Juntendo Medical Journal
Online ISSN : 2188-2126
Print ISSN : 2187-9737
ISSN-L : 2187-9737
Volume 65 , Issue 3
Showing 1-12 articles out of 12 articles from the selected issue
Contents
What's New from Juntendo University, Tokyo
  • Problem-Based Learning to Encourage Active Learning and Teamwork Among First Year Medical Students - Student Reports in 2016 -
    MARIKO KOBAYASHI, NOZOMU SUGA, MIWAKO TOYODA, RIE KOIZUMI
    2019 Volume 65 Issue 3 Pages 244-249
    Published: 2019
    Released: August 10, 2019
    JOURNALS OPEN ACCESS

     This study aims to identify the type of interview that is the most suitable for evaluating a student’s personality and communication skills as part of medical school entrance examinations. Based on the importance of interviews for testing the aptitude of a student in this context, we examined different interview formats, duration, content, evaluation criteria, and scoring methods of interview performance. We further evaluated four interview formats (i.e., an individual interview, a several-interviewer interview, a group interview, and a group discussion) from the viewpoints of practicality, reliability, and validity, as well as 11 abilities measured (i.e., communication skills, enthusiasm, logical thinking/reasoning, problem-solving ability, judgment, human nature, moral standards, physical ability, cooperativeness, resourcefulness, and personality/background). Based on our analysis, we argue that the most appropriate interview exam consists of two phases: a several-interviewer interview and a group discussion, because the several-interviewer interview comes first in terms of practicality, reliability, and validity, and ability measured scores. Furthermore, by combining the several-interviewer interview with the group discussion, problem-solving ability and cooperativeness are easier to measure than in a single interview format. Moreover, we recommend some measures to improve the interview system, for example, having a 15-minute interview for each of the two interview formats, and making the evaluation criteria for grading interviews open to the public. This improvement will enable each medical school to conduct effective interviews for entrance exams to measure an applicant’s suitability to become a medical professional.

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  • Problem-Based Learning to Encourage Active Learning and Teamwork Among First Year Medical Students - Student Reports in 2017 -
    MINORI ANDO, HARUKO HIROKAWA, KAORU YAMASHITA, RIE KOIZUMI
    2019 Volume 65 Issue 3 Pages 250-254
    Published: 2019
    Released: August 10, 2019
    JOURNALS OPEN ACCESS

     This study examined essay writing in medical school entrance exams with respect to the types of essay used, the skills they aim to evaluate, and the type of essay most frequently used. Further, we conducted a survey of Juntendo University’s first-year medical students (N=138) to understand how test takers feel about these tests. We found that essays can be classified into five essay types (i.e., theme-based essays, assignment-based essays, English-Japanese essays, subject-related essays, and other types), showing that each essay type aims to measure overlapping but varied abilities. It was also found that overall, 42.3% (44/104) of medical school entrance exams in Japan had essay-writing tests for the period 2014-2017, and that the most popular essay type was assignment-based (52%, 23/44). In contrast, the analysis of the questionnaire answered by students showed that they think that the theme-based type is the most suitable for entrance exams (67%, 61/91), followed by the assignment-based type (16%, 56/93). Three quarters of students thought that essay writing is necessary in entrance exams (77%, 72/93), but the percentage of students who thought their essay had an impact on passing their exam (60%, 56/93) was 17% lower than the percentage of students who thought that essay writing is necessary in entrance exams. We conducted follow-up interviews and presented possible reasons. Based on the results, measures to improve the essay-writing exam system are also suggested.

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  • Problem-Based Learning to Encourage Active Learning and Teamwork Among First Year Medical Students - Student Reports in 2018 -
    KUIYU YAN, HARUKA YAMADA, MAYUKA TAKAGAKI, RIE KOIZUMI
    2019 Volume 65 Issue 3 Pages 255-260
    Published: 2019
    Released: August 10, 2019
    JOURNALS OPEN ACCESS

     This paper first examines the advantages and disadvantages of multiple-choice and open-ended questions. It highlights a major merit of open-ended questions, namely that they can be used to assess the problem-solving and thinking abilities to be tested in mathematics tests. We then argue for the increased use of open-ended questions in mathematics tests, especially in the National Center Test for University Admissions (Center Test). In the latter part of the article, we investigate reasons open-ended questions have not been extensively used in large-scale examinations and possible public reactions toward introducing this question type in the Center Test. The previous literature and surveys suggest that the manual, labor-intensive, and subjective nature of scoring open-ended questions has been an obstacle to large-scale use; that most universities think open-ended questions are necessary and possible; and that a precedent exists that can be imitated in the exam for Chinese high school graduates called “Gao Kao.” Based on the information gathered, we present our opinions on feasible measures in Japan to improve the new exam being implemented starting in 2020. Specifically, we argue that the new exam should consist of more open-ended questions than in the pre-test, which demonstrated a prototype of the new exam. Furthermore, we emphasize that such questions should be completely open-ended rather than provide blanks to fill out so as to enable universities to learn about examinees’ thinking processes and their ability to construct solutions on their own.

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Original Articles
  • SATOSHI TAKIZAWA, KEN OKAMOTO, MIWA SUGINAKA, YUKI NAKAMURA, TADASHI I ...
    2019 Volume 65 Issue 3 Pages 261-267
    Published: 2019
    Released: August 10, 2019
    JOURNALS OPEN ACCESS

    Objective: Our tertiary emergency medical center is located near an amusement park, with an emergency physician from our emergency room (ER) being positioned at the first-aid station in the park. In this study, we examined patients transported from the amusement park to our ER facility, in order to clarify the role and efficiency of emergency physicians stationed at mass-gathering locations.

    Materials: Patients that were transported from an amusement park to our ER facility between April 2008 and March 2013 were included.

    Methods: We retrospectively investigated the pathophysiology, pre-hospital care, and prognosis of patients.

    Results: During the 5-year study period, 1,601 visitors transported by ambulance from the park to a hospital. Among these park visitors, 1,107 were transported to our ER facility, with 189 being immediately hospitalized, including 66 critical cases that admitted to the intensive care unit (ICU). No mass-casualty accidents occurred at this amusement park during the study period.

     Nine patients had initial cardiopulmonary arrest (CPA) at the amusement park. All the patients suffering from CPA showed a return of spontaneous circulation (ROSC), but 2 of these patients eventually died. The 1-month survival rate was 77.8%. When limited to cardiogenic CPA, the 1-month survival rate was 85.7%.

    Conclusion: Mass-gathering areas, such as amusement parks, have the risk of medical emergencies that require critical care. Emergency physicians stationed onsite could promptly respond to medical events and offer pre-hospital care. To establish a ‘chain of survival’ that involves the emergency physicians may contribute to good prognosis for critical patients.

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  • YASUE MIKI, TOHRU OHNUMA, HITOKI HIROSE, KEN NAKAYAMA, WANYI MAO, MARI ...
    2019 Volume 65 Issue 3 Pages 268-278
    Published: 2019
    Released: August 10, 2019
    [Advance publication] Released: July 24, 2019
    JOURNALS OPEN ACCESS

    Objective: The present study aimed to investigate the pleiotropic effects of candidate loci identified by genome-wide association studies, how they may function as possible proxy phenotypes for educational attainment, and how they affect clinical symptoms and their detailed psychometrics in Japanese patients with schizophrenia.

    Method: Three single-nucleotide polymorphisms (SNPs)(rs6739979, rs11588857, and rs2245901) common in Japanese individuals showing a relationship to both schizophrenia and educational attainments from a previously conducted genome-wide study (Okbay, 2016) were investigated in a case-control study between 640 unrelated Japanese patients with schizophrenia and 640 healthy controls. The relationship between these SNPs and detailed clinical information, including educational attainments and cognitive function from psychometrics, were investigated in these patients.

    Results: Results of the present study show that these SNPs are not genetic risk factors for schizophrenia. However, SNP rs2245901 in the 2q32.3 region showed a relationship to declining performance intelligent quotients in schizophrenia patients, as seen from multiple linear regression analysis.

    Conclusion: The genetic region at 2q32.3 may influence the attained education and decline of cognitive function in patients with schizophrenia.

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  • TAKASHI IKEDA, YUKI IGUCHI, YOSHIHIKO ISHIHARA, YU SHIMASAKI, HAYATO I ...
    2019 Volume 65 Issue 3 Pages 279-285
    Published: 2019
    Released: August 10, 2019
    [Advance publication] Released: July 19, 2019
    JOURNALS OPEN ACCESS

    Objective: To examine the activity profiles of international goalball players and individual player profiles using wearable devices.

    Materials: All participants were Japanese national goalball players. Nine players were male (age: 24.7±5.9 years, height: 169.1±0.06 cm, weight: 73.1±10.0 kg) and 5 were female (age: 20.8 ±7.1 years, height: 158.2±0.06 cm, weight: 55.6±7.2 kg).

    Methods: Measured items were PlayerLoadTM, acceleration, deceleration, change of direction, and heart rate responses. Inertial measurement units (IMU) and heart rate sensors were embedded in the wearable device used by participants. Each player’s highest PlayerLoadTM value in a 10-sequence interval was referred to as the “peak value”, and the average 10-sequence interval value after the peak was expressed as “post value”. Percentage of HRmax (%HRmax) observed in one playing time was also assessed.

    Results: In male players, an approximately 50% decline in the mean PlayerLoadTM value was observed (from peak to post). The same tendency was observed in the female players, although the amount of decline was not that high. In male players, 80%-90% HRmax was observed in approximately 60% of a game, whereas that of female players was 30%. Furthermore, in female players, 70%-80% HRmax was observed in approximately 50% of a game, whereas that of male players was 30%.

    Conclusions: The results provide scientific evidence for constructing a useful measurement tool when planning trainings for goalball players to improve their competitiveness.

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Case Reports
  • AKINA MATSUDA, HIDEO FUKUNAGA, HISAKO TOBAYAMA, KEISUKE NAKANISHI, TAK ...
    2019 Volume 65 Issue 3 Pages 286-291
    Published: 2019
    Released: August 10, 2019
    JOURNALS OPEN ACCESS

     A 7-month-old boy presented to the hospital with fever, vomiting, and appetite loss and was admitted with a diagnosis of dehydration due to gastroenteritis. Although he stopped drinking and eating, he continued to vomit. The day after admission, systolic murmur, tachypnea, and retractive breathing appeared, and echocardiography showed mitral regurgitation resulting from chordal rupture. Although the vomiting and pleural effusion were improved with medical therapy, retractive breathing persisted. Mitral valve plastic surgery was performed. Mitral valve chordal rupture in infants is rare and presents with nonspecific symptoms. Because most patients need surgical treatment, early and appropriate diagnosis is necessary.

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Mini Reviews
  • YUKO MURAKAMI-TONAMI
    2019 Volume 65 Issue 3 Pages 292-296
    Published: 2019
    Released: August 10, 2019
    JOURNALS OPEN ACCESS

     Cancer treatment methods based on suppressing the function of a specific target molecule that is mutated or overexpressed are defined as “molecular targeted therapy”. In molecular targeted therapy, the specific targets are identified in the drug discovery and treatment design stages. Many molecular targeted therapy methods are currently used for cancer treatment, and the group of molecular targeted drugs has grown far beyond the classical chemotherapeutic drug family. However, the design of targeted agents for certain molecules such as tumor suppressor genes, which also play a causative role in cancer, is complex. Here, I briefly review the history of molecular targeted drugs and introduce a search using synthetic lethal phenotypes as one method to identify molecular targeted drugs against tumor suppressor gene mutations.

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