We report four cases of post coronavirus disease 2019 (COVID-19) condition in which the patients suffered from a severe sense of fatigue that was successfully treated with warming-tonifying therapy using bukuryoshigyakuto, allowing them to return to normal social life. All four patients were unable to engage in social or school activities and had difficulty performing daily living tasks. Initially, they were treated with Kampo formulas corresponding to the yang pattern, which proved ineffective. However, their sense of fatigue was relieved after starting bukuryosigyakuto. Case 1 (36-year-old man) was a latent yin-deficiency pattern, in which an electro-acupuncture test revealed his interior cold. In Case 2 (53-year-old man), Case 3 (17-year-old woman) and Case 4 (11-year-old boy), the administration of bukuryoshigyakuto was based on the presence of severe sense of fatigue, characterized by the need to lie down almost all day and worsening symptoms after walking several dozen meters or taking a bath. There have been some case reports of tonifying therapies being effective in treating post COVID-19 conditions which are considered examples of qi deficiency or qi and blood deficiency following acute infectious disease. Kampo therapy with warming-tonifying formulas may be useful for post COVID-19 conditions that correspond to a late yin stage pattern in the six stage classification, particularly those presenting with severe sense of fatigue.

Background: The AO entrance examination for the Medical Course at Kochi Medical School aims to select candidates who are not only knowledgeable but also exhibit strong interpersonal and presentation skills. This study sought to determine the impact of the AO exam’s group work and presentation components on students’ success post-graduation.Methods: Clinical training supervisors’ evaluations of interpersonal and presentation abilities were compared between AO entrance exam candidates and other selected candidates.Results: AO entrants showed superior performance in establishing patient-physician relationships, participating in team medicine, and delivering case presentations compared to their counterparts.Discussion: The AO entrance examination at Kochi Medical School proves to be an effective tool for assessing candidates’ interpersonal and presentation skills, which are essential for medical practitioners.

　　We have been working to improve nursing care for patients who are receiving chemotherapy by understanding the feelings of nurses who work in the chemotherapy outpatient unit. Previous efforts to understand the feeling of nurses involved with cancer chemotherapy revealed that they felt anxious about whether their care of chemotherapy patients was sufficient. To clarify their level of anxiety and difficulties faced, structured group interview analysis was conducted in the present study. Based on our findings, a number of nurses reported anxiety and psychological burden, which were classified into four categories: “Unclear how to interact with patients and their families”, “Mental burden of nurses”, “Anxiety handling anti-cancer agents”, and “Problems with human relations”. In particular, nurses were psychologically burdened by feeling unable to provide individual nursing care to patients and their families. The findings suggest that nurses should acquire professional expertise related not only to chemotherapy nursing itself but also to palliative care. A multipronged approach based on interprofessional collaboration is also needed to satisfy the individual requirements of patients who are receiving chemotherapy and their families.

Background: The purpose of this study were to investigate the survival rate of patients with cervical cancer who were treated at our institution and to analyse its prognostic factors.Methods: One hundred twenty-two patients who underwent treatment for primary cervical cancer at Kochi Municipal Hospital between January 1996 and August 2003 (7 years 8 months) were retrospectively reviewed. There were 59 patients (48.4%) with stage 0 disease. Sixty-three patients (51.6%) had stage I-IV cervical cancer. The mean age was 56.7±15.6 years, and the median follow-up period was 31 months.Results: The overall 5-year suvival rate was 96.4% and 77.1% in stage I and II, respectively. The overall 3-year survival rate was 56.3% in stage III, and the 30-month survival rate was 0% in stage IV. Among the risk factors of histologic cell type, clinical parametrial involvement, clinical vaginal involvement and pelvic lymph node metastasis, clinical parametrial involvement had the lowest p value (p=0.0717) in a multivariate Cox proportional hazards regression analysis.;;Multivariate analysis using the Cox proportional hazard regression model showed that among the risk factors of histologic cell type, clinical parametrial involvement, clinical vaginal involvement and pelvic lymph mode metastasts, the lowest p value (p=0.0717) was for clinical parametrial involvement.Conclusion: Although there was no statistical significance comparing the prognostic factors in multivariate analysis, it was presumed that clinical parametrial involvement was the most influential factor among those which were analyzed in this study on the prognosis of patients with stage I-IV cervical cancer.
Clinical ; Diagnostic Neoplasm Staging ; Cervical Cancer ; lower case pea ; Roman Numeral IV

Objective: The prevalence of complementary and alternative medicine (CAM) in patients with various urologic disorders is unknown. We conducted the survey to determine the prevalence of CAM use in ambulatory patients.
Methods: We distributed questionnaires to 331 ambulatory patients with various urologic disorders in our department from March 10 to 31, 2004.
Results: One in third (30.5%) patients reported the use of at least one CAM. Patient age and gender were not associated with the frequency of the use of CAM. Although not statistically significant, patients with malignant disease showed a higher frequency of CAM use compared with patients with benign disease; 36.2% vs 27.0%, P=0.08. Among the CAM users, only 16 patients (15.8%) informed health care staff of their CAM use.
Conclusion: This result shows the current situation of CAM use in patients with urologic disorders. Because of the high prevalence, health care professionals should ask about patients' use of CAM.

The authors examined the frequency of thromboembolism and bleeding complications in cases of mechanical valve replacement during the past 5 years in the Tokyo area. There were 21 cases of thromboembolism and 15 cases of bleeding complications. Analyzing these cases with regard to anticoagulant therapy, 71% of the thromboembolism cases and 47% of the bleeding complication cases had 10∼25% result on the thrombotest at the time of the event. Consequently, in cases of mechanical valve replacement it is necessary to reevaluate the therapeutic range of the thrombotest results. This was a retrospective study of a TAS (The Tokyo area anticoagulation study for cardiac valve replacement by using PT-INR) trial and we intend to carry out a prospective study on the therapeutic range of the thrombotest and PT-INR.