OSCE July 23rd

On July 23rd at 6PM we will convene for an OSCE, Objective Structured Clinical Exam. We are fortunate to have several native English speakers who have agreed to be "mock" patients. Please contact Sasamoto san at #3396 or by email at ksasamoto@kameda.jp. We welcome non Kameda participants, but Kameda residents have priority.

DG

EBM Online Tutorial

The University of NC and Duke University have sponsored an online EBM tutorial. Access is at the following URL. Just paste into your browser then follow the controls at the right.

http://www.japanmed.com/resident/

Natto!

Natto beans are an amazing health food. Introduced in the Yayoi period (over 2300 years ago) they are now known to be beneficial for heart disease and have significant antibiotic effects!

1. Nattokinase is an enzyme discovered in 1990 by
Dr. Hiroyuki Sumi .

"This is a powerful dissolver of blood clots and fibrin in the arteries. To give you some idea of how powerful Nattokinase is, drug companies sell the enzyme urokinase to dissolve clots and present it in a product that sells for about JPY20,000 per dose. It lasts for just 30 minutes in the body after ingestion. 100gm of Natto on the other hand can be bought from the supermarket for a paltry JPY100, it is just as efficacious, and yet it remains effective in the body for around 8 hours."

2. Natto apparently also protects us
against salmonella and other enteric pathogens.

"Some readers may recall the June 1993 Tajimi City, Gifu schools mass poisoning of 2,700 students with E-coli O-157 virus, caused by contaminated school lunches. It was a big scandal at the time, with lots of finger pointing about what/who caused it.
A study was done later on the students who were affected versus those who were not, and the researchers found that those kids who ate Natto at least 1-3 times a week had a far lower incidence of infection by E-coli than those who ate none." quoted items from Terrie's Take

Wow! How can something that smells so bad be so good?

DG

For more information do a google search for "Terrie's take natto" June 2 issue.

Dr. O'Rourke

Ken arrived a day late at Narita Airport due to a delayed departure from Charlotte, NC on Friday. He was not quarantined but he enjoyed the Narita Hilton Hotel. He is looking forward to his time at Kameda Medical Center. Enjoy!

DG

Rebecca's Blog

Sushi Chaz
Everyone enjoyed Rebecca Chasnowitz's visit to Kameda Medical Center in April 2009. Rebecca will be a final year medical student at UNC in July. Now you can enjoy her observations in blog style.

http://sushichaz.blogspot.com

Also, you may not have seen Annie's Blog:

http://summeratkameda.blogspot.com/

Or Priya's blog:

http://hellokittyelective.blogspot.com/2008/12/sayonara-kameda.html

Weber Sensei - September

Dr. Weber has agreed to cover the Kameda faculty role from Sept 8 thru Sept 23. He is a specialist in Pediatrics Infectious Diseases and nosocomial infections.

DG

David J. Weber

Assistant Dean, UNC School of Medicine

Assoc. Chief of Medical Staff
Medicine and Pediatrics

Campus Box 7030
T: 919-966-2536
F: 919-966-1451

Education
1977	University of California, San Diego
1985	Harvard University

Research Ineterests: Epidemiology, Nosocomial infection

Key publications

Rutala WA, Barbee SL, Aguiar NC, Sobsey MD, Weber DJ (2000) Antimicrobial activity of home disinfectants and natural products against potential human pathogens. Infection Control and Hospital Epidemiology: vol.21, p.33-8.

Rutala WA, Weber DJ (1999) Infection control: the role of disinfection and sterilization. Journal of Hospital Infection: vol.43 Suppl, p.S43-55.

Weber DJ, Raasch R, Rutala WA (1999) Nosocomial infections in the ICU: the growing importance of antibiotic-resistant pathogens. Chest: vol.115, p.34S-41S.

Weber DJ; Rutala WA (1999) Zoonotic infections.. Occup Med: vol.14, p.247-84.

Weber DJ; Rutala WA; Blanchet CN; Jordan M; Gergen MF (1999) Faucet aerators: A source of patient colonization with Stenotrophomonas maltophilia.. Am J Infect Control: vol.27, p.59-63.

Medical English Podcasts

Medical podcasts are now available on iTunes. Go to iTunes online store .... podcasts ... enter medical issues in search engine. Download to your MP3 player then listen on the Tokyo Metro.

dg

Mexican Dinner at the Sanno

Yoko and Shumei (both residents heading to NYC for Internal Medicine Residency) will join Dr. G and several NMS medical students for a Mexican Buffet at 7 pm at the New Sanno Hotel. Picture ID's required. www.thenewsanno.com.

dg

Medical Japanese Podcast

Learning Medical Japanese is Challenging.

It just became much easier with the recorded mp3 podcasts of discussions with Mari Ouchi, Kayo Sasamoto and Mari Shigetome. We hope to expand this over the next few weeks to include many more anatomical and medical terms. Now it is just in the developmental stage. Try the link below to see if it works on your computer.

http://japanmed.com/documents/Japanese101_podcast.mp3

dg

Answers to Abdominal Pain

1. Ika
2. None, treatment is with endoscopic removal.
3. No change in risk with subsequent exposures.

This abdomen is from a famous ID doc here in Japan who went out to dinner with his family. No family members were affected.

dg

Abdominal Pain In Kamogawa

A 34 YO male presents with severe abdominal pain 6 hours after eating a sushi meal with his family. Endoscopy findings are shown at left.

Questions:

1. What was the type of sushi eaten?
2. What is the antimicrobial treatment of choice?
3. Is recurrence more or less likely after an episode of infection?

Medical Japanese !!

The education department and Mari O'uchi have started a program of Japanese language education for visitors. The goal is to give visiting students and guest faculty
basic instruction in Japanese conversation and medical terms. This will facilitate their experiences in the hospital and help with their interaction with hospital staff, residents and patients. Thanks to Mari Shigetomi, Jessica Colin-Durand (McGill University), and Hiroshi Nishino for their efforts to get the program going. This is a "first of its kind" program and will help visitors to feel welcome.

DG

Multiple Myeloma Case

The patient in our last blog was diagnosed with multiple myeloma. When considering the diagnosis remember the CRAB mneumonic.

Great recent review available online :

Sirohi B, Powles R, Lancet, Vol 363, March 13, 2004 (www.thelancet.com) (available online with Kameda password).

73 yo -elevated calcium and back pain

73 YO male presents with back pain and hypercalcemia. Vital signs normal ... Calcium elevated.

Diagnosis?

(see next post)

DG