1.Therapeutic Effects of Hangeshashinto, a Japanese Kampo Medicine, on Radiation-Induced Enteritis and Oral Mucositis : Case Series
Aiko NAGAI ; Keiko OGAWA ; Junya MIURA ; Ken KOBAYASHI
Kampo Medicine 2014;65(2):108-114
Despite the development of radiotherapy machines and technologies, a proportion of patients suffer from radiation-induced enteritis or oral mucositis. It has been reported that hangeshashinto has been used for not only enteritis but also oral mucositis. This study reports the effect of hangeshashinto on enteritis or oral mucositis caused by radiotherapy. Three patients with enteritis and 5 patients with oral mucositis were treated with hangeshashinto at a dose of 7.5 g/day. The severity of enteritis or oral mucositis was evaluated using the Common Terminology Criteria for Adverse Events version 4 and Numerical Rating Scale both before and after hangeshashinto treatment. After the treatment with hangeshashinto, 3 of 5 patients with oral mucositis and 2 of 3 patients with enteritis showed apparent improvement. In conclusion, it is important to control the side effects of radiotherapy, which lead to improved tumor control rates. Prospective randomized studies are necessary to confirm the findings of this case series study.
5.A retrospective study of the factors tended to transfer to palliative home care from palliative care unit at a comprehensive cancer center in Japan
Tomofumi Miura ; Yoshihisa Matsumoto ; Ayumu Okizaki ; Marie Oishi ; Tokiko Suzuki ; Shinya Motonaga ; Hatoe Sakamoto ; Asuko Sekimoto ; Keiko Abe ; Hiroya Kinoshita
Palliative Care Research 2013;8(1):107-115
Background: The palliative care unit (PCU) at the National Cancer Center Hospital East changed the administrative policy to strengthen the transition to palliative home care. This study aimed to identify the factors tended to transfer to palliative home care in Japan. Methods: We reviewed the medical records of consecutive cancer patients admitted to our PCU during period from October 2010 until September 2011. Patients with performance status 4 and duplication were excluded in this study. We identified variables associated with the discharged group and the others group, using the univariate and multivariate analyses. Results: There were 223 patients (Pts) during periods, 63 Pts (28.3%) discharged to palliative home care and 160 Pts (71.7%) deceased in our PCU. Univariate and multivariate analysis identified: admission from their own home, a good PS of ≤ 2, good oxygen saturation, a good amount of oral intake, maintain of PS at day 15, no dyspnea and no abdominal distention as predictions of a transition to home from our PCU. Conclusion: Our study indicated the factors tended to transfer to palliative home care from PCU in Japan, however this study had some limitations. A prospective study is required to validate these factors.
6.Medical Interview Skills and Patient Satisfaction Levels in a Setting Utilizing Electronic Medical Records
Yuji Nishizaki ; Yasuo Yoshioka ; Keiko Hayano ; Junichi Miura ; Kazuhisa Motomura ; Junko Takei ; Shino Fujitani ; Nobuyoshi Mori ; Seitaro Nomura ; Hiromichi Tamaki ; Takeshi Setoyama ; Yasuharu Tokuda
General Medicine 2010;11(1):17-23
BACKGROUND : Electronic medical records (EMRs) were first introduced in the 1960s, and in Japan they are starting to become popular. Recognizing the need to adapt to a new clinical setting with EMRs, we aimed to explore which interviewing skills were associated with patient satisfaction in this era of EMR use.
METHODS : A prospective observational study was conducted to evaluate interviewing skills among medical residents and to collate data on patients' satisfaction levels at an outpatient general medicine walk-in clinic at a teaching hospital in Japan. Five trained raters reviewed the video recordings of these interviews and assessed them based on a predetermined set of criteria for medical interview skills developed specifically for an outpatient EMR setting. The relationships between these assessment scores and patient satisfaction levels were analyzed.
RESULTS : Significant skills that were associated with higher scores of patient satisfaction included : employed appropriate eye contact (P=0.021) ; and, invited patients directly without using a microphone (P=0.008). In addition, the degree of keyboard typing during interviews was not associated with patient satisfaction.
CONCLUSIONS : In an outpatient setting with EMR, using good non-verbal communication skills to build trustful relationships with patients is more likely to influence patient satisfaction levels. Even when physicians are typing on a keyboard, if they keep appropriate eye contact during medical interviews, patient satisfaction can be improved.
7.The Historical Development of Theories on Night Sweat Pathophysiology
Oto MIURA ; Takanori MATSUOKA ; Yoshinari KONO ; Hidetoshi ITAKURA ; Koichiro TANAKA ; Mikumo UEMATSU ; Kazuhiko NARA ; Keiko SERIZAWA ; Asuka NAKAYAMA ; Makoto HASHIGUCHI ; Atsushi FUKUSHIMA ; Takaaki KOSUGE ; Teruo SAITO
Kampo Medicine 2012;63(1):1-14
Until the Sui Dynasty in China, night sweat and spontaneous perspiration had been thought to be caused by same pathophysiology, that is, lowered superficial resistance by deficiency of Qi.In the Tang Dynasty, these were considered to have different pathophysiologies and a new principle indicated that pathogenic heat caused night sweat.In the Song and Jing Dynasties, deficiency of blood and pathogenic heat by deficiency of Yin was also considered to cause night sweat.In the Jing Dynasty, exogenous pathogens, such as Cold were considered to cause night sweat, which indicated the principle that not only the deficiency syndrome but also the excess syndrome caused night sweat.In the beginning of the Yuan and Ming Dynasties, it was concluded that the deficiency of Yin caused night sweat and the deficiency of Yang caused spontaneous perspiration.In the middle of the Ming Dynasty, another new theory indicated that deficiency of Yang also possibly caused night sweat; therefore we should diagnose abnormal sweat depending on the pathophysiology in each case.In the Qing Dynasty, new theories were established stating that not only exogenous pathogens but also Damp-heat, undigested food and stagnation of blood, all of which are included in excess syndrome, cause night sweat, and that based on which part of the body sweats occurred we might understand pathophysiology of night sweat. The night sweat by Warm-heat, which is different from the one by Wind-cold, was considered to be caused with deficiency of Yin.Thus we conclude that the theories of night sweat developed over time, based on Chinese medical classics.
8.Analysis and Avoidance of Errors in Insulin Administration by Means of Quality Control (QC) Methods
Atsushi MIURA ; Fumi AOKI ; Hiroki MOMOI ; Kunimichi YANAGISAWA ; Keiko OOI ; Masaaki OOHASHI ; Reiko TAKEUCHI ; Yumiko KOBAYASHI ; Yumi SASAKI ; Teruaki OOKURA ; Osamu ATOBE
Journal of the Japanese Association of Rural Medicine 2008;57(5):719-725
The Saku Central Hospital classified muscular relaxants, potassium products and the like as “high-risk medicines”, but when it came to insulin, did not take any standardized measure against it to prevent accidents. Having organized a team of personnel from a wide variety of job, our hospital has recently carried out a campaign for improvements in medical care. With pharmacists playing a leading role, we grappled with measures for the prevention of errors in the administration of insulin using quality control (QC) methods. As a consequence, the campaign served to decrease the number of medical mistakes. As there still occur many incidents involving medication, the role played in risk management by pharmacists remains significant. In future, pharmacists will hopefully play a constructive role in risk management to prevent medical incidents involving medical supplies. That said, a campaign for improvements inmedical care through the practical use of QC methods seems likely to bring about favorable results.
Role
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Quality Control
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Analysis
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Avoidance
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ERROR
10.A Case of Primary Cutaneous Gamma-Delta T-Cell Lymphoma with Pautrier Microabscess.
Kohei KATO ; Takeshi NAMIKI ; Makiko UENO ; Madoka IIKAWA ; Shown TOKORO ; Aya NISHIZAWA ; Kouhei YAMAMOTO ; Keiko MIURA ; Hiroo YOKOZEKI
Annals of Dermatology 2017;29(2):229-232
No abstract available.
Lymphoma, T-Cell*
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T-Lymphocytes*