journal article

We held medical seminars for high-school students who hope to become physicians to increase their motivation and to encourage them to enter Yamaguchi University. The seminars were held two or three times a year at hospitals in six locations in Yamaguchi prefecture between 2011 and 2014, and consisted of observation of facilities in hospitals, physician lectures, experience of medical practice, and Q&A sessions with physicians and medical students. A total of 210 high-school students participated in 11 seminars. The questionnaires for the participants showed 89.9% of the participants rated the seminars“very good”and 91.4% responded,“my motivation was strengthened”.Of the seminar participants, 20 of 69 high-school graduates entered the Yamaguchi University School of Medicine. The follow-up survey showed that the percentage of medical school students studying at Yamaguchi University was 69.0% (20/29) for seminar participants and 45.5% (46/101) for non-seminar participants. The results suggest that the medical seminars were as effective as expected in encouraging high-school students to become physicians and to enter Yamaguchi University.

Duodenal varices（DV）are the most common of ectopic varices. Although bleeding from DV is rare, it is difficult to control bleeding and sometimes fatal. We have encountered four clinical cases of ruptured DV. Case 1：A man in his 80s presented with a history of partial gastrectomy with Billroth-II reconstruction and LC due to chronic hepatitis C. We performed single-balloon endoscopy and injected 67% N-butyl-2-cyanoacrylate（NBCA）for DV on the afferent loop with red plug. Case 2：A woman in her 40s with primary biliary cirrhosis complained of tarry stool and anemia. We performed endoscopic injection sclerotherapy（EIS）with 67% NBCA for spurting bleeding point in duodenum. Case 3：A man in his 50s with liver cirrhosis（LC）due to chronic hepatitis B complained of tarry stool. We performed endoscopic variceal ligation（EVL）and balloon-occluded retrograde transvenous obliteration（B-RTO）for DV. Case 4：A man in his 60s with alcoholic LC complained of tarry stool. We performed EIS with 67% NBCA for DV. We added EVL, clipping, and argon plasma coagulation after EIS to control bleeding. To control bleeding was achieved in all cases.