Amputation-free Home Management of Infected Lower Extremity Pressure Ulcer through Shared Decision-making: Enhancing the Quality of Life and Highlighting Societal Significance in Home Care.

Home healthcare is important for allowing patients to live their lives. However, home-care bedridden patients often experience pressure ulcers in the lower extremities, which can lead to life-threatening infections requiring decisions on the need for amputation. We herein report a patient with an infected lower-limb pressure ulcer with a history of spinal injury.

The Impact of the Hospital Volume on the Performance of Residents on the General Medicine In-Training Examination: A Multicenter Study in Japan.

Objective Although several studies have been conducted worldwide on factors that might improve residents' knowledge, the relationship between the hospital volume and the internal medicine residents' knowledge has not been fully understood. We conducted a cross-sectional study to compare the relationships of the hospital volume and hospital resources with the residents' knowledge assessed by the In-training Examination. Methods We conducted a retrospective survey and a clinical knowledge evaluation of postgraduate year 1 and 2 (PGY-1 and -2) resident physicians in Japan by using the General Medicine In-training Examination (GM-ITE) in 2014.

Impact of inpatient caseload, emergency department duties, and online learning resource on General Medicine In-Training Examination scores in Japan.

Background: Both clinical workload and access to learning resource are important components of educational environment and may have effects on clinical knowledge of residents.

Methods: We conducted a survey with a clinical knowledge evaluation involving postgraduate year (PGY)-1 and -2 resident physicians at teaching hospitals offering 2-year postgraduate training programs required for residents in Japan, using the General Medicine In-Training Examination (GM-ITE). An individual-level analysis was conducted to examine the impact of the number of assigned patients and emergency department (ED) duty on the residents' GM-ITE scores by fitting a multivariable generalized estimating equations.

Efficacy of magnetic resonance imaging in the diagnosis of perianal hidradenitis suppurativa, complicated by anal fistulae: A report of two cases and review of the literature.

Background: Perianal hidradenitis suppurativa (PHS) is a chronic recurrent inflammatory disease of the apocrine glands present in the skin and soft tissue adjacent to the anus. It is often misdiagnosed or treatment is delayed, resulting in the formation of an abscess or, in the worst case, leading to sepsis. It is difficult to treat perianal lesions merged with fistulae completely due to its high recurrence rate.

The hospital educational environment and performance of residents in the General Medicine In-Training Examination: a multicenter study in Japan.

Background: It is believed that the type of educational environment in teaching hospitals may affect the performance of medical knowledge base among residents, but this has not yet been proven.

Objective: We aimed to investigate the association between the hospital educational environment and the performance of the medical knowledge base among resident physicians in Japanese teaching hospitals.

Methods: To assess the knowledge base of medicine, we conducted the General Medicine InTraining Examination (GM-ITE) for second-year residents in the last month of their residency.

Primary site resection is superior for incurable metastatic colorectal cancer.

Aim: To investigate survival in patients treated with FOLFOX followed by primary site resection or palliative surgery for incurable metastatic colorectal cancer.

Methods: Between 2001 and 2009, a total of 98 patients with colorectal adenocarcinoma and non-resectable metastases were diagnosed and treated with the new systemic agent chemotherapy regimen FOLFOX. Primary site resection was carried out in 38 patients, creation of a colostomy or bypass without resection was carried out in 36 patients, and 23 were not operated on because of advanced disease.

A case report of endocrine cell carcinoma in the sigmoid colon with inferior mesenteric vein tumor embolism.

We report a case of endocrine cell carcinoma in the sigmoid colon with inferior mesenteric vein (IMV) tumor embolism. A 79-year-old woman was admitted to our hospital with narrowing of the stools. We performed colonoscopy, computed tomography and positron emission tomography, which disclosed sigmoid colon cancer with IMV tumor embolism.

Benign Pigmented Schwannoma of the Great Omentum: Report of a Rare Case and Review of the Literature.

Schwannoma in the abdomen is an uncommon neoplasm that occurs most frequently in the cranial and peripheral nerves; it is extremely rare in the great omentum and only 6 cases of schwannoma of the great omentum have been observed previously. We report the case of a schwannoma found in the great omentum of a 55-year-old man who was treated with laparoscopic surgery. Though it was difficult to diagnose preoperatively, the tumor showed malignant potential by rapidly increasing in size.