1.Current Status of the Clinical Simulation Laboratory at Kyorin University Faculty of Medicine and Affiliated Hospital
Yasuhiko Tomita ; Itsuko Sakamoto ; Michio Akagi
Medical Education 2011;42(3):141-147
1)Our Clinical Simulation Laboratory (CSL) registered 19,085 training attendances with nurses accounting for the majority of trainees in first three years. Basic Life Support training experienced the highest demand.
2)CSL usage rose markedly in both spring and fall, showing three daily peaks (9 am, 10 am and 5 pm), and lasted for an average of one and a half hours per session.
3)The lending rate of the simulators to areas outside CSL came to about half of the internal use rate. The current simulator–based training program requires improvement to increase attendance by medical students and doctors.
2.Advance patient directives prepared for end-of-life care in clinical deterioration and cardiopulmonary arrest in residential aged care facilities
Yoshihiro Moriwaki ; Yasuhiko Tomita ; Yoshio Tahara ; Jun Sugiyama
An Official Journal of the Japan Primary Care Association 2014;37(2):133-137
Introduction : This study examines the feasibility of providing end-of-life care at a residential aged care facility using advance patient directives from the perspective of the non-medical facility staff.
Methods : Efforts were made by the facility staff to obtain advanced patient directives (APD) from 240 residents. Compliance by staff and residents in documentation of APDs for cardiopulmonary arrest (CPA) was examined.
Results : APDs were obtained from 204 residents (85%) and all responded to questions regarding end-of-life care in the facility without resuscitation or emergency transfer, indicating their autonomous wishes. Of the 204 respondents, 196 indicated preferences for both resuscitation and emergency transfer, 62% of which indicated preference for no resuscitation and no emergency transfer. No statistical differences were noted based on age, sex, or diagnoses. Fourteen residents died eight (58%) of whom received end-of-life care in the facility.
Conclusion : Non-medical staff can effectively document resident's wishes using APDs addressing clinical deterioration and CPA.
3.Epstein-Barr virus and gastrointestinal lymphomas in Korea.
Woo Ick YANG ; Min Sun CHO ; Yasuhiko TOMITA ; Masahiko OHSAWA ; Katsuyuki AOZASA
Yonsei Medical Journal 1998;39(3):268-276
To analyze the association of Epstein-Barr virus (EBV) with gastrointestinal non-Hodgkin's lymphomas arising in immunocompetent patients, 56 consecutive cases of gastrointestinal lymphomas (B-cell: 52-cases, T-cell: 3 cases, T/NK-cell: 1 case) occurring in the stomach (33 cases), intestine (22 cases) and esophagus (1 case) were investigated for the presence of EBV using polymerase chain reaction analysis as a screening method followed by EBER-1 RNA and DNA in situ hybridization (ISH) and immunohistochemistry for the expression of latent membrane protein 1 (LMP-1). Forty-seven cases demonstrated extractable DNA and EBV DNA was detected only in 4 cases. Among the, RNA (EBER-1) and DNA ISH analysis confirmed the presence of the EBV genome in tumor cells in 3 cases (T/NK-cell lymphoma of ileum, gastric high-grade B-cell lymphoma of mucosa-associated lymphoid tissue, gastric diffuse large B-cell lymphoma). Only the T/NK cell lymphoma showed diffuse positivity of tumor cells while 2 gastric B-cell lymphomas demonstrated a scattered positive reaction and no cases expressed LMP-1. Nine cases without extractable DNA by the PCR method showed no nuclear signal by EBER-1 ISH. These findings suggest that most sporadic primary gastrointestinal lymphomas in Korea are not associated with EBV.
Gastrointestinal Neoplasms/virology*
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Gastrointestinal Neoplasms/pathology
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Genome, Viral
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Herpesvirus 4, Human/isolation & purification*
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Herpesvirus 4, Human/genetics
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Human
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In Situ Hybridization
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Korea
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Lymphoma/virology*
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Lymphoma/pathology
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Polymerase Chain Reaction
4.The Current Status and Issues of Clinical Training Workshops for Attending Physicians at Kyorin University Affiliated Hospital
Yasuhiko TOMITA ; Kyorin University Affiliated Hospital General Education Center ; Tomoharu YAJIMA ; Kyorin University Affiliated Hospital General Education Center ; Michio AKAGI ; Kyorin University Affiliated Hospital General Education Center ; Makiko KINOSHITA
Medical Education 2019;50(3):237-243
Objective: To analyze participants’ opinions regarding the content of clinical training workshops for attending physicians. Method: A total of 225 people participants in the workshops (approximately 17 hours in 2 days) that were held between 2013 and 2016. We provided the following training sessions: (1) Kawakita Jiro Method (KJ), (2) Process of clinical training, (3) Training program planning procedure, (4) Training objectives, (5) Classification of objectives, (6) Professionalism (PF), (7) 6 Microskills (6MS), (8) Significant event analysis (SEA), (9) Training strategies, (10) Coaching, (11) Educational evaluation, (12) Clinical training systems (CTS), and (13) Roles of attending physicians (RAP). We only used the results of questionnaires obtained from participants who consented to the investigation, and reviewed them for (1) training proficiency, (2) session interest, and (3) course evaluation. Results: Training sessions showing high proficiency were KJ, RAP, and CTS, and those indicating low proficiency were educational objectives, SEA, and PF. Training sessions that were of great interest were 6MS, Coaching, and KJ. Conclusion: In the evaluation of the entire course, overall value scored the highest, followed by significance of future participation and applicability of content. Overall, the participants felt that the time for the training course was a little long and that the difficulty level was somewhat high.