From today I should wake up at 5: 3O AM. After I had a Dorayaki and milk and immediately went to bus stop.  From 7:00 AM the meeting was started in the doctor’s office of the department of hematology, then discussed about patients. In Us, the hospitarization period is much shorter in Japan. For example, delivery or tonsillectomy is only 1day hospitalization in US, although it takes 7 to 10 days in Japan. So, the symptom of a patient was improved, he or she should leave the hospital. I often heard the conversation between physicians and Joe, just like as follows: “He goes to stay.” or “He goes Friday.”

Here, the department of oncology, PT-INR was often determined, because the patients were usually antibiotics, and the bacterial flora in the colon was destroyed. Then vitamin K was not produced by intestinal bacteria. So, Pt-INR was decreased, Vitamin K was administered.

Here, in OHSU I can always watch the medical records freely.

Tomorrow Joe will be busy with research, so I will go round with Erin from 7:00 AM.

今日会った人：Dr.Nichols, Head of hematology of Oncology

今日、学んだこと：10/18

化学療法中にはVK欠乏によりINRが低下する症例が多い。これは抗菌薬投与によるVK産生菌の死滅による。

Bandsとはband neutropilのことで、桿状核好中球のこと。

投与中止のことはdiscontinuedという。

使用期限が過ぎた薬物はお金のない人のためのクリニックにあげる

1ポンドのことを1bsとして表す

金曜日に退院のことをHe goes to Friday、退院したことをHe is gone、入院したままのことをHe goes to stayという。

PCAとはpatent controlled analgesia（鎮痛法）のこと。

Nurse Practitionerはほぼ内科医と同じ仕事をしている。

薬物療法専門薬剤師の合格率は50～60％と非常に難しい。また更新は7年ごとに行われ生涯教育研修を120時間/7年間必要で200問の試験問題を受けないと更新できない。現在はコンピュータを使った試験となっている。