Background : The incidence of anemia in the female athlete is high, and anemia causes not only a decrease in performance, but also various subjective symptoms. It is said that the cause of hemolysis -a type of anemia- is a decrease in antioxidants and an increase in the reactive oxygen species caused by exercise. Purpose : This study investigated the effect of acute exercise on hemolysis and oxidative stress in female athletes. Methods : On the basis of basal body temperature (BBT) data and urinary ovulation tests of the subjects (age 20.5±1.0 yr ), they were divided into two groups : eumenorrheic athletes (Eu, n=12) group, and irregular menstrual athletes (Am, n=9). The subjects performed an acute period of exhausting exercise on a bicycle ergometer. Lactate, hemoglobin, hematocrit, RBC, serum estradiol, haptoglobin, thiobarbituric acid reactive substances (TBARS) were determined in blood samples collected at rest and after exercise. Results : Lactate increased and hemoglobin, hematocrit, RBC, haptoglobin decreased after exercise in both the Eu and Am groups (p<0.05). However, serum TBARS did not show a significant change after exercise in both the Eu and Am groups. Conclusion : These results suggest that hemolysis may have developed, because haptoglobin decreased as a result of acute exercise. However, it is thought that the effect of oxidative stress is small because TBARS were not changed by acute exercise in both Eu and Am groups. In addition, there was no significant correlation between hemolysis and estrogen.

[Objective] The aim of this investigation was to evaluate bone metabolism responses to acute resistance exercise during the menstrual cycle. [Methods] Subjects were young healthy sedentary women (n=7) with regular menstrual cycles. The subjects performed acute resistance exercise in each phase (follicular and luteal) of the menstrual cycle. Bone metabolism markers (bone formation marker BAP and bone resorption marker ICTP), bone metabolism related hormones (parathyroid hormone, calcitonin, calcium and inorganic phosphorus) and lactate were determined. Blood samples were collected before (Pre) and immediately following the exercise (Post), 1 hour (P1h) and 24 hours (P24h) after the exercise. [Results] BAP significantly increased at Post compared with Pre both in the follicular and luteal phases (p<0.05), but significantly decreased at P1h and P24h in the luteal phase. ICTP significantly increased at Post in the follicular phase (p<0.05) and significantly decreased at P1h and P24h in the luteal phase. The bone metabolism responses in the luteal phase moved to low-bone turnover at P1h and P24h. [Conclusion] The bone metabolism response to acute resistance exercise was different between menstrual phases. These results suggest that bone metabolism is influenced by the menstrual cycle.

　　It is said that diabetes is one of the factors contributing to the onset of dementia and accelerating its progression. The number of dementia cases is expected to increase steadily year by year. Such being the circumstances, we encountered an elderly woman with diabetes and dementia, who managed to lower her blood glucose values to a proper level somehow or other, thus lightening the burden of caregivers. We shall hereby report the case because we thought it would make a good example for care in the region where the population is rapidly graying. The woman, then at age 80, visited our hospital complaining of languidness. Her blood sugar level was so high (random blood glucose level: 1,096 mg/dl) that she was hospitalized at once. By a stepwise insulin reinforcement therapy, the blood glucose levels were under control. During the stay in hospital, she was also diagnosed as having senile dementia. She was provided with effective health care and education for the control of blood sugar levels. Having snacks between meals was strictly prohibited. Considering that she was an elderly person living alone, only internal medicines were given. As a result, her blood glucose levels were elevated to about 300 mg/dl, but the combined use of GLP-1 injection and internal medicine once a week had good control over blood glucose levels. So, the patient was discharged from the hospital.

Objective: To clarify the frequency of deficient mismatch repair (dMMR) in Japanese ovarian cancer patients, we examined microsatellite instability (MSI) status and immunohistochemistry (IHC) subtypes, including endometrioid carcinoma (EMC), clear cell carcinoma (CCC), or a mixture of both (Mix). Methods: We registered 390 patients who were diagnosed with EMC/CCC/Mix between 2006 and 2015 and treated at seven participating facilities. For 339 patients confirmed eligible by the Central Pathological Review Board, MSI, IHC, and MutL homolog 1 methylation analyses were conducted. The tissues of patients with Lynch syndrome (LS)-related cancer histories, such as colorectal and endometrial cancer, were also investigated. Results: MSI-high (MSI-H) status was observed in 2/217 CCC (0.9%), 10/115 EMC (8.7%), and 1/4 Mix (25%). Additionally, loss of MMR protein expression (LoE-MMR) was observed in 5/219 (2.3%), 16/115 (14.0%), and 1/4 (25%) patients with CCC, EMC, and Mix, respectively. Both MSI-H and LoE-MMR were found significantly more often in EMC (p<0.001). The median (range) ages of patients with MMR expression and LoE-MMR were 54 (30–90) and 46 (22–76) (p=0.002), respectively. In the multivariate analysis, advanced stage and histological type were identified as prognostic factors. Conclusion The dMMR rate for EMC/CCC was similar to that reported in Western countries. In Japan, it is assumed that the dMMR frequency is higher because of the increased proportion of CCC.

Oral mucositis is reported to occurs in 40% of cancer patients on chemotherapy, suggesting the need for early oral care intervention in such patients. However, the oral care depends on each nurse and there has been no special document on the oral care for patients in the Respiratory Medicine and the Hematology/Oncology Ward, in which are managed around 100 regimens of chemotherapy per month. Here, to develop an oral care assessment sheet (OC sheet), we conducted a questionnaire survey of 24 ward nurses on oral care for chemotherapy patients and evaluated their assessment abilities using an oral care assessment test that was compliant with the items of the Eiler’s Oral Assessment Guide. The questionnaire survey revealed that nurses performed certain observations and/or interventions without basis and confidence, and that they did not always have patients’ cooperation while assessing their oral condition. They also tended to give inconsistent instructions. Use of the OC sheet enabled nurses to provide early oral care interventions and to confirm the utility of the chosen intervention. Test scores after the introduction of the OC sheet were significantly higher than before, indicating that use of the OC sheet improved nurses’ assessment and nursing care abilities.

Prolonged cough in coronavirus disease 2019 (COVID-19) is not only uncomfortable for patients, but also prolongs the length of stay in an isolation facility. This results in delays in patients' return to their daily life. Therefore, the prompt treatment of cough is important. In this report, we used Japanese traditional (Kampo) medicine, chikujountanto for the treatment of cases with residual cough, airway secretions, slight fever, anxiety, and insomnia, several days after the onset of coronavirus. From October 2020 to September 2021, we prescribed chikujountanto for thirty-three COVID-19 patients with prolonged cough in an isolation facility. Seven patients (6 women and 1 man with ages ranging 37-70 years) were treated with no other medication. Comorbid symptoms included slight fever, sputum, sore throat, nasal discharge, headache, anxiety/insomnia, and taste/olfactory disorders. The start date of treatment ranged from 9 to 21 days after the onset of COVID-19, and the time until cough and comorbid symptoms improved to values less than NRS 2 or less, was 2 to 6 days after treatment. Three patients had persistent cough and needed to switch to other medication. In COVID-19, chikujountanto may be useful for coughing during the period when the peak of the viral proliferative phase has passed but airway inflammation is still present.