular size during ovarian stimulation is crucial to obtain good-quality oocytes.
Blastocyst ; Clothing ; Female ; Fertilization ; Follicular Fluid* ; Gonadotropin-Releasing Hormone ; Humans* ; Infertility ; Membranes ; Metaphase ; Oocyte Retrieval ; Oocytes ; Ovarian Follicle ; Ovulation Induction ; Retrospective Studies ; Risk Factors ; Sperm Injections, Intracytoplasmic*

Objectives: Most cases of caffeine intoxication result from the excessive intake of over-the-counter drugs and energy drinks. However, few cases of caffeine intoxication due to the excessive consumption of bottled coffee products have been reported. Herein, we present a case report of caffeine intoxication.Patient: A 39-year-old man experienced numbness and weakness in the extremities for three nights over five days.Results: Blood tests revealed hypophosphatemia and low 25-OH vitamin D concentration. The symptoms disappeared the next day without any additional treatment. A lifestyle interview revealed that he regularly consumed bottled coffee like it was water and had approximately 1 L of it from evening to night. He was diagnosed with weakness in the extremities due to hypophosphatemia caused by caffeine intoxication. Upon investigating some bottled coffee products, we found that only a few of them had labels disclosing caffeine content and warnings of the risks of excessive caffeine intake.Conclusion: We encountered a case of caffeine intoxication via coffee. Although rare in the past, caffeine intoxication might increase owing to the widespread use of bottled coffee products. The caffeine content of coffee products should be indicated on labels to warn consumers.

OBJECTIVESystemic and myelotoxic effects of 2,3,7,8-tetrabromodibenzo-p-dioxin (TBDD) were examined by the single administration of TBDD by gavage to rats.

METHODSFifteen Wistar rats of both sexes per group received 0, 10, 30, 100 or 300 μg TBDD/kg body weight. Rats surviving to the scheduled necropsy on Days 2, 7 and 36 after TBDD administration were examined for growth rate, organ weight, hematology, histopathology and adipose tissue levels of TBDD.

RESULTSThree 300 μg/kg-dosed females died on Days 21, 23 and 27, and exhibited a marked decrease in body weight, severe thymic atrophy, decreased bone marrow hematopoiesis and hemorrhage in the subarachnoid space of brain and spinal cord. TBDD-dosed surviving rats exhibited growth retardation, decreased bone marrow hematopoiesis, decreases in red blood cell counts, hemoglobin concentrations, and hematocrit values, an increase in reticulocytes and decreases in platelet counts, white blood cell counts and eosinophils. These signs suggested TBDD myelotoxicity. Splenic extramedullary hematopoiesis was increased in both sexes given TBDD, whereas atrophy of the splenic white pulp occurred only in TBDD-dosed females. Marked decreases in body weights and the size and weight of the thymus, severe thymic atrophy and death in TBDD-dosed females suggested a wasting syndrome. The adipose tissue level of TBDD culminated on Day 7 and decreased to 20-30% of the Day 7 level on Day 36.

CONCLUSIONSThe TBDD-induced effects were characterized by a wasting syndrome and myelotoxicity that appeared at the dose levels of 30 μg/kg and higher and caused death in 300 μg/kg-dosed females.

A 74-year-old man having a right refractory foot ulcer was referred to our hospital with a diagnosis of arteriosclerosis obliterans. Angiography of the lower extremities showed occlusive lesions in the middle popliteal artery and lower-leg arteries. Preoperative examination revealed decreased cardiac function and severe stenosis of the left and right coronary arteries. Therefore, we first performed coronary artery bypass grafting, followed by revascularization of the lower limbs at a later date. Owing to the lack of suitable autologous vein grafts, our procedure of choice was popliteal endarterectomy via a posterior approach with short saphenous vein angioplasty. The patient's foot ulcer healed completely following surgery. His postoperative course was uneventful, and he remained symptom-free during a 1-year follow-up.

Introduction: Research was carried out using a mixed method approach in order to evaluate the educational effects of medical students' visit of an elderly home.Methods: Focus group interviews were conducted with 5 medical students and 5 elderlies. All interviewees had experienced the visitation program more than three times. Self-administrative questionnaires were built based on the results of the focus group interview. The questionnaire was then distributed to medical students and elderlies who participated in the program.Results: A total of 84 medical students and 30 elderlies provided informed consent to participate in the study and returned the questionnaire. Nearly 70 percent of the students answered that they had gotten to know about the life of elderly people and sixty percent of the elderlies answered they had experienced some favorable changes after joining the program. While ninety percent of the elderly were satisfied with the program, only half of the students showed positive comments toward it.Discussion: To help all students participate in this program more actively, more organized planning is necessary so that students can have more chances to build communication skills and clarify their own objectives when visiting the elderly.

Background: and Purpose Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. Methods: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). Results: There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. Conclusions During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.