Now that the measurement of Hb Aic has become routine in a diagnostic test for diabetes as part of a battery of tests in the physical checkup, we have come to know various factors cause Hb Aic values to fluctuate. Recently, we encountered a case in which the Hb Ale level is abnormally low. By isoelectric focusing, we identified Hb Malmo [β97 (FG4) His→G1n]. Some familial cases of Hb Malmo have been reported to be found in Sweden, Germany and Britain. It is first time that this case was discovered in Japan.

This study examines the effect on junior high school students’ understanding and usage frequency of medicines gained from education about medicines during elementary school. This education which we provided is tailored to the developmental stage of the child. We conducted a questionnaire directed at the first year students of a junior high school in Tokyo. We compared the responses to questions regarding the understanding and correct usage frequency of medicines between groups of students who had graduated from the elementary school (Group A : students who graduated from the elementary school where we provided the education about medicines, Group B : all students except those in Group A). In order to compare these, we calculated the scores about questions regarding the understanding and correct usage frequency of medicines using principal component analysis (PCA). The PCA score for understanding of medicine by group A was higher than that of group B ; a significant difference was found (P<0.001). Therefore, this suggests that receiving education about medicines may be a factor that enhances students’ understanding of medicines. The PCA score for correct usage frequency of medicine by group A was higher than that of group B; a significant difference was found (P＝0.043). Therefore, this suggests that receiving education about medicines may be a factor that increases students’ correct usage frequency of medicines.

We report on a case of Hailey-Hailey disease successfully treated with Sokeikakketsuto. This case was a 70-year-old woman. Her mother, grandmother and elder sister had the same symptoms. From 2004 August, she noticed erythematous exudative lesions with itching on both sides of her inguinal area. By September, she was diagnosed with Hailey-Hailey disease histologically. We treated using a topical corticosteroid at first. This had little effect, so we considered treatment using Kampo medicines. We diagnosed a kidney Yin-deficiency from a fissure of her tongue, thirstiness, numbness in the region below the umbilicus and night sweat, thus and selected Rokumigan. We then diagnosed deficiency of Qi from her general malaise, so chose Hochuekkito. The pathology of Hailey-Hailey disease exists mainly in the epidermis which covers most of the body's surface area. And this indicates the presence of pathogenic wind factor. We considered the presence of dampness as a disease-inducing factor because of her exudation, and the presence of the heat from her erythema. So we also selected Eppikajutsuto as an anti wind-wetness-heat drug. Her general condition was very much improved with these administrations, but her skin lesions improved very little. So we stopped Eppikajutsuto, and Sokeikakketsuto administration was started instead. After this change of drug, her skin lesions were improved remarkably.

The present study was carried out to elucidete whether the accumulation of triglyceride (TG) in rat liver during fasting was stimulated by swimming. Male Wistar rats were divided into three groups; C: control, 24 F: 24 hour-fasted and 48 F: 48 hour-fasted. These animals were required to swim for 120 min.
In rats with both 24F and 48F, the liver glycogen contents did not change during swimming. The level of TG in rat liver was higher in 24 F and 48 F rats than the control group, and the exercise significantly affected the liver TG in each group. There was significant correlation betweem the level of TG in rat liver and the plasma free fatty acid (FFA) concentration (r=0.681, p<0.01) . However, although plasma TG did not change during exercise in each group, the TG secretion rate (TGSR) of the 48 F group was significantly lower than that of the C and 24F groups (p<0.01) .
These results provide evidence that exercise may result in the accumulation of TG in liver during fasting and suggest that the process not only depends on the surplus supply of FFA, but also inhibits very low density lipoprotein-TG secretion from liver.

1) The aim of this study was to develop a training method for pre-educational clinical pharmacy in a 6-year curriculum. In the evaluation of training in a prepractical pharmacy by pharmacy students after completing clinical training in a 4-year curriculum, the average scores for the necessity and usefulness of training in a prepractical pharmacy were 4.5 and 3.9, respectively (maximum score, 5; minimum score, 1).
2) The average scores for usefulness in the subcategories of knowledge, technique, and attitude were 3.5, 4.2 and 3.8, respectively. The percentages of scores of 4 or 5 in these subcategories were 60.1%, 83.2%, and 64.1%, respectively.
3) The students recognized the necessity and usefulness of training in a prepractical pharmacy, but dissociation was seen in both scores. Therefore, the amount of attitude education in training in a prepractical pharmacy was thought to be insufficient. The strong desire for education by clinical pharmacists and the development of educational programs are future challenges for the Faculty of Pharmaceutical Sciences.

Medical education programs in North America are often based on the adult education theory of self-directed learning (SDL). Many kinds of SDL have been introduced into preclerkship education, clerkships, residency training, and continuing medical education. The first goal of this paper was to review SDL in North American medical education. The second goal was to describe an example of community-based clerkship in which SDL was applied in the department of family and community medicine of the University of Toronto. A third goal was to give three recommendations for Japanese clinical clerkships. The first recommendation is the effect of the learning contract. The second is that the preceptor should give quick and frequent feedback to students and that a useful Japanese feedback device should be developed with information technology. The third recommendation is that a new curriculum combining community-based education for students with continuing medical education for doctors is necessary to improve Japanese medical education.

[Objective]It was recently accepted that skin problems are aggravated in women who are stressed or neglect their health. For such conditions, acupuncture for the purpose of beautification and health improvement attracts attention, thus expanding the science of acupuncture into an entirely new field called "Beauty (Cosmetic) Acupuncture."
Here, we investigated the beauty efficacy of acupuncture and acupressure on healthy women.
[Methods]Fourteen healthy women (mean age, 43.0 ± 8.1 years) who had noticeable skin roughness were randomly divided into 2 groups:acupuncture group (n = 7) and acupressure group (n = 7). Both groups received their respective treatments twice a week for 4 weeks.
Measurements for the subjective evaluation were based on self-rated health (SRH) and subjective physical and mental fatigue, which were assessed using the Visual Analogue Scale (VAS), the Nowlis mood checklist, and a questionnaire about skin condition. Measurements for the objective evaluation were the melanin index of the skin;the Hb index;the HbO2 index; 3D measurement of the face, determined from range images;wrinkle-area ratio, determined from replicas, corneocyte surface area, and skin color (L*, a*, b*);and facial impression rating.
[Results]The acupuncture group showed a significant improvement in subjective measurement of skin condition (wrinkle, slack, and total condition) in addition to a slight decrease in wrinkle-area ratio, as determined by image analysis. The acupressure group showed a significant improvement in subjective measurement of skin condition (quantity of sebum secretion) and Nowlis mood checklist score, in addition to marginally significant improvement in skin color (L*, b*), HbO2 index, and amount of melanin in the skin.
[Conclusion]Acupuncture and acupressure may bring about morphological changes in facial skin and improvement in skin color, respectively. We conclude that acupuncture and acupressure have different effects on skin condition.

Background: Complementary medicine and alternative medicine have been included in the curricula of many medical schools and colleges; however, teaching methods have not been standardized. We gave lectures and practical instruction on acupuncture and moxibustion medicine to medical students during their clinical clerkship in anesthesiology. We used a questionnaire to evaluate the usefulness of small-group teaching.
Methods: The subjects were 93 fifth-year medical students doing clinical clerkships in anesthesiology. The clinical clerkship consists of small-group learning with 2 or 3 students per group. After a lecture and practical instruction on acupuncture and moxibustion were given, students were asked to fill out a questionnaire about their interest in and basic knowledge of acupuncture and moxibustion and whether they would like to master the technique.
Results: All 93 students answered the questionnaire （response rate, 100%）. After the small-group teaching, students became more interested in acupuncture and moxibustion and learned that the costs of treatment were covered by health insurance. Most students were interested mastering acupuncture and moxibustion in the future.
Discussion: Our results suggest that lectures and practical instruction during clinical clerkship are useful for getting medical students interested in acupuncture and moxibustion medicine.

　　[Purpose] We introduced subcutaneous suture with a synthetic absorption thread and examined its efficacy on surgical site infection after pancreaticduodenectomy (PD). [Method] In hour hospitals, PD was performed in a total of 69 cases from March 2006 through March 2014. They was divided into two groups-one consisting of 31 cases in which the skin wounds with staplers (non-subcutaneous suture group), and the other consisting of 38 cases in which surgical wounds were closed with subcutaneous sutures (subcutaneous suture group), and the incidence of surgical site infection (SSI) were compared between the two groups. [Result] Incidence of surface SSI occurred in eight cases (21.0%) in the non- subcutaneous suture group and three cases (9.7%) in the subcutaneous suture group (p＝0.17). The incidence of SSI was decreased in the subcutaneous suture group than in the non-subcutaneous suture group, but no statistically significant difference was observed between the two groups. However, taking into account the advantages such as the reduction of patient’s medical expenses, and the burden of ward duties, further examination with an additional number of patients was thought to be necessary.