Syndrome of the trephined (SoT) is a complication that develops weeks to months after decompression craniotomy. Previous studies have reported cases in which paralysis, disturbance of consciousness, and cognitive impairment associated with the primary disease worsened, and cases in which new neurological symptoms appeared in addition to the primary disease. It is known that cranioplasty rapidly improves these symptoms, but there are few reports on rehabilitation treatment for SoT. In this report, we describe a case of paralysis limited to the right hand due to SoT. The patient was a 34-year-old male who underwent decompression craniotomy for a left acute subdural hematoma on day X-180. No paralysis or cognitive impairment were observed. He was discharged home on day X-106, but paralysis of the right hand appeared around day X-100. The cause was unknown, but it was suspected to be due to the decompression craniotomy. He received cranioplasty on day X, and was referred to the rehabilitation department on day X+1. We considered that the paralysis was influenced by SoT, and a task-oriented training and electrical stimulation therapy approach was applied. The paralysis improved rapidly and the patient recovered completely on day X+29. This case suggests that SoT resulting in paralysis limited to the fingers may have a good prognosis and that high goals can be set in rehabilitation treatment.

Syndrome of the trephined (SoT) is a complication that develops weeks to months after decompression craniotomy. Previous studies have reported cases in which paralysis, disturbance of consciousness, and cognitive impairment associated with the primary disease worsened, and cases in which new neurological symptoms appeared in addition to the primary disease. It is known that cranioplasty rapidly improves these symptoms, but there are few reports on rehabilitation treatment for SoT. In this report, we describe a case of paralysis limited to the right hand due to SoT. The patient was a 34-year-old male who underwent decompression craniotomy for a left acute subdural hematoma on day X-180. No paralysis or cognitive impairment were observed. He was discharged home on day X-106, but paralysis of the right hand appeared around day X-100. The cause was unknown, but it was suspected to be due to the decompression craniotomy. He received cranioplasty on day X, and was referred to the rehabilitation department on day X+1. We considered that the paralysis was influenced by SoT, and a task-oriented training and electrical stimulation therapy approach was applied. The paralysis improved rapidly and the patient recovered completely on day X+29. This case suggests that SoT resulting in paralysis limited to the fingers may have a good prognosis and that high goals can be set in rehabilitation treatment.

The Professionalism subcommittee of Japan Society for Medical Education has been examining a diverse range of issues related to medical professionalism education for approximately the past 20 years. In July 2015, the committee formulated and presented a draft on “ The Attributes and Competencies of Physicians: An Exploration of Professionalism” Based on this, we have been conducting educational activities on professionalism education, but we had not documented this draft. We are now re-presenting the draft here with minor lexical corrections and additional notes. The professionalism of physicians is delineated in seven attributes and competencies :1. Sense of mission and responsibility towards society2. Practice of patient-centered health care3. Demonstration of integrity and justice4. Acceptance of diverse values and sharing of fundamental values5. Fulfilling roles as leaders/members in organizations and teams6. Pursuit of excellence and lifelong learning7. Self-management and career developmentThis document is presented with the expectation that it will contribute to future discussions on professionalism education.

Objective: To describe anatomic patterns of the superficial uterine vein (sUV) and assess their association with aspects of the dissection procedure of the anterior layer of the vesicouterine ligament (aVUL) by retrospectively reviewing surgical videos. Methods: We analyzed patients who underwent laparoscopic radical hysterectomy for early-stage cervical cancer from 2014 to 2019. The primary endpoint was the time required for aVUL dissection. Multiple linear regression analyses were performed to identify factors influencing the time required for aVUL dissection. Results: Fifty-three Japanese patients were included. Two sUV configurations were observed:type 1 (the vein ran ventral to the ureter along the uterine artery) and type 2 (the vein did not run along the usual ventral course; it ran dorsal to the ureter or was absent). Approximately 30% of the sUVs were type 2. The total time for dissection of both sides of the aVUL was significantly shorter for type 2 sUVs than for type 1 sUVs. The number of hemostatic interventions during dissection of each side of the aVUL was significantly lower for type 2 sUVs than for type 1 sUVs. In the multivariate analysis, the sUV configuration was the factor significantly influencing the duration of aVUL dissection on each side (right side: β=−143.4;left side, β=−160.4). Conclusion We demonstrated that the sUV had 2 types of courses, ventral and others, and its course affected the time required for dissection and the number of hemostatic interventions.Our results provide information supportive of improved radical hysterectomy outcomes.

Objective: To describe anatomic patterns of the superficial uterine vein (sUV) and assess their association with aspects of the dissection procedure of the anterior layer of the vesicouterine ligament (aVUL) by retrospectively reviewing surgical videos. Methods: We analyzed patients who underwent laparoscopic radical hysterectomy for early-stage cervical cancer from 2014 to 2019. The primary endpoint was the time required for aVUL dissection. Multiple linear regression analyses were performed to identify factors influencing the time required for aVUL dissection. Results: Fifty-three Japanese patients were included. Two sUV configurations were observed:type 1 (the vein ran ventral to the ureter along the uterine artery) and type 2 (the vein did not run along the usual ventral course; it ran dorsal to the ureter or was absent). Approximately 30% of the sUVs were type 2. The total time for dissection of both sides of the aVUL was significantly shorter for type 2 sUVs than for type 1 sUVs. The number of hemostatic interventions during dissection of each side of the aVUL was significantly lower for type 2 sUVs than for type 1 sUVs. In the multivariate analysis, the sUV configuration was the factor significantly influencing the duration of aVUL dissection on each side (right side: β=−143.4;left side, β=−160.4). Conclusion We demonstrated that the sUV had 2 types of courses, ventral and others, and its course affected the time required for dissection and the number of hemostatic interventions.Our results provide information supportive of improved radical hysterectomy outcomes.

Objective: To describe anatomic patterns of the superficial uterine vein (sUV) and assess their association with aspects of the dissection procedure of the anterior layer of the vesicouterine ligament (aVUL) by retrospectively reviewing surgical videos. Methods: We analyzed patients who underwent laparoscopic radical hysterectomy for early-stage cervical cancer from 2014 to 2019. The primary endpoint was the time required for aVUL dissection. Multiple linear regression analyses were performed to identify factors influencing the time required for aVUL dissection. Results: Fifty-three Japanese patients were included. Two sUV configurations were observed:type 1 (the vein ran ventral to the ureter along the uterine artery) and type 2 (the vein did not run along the usual ventral course; it ran dorsal to the ureter or was absent). Approximately 30% of the sUVs were type 2. The total time for dissection of both sides of the aVUL was significantly shorter for type 2 sUVs than for type 1 sUVs. The number of hemostatic interventions during dissection of each side of the aVUL was significantly lower for type 2 sUVs than for type 1 sUVs. In the multivariate analysis, the sUV configuration was the factor significantly influencing the duration of aVUL dissection on each side (right side: β=−143.4;left side, β=−160.4). Conclusion We demonstrated that the sUV had 2 types of courses, ventral and others, and its course affected the time required for dissection and the number of hemostatic interventions.Our results provide information supportive of improved radical hysterectomy outcomes.

In the revised Core Curriculum, professionalism is listed as one of the basic qualities and abilities required of physicians. The definition of professionalism and related learning objectives (1. trust, 2. compassion, 3. liberal arts, and 4. bioethics) are also presented. However, the Core Curriculum does not explain why these objectives were listed. Therefore, some of them are difficult to understand or differ from what has been discussed in previous meetings of the current subcommittee (and previous committees). To properly and effectively advance professionalism education, it is necessary to confirm the contents of the revised Core Curriculum that are insufficient or inappropriate. It is also necessary to deepen the discussion for the next revision of the Core Curriculum. A symposium was held for this purpose. The main points of each lecture are presented within this report.

With the enactment of the amended Anti-Discrimination Act, which mandates the provision of reasonable accommodations, the urgent task for all health professional education institutions is to establish a support system for students with developmental disabilities. On the other hand, they are also required to fulfill their social accountability through quality assurance in education, such as the implementation of outcome-based education curriculum. In order to consider how to balance reasonable accommodations for students with developmental disabilities, quality assurance in education, and social accountability in undergraduate medical education, Professionalism Subcommittee held a workshop on April 22, 2023. The participants engaged in active discussions during the workshop.　Through a post-workshop survey, educational needs and challenges in supporting students with developmental disabilities were clarified, providing insights for future Subcommittee activities.

In 1952, the Japanese Society for Hygiene had once passed a resolution at its 22nd symposium on population control, recommending the suppression of population growth based on the idea of cultivating a healthier population in the area of eugenics. Over half a century has now passed since this recommendation; Japan is witnessing an aging of the population (it is estimated that over 65-year-olds made up 27.7% of the population in 2017) and a decline in the birth rate (total fertility rate 1.43 births per woman in 2017) at a rate that is unparalleled in the world; Japan is faced with a "super-aging" society with low birth rate. In 2017, the Society passed a resolution to encourage all scientists to engage in academic researches to address the issue of the declining birth rate that Japan is currently facing. In this commentary, the Society hereby declares that the entire text of the 1952 proposal is revoked and the ideas relating to eugenics is rejected. Since the Society has set up a working group on the issue in 2016, there have been three symposiums, and working group committee members began publishing a series of articles in the Society's Japanese language journal. This commentary primarily provides an overview of the findings from the published articles, which will form the scientific basis for the Society's declaration. The areas we covered here included the following: (1) improving the social and work environment to balance between the personal and professional life; (2) proactive education on reproductive health; (3) children's health begins with nutritional management in women of reproductive age; (4) workplace environment and occupational health; (5) workplace measures to counter the declining birth rate; (6) research into the effect of environmental chemicals on sexual maturity, reproductive function, and the children of next generation; and (7) comprehensive research into the relationship among contemporary society, parental stress, and healthy child-rearing. Based on the seven topics, we will set out a declaration to address Japan's aging society with low birth rate.
Aging ; Birth Rate ; trends ; Child ; Child Health ; Environmental Exposure ; adverse effects ; prevention & control ; Female ; Health Planning Guidelines ; Humans ; Japan ; epidemiology ; Male ; Occupational Health ; Reproductive Health ; education ; Research Design ; standards ; Societies, Scientific ; organization & administration ; Stress, Psychological ; prevention & control ; Women's Health

Objective: For effective use of over-the-counter (OTC) drugs that are provided as relief supplies during a disaster, we aimed to develop a list of OTC drugs that can be used during a disaster.
Methods: We obtained information about OTC drugs useful during a disaster by examining results of previous studies and lists of drugs used during a disaster.  We analyzed this information with the expert pharmacist of disaster support and established a rationale for our list and developed “the List of Useful OTC Drugs During a Disaster” and “the Information Card on Useful OTC Drugs During a Disaster.”
Results: We developed our list of OTC drugs based on the following parameters: (1) while people with severe disorders (e.g. renal failure) are treated by medical teams, those with minor physical conditions are treated using OTC drugs and (2) those OTC drugs that can be used as substitutes for prescription drugs were preferably selected.  The List of Useful OTC Drugs ()—During a Disaster (containing 56 items) was developed for use mainly by medical professionals.  Further, pharmacists from disaster-relief medical teams may not always be available in disaster-stricken areas; therefore, the Information Card on Useful OTC Drugs During a Disaster was developed to enable disaster victims to independently make a certain level of decision.  The information card contained pictograms to call the attention of the disaster victims.
Conclusion: Our results can provide a common tool for drug suppliers, medical professionals engaging in relief works in disaster-stricken areas, and disaster victims.