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Introduction: The Stryker Surgical Simulator is a hybrid, temporal bone simulator that uses both tactile and haptic feedback combined with a computer interface. We sought to validate this simulator as an otolaryngology resident training tool for performing tympanomastoidectomy., Materials and Methods: 15 residents and staff performed five basic cortical mastoidectomies. Staff surgeons comprised the "expert" cohort and resident surgeons comprised the "trainee" cohort. Subjective evaluation of the face validity and content validity was assessed via pre- and postquestionnaires. Objective evaluation of content validity was assessed through grading of each temporal bone dissection specimen, comparing time to task completion, and calculating the rate of injury to critical structures. Study approved by the Institutional Review Board (2013.0001)., Results: Post hoc questionnaires showed that both staff and residents subjectively rated the simulator favorably on face validity, content validity, and all global assessment categories, though there were no significant distinctions between groups (P > 0.05). The resident group had a significantly longer drilling time compared with the staff group throughout the series of tympanomastoidectomies (P = 0.008), and both groups showed a decrease in time to task completion with repetitive drilling. However, there were no significant differences in surgical performance as evaluated by a blinded senior neurotologist (P = 0.52). There were also no critical injuries recorded by the simulator in any of the 75 trials, preventing any evaluation on this measure., Conclusions: Despite favorable subjective evaluations by both staff and residents, objective discrimination between experienced and novice participants was not achieved. This was likely in part due to inherent design flaws of the simulator. This emphasizes the potential shortcomings of surgical simulation models for highly technical procedures and points to the importance of intensive study and validation prior to incorporation of commercial training models into surgical training programs., (Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2020. This work is written by US Government employees and is in the public domain in the US.)

To reduce the volume of seaweed wastes and extract polysaccharides, seaweed-degrading bacteria were isolated from drifting macroalgae harvested along the coast of Toyama Bay, Japan. Sixty-four bacterial isolates were capable of degrading "Wakame" (Undaria pinnatifida) thallus fragments into single cell detritus (SCD) particles. Amongst these, strain 6532A was the most active degrader of thallus fragments, and was capable of degrading thallus fragments to SCD particles within a day. Although the sequence similarity of the 16S rRNA gene of strain 6532A was 100% similar to that of Microbulbifer elongatus JAMB-A7, several distinct differences were observed between strains, including motility, morphology, and utilization of D: -arabinose and gelatin. Consequently, strain 6532A was classified as a new Microbulbifer strain, and was designated Microbulbifer sp. 6532A. Strain 6532A was capable of degrading both alginate and cellulose in the culture medium, zymogram analysis of which revealed the presence of multiple alginate lyases and cellulases. To the best of our knowledge, this is the first study to directly demonstrate the existence of these enzymes in Microbulbifer species. Shotgun cloning and sequencing of the alginate lyase gene in 6532A revealed a 1,074-bp open reading frame, which was designated algMsp. The reading frame encoded a PL family seven enzyme composed of 358 amino acids (38,181 Da). With a similarity of 74.2%, the deduced amino acid sequence was most similar to a Saccharophagus enzyme (alg 7C). These findings suggest that algMsp in strain 6532A is a novel alginate lyase gene.

The reasons why I became a transcultural psychiatrist in a country considered to be culturally homogeneous are presented. Efforts to nurture cultural psychiatry in Japan through the activities of the Japanese Society of Transcultural Psychiatry are described. Experiences in Vancouver, Canada in the 1980s formed the basis of my cultural psychiatric research. Research on the mental health of Japanese community in Vancouver and on ethnic minorities in Japan is discussed. Specific examples are included to explain how unique Japanese cultural traits can affect diagnosis and treatment. The future of Japanese cultural psychiatry in a global context is considered.

In Japan, admission to a psychiatric facility for people with schizophrenia is usually for life. We developed a rehabilitation program aimed at discharging these patients into the Tokyo community. This paper describes the results for the 224 patients. Using an inpatient ward at the Tokyo Musashino Hospital, patients were enrolled in the program and subsequently discharged into the community with an assigned worker. The results indicate for the majority (79%) re-integration into the community was successful. The success of this program in a metropolitan city like Tokyo argues for the efficacy of such programs.

Functional interactions between the initial and collecting lymphatics, as well as the molecular players involved, remain elusive. In this study, we assessed the influence of nitric oxide (NO) on lymphatic fluid velocity and flow, using a mouse tail model that permits intravital microscopy and microlymphangiography. We found that NO synthase (NOS) inhibition decreased lymphatic fluid velocity in the initial lymphatics, without any effect on their morphology. Using the same model, we found a similar effect in eNOS-/- mice and in mice treated with a selective endothelial NOS (eNOS) inhibitor. Next, we uncoupled the superficial initial lymphatics from the deeper collecting lymphatics by ligating the latter and found that lymphatic fluid velocity in NOS-inhibited mice became equal to that in control animals. Surprisingly, lymphatic fluid velocity was significantly increased after ligating the collecting lymphatics, and there was a concomitant increase in injection rate and mean lymphatic vessel diameter. Our results provide the first in vivo evidence that eNOS affects function of the whole microlymphatic system and that it is regulated via the collecting lymphatics.

Although Japan is becoming a multicultural society, the policy for ethnic minorities is not as mature as that in Western countries. Mental health issues among new ethnic minorities will be discussed. New minorities are mainly South-East Asian refugees, foreign brides from the Philippines, Korea and China, and returnees from China. Because their communities are very small, they tend to have great difficulties in coping with the Japanese society. Problems in their adjustment to the host country will be discussed.

In patients with terminal cancer, there is a need for a psychosomatic approach in which both the patient's psychological state, including QOL, and physical condition are considered. We studied patients with gynecologic cancer with the following practical objectives: 1. To evaluate the effect of a psychosomatic approach to patients with terminal gynecologic cancer; 2. Using psychological tests and interviews, to clarify the character tendencies of cancer patients, which are often reported in other countries; and 3. To discuss the benefits in the patient's attitude toward living with cancer. In case studies, separation anxiety of terminal cancer patients is increased due to impending death, and often patients cannot deal with these feelings. When the medical staff accepts these emotions, the patients' feelings even in the face of death often change to positive feelings of gratitude to the people around them. All of the results of psychological testing showed model answers, close to the mean of the normal range. This suggests that the patients were suppressing emotions behind their standard responses. Patients with uterine cancer showed a type C or cancer character, while those with ovarian cancer showed type A or heart disease character. Results indicated different attitudes between patients with uterine cancer and those with ovarian cancer. Cancer patients with a vigorous attitude (high POMS-V score pattern behavior) tended to have a good prognosis. This investigation represents a pilot study of a psychosomatic approach to cancer patients. However, recent psychoneuroimmunologic studies have reported the influence of emotion on cancer. Further studies of this kind are needed.

Data obtained from 130 questionnaires distributed to immigrant Japanese housewives were analyzed to determine if family factors were associated with poor adjustment, and in particular with depressive symptoms. It was possible to identify women who had no major adjustment problems in adapting to life in Canada (n = 70), transitional adjustment problems (n = 30), late onset adjustment problems (n = 7) and chronic adjustment problems (n = 23). These categories were determined by self-report and validated by symptom identification. Style of marriage, communication with spouse and mother-child interactions were hypothesized to be related to adjustment problems. A 16 item questionnaire was developed to assess the degree to which these factors affected adjustment. The only factor which affected degree of adjustment was communication with the spouse. These results are discussed within the context of traditional hypotheses concerning adaptation to a new culture and the implication for treatment.

Brine fermentation by osmophilic lactic acid bacteria and yeasts for long periods of time is essential to produce a good quality of shoyu (Japanese fermented soy sauce). It is well known that lactic acid fermentation by osmophilic lactic acid bacteria results in the depression of alcoholic fermentation by osmophilic yeasts, but the nature of the interaction between osmophilic lactic acid bacteria and yeasts in brine fermentation of shoyu has not been revealed. The inhibitory effect of osmophilic lactic acid bacteria on the growth of osmophilic yeasts was investigated. It was recognized that osmophilic shoyu yeasts such as Saccharomyces rouxii and Torulopsis versatilis were inhibited by a metabolite produced by osmophilic lactic acid bacteria (belonging to Pediococcus halophilus) in brine fermentation of shoyu. The primary inhibitor was considered to be acetic acid, although lactic acid was slightly inhibitory.

Cells of Saccharomyces rouxii (a salt-tolerant yeast) were grown in the presence of two levels of NaCl, 0 and 15%. Mannans obtained from both the cell walls and culture filtrates (extracellular) were examined. Yields based on the dry weight of cells demonstrated that the levels of both cell wall and extracellular mannans were lower when cells were grown in the presence of 15% NaCl. However, the carbohydrate and protein contents of the mannan preparations were not altered. The cell wall mannans obtained from the two growth conditions had similar molecular weights, whereas the extracellular mannans had different molecular weight distributions. Structural analyses showed that the cell wall and extracellular mannans had similar structures. Both had an alpha1-6-linked backbone to which single mannose and mannobiose units were connected as side chains, predominantly by alpha1-2 linkages. The mannans also contained mannosyloligosaccharides, mannotriose, mannobiose, and mannose attached to protein through an O-glycosidic bond. The molecular structure of the cell wall mannans remained unchanged at both levels of NaCl. However, in the presence of 15% NaCl, the side chains consisting of a mannobiose unit were slightly reduced.

The inhibitory activity of acetic acid on osmophilic yeasts (Saccharomyces rouxii and Torulopsis versatilis) used for the brine fermentation of soy sauce increased remarkably as the pH of the medium was lowered. This increased toxicity could not be attributed to a hydrogen ion effect alone.