Recent changes in the relationship between physicians and society has affected the values and ethics of physicians, and a“Physician Charter”on medical professionalism has been drafted by the American Board of Internal Medicine Foundation, the American College of Physicians-American Society of Internal Medicine Foundation, and the European Federation of Internal Medicine.We conducted this survey to determine whether the“Physician Charter”can be used to examine the medical professionalism of Japanese physicians.
1) A questionnaire to examine the perceptions of physicians in Japan and the United States of the responsibilities of the “Physician Charter” was distributed.
2) In both countries 30% of physicians understood the contents of the “Physician Charter, ”and 60% believed the charter should be used in every country.
3) The physicians in the United States tended to consider most responsibilities more urgent than did Japanese physicians, and the perceptions of several responsibilities differed between physicians in the two countries.A generation gap among Japanese physicians was observed for some responsibilities.

OBJECTIVE: The aim of this study was to investigate the risk and recurrence of early invasive adenocarcinoma of the cervix, and to determine whether non-radical methods of management could be performed. METHODS: The medical and histopathological records of 50 patients with early invasive adenocarcinoma of the cervix treated at Keio University Hospital between 1993 and 2005 were reviewed, and compared with the literature. RESULTS: The median follow-up period was 64.3 months. The depth of stromal invasion was < or =3 mm in 33 cases and >3 mm, but < or =5 mm in 17 cases. The horizontal spread was < or =7 mm in 25 cases and >7 mm in 25 cases. One of the 33 cases that had tumor volumes of < or =500 mm3, and three of the 17 cases with tumor volumes of >500 mm3 were positive for lymph node metastasis. When our data were combined with previously reported results, statistically significant differences were observed between the tumor volume and the frequency of pelvic lymph node metastasis/the rate of recurrence (p<0.0001). The frequency of pelvic lymph node metastases was significantly higher in the lymphovascular space invasion (LVSI)-positive group than in the LVSI-negative group (p=0.02). No adnexal metastasis or parametrial involvement was noted. CONCLUSION: Assessment of the depth of stromal invasion, tumor volume, and LVSI is critical for selecting an appropriate therapeutic modality. Non-radical methods of management are considered suitable for patients with LVSI-negative adenocarcinoma of the cervix exhibiting a stromal invasion depth of < or =5 mm and a tumor volume of < or =500 mm3.
Adenocarcinoma ; Cervix Uteri ; Conization ; Female ; Follow-Up Studies ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence ; Tumor Burden ; Uterine Cervical Neoplasms

To investigate the factors affecting the rate of improvement in endurance exercise performance following pre-cooling with ice slurry, we focused on individual physical characteristics and thermoregulatory capacity. Twenty-four healthy adults (12 males and 12 females) ingested 7.5g kg-1 of either ice slurry at -1°C (ICE) or control water at 20°C (CON) before cycling at 55% VO2max and continued cycling until the rectal temperature reached 38.5°C or untill exhaustion in a hot environment (controlled at 38°C, 40% relative humidity). The relationship between the rate of improvement in exercise performance and physical characteristics and thermoregulatory factors (changes in rectal temperature, the rate of rectal temperature increase, whole body sweat loss, mean metabolic heat production, and heat storage) was investigated. No correlation was noted between the rate of improvement in exercise performance and physical characteristics and heat storage. On the other hand, the rate of improvement in exercise performance showed significant correlations with changes in rectal temperature (r = -0.497), the rate of rectal temperature increases during exercise (r = -0.784), whole body sweat loss (r = 0.407), and mean metabolic heat production (r = -0.436). The rate of inhibition of sweating and the rate of increase in metabolic heat production by ice slurry ingestion during exercise have been suggested to be related to the rate of improvement in exercise performance. On the other hand, there was no relationship between body composition or VO2max and the rate of improvement in exercise performance.