Medical statistics need to be properly understood and used in order to assess the significance of results obtained in clinical practice. To clarify whether the medical staff in our hospital appropriately understands medical statistics, this study conducted a questionnaire survey with an objective assessment of basic medical statistics. Of 1498 hospital staff, 464 responded to the questionnaire on medical statistics, which included the following items considered important for the evaluation and use of hypothesis testing: interpretation of p-values, reasons for using different tests (t-test and Mann-Whitney U-tests), presentation of test results for the Mann-Whitney's U-test, and selection of a statistical method to use as a measure of independence. The percentage of correct answers was 20.5%, 16.2%, 6.3%, and 15.1% for the interpretation of p-values, reasons for using different tests, presentation of test results, and choice of statistical method, respectively. The percentage of correct answers for each question was significantly higher for those with research and writing experience than for those without such experience. The number of correct answers was also significantly higher for those with research and writing experience than for those without such experience. Additionally, 20 of the 464 respondents were able to correctly answer all four questions. Multiple regression analysis showed that the number of correct answers was associated with experience in research, experience in writing papers, and job title (multiple regression analysis: R2=0.429758). Our medical staff’s understanding of medical statistics was low, and we were able to identify some of the factors that influence this understanding. These results suggest the importance of learning from clinical research and writing experience in order to improve understanding of medical statistics in the future.

　　This study was designed to clarify the factors affecting hospital staff behavior toward participation in lectures and workshops held in our hospital. A questionnaire survey was conducted to evaluate staff background and staff participation in these events. The survey revealed that in the past year, 78.7% of staff had attended lectures or workshops at least once. The participation rate in lectures and workshops associated with medical safety and infection control was 50.4% and 38.4%, respectively. Additionally, the participation rate was dependent on job type. Of interest, staff behavior toward participation was strongly influenced by factors related to the training content, such as medical safety and infection control, but not by environmental factors, such as marital status and familial status (with or without children). The survey results also showed that factors related to “hassle”, such as rearranging their work hours to allow for participation, negatively affected active participation in meeting events. These results suggest that factors affecting hospital staff participating in these events may, in part, be implicated in professionalism as medical staff, and that this can be influenced by job type and motivation, rather than by environmental factors.

　　This study sought to examine the impact of the approaches being taken to deal with current problems between the hospital and staff from the viewpoint of organizational identity. First, we devised educational strategies that allowed staff to speak directly to the hospital director. Next, the director spoke to staff about the background and history, the basic philosophy, and the vision of the hospital, as well as their place and mission in the community. We also conducted a 7-item questionnaire survey (1-5 graded Likert scale) of 894 staff from November 2012 to September 2013. Collection and response rates were 80.3% each. Regarding the direct communication between our hospital director with staff, response to the items “background and history of our hospital”, “espoused the basic philosophy of our hospital”, “had a collective vision our hospital”, and “understood one's place and mission in the community” were significantly increased after the on-the-job training compared with before receiving the training. We confirmed that about 90% of staff understood the items “background and history of our hospital”, “espoused the basic philosophy of our hospital”, “had a collective vision our hospital”, and “understood their place and mission in the community”. Also, two factors, “organizational identity” and “a sense of distance from the hospital organization”, were extracted from the 7 questions for factor analysis. The reliability of this scale was high and showed high internal consistency (Cronbach's α coefficient＝0.837 and 0.670, respectively). The results of these tests for validity of the scale indicate its high content validity. Together, these results suggest that direct communication between our hospital director and staff was extremely useful for penetrating the organizational environment and enhancing staff's organizational identity.

　　This study sought to elucidate factors that affect the cultivation of organizational identity among our hospital staff. We conducted a questionnaire survey among hospital staff (N＝894) from November 2012 to September 2013. The following items were queried: job category, age, sex, marital status, with or without children, participation in lectures or workshops in the previous year, and experience in clinical research and related data analysis. The response rate for the survey was 80.3%. Univariate analysis showed that all abovementioned parameters affected the cultivation of organizational identity. Further study using multivariate logistic regression analysis was performed to clarify which factors are significantly involved in the cultivation of organizational identity. Our results show that job category, participation in lectures or workshops in the previous year, and experience in clinical research and related data analysis are effective in cultivating organizational identity. These results suggest that a sense of professionalism as medical staff may play a critical role in the cultivation of organizational identity.

　The number of medical staff who can conduct clinical research in our hospital has been decreasing every year, and thus education that enhances medical staff's understanding of the importance of clinical research is an important factor in improving patient management. Although staff education has begun to develop infrastructure necessary for conducting clinical research, it is unclear whether medical staff who must play a critical role in clinical research are actually interested in conducting research and participating in research-related educational programs. We carried out a cross-sectional questionnaire survey of medical staff to determine their interest in clinical research activities and related education. Of 894 medical staff who participated in a workshop at Anjo-Kosei Hospital, 718 responded to the survey (response rate: 80.3%), 24.9% of whom had experience in clinical research and 51.0% had an interest in the field and related data analysis. Furthermore, 51.0% of respondents showed demonstrable intention to participate in staff education. Such intention to participate was particularly obvious among clinicians, pharmacists, registered dietitians, radiologists, and rehabilitation therapists. Also, staff in their 30s and 40s were frequently interested in conducting clinical research and related data analysis. This suggests that these staff prefer a research environment where they can undertake clinical research soon after completing clinical training. Moreover, regarding the question of specific educational areas, statistical methods for data analysis garnered the highest interest, followed by methods of writing a research paper, use of statistical software, data interpretation, designing research, and identifying research topics. Therefore, such educational programs should be flexible to suit medical staff who perform data analysis as well as clinical research.

　　Anti-androgen therapy is commonly used for prostate cancer and it has been reported to induce severe hyperglycemia. Diabetic chorea is characterized by acute uni- or bilateral chorea or ballismus and hyperintensity of the striata on T1-weighted magnetic resonance imaging (MRI) images, and is associated with changes in the blood glucose level. We report here a case of diabetic chorea caused by severe hyperglycemia induced by anti-androgen therapy. A 71-year-old man received a diagnosis of prostate cancer and was given leuprorelin acetate (11.25mg, every 3 months) and bicalutamide (80mg/day). After the third injection of leuprorelin acetate, he developed involuntary movements of the right extremities. His glucose and hemoglobin A1c levels were found to be markedly elevated (691mg/dl and 19.5%, respectively), and brain MRI showed high-intensity areas in the left striatum on T1-weighted imaging. The diagnosis was diabetic chorea and he was admitted to our department. His involuntary movements diminished immediately after intravenous infusion of 500 ml saline. His blood glucose level was decreased after initiation of basal/bolus insulin therapy and discontinuation of leuprorelin acetate, but he gradually developed involuntary movement of right extremities again.

　　The main purpose of our hospital training program for newly hired employees at Anjo Kosei Hospital is to encourage them to learn basic knowledge to live as a member of society. In this study, questionnaire surveys for all recruits were carried out at the beginning, at the end of, and 6 months after the training program to evaluate the significance of the training program. The number of the study subjects who had our training program was 138 in 2012 and 146 in 2013. We have placed great emphasis on our fundamental principles for the recruits to learn. The series of surveys showed that the lecture given by our hospital director on the ideals of hospital care was well received by the recruits. Moreover, the experience-oriented training program also satisfied the participants greatly, as it included the tour of hospital, and the training of safety in medical treatment, infection control, and customer support. Additionally, the surveys found that our hospital training program allowed the new employees to deeply understand a basic knowledge to live as a member of society. Furthermore, the questionnaire survey made at 6 months after the training program revealed that over 80% of the recruits thought our training program would play an important role in promoting their job skill. These results suggest that questionnaire surveys are useful to evaluate the change in their ideas of the recruits before and after the training program, leading to an improvement of the quality of our hospital training program.

  In order to intervene in the management of pain of cancer from an early stage. Our palliative care team (PCT), including pharmacists, makes the ward rounds (screening rounds) of the patients receiving opioids at our hospital. The purpose of this study was to analyze the effects of screening rounds activity by the PCT and its current problems, and to explore how to resolve the problems. We retrospectively studied the records of 196 patients who had receivede interventions by the PCT, with regard to intervention status and prescription proposal (228 subjects) about drug therapy by us. Study groups were as follows: 103 patients to whom interventions were deliveed at the request of medical doctors (intervention request group) and 93 patients who had interventions by the PCT after PCT-screening rounds (screening group). PCT-screening rounds caused to increase the number of interventions by the PCT. After PCT-screening rounds, the cases of intervention started by the request of medical doctors, who had given no heed to PCT intervention, also increased in numher. In this study, some problems with palliative intervention were also brought to light. Even in the screening group where the PCT largely intervened, 33% of prescription proposal by the PCT was ignored. This problem may be, at least in part, due to inadequate communication between PCT and ward staff through an electronic medical recording card, leading to poor relationship between PCT and ward staff. In the future, the PCT needs to work cooperatively with ward staff through direct communication such as medical conference to perform better intervention.

Tenmin NAMIKAWA (並河天民) thought the Shanghanlun (傷寒論) was an important text. He also taught his pupils the importance of prescribing Zhongjing ZHANG's (張仲景) medicines. Ryokyu ARIMA (有馬凉及) was a physician-teacher, who prescribed Chengqitang (承気湯) for the emperor without conferring with other doctors. His chengqitang formulary was derived from medical texts by Zhongjing ZHANG. Kyugo GODA (合田求吾) on the other hand, was a pupil of Ikkannsai MATSUBARA (松原一閑斎), who wrote in the Idokikigaki (医道聞書) : theKoho (古方) school started by Ryokyu ARIMA. He was a hero who was punished by the Goseiin (後西院) emperor. He taught Koho to Tenmin. This therefore reveals that Ryokyu ARIMA was a teacher who taught the importance of the Shanghanlun.

Until the Sui Dynasty in China, night sweat and spontaneous perspiration had been thought to be caused by same pathophysiology, that is, lowered superficial resistance by deficiency of Qi.In the Tang Dynasty, these were considered to have different pathophysiologies and a new principle indicated that pathogenic heat caused night sweat.In the Song and Jing Dynasties, deficiency of blood and pathogenic heat by deficiency of Yin was also considered to cause night sweat.In the Jing Dynasty, exogenous pathogens, such as Cold were considered to cause night sweat, which indicated the principle that not only the deficiency syndrome but also the excess syndrome caused night sweat.In the beginning of the Yuan and Ming Dynasties, it was concluded that the deficiency of Yin caused night sweat and the deficiency of Yang caused spontaneous perspiration.In the middle of the Ming Dynasty, another new theory indicated that deficiency of Yang also possibly caused night sweat; therefore we should diagnose abnormal sweat depending on the pathophysiology in each case.In the Qing Dynasty, new theories were established stating that not only exogenous pathogens but also Damp-heat, undigested food and stagnation of blood, all of which are included in excess syndrome, cause night sweat, and that based on which part of the body sweats occurred we might understand pathophysiology of night sweat. The night sweat by Warm-heat, which is different from the one by Wind-cold, was considered to be caused with deficiency of Yin.Thus we conclude that the theories of night sweat developed over time, based on Chinese medical classics.