Objectives: Obstructive sleep apnea syndrome (OSAS) affects patients' vital prognosis. Although adenotonsillar hypertrophy is linked to the pathogenesis of OSAS in children, the etiological role of childhood adenotonsillar hypertrophy in the later development of OSAS in the Japanese general population is unknown.

Methods: We evaluated 1121 male factory workers aged ≥20 years who underwent home portable monitoring for screening examinations of OSAS in Japan. The relative risk of developing OSAS among patients with a history of adenotonsillar hypertrophy in childhood and the relative risk reduction associated with treatment were estimated.

Results: We identified 85 men with OSAS (prevalence, 7.2%). The relative risk of OSAS in patients with untreated adenotonsillar hypertrophy was 2.92 (95% confidence interval [CI], 1.42–6.13). The relative risk reduction for treatment of adenotonsillar hypertrophy with OSAS was estimated as 78.3% (95% CI, 4.7–95.3) in men with a history of adenotonsillar hypertrophy and 11.9% (95% CI, 4.4–21.5) in the whole male population with and without a history of adenotonsillar hypertrophy.

Conclusions: The findings of this study suggest a large relative risk reduction of adult OSAS in patients who have undergone treatment of adenotonsillar hypertrophy in childhood.

Objectives: The aim of this study was to investigate changes in health university students' attitudes toward community service before and after a community-oriented education program using team-based learning (TBL).

Methods: A community-oriented educational program using TBL was carried out with a total of 529 3rd- and 4th-year students in seven faculties of two departments at Fujita Health University, and a questionnaire survey was conducted before and after the program. There were eight questions on students' attitude toward community service.

Results: Responses with no missing information from 431 students were used in the analysis. There were significant increases in the number of positive responses to three questions after TBL. The item "I think there are things that university students can do as members of the community" increased from 81.9% before TBL to 86.5% after, "I can form specific images of activities that benefit the community" increased from 46.0% before to 70.3% after, and "In the future I want to participate in activities that benefit the community" increased from 74.7% before to 80.3% after.

Conclusion: The results suggest that this community-oriented educational program using TBL raised the motivation of university students in medical and health science programs to practice community health care.

Objective: This study aimed to examine the effects of interprofessional education (IPE) using team-based learning (TBL).

Methods: We analyzed the results of a scale to measure IPE among 449 fourth-year students from seven faculties of a health university in Japan. The students took the Assembly Special Lesson as part of IPE using TBL. Before and after the lesson, the participants completed a questionnaire, which consisted of the IPE Tsukuba Model, to which we added two items. The scale was divided into five domains. We compared the scores using the Wilcoxon signed-rank test.

Results: The overall scores of four of the five domains of the IPE evaluation were significantly higher after the lesson than before (P<0.05): "Understanding the role of each profession's specialization" ; "Regarding participation in group work" ; "Thoughts regarding the team in healthcare and welfare" ; and "Feelings about cooperation among different professions."

Conclusions: It was evident that the lesson enhanced the students' understanding of the role of other professionals, enabled them to participate in group work, and allowed them to understand the responsibilities of each profession within a team, thereby leading to greater cooperation and better health care. This TBL for IPE was found to be effective by producing valuable changes in perceptions and attitudes toward professional cooperation among students.

Objectives: Demonstration of flat electroencephalogram (EEG) both at low- and high-sensitivity is required to legally determine brain death. Critically brain-injured patients frequently undergo decompressive craniectomy (DC) to relieve the raised intracranial pressure before being considered as candidates for legal brain death determination. The main objective of this study was to evaluate influence of DC on the interpretation of EEG at high-sensitivity.

Methods: A retrospective study was conducted in 23 critically brain-injured patients with flat EEGs at low-sensitivity. An experienced EEG technician determined whether each high-sensitivity EEG was interpretable as flat in a blinded manner. DC had been performed in 13 patients (57%).

Results: There was no significant difference in the demographics between the DC and non-DC group. The frequency of flat EEG at high-sensitivity was 62% in DC and 100% in the non-DC group, and the difference was statistically significant (p = 0.045). Determination of flat EEG at high-sensitivity was unable to be made in five DC patients (38%). All five patients died within 4 days of the initial EEG.

Conclusions: In DC patients, EEG amplitudes at high-sensitivity may be exaggerated on the side of DC due to the absence of the skull. The findings of this study are: (1) 38% of DC patients showed some electrical activity at high-sensitivity on the side of DC; and (2) the electrical activity disappeared within several days and did not predict resuscitability. These findings may be useful to physicians who treat critically brain injured patients.

  A 34-year-old woman with type 1 diabetes on hemodialysis was admitted to our hospital for simultaneous pancreas kidney transplantation received from her father. She had suffered from type 1 diabetes mellitus since age 13, and had complained of serious atonic gastroenteropathy and orthostatic hypotension. After the transplantation, she became free from hemodialysis and insulin injection. At the same time, her gastrointestinal symptoms disappeared. However, she still had orthostatic hypotension, which was improved by taking fludrocortisone. Two months after the transplantation, orthostatic hypotension with marked polyuria became obvious. By hypertonic saline challenge test, she was diagnosed as partial central diabetes insipidus. Although treatment with desmopressin was necessary for 5 months, she became free from medication afterwards. Diabetes insipidus seems to be a rare but could be an important complication after simultaneous pancreas kidney transplantation and/or or kidney transplantation.