ABSTRACT
It has been reported that 30% of deaths related to the Kumamoto Earthquakes were among those who had spent nights in the car. Spending nights in the car imposes heavy mental and physical burden, but it has been examined in only a few studies. At 1 year after the Kumamoto Earthquakes, this study examined the factors affecting the mental health of 460 disaster-affected workers at 13 companies who stayed in the car. It was found that 181 workers (72.7%) had spent nights in the car. They had significantly higher scores on the Athene Insomnia Scale, revised Impact of Event Scale (IES-R), and General Health Questionnaire (GHQ) 28 compared with workers who had not stayed overnight in the car. Multiple regression analysis showed that “physical functioning”, “social functioning”, “anxiety and insomnia”, and “staying in the car” were factors affecting the IES-R score, while “vitality”, “avoidance symptoms”, “staying in the car”, and “subjective symptoms” were factors affecting the GHQ 28 score. Mental burden on workers in a natural disaster are imposed in addition to accumulated work burden. Given that mental burden may not ease over a prolonged period, there appears to be a substantial need to urgently discuss how assistance measures should be provided.
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OBJECTIVES@#To assess the vitamin D status in postmenopausal women with osteoporotic fractures, determine its concentration by fracture site at the clinical setting, and compare the proportion of vitamin D deficiency with that reported in literature.@*METHODS@#The prospective study included 317 postmenopausal women with osteoporotic fractures who were treated consecutively from 2016 to 2018. After obtaining informed consent for participation in the seamless treatment of osteoporosis against fractures study, which is our initiative to prevent secondary osteoporotic fractures, we registered the patients, examined bone mineral density (BMD) at the unfractured femoral neck and lumbar spine, serum 25-hydroxyvitamin D (25(OH)D) concentration, blood chemistry, and bone turnover markers.@*RESULTS@#The mean age of the patients was 80.7 years. Moreover, 78% of patients of all fractures had 25(OH)D concentration < 20 ng/mL, whereas 12% of patients had 25(OH)D concentration ≥ 30 ng/mL 25(OH)D concentration in hip fractures was significantly lower than that in vertebral or distal radius fractures (P < 0.05). Multiple regression analysis revealed that 25(OH)D concentration is significantly associated with femoral neck BMD (β = 0.16; 95% confidence interval [CI], 0.78–12.17, P = 0.03) and serum albumin concentration (β = 0.21; 95% CI, 0.62–2.96, P < 0.001) in patients with 25(OH)D concentration < 30 ng/mL.@*CONCLUSIONS@#The results of this study show that the proportion of postmenopausal women with osteoporotic fractures who had vitamin D deficiency was higher than the proportion in previous reports that examined general postmenopausal women (35.2%–52.0%).
ABSTRACT
Nutritional status tends to be poor in patients undergoing chemotherapy. We investigated anorexia caused by olfactory dysfunction by examining olfactory sense in chemotherapy patients and healthy volunteers. We used the Open Essence® olfactometry test, which assesses the accuracy of identifying 12 different odors. Twenty-seven patients (mean age 69.8 years) who received chemotherapy for lung cancer from March 2016 to September 2017 participated in multiple olfactometry examinations from the start of their chemotherapy. We also examined 284 healthy volunteers (mean age 41.9 years), and performed an additional subgroup analysis with 35 volunteers aged 60 years or older (mean age 73.2 years) to more closely align with the mean age of the patients. The mean accuracy rate was 44.4% for the patients, although this rate varied from odor to odor. In contrast, the mean accuracy rate of the healthy volunteers was 76.8%. There were significant differences according to sex and smoking history. For the subgroup of healthy volunteers aged 60 years and older, the mean accuracy rate was 54.5%; accuracy rate decreased as age increased. There was no significant difference in the accuracy rate according to type of chemotherapy, but the overall rate for patients was lower than that for healthy volunteers. Our results show that olfactory sense in lung cancer patients undergoing chemotherapy is altered compared with that in healthy individuals. Smoking habit was shown to have the greatest effect and most of the lung cancer patients in this study were smokers. A change in olfactory sense caused by smoking was also noted in the healthy volunteer group. We intend to conduct a similar investigation of patients with diseases other than lung cancer in the future as well as utilize the findings to investigate nutritional status.
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We report a case of spindle cell type medullary carcinoma of the thyroid in a 77-year-old man. Fine needle aspiration cytology showed numerous spindle cells without inflammation and hemorrhage. The spindle cells were uniform and exhibited no malignant features. Immunocytochemistry was positive for carcinoembryonic antigen and calcitonin, and the tumor was diagnosed as spindle cell type medullary carcinoma. There are various histological subtypes of medullary carcinoma, and diagnosis by cytomorphology alone is difficult. Preservation with LBC fixative was helpful for diagnosis by immunocytochemistry in this case.
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Epidermal growth factor receptor (EGFR) gene mutation examination is now performed in most medical institutions in order to select the molecular targeted medicine for lung cancer. It became clear that the positive rate of the biopsy material was lower than that of the surgical sample in this hospital. The cause was attributed to false negatives due to low tumor cell content in biopsy specimens. We investigated the presence of the mutation using surgical samples and preoperative biopsy specimens from the same patients in 13 cases. Furthermore, we investigated the tumor cell content of the biopsy specimens by cell counting. Results showed that 3 of 6 biopsy specimens that were associated with positive surgical samples were judged to be negative. The tumor cell content was less than 5% in all negative cases. Regarding EGFR gene mutation examination, we should carefully determine tumor cell content when using biopsy specimens.
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Objectives: To investigate the effect of warming on contraction of the detrusor muscle and the micturition reflex in rats. Methods: Female Sprague-Dawley rats were used in this study. Changes in the contractile response of detrusor smooth muscle strips to 40 mM KCl caused by warming to 40°C and 42°C were evaluated by an isometric tension recording study. The effect of intravesical warming at 40.7±1.0°C on the micturition reflex was evaluated by continuous infusion cystometry in conscious rats. Results: Warming to 40°C and 42°C inhibited 40 mM KCl-induced contractions of detrusor smooth muscle strips by 10% and 15.5%, respectively. Intravesical warming at 40.7±1.0°C decreased the pressure threshold for inducing micturition by 14%, resting pressure by 30%, closing peak pressure by 22%, 2nd phase contraction duration by 36%, bladder contraction duration by 26%, and increased bladder compliance by 17%. Maximal voiding pressure and 1st phase contraction duration were unaltered. Conclusions: Our results demonstrated that warming relaxed the detrusor muscle and increased bladder compliance. This suggests that warming might be useful for treatment of low compliance bladder observed in the neurogenic bladder due to neurological diseases such as spinal cord injury. To clarify the usefulness of warming or hot springs for the treatment of neurogenic bladder, the effect of warming on the body surface on the micturition reflex should be investigated.
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In breast cancer cases, intra-operative diagnosis of sentinel lymph node metastasis has been performed widely. It is diagnosed at present by HE staining, but more objective methods are needed. In this study using 166 examples, we compared the methods using rapid immunostaining with the genetic examination. In rapid immunostaining, we recognized metastasis using cytokeratin which was an epithelial cell marker used in the serial sections for frozen histological diagnosis. In conclusion, because metastasis could be diagnosed accurately and pathologist&rsqup;s stress would be reduced, rapid immunostaining is useful for intraoperative diagnosis.
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<b>Objectives:</b> To investigate the effect of warming on contraction of the detrusor muscle and the micturition reflex in rats.<BR><b>Methods:</b> Female Sprague-Dawley rats were used in this study. Changes in the contractile response of detrusor smooth muscle strips to 40 mM KCl caused by warming to 40°C and 42°C were evaluated by an isometric tension recording study. The effect of intravesical warming at 40.7±1.0°C on the micturition reflex was evaluated by continuous infusion cystometry in conscious rats.<BR><b>Results:</b> Warming to 40°C and 42°C inhibited 40 mM KCl-induced contractions of detrusor smooth muscle strips by 10% and 15.5%, respectively. Intravesical warming at 40.7±1.0°C decreased the pressure threshold for inducing micturition by 14%, resting pressure by 30%, closing peak pressure by 22%, 2nd phase contraction duration by 36%, bladder contraction duration by 26%, and increased bladder compliance by 17%. Maximal voiding pressure and 1st phase contraction duration were unaltered.<BR><b>Conclusions:</b> Our results demonstrated that warming relaxed the detrusor muscle and increased bladder compliance. This suggests that warming might be useful for treatment of low compliance bladder observed in the neurogenic bladder due to neurological diseases such as spinal cord injury. To clarify the usefulness of warming or hot springs for the treatment of neurogenic bladder, the effect of warming on the body surface on the micturition reflex should be investigated.
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We investigated the detection situation of the HER-2 examination that was performed to investigate the adaptation of the molecular targeted medicine trastuzumab for mammary and gastric cancers. The HER-2 positive rate was higher in biopsy specimens than in surgical specimen. In gastric cancer, the positive rate was significantly high when it was of the papillary type, histologically. In comparison with mammary cancer, the percentage of FISH positive was high in 2＋ cases. In addition, as the results of trial investigation showed, HER-2 positive cases ware few in colon cancer.
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It is known that uterine cervical cancer is caused by persistent infection with high-risk type of HPV (human papilloma virus). We have run HPV genotyping tests on patients since November, 2011. In 111 cases so far examined, HPV types 16, 52 and 58 were detected with high frequency, but type 18 was with low frequency. This trend was comparable to nationwide tendency. Type 52, 56 and 58 were detected from the patients of advanced age frequently. There weredifferences in HPV infection rate between cytology-negative cases and positive cases, but there was not the difference in HPV typing by cytology-negative and positive patients. Furthermore, it was made clear that the superinfection of HPV who significantly related to the development of tumor. In the cytology negative patients who were followed up because of dysplasia, there are many who are negative for high risk HPV. Therefore, HPV genotyping examination may help physicians determine the relative priority for treatment.