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Development of analysis and coordination tools of clinical ethics in critical care medicine

Yamaguchi medical journal Volume 71 Issue 1

We have developed ACTce‑CCM̶ Analysis and Coordination Tools of Clinical Ethics in Critical Care Medicine. The preparation process was carried out in four stages:construct setting and prototype creation, application of prototype version to fictitious cases, clarification of the construct based on focus group interviews, and a fact-finding survey on ethical issues and ethical adjustment. The completed version of ACTce-CCM consists of information organization and assessment frameworks, problem analysis and integration, problem lists, goals, care practices, and ethical adjustment. There are six frameworks for information organization and assessment:pathology and treatment, QOL and QOD, patient intention, family psychosocial situation, medical team situation, and the surrounding situation. The problem lists include those related to the patient, the family, and the medical staff. Goals include those of the medical team and the expected outcomes for the patient/family. Care practices and ethical adjustment consist of three aspects: direct patient care, direct family care, and medical team adjustment.

Decision making support in end-of-life care for patients with non-cancer respiratory disease in Japan : a literature review

山口医学 Volume 70 Issue 3

Creators : Ishikawa Yoshiko | Ito Misae Publishers : 山口大学医学会 Date Issued : 2021-09-01

A case of raspberry-like foveolar-type gastric adenocarcinoma resected by strip biopsy

山口医学 Volume 70 Issue 1

A case of large breast spindle cell carcinoma which resected pulmonary metastasis 3 years after the primary surgery

山口医学 Volume 67 Issue 3

Evaluation of support training to improve new nurses' fundamentals

山口医学 Volume 67 Issue 1

Creators : Yamashita Junko Publishers : 山口大学医学会 Date Issued : 2018-02-01

A case of femoral hernia with incarcerated small intestine treated with laparoscopic surgery

山口医学 Volume 66 Issue 4

Long-term outcomes of interstitial brachytherapy with the high dose rate iridium source for tongue cancer treatment

山口医学 Volume 66 Issue 4

A case of invasive perianal paget’s disease mimicking pagetoid spread of internal malignancy

山口医学 Volume 66 Issue 3

A case of synchronous double cancer of the breast and rectum being surgically resected in a planned way

山口医学 Volume 66 Issue 3

A case of local advanced colorectal cancer, for which radical surgery is difficult, responding well to neoadjuvant chemotherapy(sox+bevacizumab)and subsequently resected surgically.

山口医学 Volume 66 Issue 2

A case of multiple liver metastases over 8 years after excision of sigmoid colon cancer with submucosal invasion

山口医学 Volume 66 Issue 2

Study of optimal administration method of tazobactam / piperacillin using monte carllo simulation

山口医学 Volume 66 Issue 2

Creators : Kawaguchi Yoshitaka Publishers : 山口大学医学会 Date Issued : 2017-05-01

Low-grade differentiated adenocarcinoma of the gastric foveolar type arising in the helicobacter pylori -negative stomach

山口医学 Volume 66 Issue 1

A case of anaplastic ductal carcinoma with adenosquamous carcinoma of the pancreas

山口医学 Volume 65 Issue 3

The relationship between symptoms and the concentration of air pollutant (yellow dust and PM2.5) in patients of allergic rhinitis

耳鼻咽喉科免疫アレルギー Volume 33 Issue 3

Creators : Sugahara Kazuma | Yamashita Hiroshi Publishers : 日本耳鼻咽候科免疫アレルギー学会 Date Issued : 2015-09

A case of INH-resistant tuberculosis after INH monotherapy for latent tuberculosis infection

山口医学 Volume 64 Issue 4

Effectiveness of medical seminars for high-school students : results of a follow-up survey

山口医学 Volume 64 Issue 3

We held medical seminars for high-school students who hope to become physicians to increase their motivation and to encourage them to enter Yamaguchi University. The seminars were held two or three times a year at hospitals in six locations in Yamaguchi prefecture between 2011 and 2014, and consisted of observation of facilities in hospitals, physician lectures, experience of medical practice, and Q&A sessions with physicians and medical students. A total of 210 high-school students participated in 11 seminars. The questionnaires for the participants showed 89.9% of the participants rated the seminars“very good”and 91.4% responded,“my motivation was strengthened”.Of the seminar participants, 20 of 69 high-school graduates entered the Yamaguchi University School of Medicine. The follow-up survey showed that the percentage of medical school students studying at Yamaguchi University was 69.0% (20/29) for seminar participants and 45.5% (46/101) for non-seminar participants. The results suggest that the medical seminars were as effective as expected in encouraging high-school students to become physicians and to enter Yamaguchi University.

Four cases of ruptured duodenal varices

山口医学 Volume 64 Issue 2

Duodenal varices（DV）are the most common of ectopic varices. Although bleeding from DV is rare, it is difficult to control bleeding and sometimes fatal. We have encountered four clinical cases of ruptured DV. Case 1：A man in his 80s presented with a history of partial gastrectomy with Billroth-II reconstruction and LC due to chronic hepatitis C. We performed single-balloon endoscopy and injected 67% N-butyl-2-cyanoacrylate（NBCA）for DV on the afferent loop with red plug. Case 2：A woman in her 40s with primary biliary cirrhosis complained of tarry stool and anemia. We performed endoscopic injection sclerotherapy（EIS）with 67% NBCA for spurting bleeding point in duodenum. Case 3：A man in his 50s with liver cirrhosis（LC）due to chronic hepatitis B complained of tarry stool. We performed endoscopic variceal ligation（EVL）and balloon-occluded retrograde transvenous obliteration（B-RTO）for DV. Case 4：A man in his 60s with alcoholic LC complained of tarry stool. We performed EIS with 67% NBCA for DV. We added EVL, clipping, and argon plasma coagulation after EIS to control bleeding. To control bleeding was achieved in all cases.

A case of early duodenal bulb carcinoma

山口医学 Volume 64 Issue 2

Creators : Dairaku Koji | Kawamura Daichi | Tokiyama Hiroshi | Kawano Hiroo Publishers : 山口大学医学会 Date Issued : 2015-05-01

Successful management of walled-off necrosis and pseudo-aneurysm related with severe acute pancreatitis;a case report

山口医学 Volume 64 Issue 2