To accurately assess the clinical competencies of medical students at Fukushima Medical University, we have developed a novel online self–assessment system, which covers all goals in the "Model Core Curriculum for Medical Education in Japan." We added "Emergency," "Communication skills with staff," and "Simulation–based learning." Following their clinical clerkships, 79 sixth–year medical students assessed themselves and their clinical clerkships.
1)This novel online self–assessment system, consisting of 68 checklists in 15 fields, easily informs us of the actual conditions of clinical clerkships and students' confidence in their clinical competencies.
2)This internet–based self–assessment system revealed the current status and problems of clinical clerkships, prompting feedback to clinical instructors and members of the instruction committee.
3)Students felt "confident" or "confident to a certain degree" in most learning areas; however, simulation–based learning seems to be necessary in several areas, such as clinical skills, where feelings of shame or discomfort may be associated with patient care.
4)Students who had high total self–assessment scores evaluated clinical clerkships favorably. In contrast, students whose self–assessments frequently included "no learning experience" evaluated their clerkships negatively in the educational aspects of "skill" and "attitude."

  Pretests and posttests in the field of preventive medicine and public health were administered to third–year medical students of Shinshu University School of Medicine. This study aimed to determine whether pretest scores or posttest scores correlated with the term–end examination scores.
1）Pretests and posttests were administered 7 times to 112 third–year medical students, and the term–end examination was given in the first semester of the 2010 academic year.
2）Correlations were determined between pretest scores, posttest scores, the difference between pretest and posttest scores, and term–end examination scores. In addition, students were divided into quartiles in accordance with the pretest scores, and the posttest and term–end examination scores were compared among these quartiles.
3）The pretest scores significantly correlated with the posttest and term–end examination scores. The posttest and term–end examination scores were significantly higher in the fourth quartile（the highest pretest score quartile）than in the first quartile（the lowest pretest score quartile）.
4）The posttest scores did not correlate with the term–end examination scores.
5）Thus, we concluded that the pretest score rather than the posttest score is a useful predictor of the term–end examination score.

This study aimed to investigate the changes in physical function, fatigue, and psychiatric symptoms in patients with hematological malignancy undergoing chemotherapy and low-intensity exercise training. Sixty-two hospitalized patients with hematological malignancy undergoing chemotherapy and low-intensity exercise were recruited. At the time of exercise initiation and hospital discharge, grip strength, knee extension muscle strength, maximum walking speed, Eastern Cooperative Oncology Group (ECOG) performance status, a measure of functional independence, cancer fatigue pain, and hospital anxiety and depression were evaluated. When longitudinal data were analyzed in each group, changes in grip strength and knee extension muscle strength were unevenly distributed: some patients showed a decrease in knee extension strength. On the other hand, maximum walking speed, the measure of functional independence, and ECOG performance status were maintained or improved in more than 90% of the patients. Results of fatigue, anxiety, and depression tended to show an improvement in female patients, but not in male patients. In conclusion, physical function was maintained in nearly all patients with hematological malignancy undergoing chemotherapy and low-intensity exercise training. Sex differences were found in changes of fatigue, anxiety, and depression.

Introduction: To implement effective medical education, it is important to clarify the process of recognizing and comprehending medical terms.　Methods: We conducted a questionnaire survey of 492 first- to fifth-year medical students to evaluate the recognition and comprehension rates of 57 medical terms in each grade. The terms were classified using the hierarchical cluster analysis based on the recognition and comprehension rates.　Results: The response rate was 91.1% (n=448). The 57 terms were classified into the following five clusters: #1, 30 terms that the students recognized and comprehended from Y1; #2, 18 terms that the students recognized from Y1 and comprehended as the grade increased; #3, six terms that the students recognized and comprehended as the grade increased; #4, two terms that the students recognized from Y1 but had not comprehended even in upper grades; #5, one term that the students recognized as the grade increased but had not comprehended even in Y5.　Discussion: Teachers may need to devise educational strategies while considering different patterns of students’ recognition and comprehension of medical terms.

Vision loss in diabetic retinopathy (DR) is ascribed primarily to retinal vascular abnormalities—including hyperpermeability, hypoperfusion, and neoangiogenesis—that eventually lead to anatomical and functional alterations in retinal neurons and glial cells. Recent advances in retinal imaging systems using optical coherence tomography technologies and pharmacological treatments using anti-vascular endothelial growth factor drugs and corticosteroids have revolutionized the clinical management of DR. However, the cellular and molecular mechanisms underlying the pathophysiology of DR are not fully determined, largely because hyperglycemic animal models only reproduce limited aspects of subclinical and early DR. Conversely, non-diabetic mouse models that represent the hallmark vascular disorders in DR, such as pericyte deficiency and retinal ischemia, have provided clues toward an understanding of the sequential events that are responsible for vision-impairing conditions. In this review, we summarize the clinical manifestations and treatment modalities of DR, discuss current and emerging concepts with regard to the pathophysiology of DR, and introduce perspectives on the development of new drugs, emphasizing the breakdown of the blood-retina barrier and retinal neovascularization.
Adrenal Cortex Hormones ; Angiopoietins ; Animals ; Diabetic Retinopathy* ; Endothelial Cells ; Endothelial Growth Factors ; Ischemia ; Macular Edema ; Mice ; Models, Animal ; Neuroglia ; Pericytes ; Retinal Neovascularization ; Retinal Neurons ; Retinaldehyde ; Tomography, Optical Coherence ; Vascular Endothelial Growth Factors

Background/Aims: Herbal medicine is an important complementary therapy for functional dyspepsia (FD). However, its effect against gastric hypersensitivity in patients with FD has rarely been evaluated. Yokukansan (YKS), a traditional Japanese herbal medicine, is effective against neuropathic and inflammatory pain. This study aims to use a maternal separation (MS) stress-induced FD model to investigate the effects of YKS against gastric hypersensitivity, gastric motility, and duodenal micro-inflammation. Methods: The MS stress model was established by separating newborn Sprague-Dawley rats from their mothers for 2 hours a day from postnatal days 1 to 10. At the age of 7-8 weeks, the rats were treated with YKS at a dose of 5 mL/kg (1 g/kg) for 7 consecutive days. AfterYKS treatment, electromyographic activity in the acromiotrapezius muscle by gastric distention and the gastric-emptying rate were assessed. Immunohistochemical analysis of eosinophils in the duodenum and phosphorylated extracellular signal-regulated kinase(p-ERK) 1/2 in the spinal cord was performed. Results: YKS treatment suppressed MS stress-induced gastric hypersensitivity and decreased the elevated levels of p-ERK1/2 in the spinal cord.In the gastroduodenal tract, YKS inhibited eosinophil-associated micro-inflammation but did not improve gastric dysmotility. Conclusions YKS treatment improved gastric hypersensitivity by alleviating eosinophil-associated micro-inflammation in the gastroduodenal tract.This treatment may be considered an effective therapeutic option for epigastric pain and micro-inflammation in patients with FD.

Background: With the expanding use of social media, medical students have been posting an increasing amount of content that against ethics and professionalism.　Objective: To develop a checklist for social media use within medical education based on our national survey.　Methods: We analyzed and classified unprofessional behaviors that occurred over the past ten years in Japan. Then, we developed an event-based checklist for the use of social media use.　Result: The behaviors violating ethics and professionalism were classified into 3 categories. We have developed a social media checklist consisting of 10 items.　Discussion: Since social networking services are becoming vital information technology, every medical student or professional may risk unprofessional behaviors when they post or exchange any professional information. We propose appropriate education using an event-based checklist for social media usage.

BACKGROUND: Systemic and local factors may lead to disruption of craniofacial growth and development, causing an imbalance between the orofacial skeleton, muscle and soft tissue, dental occlusion, and the dental arch during growth periods. We aimed to reveal whether the prevalence of incompetent lip seal (ILS) varies with age and region, as well as to clarify the factors related to an ILS, in a national, large-scale epidemiological study. METHODS: We surveyed 3399 children, from 3 to 12 years of age, visiting 66 pediatric dental clinics throughout Japan. For this survey, we employed a questionnaire consisting of 44 questions regarding daily health conditions and lifestyle habits. We evaluated the differences in ILS prevalence by age and region (using a Cochran-Armitage test for trend and a Kruskal-Wallis test), and the relationship between ILS and factors investigated in the questionnaire (using Spearman's rank correlation coefficient). RESULTS: We observed that 30.7% of Japanese children exhibited an ILS and that the ILS rate increased with age (p < 0.001). There were no regional differences in the rate of ILS in Japanese children (p = 0.506). We revealed that 12 of 44 survey items exhibited a statistically significant correlation with ILS (p < 0.001), using Spearman's rank correlation coefficient. These items involved orofacial morphology, mouth breathing, and possibly, allergic rhinitis. CONCLUSION The rate of ILS seems to increase with age in children, throughout Japan. Therefore, this disorder may not self-correct during the growth periods in these children. Guidelines are required for pediatric dentists to recognize ILS among children aged 3-12 years.
Child ; Child, Preschool ; Cross-Sectional Studies ; Female ; Humans ; Japan/epidemiology* ; Lip/abnormalities* ; Male ; Prevalence