Surgical removal of an isolated femoral metastasis of uterine cervical squamous cell carcinoma: a case report and review of the literature

A bone metastasis from uterine cervical cancer normally indicates short life expectancy. Resection of the lesion is therefore palliative. The authors consider herein whether surgical resection can promote disease control while improving quality of life. A 33-year-old woman -presenting FIGO Stage IB 1 uterine cervical squamous cell carcinoma underwent a radical hysterectomy and pelvic irradiation. Twenty-two-months later, a solitary femoral metastasis was detected. Given the pain, imminent bone fracture, the patient's relative youth, absence of other metastases, and complete control of the primary lesion, wide excision of the lesion, and reconstruction were performed. Sixteen months later, she was disease-free and ambulatory using a cane. The findings of both the present case and the review showed that patients were disease-free for over one year after surgery, suggesting that resection may assist disease control as well as improve patients' quality of life.

Effect of Gd-DTPA and/or Magnetic Field and Radiofrequency Exposure on Sister Chromatid Exchange in Human Peripheral Lymphocytes

The effects of a magnetic field, radiofrequency, and gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) on the sister chromatid exchange (SCE) in human peripheral lymphocytes were investigated. Whole blood was taken from a nonsmoker and samples were exposed to magnetic force (1.5 T) alone, and to a magnetic force combined with radiofrequency waves (63.86 MHz, specific absorption rate, SAR, 0.4 W/kg). Gd-DTPA was then added to other blood samples in varying amounts and concentrations. After exposure to the conditions described above, these blood samples were cultured for 69 hours. Slides were made for an SCE evaluation. As the concentration of Gd-DTPA added to the blood increased, the SCE frequency also increased. However, the addition of Gd-DTPA at the clinical concentrations normally used did not affect the SCE frequency.

Intracranial Aneurysm Embolization Using Interlocking Detachable Coils

The relationship between volume embolization ratio and coil compaction on the intracranial aneurysm occluded using interlocking detachable coils (IDCs) was determined.

From February 1994 to October 1996, 7 intracranial aneurysms were embolized using IDCs. Aneurysm capacity (volume) was calculated assuming that aneurysms are ellipsoid of the diameter in 3 planes. Coil volume was calculated assuming that IDCs are cylinders of primary coil.

Coil compaction was observed in aneurysms embolized at a volume embolization ratio under 25%. There was no coil compaction in aneurysms embolized at a volume embolization ratio of over 25%.

Measurement of the volume embolization ratio is useful to predict coil compaction. Intracranial aneurysms should be embolized at a volume embolization ratio of 25–33%.

Measurement of Volume Ratio to Predict Coil Compaction, on Aneurysmal Embolization

The relationship between volume embolization ratio and coil compaction on the intracranial aneurysms occluded using Guglielmi detachable coils (GDCs) was determined. From March 1997 to February 1998, 38 intracranial aneurysms were embolized using GDCs. Aneurysm volume was calculated assuming that aneurysms are ellipsoids of the diameter in three planes. Coil volume was calculated assuming that detachable coils are cylinder of primary coil. Coil compaction was observed in aneurysms embolized at a volume embolization ratio under 21%. There was no coil compaction in aneurysms embolized at a volume embolization ratio of over 21%. Measurement of the volume embolization ratio is useful to predict the coil compaction. Intracranial aneurysms should be embolized at a volume embolization ratio of 25–33%.

Changes in standing body sway of pregnant women after long-term bed rest

Pregnant women tend to fall and increased body postural instability, namely body sway, may be one of the causative factors. We had a clinical impression that pregnant women after long-term bed rest tend to fall. We hypothesised that such women may show increased body sway, which we attempted to determine. Pregnant women (n = 161) were divided into three groups: (i) women with preterm labour after 2-week bed rest, (ii) those after 4-week bed rest, and (iii) those without bed rest or preterm labour. Body sway was analysed using stabilometry, that is, computed analysis of movement of the centre of gravity. The 3 groups fundamentally showed the same stabilometric measurements. Women with oedema showed greater medial-lateral sway than those without it. Factors other than oedema yielded no differences in stabilometric parameters. Long-term bed rest fundamentally did not increase body sway to the extent that stabilometry could reveal it. It may be prudent to consider that pregnant women with oedema tend to fall.

Vaccination during the 2013-2014 influenza season in pregnant Japanese women

This questionnaire survey was conducted at 11 hospitals in Japan to determine vaccination coverage against seasonal influenza and the prevalence rate of influenza among pregnant Japanese women. Of 2,808 postpartum women who gave birth at the 11 hospitals during the study period from March 1, 2014, to July 31, 2014, 1,713 (61 %) participated in this study and 876 (51 %) reported having received vaccination against influenza in or after October 2013. Women aged <25 years had a significantly lower vaccination rate than those aged ≥25 years (31 % vs. 53 %, respectively; p = 0.0000). Eighty-seven (5.1 %) and 1,626 (94.9 %) women did and did not contract influenza, respectively. Although prior birth did not affect overall vaccination coverage (50 % for primiparous vs. 53 % for multiparous), multiparous women had a significantly higher rate of contracting influenza than primiparous women, irrespective of vaccination status (5.6 % vs. 2.2 % [p = 0.0216] and 9.7 % vs. 3.5 % [p = 0.0003] for women with and without vaccination, respectively). The 2013-2014 vaccination program significantly reduced the influenza infection rate by 35 % (3.9 % vs. 6.3 % for women with and without vaccination, respectively; p = 0.0272). Seventy-two (83 %) of the 87 women took antiviral agents for the treatment of influenza and two (2.3 %) required hospitalization. These results suggested that pregnant Japanese women had a high level of concern regarding seasonal influenza. However, campaigns targeting young pregnant Japanese women, as well as multiparous women, for vaccination are needed in order to further reduce the incidence of influenza among pregnant Japanese women.

Supporting rural remote physicians to conduct a study and write a paper: experience of Clinical Research Support Team (CRST)-Jichi

CONTEXT

Jichi Medical University (JMU) is the only medical school in Japan that is devoted solely to producing rural and remote doctors. To support research activities of its graduates, mainly young graduates under obligatory rural service, JMU established a voluntary team, Clinical Research Support Team (CRST)-Jichi.

ISSUES

CRST-Jichi consists of current and past JMU faculty members; all of them are specialists of certain medical fields and many are also graduates of JMU who have completed rural service. A client who asks the CRST for advice on study design or editing a paper emails the CRST to ask for support in conducting a study. Then, core members of the CRST assign the job to a registered specialist of the corresponding topic, who becomes a 'responsible supporter' and continues to support the client until a paper has been published. During the 3 years from July 2010, 12 English papers have been published in international peer-review journals, two Japanese papers in domestic journals, and 13 studies are in progress. Ninety-one percent of clients were satisfied with the service, and eighty-two percent considered their papers would not have been published if they had not used the service. Sense of commitment, existence of JMU-graduated specialists, and quick response were reported by clients as major strengths of CRST-Jichi.

LESSONS LEARNED

The experience of CRST-Jichi can potentially be transferred to not only other Japanese medical schools with rural doctor production programs, which are now rapidly increasing as part of a national policy, but also rural medical education systems in other countries.