Kurokawa Award (Medical Student Category) Recipient’s Remarks
Eriko Kamijo, MD, St.Luke’s International Hospital Junior Resident
University of Chiba, 2015-2021
I am honored to have received the Kurokawa Award at the ACP Chapter Annual Meeting, 2021.
I reported a case of “Lower extremity edema caused by squamous cell carcinoma: physical findings and tests useful for differentiating lymphedema”. Malignant tumors sometimes develop secondary lymphedema and need to be diagnosed early. I focused on the usefulness of Stemmer’s sign and Indocyanine green (ICG) lymphangiography in diagnosing secondary lymphedema.
When trying to pinch the dorsal skin over the proximal phalanx of the second or third toe, Stemmer’s sign is positive if the skin cannot be pinched. It is a useful physical examination to diagnose lymphedema. The sign is often used on the place we showed above, but can be used on all other toes; pinching the dorsal skin immediately proximal to the metatarsophalangeal joint can also be substituted for technical simplicity.
ICG lymphography is also useful for diagnosis. The diagnostic ability of ICG lymphography and its evaluation capability for disease severity is similar to lymphoscintigraphy which is the gold-standard examination for extremity lymphoedema but with less invasiveness and a lower cost.
In this case, the primary lesion was a black ulcer on the lower limb, causing the edema throughout the ipsilateral lower limb, and we were able to make a diagnosis through an accurate physical examination. I would like to gain my experience to find a quicker, easier, and more accurate way to diagnose edema and other conditions that I encounter in my daily practice.
This was my first time to present a case report, and I stumbled over a lot how to summarize and convey the information. However, I realized that by looking back on each case from an academic perspective, it became an opportunity to learn deeply and connect it to my next medical examination.
I would like to take this opportunity to thank the teachers of the Department of General Medicine, Chiba University, who have given me great guidance since my clinical training. I would also like to express my gratitude to all those involved in the Japanese Section Meeting of the American Society of Internal Medicine for giving me the opportunity to make a presentation.
Kurokawa Award (Early Career Physicians Category) Recipient’s Remarks
Shinichi Katsukura, Dokkyo Medical University
I am very honored to receive the prestigious Kurokawa Award at the 2021 Annual Meeting of the ACP Japan Chapter.
The rise of artificial intelligence in the medical field has been remarkable, and the same is true for the research in clinical diagnosis, which our team espouses as the research interest.
There are two AI-based outpatient medical support systems: The AI-driven automated medical-history-taking systems and the AI-driven differential-diagnosis lists.
However, there have been no reports comparing and verifying which of the two systems contributes more to the physician’s diagnostic process, which prompted us to plan this study.
Consequently, this study showed that the AI-driven differential-diagnosis lists did not have much efficacy on the physicians’ diagnostic accuracy, but the results also suggested that as the diagnostic accuracy of AI improves, the physicians with the system will also improve their diagnostic accuracy.
Our team, the Department of Diagnostic and General Medicine at Dokkyo Medical University, whose core interest is the development of diagnostic thinking strategy, will continue to promote augmentation in diagnosis between physicians and AI towards the singularity.
I am very grateful to Professor Taro Shimizu, Dr Yukinori Harada, and other fellow members of my department for their generous guidance from the planning of the research to the presentation.
Finally, I would also like to express my gratitude to the staff of the ACP Japan Chapter for providing such a wonderful setting for my presentation. I would appreciate so much.
Kurokawa Award (Resident/Fellow Category) Recipient’s Remarks
Yoji Hoshina, U.S. Naval Hospital Yokosuka
I am extremely honored to receive this prestigious Kurokawa Award at the ACP Japan Chapter Annual Meeting 2021.
The case I presented was “A case of myasthenia gravis after administration of COVID-19 vaccine,” which I experienced during my rotation in the Department of Neurology at the U.S. Naval Hospital Yokosuka. Myasthenia gravis is known to be triggered and exacerbated by various factors, including infection and medications. In this case, there were no obvious changes in the patient’s daily life before the presentation of symptoms, except for the administration of the COVID-19 vaccine. Although we cannot conclude that the vaccination was related to the exacerbation of his symptoms, I thought discussing and presenting this case would lead to the “activation of the academic mind,” which is the annual meeting theme. The difficult part of the discussion was that there were no identical cases in the past, so we had to hypothesize based on similar cases and the mechanism of vaccine and COVID-19 infection. I could not have done it without Dr. Baker and Dr. Sowers, who have supported me. I would like to thank Dr. Baker and Dr. Sowers from the bottom of my heart.
Last but not least, I would like to express my deepest gratitude to the staff at Chiba University Department of General Medicine, where I spent time before going to Yokosuka, for encouraging me to pursue my interest in an academic area. I would also like to express my sincere gratitude to the people involved in the ACP Japan Chapter Meeting, who decided to hold the meeting virtually during the COVID-19 pandemic and worked hard until the end.