To understand how often and how well medical and nursing students use information and data on the Internet for selflearning, we conducted a survey of students in the first through fourth years at Kochi Medical School. To allow comparison we also conducted a small survey of medical students at Maastricht University. These surveys indicated several problems in the use of the Internet by students at Kochi Medical School.

We conducted a 14−year follow−up study to analyze the hazard ratio(HR) of mortality regarding lifestyle−related factors in Saga Prefecture, Japan. The subjects included 2, 170 people, who were randomly selected from men and women aged from 40 to 69 years old, and who also completed the standardized questionnaire on lifestyle in 1983. Information about death and corresponding data were obtained either by mail and/or through the city offices in 1997. We found that a lower body weight, a lower physical fitness level, not consuming a balanced diet, and cigarette smoking to be significantly elevated risks for all−causes of death in males after adjustment by age and health status. In addition, these results did not change even after excluding subjects for early death. The HR of the female subjects who quit smoking was significantly high, although it changed to insignificant after excluding subjects for early death. These results suggested that being underweight might be an index of a positive risk of death, while maintaining a higher physical fitness level, being careful to consume a more balanced diet, and non smoking all appear to be indexes of a negative risk of death. In addition, these results might also be considered good evidence for improving poor health habits in health promotion activities.
Cessation of life ; Life Style ; Male population group ; Related ; Total

The need for medical team care is increasing because of advances in medical care and changing national needs. For more than 20 years medical students at the University of Tsukuba have participated in medical team care practice before bedside learning during the third trimester of their 4th year. The objective of this practice is to understand patients from the nurses' point of view and to learn cooperation between doctors and co-medical staff. We analyzed students reports to study what they had learned. A total of 326 items in 11 categories were specified in the free-response part of the reports. The largest category was “nursing/nurses” and the second largest was “communication/human relations.” The results show that the students learned points other than the General Instruction Objectives and that the practice was extremely effective.

The apparent degradation rate constant of fluticasone propionate (FLT) in 0.1 M NaOH:methanol=1:1 at 37 ℃ was previously reported to be 0.169 ± 0.003 h?1, and four degradation products (products 1–4) were observed in the solution. The aims of the present study were to assess the degradation rates of FLT in other alkaline solutions and clarify the chemical structures of the four degradation products in order to obtain basic data for designing an enema for inflammatory bowel disease. The apparent degradation rate constants in 0.05 M NaOH and 0.1 M NaOH:CH3CN=1:1 were 0.472 ± 0.013 h?1 and 0.154 ± 0.000 h?1 (n=3), respectively. The chemical structures of products 1–4 in 0.1 M NaOH:methanol=1:1 were revealed by nuclear magnetic resonance (NMR) and mass spectrometry data. The chemical structure of products 2 was that the 17-position of the thioester moiety of FLT was substituted by a carboxylic acid. The degradation product in 0.1 M NaOH:CH3CN=1:1 was found to be product 2 based on 1H NMR data. The degradation product in 0.05 M NaOH was considered to be product 2 based on the retention time of HPLC. These results are useful for detecting the degradation products of FLT by enzymes of the intestinal bacterial flora in the large intestine after dosing FLT as an enema.

The apparent degradation rate constant of fluticasone propionate (FLT) in 0.1 M NaOH:methanol=1:1 at 37 ℃ was previously reported to be 0.169 ± 0.003 h?1, and four degradation products (products 1–4) were observed in the solution. The aims of the present study were to assess the degradation rates of FLT in other alkaline solutions and clarify the chemical structures of the four degradation products in order to obtain basic data for designing an enema for inflammatory bowel disease. The apparent degradation rate constants in 0.05 M NaOH and 0.1 M NaOH:CH3CN=1:1 were 0.472 ± 0.013 h?1 and 0.154 ± 0.000 h?1 (n=3), respectively. The chemical structures of products 1–4 in 0.1 M NaOH:methanol=1:1 were revealed by nuclear magnetic resonance (NMR) and mass spectrometry data. The chemical structure of products 2 was that the 17-position of the thioester moiety of FLT was substituted by a carboxylic acid. The degradation product in 0.1 M NaOH:CH3CN=1:1 was found to be product 2 based on 1H NMR data. The degradation product in 0.05 M NaOH was considered to be product 2 based on the retention time of HPLC. These results are useful for detecting the degradation products of FLT by enzymes of the intestinal bacterial flora in the large intestine after dosing FLT as an enema.

Introduction: G-CSF producing tumors often cause various symptoms at the end of life, such as fever, fatigue, and fluid retention as a result of high cytokine status. Case: The patient was an 80-year-old woman. She was referred to our hospital because of anorexia and urine volume reduction. After a detailed examination, she was diagnosed with duodenal cancer. Although she decided not to receive anticancer treatment because of her old age and poor general condition, she felt a great distress with abdominal distension by large ascites. Furthermore, peripheral blood smear examination showed remarkably increased levels of normal neutrophils. We suspected G-CSF producing tumor and, hence, dexamethasone administration was initiated to suppress cytokine release. As a result, renal dysfunction and urine volume were improved, and ascites accumulation was not observed again since initial paracentesis. The number of neutrophils also declined, and the patient was in a good condition, even though it lasted for a short time. Conclusion: In patients with high cytokine status caused by G-CSF producing tumor, steroids may be useful for pain relief.

Drug dispensing is a statutory and designated duty of a pharmacist. We aimed to examine the changes in the nature of drug dispensing using a text mining method. Our corpus consisted of text documents from “Chozai Shishin”, the most standard manual for dispensing drugs in Japan, Editions 1 to 13 (Japan Pharmaceutical Association), and we used the KH Coder software for text mining. We constructed networks showing the association between frequent word co-occurrence and edition number, and co-occurrence relations for frequent words in each edition. We found that “patient” superseded “dispensing” as a frequent term over time. “Dispensing” was another frequent term with a highly centralized node in each edition. Accordingly, we targeted the term “dispensing” for network analysis to depict its co-occurrence relations. We found that the range of related words for “dispensing” broadened from “preparation” and “compounding” to include “patient adherence instructions”, “assessment”, “medical treatment”, and “information provision”. Accordingly, we concluded that the content of “dispensing”, which is a pharmacist’s duty, has expanded from the duties of “dispensing drugs” to include “responding to patients” within the definition of “dispensing”, and we were able to present this finding as objective data by using the mechanical method known as text mining.

Drug dispensing is a statutory and designated duty of a pharmacist. We aimed to examine the changes in the nature of drug dispensing using a text mining method. Our corpus consisted of text documents from “Chozai Shishin”, the most standard manual for dispensing drugs in Japan, Editions 1 to 13 (Japan Pharmaceutical Association), and we used the KH Coder software for text mining. We constructed networks showing the association between frequent word co-occurrence and edition number, and co-occurrence relations for frequent words in each edition. We found that “patient” superseded “dispensing” as a frequent term over time. “Dispensing” was another frequent term with a highly centralized node in each edition. Accordingly, we targeted the term “dispensing” for network analysis to depict its co-occurrence relations. We found that the range of related words for “dispensing” broadened from “preparation” and “compounding” to include “patient adherence instructions”, “assessment”, “medical treatment”, and “information provision”. Accordingly, we concluded that the content of “dispensing”, which is a pharmacist’s duty, has expanded from the duties of “dispensing drugs” to include “responding to patients” within the definition of “dispensing”, and we were able to present this finding as objective data by using the mechanical method known as text mining.