A message from the Professor

Kawada Norifumi Chairman,
Department of Hepatology,
Graduate School of Medicine,
Osaka Metropolitan University Department Head,
Department of Hepatology,
Osaka Metropolitan University Hospital Section Head,
Central Blood Transfusion Section,
Osaka Metropolitan University Hospital

The hepatology department was established in 2001 as part of the reorganization of the medical faculty of the Graduate School of Medicine using the existing 3rd department of internal medicine as its base. It is related to the department of gastroenterology established by Professor Tetsuo Arakawa. In 1968 the 3rd department of internal medicine set up by Professor Sukeo Yamamoto became famous throughout Japan and a mecca for hepatology, thereafter becoming a base for the diffusion of new information both nationally and overseas. Our course on liver diseases produced one professor after another so that it might almost be termed an incubator for high quality researchers. On the 1st of January 2007 I was officially appointed as the first Chairman of the Department, which was to become the spiritual successor of the noted 3rd department of internal medicine. I am, of course, painfully aware of the heavy responsibility that this entails.

Our hepatology course (specializing in hepato-biliary-pancreatic medicine) is in fact working widely with liver related illnesses. When Professor Sukeo Yamamoto set up the department, the main topic under discussion was to shed light on the mechanism of drug induced hepatitis caused by antitubercular drugs. Since then we have achieved numerous outstanding world class results in research and clinical practice for fulminant and post transfusion hepatitis, the promotion of interferon treatment for hepatitis B and C, the suppression of liver cancer with interferon and herbal medicines and more. Even now we are working on the treatment of chronic viral liver diseases using the latest drug treatments, ultrasound guided or laparoscopic liver cancer treatment, diagnosis and analysis of non-alcoholic steatohepatitis and other diseases. In addition to the transcatheter arterial embolization (TAE) technique for liver cancer developed by the Department of Radiology, the Department of Hepato-biliary-pancreatic Surgery boasts some of the foremost techniques in the country related to hepatectomy for liver cancer, and the Departments of Public Health, Biochemistry, Anatomy, Pathology and others work closely with the clinical and basic graduate courses in the University, providing flexible support to the specific needs of the Osaka City area, which has a particularly high number of liver disease patients, whilst contributing academically to the development of hepatology.

Our hepatology course uses an abundance of doctors certified by the Japanese Society of Internal Medicine, the Japanese Society of Gastroenterology, the Japan Society of Hepatology, the Japan Gastroenterological Endoscopy Society, the Japan Society of Ultrasonics in Medicine as well as other specialists and medical instructors and has built a program to enable participants to carry out productive research in the early and latter stages of their study. We support doctors who aim to become certified by the various societies or obtain specialist qualifications and help them write case reports and give conference presentations. We place staff in associated institutions (hospitals) some of which include Osaka City General Hospital, Osaka City Juso Hospital, Osaka City Sumiyoshi Hospital, Fujidera Municipal Hospital, Izumi Municipal Hospital, Kashiwara Municipal Hospital and other public hospitals as well as private hospitals which have been recognized by their respective societies as accredited teaching facilities. This allows participants to receive highly satisfactory clinical training in the early or latter stages of their study even while working at these associated facilities.

Of course, doctors interested in research advance to the graduate course and carry out basic and clinical research and can aim to obtain a Doctor of Medicine degree by giving conference presentations and writing research papers. For those wishing to study overseas in the future, we can refer them to Mount Sinai Hospital, Columbia University (New York), the University of Southern California (USC), the University of California, San Diego Campus (UCSD, San Diego), the University of Florence (Italy), University College London, Shanghai University of Traditional Chinese Medicine (Shanghai) and other overseas institutions with relative ease so please feel free to consult me on this matter.

The main subject of my research has been the study of sinusoidal cells that make up the capillaries of the liver. This basic research can of course not be directly applied to everyday clinical practice, but its attraction lies in the possibility of producing research results which will rewrite medical textbooks, obtaining patents and discovering new genes to be registered on data bases. By applying myself to research, I have discovered many things applicable to my view of life. One is ‘Perseverance is power’. Continuing to work assiduously on something will lead to results, which will in turn be recognized by society. But just doing our job is not enough, it is important to do a bit of ‘self-promotion’, too. Japanese are said to be a people who like being much of a muchness but sometimes it is necessary to step forward and take various measures to create an impression, so that others will understand what we have been working on. The last thing I have learned is ‘Reject nothing’. We should do whatever job we are given to the best of our abilities. Doing a job that we have not done before gives us the feeling of overcoming a hurdle, taking us to the next level. So it is important to be forward looking and optimistic. I have learned these lessons not because I was doing basic research but because I believe they are common basic precepts for a clinical and teaching environment.

The hepatology department has inherited the motto of the 3rd department of internal medicine ‘Enjoy your work and your day to day life in harmony’. You might even say it’s ok to go out and enjoy ourselves every day. Enjoyment at work means getting a sense of fulfillment but it is also accompanied by some hardships. Enjoyment and hardship are two sides of the same coin but once hardships are over, they turn to enjoyment. So I feel if we just remember that today only comes once then it’s ok to enjoy it to the fullest. All of the department members should work as a unit and diffuse new information about liver disease to the world. That information applied to the diagnosis and treatment of the illness will help the welfare of patients and contribute to the advance of medicine. This would be my greatest joy and I propose we move forward one step at a time.

January 15, 2008