Objectives: The aim of this study was to explore the first-year medical students’ perception of their learning from a lecture about sexual minorities.
Methods: In September 2012, a physician and a gynecologist first lectured about sex differences, reproductive medicine, and sexually transmitted infections. Next, the representative of a support group for a sexual minority talked about the prejudice and discrimination toward sexual minorities. He showed a video about a high school student who had publicity revealed his sexual orientation. We analyzed the students’ reports by the qualitative data analysis method Step Coding and Theorization. The students’ descriptions were extracted, coded by contents, and then grouped into several categories.
Results: Many students were surprised at the percentage of persons belonging to a sexual minority. By watching the DVD they came to realize that homosexuals are just like other persons in most ways. They mentioned the need for correct knowledge about sexual minorities.
Conclusion: We believe that the educational session about sexual minorities is meaningful for and valued by medical students, and medical care for sexual minorities should be taught to medical students.

BACKGROUND/AIMS: The gastrointestinal motility effects of endogenous incretin hormones enhanced by dipeptidyl peptidase-IV (DPP-IV) inhibitors have not yet been sufficiently investigated. The aim of this study was to determine whether single pre-prandial sitagliptin, the DPP-IV inhibitor, administration might have an effect on the rate of liquid gastric emptying using the 13C-acetic acid breath test. METHODS: Ten healthy male volunteers participated in this randomized, two-way crossover study. The subjects fasted for overnight and were randomly assigned to receive 50 mg sitagliptin 2 hours before ingestion of the liquid test meal (200 kcal per 200 mL, containing 100 mg 13C-acetate) or the test meal alone. Under both conditions, breath samples were collected for 150 minutes following the meal. Liquid gastric emptying was estimated by the values of the following parameters: the time required for 50% emptying of the labeled meal (T1/2), the analog to the scintigraphy lag time for 10% emptying of the labeled meal (Tlag), the gastric emptying coefficient and the regression-estimated constants (beta and kappa), calculated by using the 13CO2 breath excretion curve using the conventional formulae. The parameters between the 2 test conditions were compared statistically. RESULTS: No significant differences in the calculated parameters, including T1/2, Tlag, gastric emptying coefficient or beta and kappa, were observed between the 2 test conditions. CONCLUSIONS: The present study revealed that single-dose sitagliptin intake had no significant influence on the rate of liquid gastric emptying in asymptomatic volunteers.
Breath Tests ; Cross-Over Studies ; Eating ; Gastric Emptying ; Gastrointestinal Motility ; Humans ; Incretins ; Male ; Meals ; Pyrazines ; Triazoles ; Sitagliptin Phosphate

Objective: We investigated the relation between fasting insulin (FI) and risk of cerebral infarction in a Japanese general population. Methods: The subjects were 2,610 men and women without past history of stroke or myocardial infarction and under treatment for diabetes, examined between 1992 and 1995 as part of the Jichi Medical School Cohort Study. The FI level was measured once at the baseline. Subjects were divided into quintiles by FI levels, and Cox’s proportional hazard model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for cerebral infarction. Results: During an average of 11.1 years of follow-up, 87 participants developed cerebral infarction. Crude incidence rates of FI quintiles 1-5 were 4.69, 2.35, 1.85, 2.77 and 3.30 per 1,000 person-years, respectively. The multivariate-adjusted HRs for cerebral infarction were 2.33 (95% CI, 1.10 – 4.96) in quintile 1 (Q1), 1.25 (95% CI, 0.55 – 2.84) in Q2, 1.68 (95% CI, 0.76 – 3.70) in Q4 and 2.06 (95% CI, 0.94 – 4.47) in Q5, using Q3 as the reference. Conclusions: The lowest FI level was associated with increased risk of cerebral infarction and the association between FI and risk of cerebral infarction appeared to be a U-shaped relationship.

BACKGROUND/AIMS: The administration of liquid nutrients to patients is often accompanied by complications such as gastroesophageal reflux. To prevent gastroesophageal reflux, high-viscosity liquid meals are used widely, however, it still remains controversial whether high-viscosity liquid meals have any effect on the rate of gastric emptying. The present study was conducted with the aim of determining whether high-viscosity liquid meals had any effect on the rate of gastric emptying and mosapride might accelerate the rate of gastric emptying of high-viscosity liquid meals. METHODS: Six healthy male volunteers underwent 3 tests at intervals of > 1 week. After fasting for > 8 hours, each subject received one of three test meals (liquid meal only, high-viscosity liquid meal [liquid meal plus pectin] only, or high-viscosity liquid meal 30 minutes after intake of mosapride). A 13C-acetic acid breath test was performed, which monitored the rate of gastric emptying for 4 hours. Using the Oridion Research Software (beta version), breath test parameters were calculated. The study parameters were examined for all the 3 test conditions and compared using the Freidman test. RESULTS: Gastric emptying was significantly delayed following intake of a high-viscosity liquid meal alone as compared with a liquid meal alone; however, intake of mosapride prior to a high-viscosity liquid meal was associated with a significantly accelerated rate of gastric emptying as compared with a high-viscosity liquid meal alone. CONCLUSIONS: This study showed that high-viscosity liquid meals delayed gastric emptying: however, mosapride recovered the delayed rate of gastric emptying by high-viscosity liquid meals.
Benzamides ; Breath Tests ; Cross-Over Studies ; Fasting ; Gastric Emptying ; Gastroesophageal Reflux ; Humans ; Male ; Meals ; Morpholines ; Pectins

1)Professionalism should be explicitly introduced as a fundamental content into curricula/programs of undergraduate medical education, postgraduate clinical training, and of continuing medical education provided by professional societies and the Japan Medical Association.
2)We need to enhance our research activities on goals and objectives which should be accomplished through professionalism education, effective learning strategies, appropriate assessment methods, as well as the impact of informal and hidden curricula.
3)We propose that the medical profession should collaboratively develop various activities to win the trust of the general society in tandem with the introduction of professionalism education.

BACKGROUND/AIMS: There are few reports on the correlation between chewing gum and the gastrointestinal functions. But previous report showed use of chewing gum to be an effective method for controlling gastrointestinal symptoms. The aim of this study was to determine the correlation between chewing gum and gastric emptying using the continuous real time 13C breath test (BreathID system). METHODS: Ten healthy male volunteers participated in this randomized, 2-way crossover study. The subjects fasted overnight and were randomly assigned to chewing gum (Xylish, 2-3/1 tablet) for an hour following intake of a test meal (200 kcal/200 mL) or intake of the test meal alone. Gastric emptying was monitored for 4 hours after administration of the test meal by the 13C-acetic acid breath test performed continually using the BreathID system. RESULTS: No significant differences in the calculated parameters, namely, T1/2 (median, 111.82 vs 109.26 minutes; P = 0.575), Tlag (median, 53.28 vs 56.53 minutes; P = 0.333), gastric emptying coefficient (median, 3.58 vs 3.65; P = 0.285), regression-estimated constant beta (median, 1.85 vs 1.80; P = 0.575) and regression-estimated constant kappa (median, 0.61 vs 0.62; P = 0.959) were observed between the test meal alone group and the test meal and chewing gum group. CONCLUSIONS: This study showed that chewing gum had no effect on the rate of gastric emptying. Therefore, since chewing gum did not enhance the speed of gastric emptying, it may ameliorate gastrointestinal symptoms through other mechanisms, such as saliva and autonomic nervous system.
Autonomic Nervous System ; Breath Tests ; Chewing Gum ; Cross-Over Studies ; Gastric Emptying ; Humans ; Male ; Mastication ; Meals ; Saliva

1) To our knowledge, medical student abuse has not previously been studied in Japan.
2) In our survey, 68.5% of respondents experienced medical student abuse.
3) Several students reported that they had been frequently neglected or ignored by teaching physicians during clinical clerkships and that such attitudes discouraged them and decreased their motivation.
4) To improve the learning environment, medical educators must take action to resolve this serious issue.

Since the publication of To Err is Human in 1999, medical schools around the worldhave been discussing ways to teach medical students about patient safety. To deepen the understanding of patient-safety curriculums used in the United States, Dr. Matthew Weinger, director of the San Diego Center for Patient Safety and a professor at the University of California, San Diego, School of Medicine (UCSD), was invited to participate in around-table discussion on “Patient Safety Curriculum for Medical Students” held at Yokohama City University. Althoughthere have been active discussions in journals and within medical school faculties, no discernable consensus has emerged in the United States, other than that patient safety should become part of the educational system. The patient-safety curriculum used at UCSD and the curriculums promoted by the Department of Veterans' Affairs National Center for Patient Safety are introduced.

A survey was performed to examine residents' awareness of patient safety. Sixty-two residents who had just finished their first year of residency participated in the study. Of the 62 residents, 30 were training at Yokohama City University Hospital and 32 were training at other hospitals. Although all residents knew about the serious medical mishap ( “surgical mix-up” ) that had occurred at Yokohama City University Hospital in 1999, only 53% knew about the judicial verdict in this case. The residents most often believed that the mishap was the fault of the hospital and its system (82%), followed by nurses (73%), supervising doctors (62%), and residents (45%). Seventy percent of the residents knew about the “Incident Reporting System, ” but only 20% had written an incident report. Incidents experienced or observed by residents were most often medication-related. No significant differences in the results of the survey were found between residents of Yokohama City University Hospital and those of other hospitals. In conclusion, although residents recognize the importance of patient safety at the end of the first year of their residency program, they still cannot deal properly with incidents.

In autumn 2005, a 15-hour patient-safety education program was incorporated into the core curriculum for fourth-year medical students at the Yokohama City University School of Medicine. Sixty students took part in the program. The goals of the curriculum are for students to understand the prevalence and origins of medical errors and to increase awareness of the physician's responsibility for patient safety. Because typical learning methods, such as didactic lectures, might not be effective, we developed an experimental or case-based learning method. Educational modalities included small-group discussion of medical errors, role-playing of medical error disclosure, and experience operating infusion pumps. In addition, to bridge the gap between educational systems and hospital systems, we collaborated with other healthcare workers, such as nurses and hospital pharmacists. Students evaluated the program favorably; most recommended continuing the curriculum for future medical student classes.