研究者詳細 - 安藤　崇之

大学病院における総合診療科の臨床実習において医学生が総合診療の専門性をどのように理解しているのかを明らかにするために,実習前後の「総合診療の専門性とは?」というアンケートの自由記載に対して内容分析を行った.大学病院での臨床実習を通して,診断学だけではなく心理・社会的側面を踏まえた診療や健康維持なども総合診療の専門性であることが学生により獲得されていることが明らかになった.(著者抄録)

Association of polydoctoring and mortality among persons over 85 years with multimorbidity: a prospective cohort study in Japan.

Ando T, Sasaki T, Abe Y, Nishimoto Y, Hirata T, Tajima T, Oguma Y, Haruta J, Arai Y

BJGP open 8 （ 3 ） 2024年04月

BACKGROUND: Polydoctoring is a crucial aspect of care fragmentation among patients with multimorbidity, but its impact on health outcomes remains unclear. AIM: To determine the effects of polydoctoring, as measured by the Regularly Visited Facility (RVF) indicator, on patient outcomes among older individuals with multimorbidity. DESIGN & SETTING: Data from the ongoing prospective cohort study, Kawasaki Aging and Wellbeing Project (KAWP), was utilized in this study. Among the 1,026 KAWP participants aged 85-89 years, those with two or more chronic conditions were enrolled in this study. METHOD: Care fragmentation or polydoctoring, was evaluated using the RVF, a new indicator that measures the number of medical facilities consistently involved in a patient's care. Based on RVF, mortality was analysed using the Cox-hazards model, with adjustments for age, sex, frailty, and number of comorbidities. RESULTS: A significant reduction in mortality rates was observed in participants with an RVF of ≥3 and 2-4 comorbidities (hazard ratio [HR] 0.46, 95% confidence interval [CI]: 0.18-0.99). However, no significant difference in mortality based on RVF was observed for those with ≥5 comorbidities. Notably, individuals with ≥5 comorbidities and an RVF of 0 had a significantly higher HR for death (HR 2.68, 95% CI 1.05-6.84). CONCLUSIONS: In older patients with multimorbidity, polydoctoring reduces mortality in patients with ≤4 coexisting conditions, but it does not significantly impact mortality in those with ≥5 conditions. These findings provide insights for healthcare decision-making in managing older patients with multimorbidity.

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Public Health Outreach in Impoverished Areas of Cambodia: Addressing the Issues Related to Prescription Practices

Chisato Iba, Mira Namba, Yudai Kaneda, Takayuki Ando

International Journal of Medical Students 2024年04月

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Author reply to the definition and evaluation of uncoordinated involvement of multiple healthcare providers; "Polydoctoring" as a component of care fragmentation among patients with multimorbidity.

Ando T, Sasaki T, Abe Y, Nishimoto Y, Hirata T, Haruta J, Arai Y

Journal of general and family medicine 25 （ 2 ） 116 - 117 2024年03月

ISSN 2189-6577

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Re: Letter to the Editor of Public Health in response to ‘Effect of influenza vaccine subsidies for older adults on vaccination coverage and mortality before and during the COVID-19 pandemic: An ecological study in Japan’

T. Ando, Y. Ibuka, R. Goto, J. Haruta, D.D. Le, S. Fujishima

Public Health 224 152 - 158 2024年02月

筆頭著者, 責任著者

OBJECTIVE: We aimed to determine how municipal subsidies for seasonal influenza vaccines for the elderly affected vaccination coverage and health outcomes and how responses to vaccine prices changed during the COVID-19 pandemic. STUDY DESIGN AND METHODS: This ecological study includes 1245 municipalities in Japan between 2019 and 2020. Fixed-effects regression analysis was performed to evaluate the effect of influenza vaccine cost subsidy for people aged 65 years or older on vaccination coverage, all-cause mortality, and influenza-related mortality. RESULTS: The vaccination rate increased when patients' copayments decreased, and reducing the copayment by 1000 Japanese Yen (JPY) was estimated to increase the vaccination rate by 6.3% (95% confidence interval [CI] 4.5-8.2%) in the adjusted model. When examining the additional effect of a zero price compared to a nearly zero price, we found that a zero price increased the immunization rate by 6.4% (95% CI 1.4-11.5%). The effect of copayment on the increase in vaccination coverage was significantly lower during the pandemic than in the pre-pandemic period. The municipal and prefectural analyses found no association between influenza vaccine copayments and all-cause, influenza, or pneumonia mortality. CONCLUSION: Cost subsidies and the zero-price effect were shown to increase vaccination coverage but were not associated with relevant mortality measures. Although the impact was attenuated under pandemic conditions, cost subsidy effectively increases the vaccination rate.

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一般内科外来、ひとりでできますか? : よく出合う慢性疾患への評価・処方・指導と、診察時間を最大限に活かすコツ

安藤崇之

レジデントノート（東京 : 羊土社） 25 （ 17 ） 2993 - 3252 2024年02月

ISSN 13446746

CiNii Research

A Case of Focal Seizures Presented With Recurrent Sweating and Chills.

Ando T, Fujikawa H

Cureus 16 （ 1 ） e53139 2024年01月

ISSN 2168-8184

Focal seizures, characterized by excessive electrical excitation in a brain region, present diagnostic challenges due to diverse manifestations, particularly with non-motor symptoms. Here, we present a 69-year-old Japanese woman experiencing unexplained recurrent episodes of sweating, chills, and shivering. Despite exhaustive investigations that identified no abnormalities, her symptoms remained unalleviated by symptomatic treatments. The episodic nature of her presentations subsequently prompted a clinical suspicion of seizures, leading to further neurological evaluations. Magnetic resonance imaging (MRI) of the brain and electroencephalography (EEG) revealed chronic ischemic changes in the cerebral white matter and intermittent sharp and slow wave bursts in the frontal regions. These findings led to a diagnosis of focal seizures manifesting as autonomic symptoms. The patient's symptoms were successfully treated with carbamazepine. This case illustrates the importance of considering non-motor focal seizures in patients with episodic symptoms, even when routine tests show no abnormalities.

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Effect of influenza vaccine subsidies for older adults on vaccination coverage and mortality before and during the COVID-19 pandemic: an ecological study in Japan.

T Ando, Y Ibuka, R Goto, J Haruta, D D Le, S Fujishima

Public health 224 152 - 158 2023年11月

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Measurement of polydoctoring as a crucial component of fragmentation of care among patients with multimorbidity: Cross-sectional study in Japan.

Ando T, Sasaki T, Abe Y, Nishimoto Y, Hirata T, Haruta J, Arai Y

Journal of general and family medicine 24 （ 6 ） 343 - 349 2023年11月

筆頭著者, 最終著者, ISSN 2189-6577

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特集都市のプライマリ・ケア-「見えにくい」を「見えやすく」【セクション2】実践!　都市のプライマリ・ケア-4つの現場から＠教育 ❼都市での卒前教育の実践

安藤崇之

総合診療（株式会社医学書院） 33 （ 8 ） 924 - 926 2023年08月

ISSN 21888051

都市での卒前教育の実践

安藤崇之

総合診療 = Journal of generalist medicine : ジェネラルに診ることが求められる時代の臨床誌（東京 : 医学書院） 33 （ 8 ） 924 - 926 2023年08月

ISSN 21888051

CiNii Research

食物アレルギー診断・検査2 思春期・成人食物アレルギー診療支援アプリの開発と有用性の検証

小西駿一郎, 正木克宜, 上條慎太郎, 安藤崇之, 冨保紗希, 小山薫, 大津陽, 林玲奈, 松山笑子, 栗原桃子, 加畑宏樹, 宮田純, 寺井秀樹, 佐藤泰憲, 森田久美子, 伊藤潤, 原田紀宏, 鈴木慎太郎, 藤澤隆夫, 福永興壱

アレルギー（(一社)日本アレルギー学会） 72 （ 6-7 ） 895 - 895 2023年08月

ISSN 0021-4884

食物アレルギーの社会的対応アレルギー専門医を対象とした思春期・成人食物アレルギーの診療内容の均質性に関する調査研究

冨保紗希, 正木克宜, 上條慎太郎, 鈴木慎太郎, 伊藤潤, 安藤崇之, 加畑宏樹, 宮田純, 森田久美子, 明石真幸, 原田紀宏, 藤澤隆夫, 福永興壱

アレルギー（(一社)日本アレルギー学会） 72 （ 6-7 ） 909 - 909 2023年08月

ISSN 0021-4884

食物アレルギーの社会的対応アレルギー専門医を対象とした思春期・成人食物アレルギーの診療内容の均質性に関する調査研究

冨保紗希, 正木克宜, 上條慎太郎, 鈴木慎太郎, 伊藤潤, 安藤崇之, 加畑宏樹, 宮田純, 森田久美子, 明石真幸, 原田紀宏, 藤澤隆夫, 福永興壱

アレルギー（(一社)日本アレルギー学会） 72 （ 6-7 ） 909 - 909 2023年08月

ISSN 0021-4884

【Making of医学教育モデル・コア・カリキュラム】資質・能力に新設された総合的に患者・生活者をみる姿勢について

春田淳志, 安藤崇之, 遠藤周, 金子惇, 鋪野紀好, 長嶺由衣子, 錦織宏, 藤川裕恭, 山梨啓友

医学教育（(一社)日本医学教育学会） 54 （ 2 ） 142 - 148 2023年04月

ISSN 0386-9644

少子高齢化社会の背景と令和2年度からの調査を踏まえ,患者の抱える問題を臓器横断的に捉えた上で,心理社会的背景も踏まえた総合的な視点とアプローチの必要性が示され,医学教育モデル・コア・カリキュラム(令和4年改訂版)に総合的に患者・生活者をみる姿勢が資質・能力に新設された.下位目標として「全人的な視点とアプローチ」「地域の視点とアプローチ」「人生の視点とアプローチ」「社会の視点とアプローチ」が位置づけられた.抽象と具体,概念と経験,自己と他者等の視点を統合し,自己の在り方を省察できるような複数の学習理論を踏まえた教育方法が提案された.このような医学教育を通じて,患者・生活者のウェルビーイングが向上することを期待する.(著者抄録)

成人食物アレルギー診療支援アプリの開発と有用性の検証

正木克宜, 冨保紗希, 上條慎太郎, 安藤崇之, 加畑宏樹, 佐藤泰憲, 原田紀宏, 鈴木慎太郎, 藤澤隆夫, 福永興壱

日本内科学会雑誌（(一社)日本内科学会） 112 （臨増） 190 - 190 2023年02月

ISSN 0021-5384

How do medical students learn in an online community diagnostics program?

Haruta J, Ando T, Fujishima S

BMC medical education 23 （ 1 ） 15 - 15 2023年01月

BACKGROUND: The need to engage medical students in understanding the social and environmental determinants of health in disparate communities is increasing. However, previous reviews have noted the limited community diagnosis programs and program evaluation. Given the feasibility of the programs, it is expected to be widely available online. Therefore, this study used a realist approach to identify learning patterns through an online community diagnosis program, namely context (C), mechanism (M), and outcomes (O) patterns. METHODS: A 2-week general medicine clinical practice program was conducted for 4th- and 5th-year medical students at a medical university in Japan. The program included a one-hour zoom-based lecture, feedback for students on their presentations on community diagnosis, and a structural report on community diagnosis. We developed the program based on variation theory, which views discernment and variation in situations having time, space, and social dimensions as core learning. The students' reflections on their learning through the program were thematically analyzed through CMO perspectives. The realist approach used in the online diagnosis program evaluation allows us to explore, test, and refine what mechanisms work under what conditions (context) and with what interventions (including opportunities and resources), from which we can describe iteratively explainable results. RESULTS: First, the medical students, who spent most of their time in the limited residential areas they lived in, discovered the characteristics of their own community by discovery learning and comparison among peers. Second, they increased their intrinsic interest in the community by discerning specific issues in their familiar community through community diagnosis. Third, they valued community diagnosis by identifying relationships between local data on health issues under their learning responsibility. Fourth, they become more flexible in their thinking and created new knowledge that would fit the local community, and their reflection on themselves was encouraged. CONCLUSION: In this online community diagnosis program, medical students learned about the community through four types of learning patterns. Medical students may develop an understanding of community with interest using variation theory as a program development perspective and cognitive flexibility theory surrounding the essential ambiguity and abstraction of community.

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リアルワールドデータに基づくBERTを用いた新しい医薬品安全性シグナル検出手法の提案

八重樫昇吾, 石川智貴, 安藤崇之, 原梓, 大石尚央, 漆原尚巳

AICカンファレンス予稿集（慶應義塾大学AI・高度プログラミングコンソーシアム） 6 - 12 2023年

CiNii Research

オンライン・トークプロジェクト語ろう! 若手研究者の日常大学院にいくべきか

安藤崇之, 官澤洋平, 富田詩織, 日向佑樹

プライマリ・ケア : 実践誌 / 日本プライマリ・ケア連合学会実践誌編集委員会編（東京 : 日本プライマリ・ケア連合学会） 8 （ 3 ） 38 - 41 2023年

ISSN 24323098

CiNii Research

オンライン・トークプロジェクト語ろう! 若手研究者の日常

安藤崇之, 官澤洋平, 富田詩織, 日向佑樹

プライマリ・ケア : 実践誌 / 日本プライマリ・ケア連合学会実践誌編集委員会編（東京 : 日本プライマリ・ケア連合学会） 8 （ 2 ） 44 - 46 2023年

ISSN 24323098

CiNii Research

Disparities in co-payments for influenza vaccine among the elderly, during the COVID-19 pandemic in Japan.

Ando T, Maruyama T, Tamai A, Murakami T, Kido Y, Ishida T, Taya H, Haruta J, Sugiyama D, Fujishima S

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy （Elsevier BV） 28 （ 7 ） 896 - 901 2022年07月

査読有り, ISSN 1341-321X

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鉄蕉会亀田メディカルセンター地域ジェネラリストプログラム10年のあゆみ

岡田唯男, 濱井彩乃, 西野洋, 片多史明, 松田愉, 安藤崇之, 鈴木真央, 栖原とし子

医学教育（(一社)日本医学教育学会） 53 （ Suppl. ） 177 - 177 2022年07月

ISSN 0386-9644

日本の診療所における血液検査電子オーダーシステムのデザイン変更による医師の検査オーダー行動の変化

河田祥吾, 安藤崇之, 岡田唯男

日本プライマリ・ケア連合学会学術大会（(一社)日本プライマリ・ケア連合学会） 13回 O - 102 2022年06月

Association between multimorbidity, self-rated health and life satisfaction among independent, community-dwelling very old persons in Japan: longitudinal cohort analysis from the Kawasaki Ageing and Well-being Project.

Ando T, Nishimoto Y, Hirata T, Abe Y, Takayama M, Maeno T, Fujishima S, Takebayashi T, Arai Y

BMJ open 12 （ 2 ） e049262 2022年02月

査読有り, ISSN 2044-6055

OBJECTIVE: This study aimed to identify associations between multimorbidity and subjective health outcomes among the very old persons, after adjusting for coexisting conditions such as frailty and depression. STUDY SETTING AND PARTICIPANTS: This was an observational cross-sectional study involving 1012 independent, community-dwelling very old persons (507 men, 505 women; aged 85-89 years) in Kawasaki city, Japan. OUTCOME MEASURES: The primary outcome was the cross-sectional associations between multimorbidity and poor self-rated health (SRH) and life satisfaction using binary logistic regression. The secondary outcome was the association of subjective health with each chronic condition. RESULTS: The prevalence of multimorbidity (≥2 conditions) was 94.7%, and the average number of chronic conditions was 4.47±1.9. Multimorbidity was significantly associated with poor SRH in the adjusted model only when six or more chronic conditions were present (OR 4.80; 95% CI 1.34 to 17.11; p=0.016). Cerebrovascular disease, heart disease, respiratory disease, connective tissue disease and arthritis showed significant associations with poor SRH after multivariate adjustment. Sex-specific analysis replicated associations between multimorbidity with six or more conditions and SRH in both men and women, while the diseases with the greatest impact on SRH differed between men and women. Most conditions were not associated with low satisfaction with life scale, with the exception of arthritis (OR 1.92, 95% CI 1.32 to 2.78, p=0.001). CONCLUSIONS: Multimorbidity is prevalent in the independent, community-dwelling very old persons and is associated with poor SRH when six or more conditions are present; conditions causing mobility limitations, such as cerebrovascular disease, connective tissue disease and arthritis, have a negative impact on SRH. TRIAL REGISTRATION NUMBER: UMIN000026053.

多職種連携の秘訣(後編)現場の薬剤師,リハビリセラピストからのメッセージ

安藤崇之

Gノート（羊土社） 8 （ 3 ） 562 - 567 2021年04月

ISSN 2188-3033

地域医療へのきっぷ私の資格取得エピソード(7)日本DMAT隊員

安藤崇之

Gノート（羊土社） 8 （ 1 ） 172 - 174 2021年02月

ISSN 2188-3033

CiNii Research

Google mapと地理情報システム（GIS）を用いた地域診断マッピングと高齢者の免許返納支援への応用

安藤崇之

日本プライマリ・ケア連合学会誌（(一社)日本プライマリ・ケア連合学会） 43 （ 4 ） 148 - 150 2020年12月

研究論文（学術雑誌）, 単著, 査読有り, ISSN 2185-2928

Google mapを用いた簡便なGISの利用方法を開発し、地域診断・免許返納支援を行った。公開されている交通、食料品店、医療機関の位置データや人口データなどの情報をQGISというソフトを用いて変換し、Google map上に取り込んだ。このマップを用いて診療圏の地域のインフラを可視化して地域の医療機関や生鮮食料品店へのアクセスを可視化し、地域診断や高齢患者の免許返納支援を行った。(著者抄録)

Control of a Nosocomial Outbreak of COVID-19 in a University Hospital.

Sei Harada, Shunsuke Uno, Takayuki Ando, Miho Iida, Yaoko Takano, Yoshiki Ishibashi, Yoshifumi Uwamino, Tomoyasu Nishimura, Ayano Takeda, Sho Uchida, Aya Hirata, Mizuki Sata, Minako Matsumoto, Ayano Takeuchi, Hideaki Obara, Hirokazu Yokoyama, Koichi Fukunaga, Masayuki Amagai, Yuko Kitagawa, Toru Takebayashi, Naoki Hasegawa

Open forum infectious diseases 7 （ 12 ） ofaa512 2020年12月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 2328-8957

Background: Nosocomial spread of coronavirus disease 2019 (COVID-19) causes clusters of infection among high-risk individuals. Controlling this spread is critical to reducing COVID-19 morbidity and mortality. We describe an outbreak of COVID-19 in Keio University Hospital, Japan, and its control and propose effective control measures. Methods: When an outbreak was suspected, immediate isolation and thorough polymerase chain reaction (PCR) testing of patients and health care workers (HCWs) using an in-house system, together with extensive contact tracing and social distancing measures, were conducted. Nosocomial infections (NIs) were defined as having an onset or positive test after the fifth day of admission for patients and having high-risk contacts in our hospital for HCWs. We performed descriptive analyses for this outbreak. Results: Between March 24 and April 24, 2020, 27 of 562 tested patients were confirmed positive, of whom 5 (18.5%) were suspected as NIs. For HCWs, 52 of 697 tested positive, and 40 (76.9%) were considered NIs. Among transmissions, 95.5% were suspected of having occurred during the asymptomatic period. Large-scale isolation and testing at the first sign of outbreak terminated NIs. The number of secondary cases directly generated by a single primary case found before March 31 was 1.74, compared with 0 after April 1. Only 4 of 28 primary cases generated definite secondary infection; these were all asymptomatic. Conclusions: Viral shedding from asymptomatic cases played a major role in NIs. PCR screening of asymptomatic individuals helped clarify the pattern of spread. Immediate large-scale isolation, contact tracing, and social distancing measures were essential to containing outbreaks.

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特集総合診療医の"若手ロールモデル"を紹介します!-私たちはどう生きるか【若手ロールモデル & データファイル集】私の総合診療=❺(卒前教育＋アカデミックGP)×大学

安藤崇之

総合診療（株式会社医学書院） 30 （ 1 ） 39 - 41 2020年01月

ISSN 21888051

プライマリ・ケア医による性感染症スクリーニングと予防

安藤崇之

日本臨床 = Japanese journal of clinical medicine （日本臨床社） 77 （ 2 ） 338 - 343 2019年02月

ISSN 00471852

CiNii Research

プライマリ・ケア医だからこそできる性感染症スクリーニング・予防 (特集お母さんを守ろう : 家庭医は産前家族の応援団) -- (次世代のための予防医療)

安藤崇之

治療（南山堂） 100 （ 4 ） 380 - 385 2018年04月

ISSN 0022-5207

CiNii Research

第3回日英プライマリ・ケア交換留学プログラム―英国短期訪問プロジェクト参加報告―

八百壮大, 師井邦竹, 櫻井広子, 松尾良子, 安藤崇之, 澤憲明

日本プライマリ・ケア連合学会誌（一般社団法人日本プライマリ・ケア連合学会） 41 （ 1 ） 24 - 28 2018年

ISSN 2185-2928

<p>本稿は，第3回日英プライマリ・ケア交換留学プログラムにおける英国短期訪問プロジェクトの活動報告書である．派遣団員が2015年9月に英国スコットランドを訪問し，家庭医診療所の見学や英国家庭医学会（Royal College of General Practitioners）学術大会への参加を通して印象深いと感じた内容のうち，「英国のがん検診とがん患者・家族支援」，「GPの労働条件」，「Half-Day Release Programme―英国家庭医研修のハーフデイバック―」の3つを紹介し，考察する．</p>

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Changeability of the fully methylated status of the 15q11.2 region in induced pluripotent stem cells derived from a patient with Prader-Willi syndrome.

Okuno H, Nakabayashi K, Abe K, Ando T, Sanosaka T, Kohyama J, Akamatsu W, Ohyama M, Takahashi T, Kosaki K, Okano H

Congenital anomalies 57 （ 4 ） 96 - 103 2017年07月

査読有り, ISSN 0914-3505

Prader-Will syndrome (PWS) is characterized by hyperphagia, growth hormone deficiency and central hypogonadism caused by the dysfunction of the hypothalamus. Patients with PWS present with methylation abnormalities of the PWS-imprinting control region in chromosome 15q11.2, subject to parent-of-origin-specific methylation and controlling the parent-of-origin-specific expression of other paternally expressed genes flanking the region. In theory, the reversal of hypermethylation in the hypothalamic cells could be a promising strategy for the treatment of PWS patients, since cardinal symptoms of PWS patients are correlated with dysfunction of the hypothalamus. The genome-wide methylation status dramatically changes during the reprograming of somatic cells into induced pluripotent stem cells (iPSCs) and during the in vitro culture of iPSCs. Here, we tested the methylation status of the chromosome 15q11.2 region in iPSCs from a PWS patient using pyrosequencing and a more detailed method of genome-wide DNA methylation profiling to reveal whether iPSCs with a partially unmethylated status for the chromosome 15q11.2 region exhibit global methylation aberrations. As a result, we were able to show that a fully methylated status for chromosome 15q11.2 in a PWS patient could be reversed to a partially unmethylated status in at least some of the PWS-iPSC lines. Genome-wide DNA methylation profiling revealed that the partial unmethylation occurred at differentially methylated regions located in chromosome 15q11.2, but not at other differentially methylated regions associated with genome imprinting. The present data potentially opens a door to cell-based therapy for PWS patients and, possibly, patients with other disorders associated with genomic imprinting.

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Functional Neurons Generated from T Cell-Derived Induced Pluripotent Stem Cells for Neurological Disease Modeling.

Matsumoto T, Fujimori K, Andoh-Noda T, Ando T, Kuzumaki N, Toyoshima M, Tada H, Imaizumi K, Ishikawa M, Yamaguchi R, Isoda M, Zhou Z, Sato S, Kobayashi T, Ohtaka M, Nishimura K, Kurosawa H, Yoshikawa T, Takahashi T, Nakanishi M, Ohyama M, Hattori N, Akamatsu W, Okano H

Stem cell reports （CELL PRESS） 6 （ 3 ） 422 - 35 2016年03月

査読有り, ISSN 2213-6711

Modeling of neurological diseases using induced pluripotent stem cells (iPSCs) derived from the somatic cells of patients has provided a means of elucidating pathogenic mechanisms and performing drug screening. T cells are an ideal source of patient-specific iPSCs because they can be easily obtained from samples. Recent studies indicated that iPSCs retain an epigenetic memory relating to their cell of origin that restricts their differentiation potential. The classical method of differentiation via embryoid body formation was not suitable for T cell-derived iPSCs (TiPSCs). We developed a neurosphere-based robust differentiation protocol, which enabled TiPSCs to differentiate into functional neurons, despite differences in global gene expression between TiPSCs and adult human dermal fibroblast-derived iPSCs. Furthermore, neurons derived from TiPSCs generated from a juvenile patient with Parkinson's disease exhibited several Parkinson's disease phenotypes. Therefore, we conclude that TiPSCs are a useful tool for modeling neurological diseases.

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Comparison of two large earthquakes: the 2008 Sichuan Earthquake and the 2011 East Japan Earthquake.

Otani Y, Ando T, Atobe K, Haiden A, Kao SY, Saito K, Shimanuki M, Yoshimoto N, Fukunaga K

The Keio journal of medicine 61 （ 1 ） 35 - 9 2012年

査読有り, ISSN 0022-9717

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. First, all relevant agencies should formulate emergency plans and should supply information regarding the emergency to the general public and health professionals on a normal basis. Second, each citizen should be educated and trained in how to minimize the risks from earthquake-induced secondary effects. 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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