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Hayashino Y.,Kyoto University | Utsugi-Ozaki M.,Horikawa Hospital | Feldman M.D.,University of California at San Francisco | Fukuhara S.,Kyoto University
PLoS ONE | Year: 2012

The presence of hope has been found to influence an individual's ability to cope with stressful situations. The objective of this study is to evaluate the relationship between medical errors, hope and burnout among practicing physicians using validated metrics. Prospective cohort study was conducted among hospital based physicians practicing in Japan (N = 836). Measures included the validated Burnout Scale, self-assessment of medical errors and Herth Hope Index (HHI). The main outcome measure was the frequency of self-perceived medical errors, and Poisson regression analysis was used to evaluate the association between hope and medical error. A total of 361 errors were reported in 836 physician-years. We observed a significant association between hope and self-report of medical errors. Compared with the lowest tertile category of HHI, incidence rate ratios (IRRs) of self-perceived medical errors of physicians in the highest category were 0.44 (95%CI, 0.34 to 0.58) and 0.54 (95%CI, 0.42 to 0.70) respectively, for the 2nd and 3rd tertile. In stratified analysis by hope score, among physicians with a low hope score, those who experienced higher burnout reported higher incidence of errors; physicians with high hope scores did not report high incidences of errors, even if they experienced high burnout. Self-perceived medical errors showed a strong association with physicians' hope, and hope modified the association between physicians' burnout and self-perceived medical errors. © 2012 Hayashino et al.


Miyagawa K.,Horikawa Hospital | Yata Y.,Horikawa Hospital | Yamaoka N.,Horikawa Hospital | Sagara Y.,Horikawa Hospital
Japanese Journal of Cancer and Chemotherapy | Year: 2010

Pancreatic cancer is among the most lethal of all digestive cancers, and it is very difficult to obtain long-term survival of unresectable cases. This case report reveals that combination chemotherapy with S-1/gemcitabine (GEM) was very effective for a patient with unresectable pancreatic body cancer. The patient was a 72-year-old female (Stage IVb). They were administered S-1 80 mg/day for 2 weeks and GEM 1, 000 mg/m2 on day 8 and 15 followed by a 2-week recovery period. After finishing the 2 courses, there was a notable reduction in tumor size. After finishing 9 courses, the tumor could not be observed and it was judged it to be CR. Currently, at 1 year and 4 months from the initial diagnosis, there is no recurrence of tumor, and the general condition of the patient is very good. Combination chemotherapy with S-1/GEM may be useful to improve the prognosis for unresectable pancreatic cancer.


Konishi H.,Horikawa Hospital | Okamura H.,Horikawa Hospital | Kawai K.,Horikawa Hospital | Sagara Y.,Horikawa Hospital
Japanese Journal of Gastroenterological Surgery | Year: 2014

The patient was a 74-year-old woman who developed thoracolumbar vertebral metastases after surgery for bilateral breast cancer and underwent palliative therapy by oral administration of oxycodone. She urgently came to our hospital due to increased back pain and malaise. Abdominal CT showed the presence of free air in the abdominal cavity and an emphysematous lesion. Peritoneal irritation signs were not apparently detected by the initial physical examination. However, the lack of symptoms was thought to be caused by oxycodone. As the possibility of gastrointestinal perforation could not be denied, exploratory laparotomy was performed. Surgery revealed an emphysematous lesion about 10 cm in length at the ileum site of the mesentery but no perforation. Assuming the possibility of metastasis of breast cancer to the small intestine, partial ileal resection was performed. Postoperative histopathology indicated pneumatosis cystoides intestinalis. Recently, pneumatosis cystoides intestinalis has been increasingly reported and there is a certain level of consensus on the diagnosis and treatment. Herein, we report the present case, demonstrating the difficulty in the diagnosis and treatment of pneumatosis cystoides intestinalis associated with free air in the abdomen during palliative therapy, with a review of the literature. © 2014 The Japanese Society of Gastroenterological Surgery.

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