Dr. Harumi Gomi on the importance of history and its role in effective diagnosis

2021年12月24日

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https://www.acponline.org/membership/medical-students/acp-impact/archive/april-2019/dr-harumi-gomi-on-the-importance-of-history-and-its-role-in-effective-diagnosis
Harumi Gomi, MD, FACP, FIDSA, AFAMEE

Harumi Gomi, MD, FACP, FIDSA, AFAMEE, (second from right) joins colleagues at a recent national annual infectious disease conference in her hometown of Okayama, Japan.
 

Harumi Gomi, MD, FACP, FIDSA, AFAMEE
— OCCUPATION —
Professor, Office of Medical Education and Center for Infectious Diseases, International University of Health and Welfare, School of Medicine, Narita, Japan— MEDICAL SCHOOL —
Okayama University Medical School, Okayama, Japan— RESIDENCY —
Okayama Red Cross Hospital, Okayama, Japan, and Beth Israel Medical Center, New York, NY

 

Although she was born, raised, and attended medical school in Japan, Dr. Harumi Gomi dreamed of doing her medical residency in the United States. She studied and worked in Dartmouth, NH, New York City, Baltimore, Houston, and Springfield, IL, before returning to Japan to teach medical students a different way of examining patients.

What inspired you to become a physician?

My interest began when I was 4 or 5 years old and I watched a TV program showing surgeries. It was truly exciting to me, and I started to dream about becoming medical doctor. My major turning point came in high school, when I met Yuko Ishizaki, who was medical student at the time and just a bit older than me. She explained how much she was enjoying medical school and she completely convinced me to pursue a career in medicine. We’ve been very good friends in the 35 years since then. She’s a professor of pediatrics in Osaka and we still meet occasionally and talk about our personal and professional lives.

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Governor’s Newsletter(Nov. 2021)

2021年11月4日

Fall is in full swing now and the covid-19 patients are rapidly decreasing in number, thanks to your endeavor. Subsequently, Winter is approaching but I hope there won’t be the sixth wave of the pandemic even in the cold season. To prevent the recurrence of the disease, we should be careful enough and learn about the virus. As a member of ACP I have appreciated the resources and support from ACP in providing care for the covid-19 patients. I encourage you to review the latest updates in the ACP homepage.

In this season, we are going to elect the Governor-Elect (GE) in the vote. Both of the candidates have leadership and cognizant of ACP matters well. So I firmly believe that he/she will be a good GE. If you haven’t voted yet, please make haste with your vote – the deadline is November 5th.

Lastly, let me ask you to stay current with your ACP membership, and to recommend to your professional IM colleagues and student/resident affiliates that they maintain and/or renew ACP membership. Membership provides you with various privileges including free access to Annals of Internal Medicine and other multiple free online resources, and we are planning to add more to the Japan chapter members in the near future.

I wish all of you a safe, healthy, and happy upcoming holiday season.

Kenji Maeda

Kurokawa Award Winner (Medical Student Category)

2021年10月7日

Kurokawa Award (Medical Student Category) Recipient’s Remarks
Eriko Kamijo, MD, St.Luke’s International Hospital Junior Resident
Chiba University, 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 Winner (Early Career Physicians Category)

2021年9月16日

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 Winner (Resident/Fellow Category)

2021年9月16日

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.