1.An Opinion Poll of Doctors Concerning Working Conditions in Kohseiren Hospitals and the Medical Service System in Japan.
Kenji KATAGIRI ; Satoshi WAKITA ; Takeshi YOKOI ; Higashi SUGIMOTO ; Hirofumi TAHARA ; Tatsuya HAGA ; Masahiro IKEUCHI ; Hitoshi KANAYAMA ; Kohji OHHASHI ; Masaaki IKEDO
Journal of the Japanese Association of Rural Medicine 2002;51(4):633-650
A survey was conducted by sending questionnaires to 466 doctors working at nine hospitals affiliated with the Aichi Prefectural Federation of Agricultural Cooperatives for Health and Welfare (Kohseiren).
The survey found that the length of service was under 5 years in 60% of the respondents and that many of them identified themselves strongly with the department of the teaching hospital where they were trained.
They were found to be little intersted in the present situation of the agricultural cooperatives and Japanese agriculture. However, they said they were satisfied with the present working conditions, because they could show their skills. Most approved of organ transplants after brain death but disapproved of human cloning. They showed a positive attitude toward the allowing of each patient to give access to his or her clinical records and standardization of medical treatment. Some 67% of the doctors admitted they had made medical mistakes and keenly realized the necessity of risk management.
While feeling uneasy about the recent upsurge of lawsuits brought by patients about medical treatment, they said they are endeavoring to provide safe and high quality medical service. Their recent concerns were rearrangement of dispensaries based on the subspecialty, reinforcement of postgraduate courses in medical schools and the postgraduate training system which will be a legal obligation from 2005. They suported the reform plans for the national medical service for aged patients and recognized the necessity of joining hands with local agricultural cooperatives in providing nursing care services. They said they wish to continue their career as a physican at the Kohseiren hospital.
2.A Case of Advanced Carcinoma of the Tongue Extending to the Base Successfully Treated with Intra-arterial Chemoradiotherapy
Akio YASUI ; Takeshi WAKITA ; Yoshihito MATSUI ; Daiki KOIDE ; Hisanobu MARUO ; Shoichiro KITAJIMA ; Akihiro MORI ; Wataru HAYAMI ; Kiyotada TOKIDA ; Minoru TERAZAWA
Journal of the Japanese Association of Rural Medicine 2021;70(1):62-68
Intra-arterial chemoradiotherapy for advanced oral cancer has recently been reported and can preserve the form and function of the tongue by avoiding surgery at the primary site. We report here a case of advanced tongue cancer treated with intra-arterial chemoradiotherapy that preserved phonation and swallowing function. A 71-year-old man presented with an ulcerative mass, 43×28 mm in size, extending from the left lingual margin to the base of the tongue. The pathological diagnosis was squamous cell carcinoma based on biopsy results, and the clinical diagnosis was left lingual carcinoma (cT3N0M0, stage III) based on imaging findings. A polyurethane catheter was inserted into the left lingual artery, and intra-arterial chemotherapy was administered using docetaxel (15 mg/m2/week, total dose 60 mg/m2) and cisplatin (5 mg/m2/ day, total dose 125 mg/m2) with concurrent radiotherapy (2 Gy/day, total dose 50 Gy). Posttreatment biopsy results showed no tumor cells, and complete response was achieved, thus avoiding surgical resection of the primary site. Six years after completing treatment, the patient remains in good health with no recurrence, metastasis, phonation problems, or dysphagia.