Giant Ulcerated Fibroepithelial Stromal Polyp of the Vulva: A Case Report

Fibroepithelial stromal polyps (FEPs) are benign skin tumors or lesions of mesenchymal and ectodermal origin, also referred to as acrochordons. Herein, we report the case of a 45-year-old woman with a large ulcerated fibroepithelial stromal polyp extending from the right labium of the vulva. No known predisposing factor was recorded to justify the presence and rapid growth of the polyp. Antibiotic treatment was given due to inflammation, and magnetic resonance imaging was useful in establishing a diagnosis. A wide surgical excision was performed, and a histopathological examination confirmed the initial diagnosis, revealing no nuclear atypia or mitoses. The patient recovered well, and follow-up after one year showed no evidence of complications or recurrence.

The influence of transient change of total body water on relative body fats based on three bioelectrical impedance analyses methods. Comparison between before and after exercise with sweat loss, and after drinking

BACKGROUND

The purpose of this study was to clarify the influence of change of total body water caused by exercise and drinking, on relative body fat (%BF) based on three bioelectrical impedance analyses (BIA) methods, between hand and foot (H-F), between hand and hand (H-H), and between foot and foot (F-F).

METHODS

The subjects were 30 Japanese healthy young adults aged 18 to 23 years (15 males, 15 females). Measurements were made three times for each BIA method; before and after exercise with sweat, and after drinking, and also twice according to the under water weighing (UW) method, before exercise and after drinking. A pedaling exercise, with a bicycle ergometer, was used for 60 minutes as the exercise.

RESULTS

The relationship of %BF between the UW method and each BIA method was mid-range or more (r=0.765-0.839). However, %BF based on the H-F and F-F BIA methods were higher than that based on the UW method. After drinking, %BF of all the BIA methods were higher than the UW method. %BF of the BIA methods after exercise indicated values lower than those before exercise. %BF of the H-F and H-H BIA methods after drinking were a little higher than those before exercise, indicating that those measurements reflect a slight change of body water.

CONCLUSIONS

It was demonstrated that %BF of any BIA method reflect the change of body water caused by exercise, sweating, and drinking.

Utility of ADL index for partially dependent older people: discriminating the functional level of an older population

In the present study, the ADL index for the partially dependent older people (Demura et al., 1999) was applied to 218 bedridden (BED), 466 partially dependent (PD) and 245 independent living (IL) people in older groups. The purposes of this study were to clarify the meaning of the evaluation of this index and to examine how ADL items are useful in determining each older group. It is suggested that a perfect score with our ADL index means independent living level, and a score of zero means bedridden level. The results of discriminant analysis indicated that four items with low-difficulty, such as "eating," "going to the toilet," "tossing about in bed" and "writing," are useful in determining if the PD is becoming bedridden. While five items with high-difficulty, such as "putting on slacks," "putting on trousers," "standing up from a sitting posture," "going up stairs" and "washing the whole body," are useful in determining if the PD is becoming independent living. Furthermore, it is inferred that the possibility of falling into a bedridden situation increases when the total score is 5 or less, while the functional level is close to independent living when the total score is 13 or more. These findings make clear the meaning of the evaluation of our ADL index. Furthermore, the functional level of older population may be screened using evaluation of total and item scores of this ADL index.

Lateral dominance of legs in maximal muscle power, muscular endurance, and grading ability

The purpose of this study was to examine lateral dominance in maximal muscle power, muscular endurance, and grading ability, using isokinetic mulscular strength in knee extension and flexion. The subjects were 50 healthy male students whose ages ranged from 19 to 23 years (M height: 173.6+/-6.2 cm, M weight: 67.2+/-6.8 kg). Their dominant legs for power exertion and for functional use were based on questionnaire items selected from those used in previous studies. The angular velocities of extension and flexion for exerting maximal muscle power were 60, 180, and 300 x sec.(-1). A continuous exertion 30 times at an angular velocity of 180 sec.(-1) was used as the load for muscular endurance. For grading ability, 25%, 50% and 75% of the maximal muscle strength at angular velocities of 60 and 180 x sec.(-1) were the required values, and the difference between these values and the exerted muscular strength was evaluated. The dominant leg and nondominant leg were compared for both power exertion and functional use. There was no lateral dominance in maximal muscle power and muscular endurance. In muscular endurance, especially, some subjects showed one leg superior in power exertion and some superior in functional use. Lateral dominance was noted across maximal muscle power and muscular endurance in grading ability. The dominant leg tended to be better than the nondominant leg in functional use. However, lateral dominance was not remarkable for flexing motion and in exertion for a short time.

The influence of posture change on measurements of relative body fat in the bioimpedance analysis method

The purpose of this study was to clarify the influence of posture change on relative body fat in the bioelectrical impedance analysis (BIA) method. The subjects were 30 Japanese healthy young adult males (age: 19.8 +/- 1.4 years, height: 172.3 +/- 5.8 cm, weight: 67.1 +/- 8.2 kg). We used devices with different body segment inductions, between the hand and foot (H-F BIA) and between hands (H-H BIA), and set four measurement conditions differing in posture (supine or sitting), during rest and measurement. The reliabilities of %BF in the H-H and H-F BIA methods were very high (r = 0.995, 0.966), and the relationship in %BF between the UW method and each BIA method was mid-range (r = 0.767, 0.709). Although there were no differences in %BF among different measurement postures in the H-F BIA method, %BF in the H-H BIA method increased significantly when the posture was changed just before measurement. This indicated that it is necessary to pay attention to the posture change just before measurement in the H-H BIA method.

[Construction of a subjective fatigue scale for adolescent students]

OBJECTIVE

There is no appropriate scale to evaluate subjective symptoms of fatigue (SSF) in everyday life in adolescent students. An existing scale long before constructed for laborers has been used. It is essential to establish a practical, rational scale. The purpose of this study was to construct a practical scale to measure subjective symptoms of fatigue for high school and college students.

METHODS

A questionnaire on SSF was administered to 5,435 students aged 15-20 yr. Factor analysis based on the oblique Promax rotation method was applied to a correlation matrix consisting of 44 items.

RESULTS

Six factors were interpreted as follows: difficulty with concentrated thinking, languor, reduced activation, reduced motivation, drowsiness and feeling of physical disintegration. A subjective fatigue scale (SFS-Y: 24 items) was constructed using these factors. The eigen-value of principal component analysis, alpha reliability coefficients, and test-retest reliability coefficients for each subscale were very high.

CONCLUSION

The SFS-Y generated in the present study is a very practical scale with high validity and reliability.

Use of subjective estimation in motor skill tests of young children: judgment based on observation of behavior in daily life

This study assessed what motor skill tests were appropriate by observing 636 young children's behavior in daily life (low-aged classes, M = 3.7 yr.; middle-aged classes, M = 4.7 yr.; high-aged classes, M = 5.7 yr.). A homeroom teacher and an assistant teacher estimated motor achievement as pass-or-fail, and then judged pass-or-fail based on practical testing. Estimate-re-estimate agreement, interrater agreement, and agreement between estimated values and measured values were examined for 27 items, e.g., skipping, bouncing a ball, and turning on one leg. Estimate-re-estimate agreement was high on the whole. Interrater agreement ranged from 34% to 100% for 3-yr.-olds, 21% to 100% for 4-yr.-olds, and 89% to 100% for 5-yr.-olds. Agreement between estimated values and measured values greater than 80% was found in most items for 5-yr.olds (14 items). After examining the above-mentioned agreements, 26 items were selected as possible tests to judge motor development, using a pass-or-fail, from the observation of young children's behavior in daily life.

[Trends in variation within the day and between days of subjective symptoms of fatigue in adolescent males]

The purpose of this study was to clarify the trends in the variation within the day, and between days, of subjective symptoms of fatigue (SSF) in the daily life of male students. A SSF questionnaire (54 items) with guaranteed validity and reliability was administered to 104, 15-16 year-old healthy students, 3 times a day, in the morning (about 08:50), mid-day (about 12:10) and afternoon (about 16:10) for 5 days from Monday to Friday. As the main statistical analysis, two-way (day and week) ANOVA and post-hoc t tests were used. The SSF questionnaire was considered to have very high reliability because Cronbach's alpha coefficients in each survey point of time were .967-.977. SSF complaints between days were low on the whole, but complaints of drowsiness were relatively high. The trends in variation of SSF between days were greater than those within the day. The trends in variation within the day were noticeable in complaints regarding drowsiness and loss of vigor. Complaints regarding languor became high from the middle of the week to the weekend. On the other hand, SSF complaints except for languor, were high at the beginning of the week, especially on Monday and became lower after Tuesday. There is a trend in variation within the day for symptoms regarding drowsiness and loss of vigor. The trend in variation between days was confirmed for many SSFs, and was noticeable as compared to those within the day. Complaints regarding languor were high on the weekend, and SSF complaints except for languor were high at the beginning of the week, especially on Monday.

[Characteristics of each activity domain comprising ADL for partially dependent older adults]

The purpose of this study was to examine the characteristics of each activity domain which make up activities of daily living (ADL). We used the ADL index with a unidimensional scale for partially dependent older adults, and examined the distribution of the ADL score and self-evaluation of health and physical fitness. There were 466 subjects from age 60 to 98 (132 male, 81.7 +/- 8.22 years; 334 female, 82.5 +/- 7.25 years). Seventeen items representing 7 domains (holding and changing the posture of the body, dressing, toilet usage, bathing, manual activity, walking, and locomotion and carrying) were selected as ADL items. Each item was measured on a dichotomous scale. A questionnaire consisting of 17 ADL items and two questions concerning self-evaluation of health and physical fitness were administered on subjects by institutional therapists (OT, PT, nurse, social worker). An examination of the cumulative relative frequency distribution curve of total score showed that ADL scores of all domains can be used to assess ADL achievement ability level with a wide range from low to high level. It is inferred that the total score will be low when the score is low for holding and changing body-posture, toilet usage and manual activity. On the other hand, it will be high when the score is high for dressing and walking. ADL abilities for all domains also tended to be higher in persons with higher perceptual levels of health and physical fitness.

[Examination of subjective symptoms of fatigue in young men. From the viewpoint of age, subjective fatigue feeling and daily activity condition]

OBJECTIVE

The purpose of this study was to examine the characteristics of subjective symptoms of fatigue (SSF) in high school and college students from the viewpoints of age, subjective feelings of fatigue and an association with daily activity conditions.

METHODS

A questionnaire consisting of 54 items on SSF, including feelings of subjective feelings of fatigue, type of fatigue and daily activity conditions was administered to male students aged 15-20 yrs. Data from 1972 subjects, responding to the questionnaire were used for statistical analysis.

RESULTS

A Cronbach alpha coefficient of 0.97 indicated the reliability of the SSF items. In analyzing the results for frequency and means of SSF items, it was determined that complaints regarding drowsiness were very high compared to other SSF factors and the degree of mental fatigue symptoms is lower in the higher age-groups. Most students had subjective feelings of fatigue, which related closely to SSF regarding languor and drowsiness. It was considered that daily activity conditions regarding sleep are important to improving chronic fatigue because students with stronger subjective feelings of fatigue tend to have complaints about living conditions such as sleeplessness at night, waking in the morning, and physical condition during the day.

CONCLUSION

It is characteristic of SSF in young men that complaints of drowsiness are relatively high and most of the students have subjective feelings of fatigue. It is considered that improving the activities of daily living factors that produce drowsiness is important.

[The relationship among subjective symptoms of fatigue, subjective fatigue feeling, and life habits of high school and college students]

The relationship among subjective symptoms of fatigue, subjective fatigue feeling, and life habits of high school and college students. The purpose of this study was to examine the relationship among subjective symptoms of fatigue (SSF), subjective fatigue feeling (SFF), life habits (behavioral patterns (BP) and life-style consciousness (LC)) in male students. A questionnaire on SSF, SFF, fatigue content, BP and LC was administered to 1802 male students aged 15-20 yr, and data from 1792 properly completed questionnaires was analyzed. The results were: 1) Students experience high SFF from daily activity. Students with a higher SFF tend to have more complaints of SSF, especially symptoms of languor, but the relationship between SFF and symptoms of irritation and physical disintegration are low. 2) Relationships between SFF and BP and LC are relatively low, except for physical condition. Even if the BP is successful, student's SFF is relatively high. 3) Subjective degree of health and physical condition relate highly to SSF. Exercise habits relate to loss of vigor, dietary habits to languor, loss of vigor, drowsiness and a decrease in concentration, and LC to SSF except for languor. It was inferred that SSF is influenced by BP and LC.

Characteristics of ADL ability on partially dependent older adults: comparison among different ambulatory activities levels

The purpose of the present study was to clarify the characteristics of ADL ability among different ambulatory level groups. The subjects were 448 partially dependent older adults (PD; 126 male, 81.7 +/- 8.22 year; 322 female, 82.5 +/- 7.25 year) over 60 years of age, and they were divided into 3 groups based on ambulatory activity level; G1 could not walk without assistance; G2 could walk with a stick; G3 could walk without assistance. The PD were asked 17 ADL questionnaires representing seven ADL domains to evaluate the ADL ability. Total and domain ADL scores, and achievement rates for each item were calculated, and compared among different ambulatory activity groups. It is confirmed that ADL ability level in PD significantly relates to ambulatory level and becomes gradually higher as the ambulatory activity level advances. It is considered that in the G1, lower limb ability level is low, and the contribution of ability level regarding changing posture and manual activities to total ADL ability level is high. On the other hand, in the G3 the achievement levels in manual activities and high-difficulty ADLs using lower limbs reflects the differences in the ADL ability level among individuals. Gender differences for ADL ability are not found in any ADL domain, while age differences are found in only the G3. It is inferred that for the G1, the achievement levels of ADLs are largely influenced by disease morbidity and age contributes very little to the decline of ability level.

Selection of effective tests of motor ability in preschool children based on pass-or-fail criteria: examination of reliability, objectivity, and rate of passing

The purpose of this study was to select effective tests of motor ability based on pass-or-fail criteria for use with preschool children. 37 items selected by examining theoretical validity and the results of preliminary tests were administered to preschool children (3 yr.: M = 3.7 yr., SD = 0.28; 4 yr.: M = 4.7 yr., SD = 0.28; 5 yr.: M = 5.7 yr., SD = 0.28). A skilled tester and each child's homeroom teacher rated whether the child's performance passed certain criteria or not. With agreement on two trials as an index of test-retest reliability, the mean agreement among the three grades ranged from 69% to 99% for Locomotion, 59% to 95% for Manipulation; and 66% to 100% for Stability. Disagreement on two trials may reflect instability in movement, practice effects, and so on. With agreement between two testers as an index of objectivity for 37 items, 33 showed interrater agreement of 80% or more for all three grades. No significant increase in pass rate with age was found on 10 items. In examining the three conditions mentioned above 27 items were selected as tests of motor ability: 14 items for Locomotion, 7 items for Manipulation, and 6 items for Stability.