The Keio journal of medicine
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We report the case of a 29-year-old woman who attempted suicide by oral ingestion of potentially fatal doses of multiple drugs including quetiapine. Intravenous lipid emulsion (ILE) was administered at a dose higher than that used in the standard management of toxicity. ⋯ No adverse effect of lipid administration was observed. ILE treatment seems to have great potential in the management of lipophilic drug toxicity in the future.
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Comparative Study
Comparison of two large earthquakes: the 2008 Sichuan Earthquake and the 2011 East Japan Earthquake.
Between August 15th and 19th, 2011, eight 5th-year medical students from the Keio University School of Medicine had the opportunity to visit the Peking University School of Medicine and hold a discussion session titled "What is the most effective way to educate people for survival in an acute disaster situation (before the mental health care stage)?" During the session, we discussed the following six points: basic information regarding the Sichuan Earthquake and the East Japan Earthquake, differences in preparedness for earthquakes, government actions, acceptance of medical rescue teams, earthquake-induced secondary effects, and media restrictions. Although comparison of the two earthquakes was not simple, we concluded that three major points should be emphasized to facilitate the most effective course of disaster planning and action. ⋯ Finally, the central government should establish a single headquarters responsible for command, control, and coordination during a natural disaster emergency and should centralize all powers in this single authority. We hope this discussion may be of some use in future natural disasters in China, Japan, and worldwide.
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Adult neural stem cells (NSCs) are a potential endogenous source for neuronal cell replacement in the diseased adult central nervous system (CNS). However, the recruitment of adult NSCs for repair is hampered by the current lack of knowledge about the cellular and molecular mechanisms that control their behavior in vivo. ⋯ In this review I will examine in vitro and in vivo the molecular mechanisms underlying the neuronal fate instruction of adult NSCs by the local astrocyte population in the adult hippocampus. In particular, I will focus on the Wnt family of proteins, which we have found to be expressed in adult hippocampal astrocytes; our preliminary studies have also shown that these proteins enhance the generation of neurons from adult NSCs in vitro.
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The medical curriculum at King's College London School of Medicine is a 5 year course; an extended program (6 years) and a graduate entry program (4 years) are also available. The first 2 years of the curriculum comprise phases 1 and 2. The curriculum consists of core material that is common to all students and student-selected components (students undertake three such components in the first 2 years). ⋯ Assessment consists of in-course assessment (e.g., presentations, tests and essays) and end-of-year examinations which consist of written papers and an objective structured clinical examination at the end of year 2. The main strengths of the program include the scenario format of learning and the practice of medicine early on. The difficulties arise mainly from the large numbers of students (420 per year).