Opinions of young physicians about a course on end-of-life care which they took at the Kyushu University Medical School 10 years earlier were analyzed. Fifty-seven (23%) of 247 graduates responded to a questionnaire. All clinicians had been involved in end-of-life care to some extent. All respondents agreed that a course about end-of-life care should be included in the medical school curriculum. In general, they thought highly of the course on end-of-life care that they took in medical school. They thought that such a course should last 10 to 20 hours and should be given after the end of clinical lectures and before the start of clinical training. The respondents suggested a good basic policy would be to attach importance to contemplating the end of life rather than to simply memorizing information about end-of-life care.

A 21-hour education program for fifth-year medical students in terminal care was started at Kyushu University in 1991 with the participation of more than 20 lecturers from different specialties. Problems encountered as this curriculum was introduced are discussed. We believe that establishing a professorship in terminal care is essential for improving this curriculum.

Objective: Precursor lesions may be identified in fallopian tube tissue after risk-reducing salpingo-oophorectomy (RRSO) in patients with pathogenic variants of BRCA1/2. Serous tubal intraepithelial carcinoma (STIC) is considered a precursor of high-grade serous carcinoma, whereas the significance of the p53 signature remains unclear. In this study, we investigated the relationship between the p53 signature and the risk of ovarian cancer. Methods: We analyzed the clinicopathological findings and conducted DNA sequencing for TP53 variants of p53 signatures and STIC lesions isolated using laser capture microdissection in 13 patients with pathogenic variants of BRCA1/2 who underwent RRSO and 17 control patients with the benign gynecologic disease. Results: TP53 pathogenic variants were detected significantly higher in RRSO group than control (p<0.001). No difference in the frequency of p53 signatures were observed between groups (53.8% vs 29.4%; p=0.17). TP53 sequencing and next-generation sequencing analysis in a patient with STIC and occult cancer revealed 2 TP53 mutations causing different p53 staining for STICs and another TP53 mutation shared between STIC and occult cancer. Conclusion The sequence analysis for TP53 revealed 2 types of p53 signatures, one with a risk of progression to STIC and ovarian cancer with pathological variants in TP53 and the other with a low risk of progression without pathological variants in TP53 as seen in control.