We began a new project in which medical students record their experiences during clinical practice using the electronic syllabus system “eYUME” since 2018. The contents are based on the Model Core Curriculum for Medical Education and include items related to entrustable professional activities（EPA），basic clinical skills, and clinical inferences. The data is important for institutional research（IR）in medical education, for clarifying the status of students' experiences, and for identifying issues and improvements in the current clinical practice program. The data showed that while students had enough opportunities to experience basic items such as medical interview and physical examination, medical record, and presentation, they had less opportunities to experience developmental items such as prescription planning, initial response to urgent patients, and interprofessional work. The experience with clinical inferences varied by syndrome and disease, and while there were many opportunities for experience with common and typical diseases, there were not enough opportunities for experience with remaining diseases. By feeding back the data through this project to students and faculty, we continue our efforts to enhance the clinical practice program.

We report a case of jejunal mesenteric lymphangioma treated with laparoscopy-assisted surgery. A-67-year-old man was admitted to our hospital because of lower quadrant pain. On admission, abdominal contrast-enhanced computed tomography（CT）and ultrasonography revealed a cystic mass without enhancement effect located in the mesentery of the jejunum. It was diagnosed as a mesenteric cyst, and laparoscopic surgery was performed. Laparoscopic examination confirmed a soft white cystic tumor in the mesentery of the jejunum near the ligament of Treitz, and we performed partial resection of the small intestine including the tumor under small incision. The histopathological diagnosis was lymphangioma of the jejunal mesentery. It was rare to diagnose as lymphangiomas in adulthood by abdominal pain. We report this unique case with some discussion of existing literature.

In Japan, the field of regenerative medicine has experienced substantial growth over the past decade with increased clinical research and commercialization. Market formation, lower costs, and quality control of regenerative medicine and other products are required for further growth. To achieve these goals, it is necessary to develop human resources for manufacturing cells and establish a manufacturing technology infrastructure. This article outlines the manufacturing processes of regenerative medicine products and focuses on cell expansion culture technology, an upstream process in the manufacturing process, and introduces the characteristics of representative culture technologies（plane culture method, stirred tank bioreactor, fixed-bed bioreactor）．In research and development stages, it is important to select one of several expansion culture technologies and determine a development strategy. Therefore, we applied each culture technology to a series of manufacturing processes and conducted simulations to evaluate manufacturing costs. Based on the results, we discussed upstream processes suitable for cell manufacturing.