The Institute for Environmental and Gender-Specific Medicine, Juntendo University Graduate School of Medicine (the founding director; CEO Hideoki Ogawa, M.D., Ph.D.), was founded in 2002, supported by a grant of High-Tech Research Center Project for Private Universities: matching fund subsidy from the Ministry of Education, Culture, Sports, Science and Technology (MEXT) of Japan. To date, we have conducted research in environmental and gender-specific medicine and related fields with the help of visiting faculty members and many collaborators. In 2013, we were awarded a grant of Strategic Research Foundation Grant-aided Project for Private Universities from MEXT, to support our project to elucidate pathogenic mechanisms and develop preventive and therapeutic methods targeting intractable itch. To further advance this project, which remains ongoing, we held the 2nd Symposium and the 3rd Workshop from 2015 to 2016 at Juntendo University. In brief, we here report on the 2nd Symposium and the 3rd Workshop on intractable itch.
I graduated from Juntendo University in 1976. Until my retirement, I have belonged to Jichi Medical School and Juntendo University for approximately 10 and 30 years, respectively. My 30-year activity at Juntendo University is divided into 15 years in the Department of Respiratory Medicine and 15 years in medical education and the Department of General Medicine. I also worked for the Postgraduate Clinical Training Center for 14 years.
As my “Farewell Lectures of Retiring Professor on March 30, 2016”, this paper reports my activities related to medical education of pre-/postgraduate and the application of ultrasonography in the respiratory diseases at Juntendo University.
In Urayasu City, lung cancer screening was initiated in April 1988. The city has adopted a clinic-based individual screening method using chest X-ray images. Here, we present indices associated with quality control of the lung cancer screening conducted over the period of 27 years until March 2015. The total number of persons screened was 293,263. During this 27-year period, the city’s population grew 1.6 times, while the annual number of persons screened for lung cancer grew 5 times. The mean screening rate for the 6 years from 2008 through 2014 was 56.1%, higher than the percentage targeted by the Cancer Control Act. The recall rate was 1%, lower than the national average of 2.6%. Excluding those with other active pulmonary diseases from the cases recalled to undergo detailed examination, the recall rate was approximately 0.7%. The detailed examination rate among those recalled for such an examination used to be high, exceeding 80%, but has been on a declining trend in recent years. The lung cancer detection rate for the aforementioned 27-year period was 64.8/100,000 persons, higher than the national average. Since the Great East Japan Earthquake, population growth has ceased and the lung cancer detection rate has been on a declining trend. The positive predictive value fluctuates from year to year but has remained within the range of 4-7%. These indices compared favorably with those in other municipalities in Chiba Prefecture. Particularly, the city’s screening rate was higher than the rates in municipalities using mass screening.
The age-adjusted mortality from lung cancer in Urayasu is declining on an annual basis, which may be attributable to lung cancer screening, along with anti-smoking measures.
I had a valuable experience at Juntendo. First, I chose plasmapheresis (plasma exchange therapy) as my research theme and conducted experiments for many years. As a result, the plasmapheresis center was established in December 1984, the first and only in Japan. In the meantime, two devices (SELESORB and CELLSORBA) were developed. Second, I started working at Juntendo Tokyo Koto Geriatric Medical Center 11 years ago. I have managed the center since then and was inaugurated as director for 3 years.
Objective: The use of postoperative adjuvant chemotherapy (POAC) after surgery for patients with stage II colon cancer remains controversial. The current study was conducted to investigate the effectiveness of POAC using propensity score (PS) matching analysis based on prognostic factors.
Materials: Two hundred and nineteen patients with stage II colon cancer who underwent surgery with curative intent between 1995 and 2005 were enrolled.
Methods: PS matching analysis was used to adjust for differences in clinicopathological severity between the patients with and without POAC.
Results: Before PS matching analysis significant survival benefits from POAC were not recognized for recurrence-free survival (Hazard ratio=0.76, 95%CI; 0.40-1.45, p=0.41) or cancer-specific survival (Hazard ratio=0.52, 95%CI; 0.22-1.19, p=0.12). After PS matching analysis significant survival benefits from POAC were not recognized for recurrence-free survival (Hazard ratio=0.55, 95%CI; 0.23-1.23, p=0.15) or cancer-specific survival (Hazard ratio=0.46, 95%CI; 0.16-1.18, p=0.11).
Conclusion: The one-to-one pair PS matching successfully balanced the clinicopathological factors between the patients with and without POAC. The PS matching analysis demonstrated no significant difference in survival in the patients with stage II colon cancer.
Objective: The aim of this study is to elucidate underlying distinctive common features of currently used measures.
Patients: This study was conducted as a part of nationwide cross-sectional and observational study of “Prostate cancer background, quality of life (QOL), patient’s satisfaction and treatment survey by Japan Prostate Cancer Study Group (J-CaP)”. PCa survivors were invited to answer Short Form 36 (SF-36), Expanded Prostate Cancer Index Composite (EPIC), Functional Assessment of Cancer Therapy (FACT) through the web page of J-CaP.
Methods: Significant conceptual components of three health-related quality of life (HRQoL) questionnaires: EPIC, FACT, and SF-36 were identified by principle component analysis in Japanese patients.
Results: All of the questions from EPIC, FACT, and SF-36 were classified into 9 categories by principle component analysis. Our result suggests that a more feasible and integrated HRQoL measure can be created based on those components identified in our study.
Conclusion: Three HRQoL questionnaires containing 128 questions in total could be narrowed down to 9 principle components. Our future assignment is to create an integrated and more feasible version of scoring system that comprehensively covers these 9 components.
Here I report my observations and assessments following two weeks of training at Juntendo University, including stints at the main hospital, the Tokyo Koto Geriatric Medical Center, and Shizuoka Hospital with its associated Faculty of Health Science and Nursing. I focus on three facets: work division and specification of duties, coordination both multidisciplinary and multi-facility to achieve state-of-the-art treatment, and finally, exemplary nurse training programs. All three facets combine to ensure that patients receive the highest level of care from thoroughly trained and motivated health care professionals who are dedicated to serving patients’ medical needs while deeply respecting individual dignity.