It is hard to believe that the year 2022 is almost over. My term as a governor will end at the next annual meeting, Internal Medicine 2023, which will be held in San Diego during April 27th until 29th next year. I have not been able to attend the annual meetings since 2020 because of covid-19 turmoil and the last BOG meeting in autumn this year in Savannah GA was cancelled because of the Hurricane Ian (and switched to the remote conference). That’s the reason why I strongly hope to participate in the next annual meeting in San Diego. I hope many members from our chapter will attend the meeting too.
Some of the committees in our chapter are planning to hold seminars in December: a seminar concerning PMR will be hosted by Generalism-Continuing Medical Education Committee on December 13th and a seminar for residents and early carrier physicians concerning “how to make clinical questions through case studies” will be hosted by Resident Fellow Committee on December 3rd. I hope many attendees will get something to bring back home.
Finally, I want to wish all of you and your family happy, safe and peaceful Holiday Season.
Kurokawa Award (Medical Student Category) Recipient’s Remarks
Junna Iwata, Keio University, School of Medicine
I am honored to receive the Kurokawa Award at the ACP Japan Chapter Annual Meeting 2022.
I presented “Japanese medical student perceptions of working abroad: a national, online survey”. The results of a survey conducted by the ACP Japan Chapter Student Committee during the COVID-19 pandemic in 2020 were so interesting that I wanted to share them with the audience.
There is arising importance of internationalization in medical education in Japan. However, there are very limited data in Japan regarding medical student perceptions of international careers. This study aims to assess the perceptions toward working abroad among medical students in Japan and characterize the support they require. A total of 548 medical students from 59 medical schools in Japan participated in this study. Nearly 70% of participants were interested in working abroad while only 40% seriously considered it. A lot of students showed interest in clinical training abroad programs in the short term or while they are in medical school. Also, the need for language support and providing career options by role models were identified.
We hope that the results of this study will be useful for the further development of medical education in Japan. We are currently working on our next step, which is to publish our findings in an academic paper.
It was the first time for me to experience conducting research from scratch and presenting the results by myself, and I felt nervous before my presentation. However, I was encouraged by the many comments and questions I received during my presentation. I was so glad to conduct research from the viewpoint of medical students at the end of my medical school life.
I would like to take this opportunity to thank Dr. Harumi Yano, the advisor of the ACP Japan Chapter Student Committee, Dr. Nishizono and Dr. Hashimoto of Oita University, Mr. Cyrus of WashU, the Student Committee members who have worked together, and everyone involved in the ACP Japan Chapter Annual Meeting 2022.
Kurokawa Award (Resident/Fellow Category) Recipient’s Remarks
Shun Nakahara, United States Naval Hospital Okinawa, Japan
I am honored to receive this prestigious Kurokawa Award. The case was “Cerebral venous sinus thrombosis potentially provoked by previous COVID-19,” which I experienced during my rotation in Internal Medicine at U.S. Naval Hospital Okinawa, Japan. The patient was diagnosed with cerebral venous sinus thrombosis 35 days after mild COVID-19. Although it was difficult to prove the causal relationship, the increased risk of venous thromboembolism after COVID-19 had been reported and CVST, in this case, might relate to his recent COVID-19. This case taught us that a careful history, including red flags of headache, must be obtained to maintain a low threshold to suspect CVST.
I could not receive this award without Dr. Early and Dr. Balter, who helped take care of this case and checked the abstract. I would like express my gratitude to Dr. Tsutsumi at Takatsuki Hospital, who helped improve my case presentation.
Lastly, I would also like to express my sincere gratitude to everyone involved in the ACP Japan Chapter Meeting. Thank you all so much for offering us this precious opportunity.
Kurokawa Award (Early Career Physicians Category) Recipient’s Remarks
Ko Harada, Icahn School of Medicine at Mount Sinai
I am extremely honored to receive the Kurokawa Award at the 2022 ACP Japan Chapter Annual Meeting. I presented the study titled “Increase in sarcoidosis mortality rate among the older population in Japan: A population-based study from 2001 to 2020.” in which we reported on trends in sarcoidosis-associated crude and age-adjusted mortality in Japan over the past 20 years using national death certificate data. Joinpoint analysis was used to analyze the trends. Our study revealed that sarcoidosis-associated deaths in Japan have significantly increased over the past two decades, especially among the older population with a female predominance. Since sarcoidosis is a relatively rare but increasingly recognized disease, I believe that many participants found this presentation interesting.
I attended and presented at several ACP Japan Chapter meetings when I was a junior and senior resident in Japan. I moved to the U.S. in 2021 and am currently working as an internal medicine resident at a community hospital in New York City. This year, due to the COVID pandemic, the conference was held online, allowing me to participate from overseas. I would like to continue my research and contribute to the development of medicine in Japan and ACP Japan Chapter in any way I can. I would also like to submit an abstract for the 2023 ACP Annual Meeting in the U.S. Finally, I would like to express my gratitude again to the people involved in the ACP Japan Chapter meeting for providing such a wonderful opportunity for me to present my research.
It was unfortunate that we couldn’t attend the ACP 2022 Annual Meeting in Chicago (IMM 2022) at the end of April due to the Covid-19 restrictions. But you should find good things in a bad situation – as it was held in a hybrid style, we could see some of the lectures online, although time difference was a limiting factor. Many sessions were recorded and are available for several months after the meeting so that you can watch some of them later.
The 2023 ACP Annual Meeting will be held at the end of April 2023 in San Diego. I hope that next year there will be many physicians from Japan at the meeting. Start planning now!
Let’s talk about our Chapter’s Scientific Meeting 2022. It will be held completely online on Saturday 25th and Sunday 26th this month. Some of the sessions will be distributed on-demand to the participants during some period after the meeting so that you can view sessions you missed.
With Covid-19 still a present threat to our health and well-being, please remember to take care of yourselves and take time to treasure those who are most dear in your lives.
— 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.
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.
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 (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.