1.Occurrence of Child Peptic Ulcer in A Rural Community
Waichi Sato ; Kanji Komatsu ; Norihiko Moriai ; Chiyuki Nakanome ; Masayoshi Sasaki ; Hideo Yamazaki ; Naoaki Tanno ; Toshimitsu Akazawa ; Toshihiro Okamura ; Hiroaki Sato ; Kazuhiro Haginoya ; Yasushi Akimoto
Journal of the Japanese Association of Rural Medicine 1982;31(4):656-659
During the 18-month period from January 1, 1981 to June 30, 1082, we encountered a total of 11 cases of child peptic ulcer-three gastric ulcer and eight duodenal ulcer casen.
There is every indication that the incidence of child peptic ulcer will increase in a rural area like Yuri, which is situated in Japan's northeastern prefecture of Akita.
To be noted is the fact that 10 cases out of 11 of peptic ulcer were found in three-year lower secondary schoolchildren and the remaining one was found in a sixth grader of six-year elementary school. The incidence as well as the number of visits to our clinics went up as the age advances and reached a peak in third graders of lower secondary school.
The reason why third graders of lower secondary school were attacked most by peptic ulcer is probably that they, at puberty, are under psychic or psychogenic stress with anxiety over high school entrance examinations, mental strain from forced attendance at a cramming school, trouble in getting along with friends, and dissatisfaction with parents.
Therefore, child peptic ulcer should not be treated as a disease of the digestive organ alone but as a disorder in the autonomic nervous system with an aid of psychosomatic medicine and psychiatry. For the prevention of the disease, it would also be necessary to take account of socio-cultural factors.
2.Impact of COVID-19 on gynecologic cancer treatment in Japan: a nationwide survey by the Japan Society of Gynecologic Oncology (JSGO)
Yuya NOGAMI ; Hiroaki KOMATSU ; Takeshi MAKABE ; Yuri HASEGAWA ; Yoshihito YOKOYAMA ; Kei KAWANA ; Aikou OKAMOTO ; Mikio MIKAMI ; Hidetaka KATABUCHI ;
Journal of Gynecologic Oncology 2022;33(1):e8-
Objective:
As coronavirus disease 2019 (COVID-19) rages on, it is a challenging task to balance resources for treatment of COVID-19 and malignancy-based treatment. For the development of optimal strategies, assessing the conditions and constrains in treatment during the COVID-19 pandemic is pertinent. This study reported about a nationwide survey conducted by the Japan Society of Gynecologic Oncology.
Methods:
We interviewed 265 designated training facilities about the state of their clinical practice from the time period between March and December 2020. We asked the facility doctors in charge to fill a web-based questionnaire.
Results:
A total of 232 facilities (87.5%) responded. A decrease in the number of outpatient visits was reported, and the major reason attributed was reluctance of patients to visit hospitals rather than facility restrictions. The actual number of surgeries decreased by 3.9%, compared to 2019. There was a significant difference when the variable of “Prefectures operating under special safety precautions” or not was introduced. There was no increase in the rate of advanced stages in the three cancer types studied. However, 34.1% participants perceived COVID-19 affected management and prognosis.
Conclusion
Refraining from visiting hospitals based on the patient's judgment may be expected to be an issue in the future. No significant decrease in surgeries was observed, and it would seem that there were few forced changes in treatment plans, but “the State of Emergency” had an impact. There was no increase in the rate of advanced cancers, but this will need to be monitored.
3.Comparison of the oncological outcomes of stenting as a bridge to surgery and surgery alone in stages II to III obstructive colorectal cancer: a retrospective study
Hiroaki UEHARA ; Toshiyuki YAMAZAKI ; Akira IWAYA ; Hitoshi KAMEYAMA ; Masaru KOMATSU ; Motoharu HIRAI
Annals of Coloproctology 2022;38(3):235-243
Purpose:
We evaluated the oncological outcomes of bridge to surgery (BTS) using stent compared with surgery alone for obstructive colorectal cancer.
Methods:
Consecutive patients who underwent curative resection for stages II to III obstructive colorectal cancer at our institution from January 2009 to March 2020, were registered retrospectively and divided into 43 patients in the BTS group and 65 patients in the surgery alone group. We compared the surgical and oncological outcomes between the 2 groups.
Results:
Stent-related perforation did not occur. One patient in whom the stent placement was unsuccessful underwent emergency surgery with poor decompression (clinical success rate, 97.7%). The pathological characteristics were not significantly different between the groups. The following surgical outcomes in the BTS group were superior to those in the surgery alone group; nonemergency surgery (P<0.001), surgical approach (P=0.006), and length of hospital stay (P=0.020). The median follow-up time was 44.9 months (range, 1.1–126.5 months). The 3-year relapse-free survival rates were 68.4% and 58.2% (P=0.411), and the overall survival rates were 78.3% and 88.2% (P=0.255) in the surgery alone and BTS groups, respectively. The 3-year locoregional recurrence rates were 10.2% and 8.0% (P=0.948), and distant metastatic recurrence rates were 13.3% and 30.4% (P=0.035) in the surgery alone and BTS groups, respectively.
Conclusion
This study revealed that BTS with stent may be associated with a higher frequency of distant metastatic recurrence. Stent for stages II to III obstructive colorectal cancer potentially worsens oncological outcomes.
4.Asian Young Doctors Session at the 64th Annual Meeting of the Japanese Society for Gynecologic Oncology (JSGO): Educational Initiatives in the Next Generation for a New Era after the COVID-19 Pandemic
Yusuke KOBAYASHI ; Hiroaki KOMATSU ; Masanori ISOBE ; Jyoti MEENA ; Chia-Sui WENG ; Se Ik KIM ; Jeslyn JL WONG ; Shuk Tak KWOK ; Jie YANG ; Panida MATHAVEECHOTIKUL ; Kanddy Loo Chin YEE ; Jae-Weon KIM ; Kimio USHIJIMA
Journal of Gynecologic Oncology 2023;34(1):e22-