3.General Education Course in Medical Schools. Report from the Committee for Faculty Education of the Japan society for Medical Education
Fumimaro TAKAKU ; Kohei NAKANO ; Tsutomu IWABUCHI ; Hidenobu MASHIMA ; Yonezo NAKAGAWA ; Kentaro NAKAYAMA ; Kuniomi OKA ; Kenichi UEMURA ; Yujiro IKEMI ; Daizo USHIBA
Medical Education 1980;11(2):115-118
4.A plan of the curriculum of chemistry for medical students.
Hiroshi WATANABE ; Yoshito TAKEUCHI ; Machiko TOZAWA ; Yasuo KAGAWA ; Gunji MAMIYA ; Yuzuru ISHIMURA ; Akiyuki OKUBO ; Toshio TSUSHIMA ; Kohei NAKANO ; Yonezo NAKAGAWA ; Tsuneyoshi NIITSU ; Junichi SUZUKI ; Shigetoshi TAGUCHI ; Fumimaro TAKAKU ; Susumu TANAKA
Medical Education 1990;21(2):104-107
Based on two years working of “the enlarged working group for the curriculum of chemistry for medical education”, a provisional plan of the curriculum of chemistry for medical students is proposed. The article is consist of four sections; namely A: general problems, B: “chemistry” as a general education, C: purpose and specific problems of the general education for medical students, D: a provisional plan of the curriculum of chemistry for medical students.
The main part D is consist of three subsections: namely (1) a plan of the curriculum of physical and inorganic chemistry, (2) a plan of the curriculum of organic chemistry, (3) a plan of the curriculum of experiments.
5.Non-invasive continuous blood pressure monitoring using the ClearSight system for pregnant women at high risks of post-partum hemorrhage: comparison with invasive blood pressure monitoring during cesarean section
Takuya MISUGI ; Takashi JURI ; Koichi SUEHIRO ; Kohei KITADA ; Yasushi KURIHARA ; Mie TAHARA ; Akihiro HAMURO ; Akemi NAKANO ; Masayasu KOYAMA ; Takasi MORI ; Daisuke TACHIBANA
Obstetrics & Gynecology Science 2022;65(4):325-334
Objective:
This study aimed to investigate the accuracy and precision of continuous, non-invasive blood pressure obtained using the ClearSight system by comparing it with invasive arterial blood pressure, and to assess the hemodynamic changes using invasive methods and the ClearSight system in patients undergoing cesarean section.
Methods:
Arterial pressure was measured invasively with an intra-arterial catheter and non-invasively using the ClearSight system during cesarean section in patients with placenta previa or placenta accreta. Blood pressure measurements obtained using these two means were then compared.
Results:
Total 1,277 blood pressure measurement pairs were collected from 21 patients. Under Bland-Altman analysis, the ClearSight system demonstrated an acceptable accuracy with a bias and standard deviation of 8.8±13.4 mmHg for systolic blood pressure, -6.3±7.1 mmHg for diastolic blood pressure, and -2.7±8.0 mmHg for median blood pressure. Cardiac index levels were significantly elevated during fetal delivery and 5 minutes after placental removal, and systemic vascular resistance index levels were significantly decreased during fetal delivery and 40 minutes after placental removal.
Conclusion
In patients undergoing cesarean section, the ClearSight system showed excellent accuracy and precision compared to that of the currently used invasive monitoring system.
6.Cross-sectional area of psoas muscle as a predictive marker of anastomotic failure in male rectal cancer patients: Japanese single institutional retrospective observational study
Yusuke MIZUUCHI ; Yoshitaka TANABE ; Masafumi SADA ; Koji TAMURA ; Kinuko NAGAYOSHI ; Shuntaro NAGAI ; Yusuke WATANABE ; Sadafumi TAMIYA ; Kohei NAKATA ; Kenoki OHUCHIDA ; Toru NAKANO ; Masafumi NAKAMURA
Annals of Coloproctology 2022;38(5):353-361
Purpose:
Preoperative sarcopenia worsens postoperative outcomes in various cancer types including colorectal cancer. However, we often experienced postoperative anastomotic leakage in muscular male patients such as Judo players, especially in rectal cancer surgery with lower anastomosis. It is controversial whether the whole skeletal muscle mass impacts the potential for anastomotic failure in male rectal cancer patients. Thus, the purpose of this study was to clarify whether skeletal muscle mass impacts anastomotic leakage in rectal cancer in men.
Methods:
We reviewed the medical charts of male patients suffering from rectal cancer who underwent colo-procto anastomosis below the peritoneal reflection without a protective diverting stoma. We measured the psoas muscle area and calculated the psoas muscle index.
Results:
One hundred ninety-seven male rectal cancer patients were enrolled in this study. The psoas muscle index was significantly higher in patients with anastomotic leakage (P<0.001). Receiver operating characteristic curve determined the optimal cut-off value of the psoas muscle index for predicting anastomotic leakage as 812.67 cm2/m2 (sensitivity of 60% and specificity of 74.3%). Multivariate analysis revealed that high psoas muscle index (risk ratio [RR], 3.933; P<0.001; 95% confidence interval [CI], 1.917–8.070) and super low anastomosis (RR, 2.792; P=0.015; 95% CI, 1.221–6.384) were independent predictive factors of anastomotic leakage.
Conclusion
This study showed that male rectal cancer patients with a large psoas muscle mass who underwent lower anastomosis had a higher rate of postoperative anastomotic leakage.
7.Small Bowel Obstruction After Ileal Pouch-Anal Anastomosis With a Loop Ileostomy in Patients With Ulcerative Colitis.
Hitoshi KAMEYAMA ; Yoshifumi HASHIMOTO ; Yoshifumi SHIMADA ; Saki YAMADA ; Ryoma YAGI ; Yosuke TAJIMA ; Takuma OKAMURA ; Masato NAKANO ; Kohei MIURA ; Masayuki NAGAHASHI ; Jun SAKATA ; Takashi KOBAYASHI ; Shin ichi KOSUGI ; Toshifumi WAKAI
Annals of Coloproctology 2018;34(2):94-100
PURPOSE: Small bowel obstruction (SBO) remains a common complication after pelvic or abdominal surgery. However, the risk factors for SBO in ulcerative colitis (UC) surgery are not well known. The aim of the present study was to clarify the risk factors associated with SBO after ileal pouch-anal anastomosis (IPAA) with a loop ileostomy for patients with UC. METHODS: The medical records of 96 patients who underwent IPAA for UC between 1999 and 2011 were reviewed. SBO was confirmed based on the presence of clinical symptoms and radiographic findings. The patients were divided into 2 groups: the SBO group and the non-SBO group. We also analyzed the relationship between SBO and computed tomography (CT) scan image parameters. RESULTS: The study included 49 male and 47 female patients. The median age was 35.5 years (range, 14–72 years). We performed a 2- or 3-stage procedure as a total proctocolectomy and IPAA for patients with UC. SBO in the pretakedown of the loop ileostomy after IPAA occurred in 22 patients (22.9%). Moreover, surgical intervention for SBO was required for 11 patients. In brief, closure of the loop ileostomy was performed earlier than expected. A multivariate logistic regression analysis revealed that the 2-stage procedure (odds ratio, 2.850; 95% confidence interval, 1.009–8.044; P = 0.048) was a significant independent risk factor associated with SBO. CT scan image parameters were not significant risk factors of SBO. CONCLUSION: The present study suggests that a 2-stage procedure is a significant risk factor associated with SBO after IPAA in patients with UC.
Colitis, Ulcerative*
;
Female
;
Humans
;
Ileostomy*
;
Logistic Models
;
Male
;
Medical Records
;
Risk Factors
;
Tomography, X-Ray Computed
;
Ulcer*
8.Muscle loss and sarcopenia associated with physical function and functioning capacity in community-dwelling older women with bone loss
Tsuyoshi KATSURASAKO ; Shin MURATA ; Akio GODA ; Yuki KIKUCHI ; Kohei MORI ; Hideki NAKANO
Japanese Journal of Physical Fitness and Sports Medicine 2024;73(4):149-156
This study aimed to characterize physical function and functional capacity related to low muscle mass and sarcopenia in older women with low bone mass. In the study, 122 older women with bone loss were included and divided into three groups according to the presence or absence of muscle loss and sarcopenia; bone loss only, bone loss and muscle loss, and bone loss and sarcopenia groups. Multinomial logistic regression analysis was conducted using the three groups as dependent variables. Body mass index (BMI) (odds ratio; 0.566, 95% confidence interval; 0.431-0.742), Kihon checklist of “motor function” (odds ratio; 2.230, 95% confidence interval; 1.179-4.217), and “homebound” (odds ratio; 5.123, 95% confidence interval; 1.122-23.391) were extracted as relevant factors in the bone loss and sarcopenia group. In addition to low BMI, sarcopenia in older women with reduced bone mass is associated with lower “motor function” and “homebound” functional capacity.