Background: A nonprofit organization―the Supporting Center for Clinical Research and Education—has outsourced medical education to the Osaka University Graduate School of Medicine. The main targets of this education are researchers and developers in pharmaceutical and medical-equipment companies.
Method: Since 2004, the Supporting Center for Clinical Research and Education has provided short, intensive seminars on 25 subjects to 214 company employees. The key components of the seminars are lectures, practice, case conferences, interviews with patients, and comprehensive discussions.
Results: After each seminar was completed, it was evaluated with questionnaires filled out by participants. Participants expressed high levels of satisfaction with all components of the seminars, with interviews with patients being the most highly rated.
Conclusions: Medical educational activities for company employees have increased in recent years. These seminars are intended to provide short, intensive, small-group instruction to researchers and developers in pharmaceutical and medical-equipment companies with a goal of patient-centered medical practice based on a proper understanding of the actual condition of patients.

Herb supplies can become unstable because of climate change and the economic development of herb exporters. In this paper, in order to increase the self-sufficiency of herbal resources we examined the possibil ity of changing to herb crop production from tobacco, for which demand is declining. Firstly, we considered demand, quality and the price of raw herb materials to make recommendations for corrections, and selected Angelica (A. ) acutiloba and Bupleurum (B. ) falcatum Linne. Next, we compared the profitability of tobacco and the herbs. Profit margins for A. acutiloba were less than for tobacco. It was thought that the profitability of A. acutiloba could become equivalent to tobacco if an adjustment subsidy were provided. The self-sufficiency rate for A. acutiloba would be one hundred percent with 35 million yen in every year. Although the profitabil ity of B. falcatum has exceeded tobacco, its selling price was about 3 times that of imports, while the price of medical B. falcatum was lower than its selling price. It was thought that the price competitiveness problem of B. falcatum can be covered if a production subsidy is provided, and to reach a 50 percent B. falcatum self sufficiency rate with 660 million yen per year.

Objectives

  The aim of this study was to investigate the knowledge, attitude, and practice (KAP) of healthcare providers regarding the utilization of oxytocin for induction or augmentation of labor.

Methods

  A qualitative study composed of direct observation and individual interview was conducted at a national tertiary maternity hospital in Phnom Penh, Cambodia in January and February 2013. The progress of labor in women who received oxytocin for induction or augmentation of labor was directly observed to confirm the healthcare providers’ management of oxytocin infusion. The attending doctors and midwives were individually interviewed after the women delivered.

Results

  During the study period, 10 women were observed, and 12 healthcare providers (three doctors and nine midwives) were interviewed individually. Indications for labor induction or augmentation seemed to be appropriate for nine women. However, we found discrepancies between the national protocol and healthcare providers’ knowledge and actual practices. For example, 11 healthcare providers had never read the national protocol for the management of labor induction and augmentation, which implied limited access to the correct knowledge. A misconception was noted in that the sudden increase of oxytocin was not dangerous during the second stage of labor, despite the establishment of a good contraction pattern. Furthermore, a lack of unified initial dose and extremely high maximum dose above that recommended by the national protocol were observed. About half of observed women were not monitored for more than 2 hours from the beginning of oxytocin infusion.

Conclusion

  　In the present study, lack of knowledge, misconceptions regarding the management of oxytocin infusion, and a large gap between the national protocol and the actual clinical practices were confirmed. To maximize patient safety and therapeutic benefit, dissemination of the national protocol through in-service training is required.

OBJECTIVE: To develop and validate a 3-year recurrence prediction score (RPS) system for predicting the baseline risk of recurrence of stage I–II endometrial carcinoma. METHODS: We reviewed 427 patients with International Federation of Gynecology and Obstetrics staging I–II endometrial carcinoma underwent surgery without any adjuvant therapy from 2005 to 2013. The patients were divided into 2 groups: the test cohort (n=251) comprising those who underwent surgery in odd-numbered years, and the validation cohort (n=176) comprising those who underwent surgery in even-numbered years. Multivariate analysis was performed using 7 candidate predictors to identify the risk factors for 3-year recurrence-free interval (RFI) in the test cohort. Each risk factor was scored based on logistic regression analyses of the test data set, and the sum of the risk factor scores was defined as the RPS system. We then applied the system in the validation cohort. RESULTS: Multivariate analysis revealed that the significant risk factors were age ≥60 years, pathological type II, positive cervical stromal invasion, and positive peritoneal cytology. In the test cohort, the 3-year RFI rates were 100%, 95.8%, 79.9%, and 33.3% for RPSs of 0, 1, 2, and 3, respectively. In the validation cohort, the 3-year RFI was significantly higher in the low-RPS group (RPS 0 or 1) than in the high-RPS group (RPS 2 or 3) (95.2% vs. 79.9%, p < 0.01). CONCLUSIONS: The RPS system shows significant reproducibility for predicting the baseline risk of recurrence. The system could potentially impact the choice of adjuvant therapy for stage I–II endometrial carcinoma.
Cohort Studies ; Dataset ; Endometrial Neoplasms* ; Female ; Gynecology ; Humans ; Logistic Models ; Multivariate Analysis ; Obstetrics ; Recurrence* ; Risk Factors

OBJECTIVE: Though there are no evidences that postoperative therapy improves overall survival (OS) in stage I–II endometrial carcinoma, many women receive postoperative radiation or chemotherapy. This study aimed to investigate the baseline risk of recurrence after complete resection without any adjuvant therapies and to suppose the validity of postoperative therapy for stage I–II endometrial carcinoma. METHODS: Charts for patients with stage I–II endometrial carcinoma who underwent operation without postoperative therapy between January 2005 and December 2011 were retrospectively reviewed and the baseline risk of recurrence and prognosis were assessed. Risk classifications were performed according to European Society for Medical Oncology (ESMO) clinical practice guidelines and Japanese guideline written by Japan Society of Gynecologic Oncology Group. RESULTS: Among 374 patients who underwent complete resection, 311 were evaluable. Five-year recurrence rates by ESMO and Japanese were 2.6% and 3.1% in low-risk, 9.2% and 6.6% in intermediate-risk and 13.5% and 13.8% in high-risk group (p=0.003 and 0.015, respectively). High-risk group had worse OS compared with low- and intermediate-risk groups (5-year OS, low: 97.9% and 97.6%, intermediate: 97.9% and 98.8%, and high: 89.5% and 87.5%; p=0.003 and 0.008, respectively). Independent predictive factors of recurrence were age over 60 years, type 2 (estrogen-independent) and peritoneal cytology. CONCLUSION: ESMO and Japanese risk classification similarly stratify the baseline risk of recurrence. Patients with stage I–II endometrial carcinoma, especially low- and intermediate-risk diseases, have low recurrence rate and favorable OS, and the benefit of postoperative therapy might be small.
Asian Continental Ancestry Group ; Classification ; Drug Therapy ; Endometrial Neoplasms ; Female ; Humans ; Japan ; Medical Oncology ; Postoperative Care ; Prognosis ; Recurrence ; Retrospective Studies

A 52-year old woman was referred to our hospital because of abdominal pain and restlessness. A chest contrast-enhanced CT showed huge pericardial effusion and intraluminal defects in the main pulmonary artery. We could not make a diagnosis based on the cytology of the pericardial effusion and histopathology of the mass with a sample taken by a catheter. Therefore, we undertook biopsies of the mass by median sternotomy, which led to the diagnosis of pulmonary intimal sarcoma. The tumor resection was performed to release the right ventricular outflow stenosis. We tried to resect the tumor as much as possible, and reconstructed the pulmonary artery and aortic root. She was discharged to home and survived 5 months after surgery.