A 50-year-old female developed severe dermatitis on her face during topical therapy with Shiun-ko and Taitsu-ko. The skin lesions almost disappeared in two weeks with oral steroid therapy and did not recur. Patch testing showed positive reactions to Shiun-ko, Taitsu-ko and Lithospermi radix, and beeswax, which were constituents of Shiun-ko and Taitsu-ko. The result suggests that the patient was sensitized with these topical medicaments and developed allergic contact dermatitis.

Background A behavioral science-based approach is essential for constructing effective intervention programs to promote the shift from a sedentary to active lifestyle. Recently, the influences of social and physical environment on physical activity have been recognized as key factors for promoting physical activity. The present study attempts to identify the social and physical environmental influences associated with physical activity promotion.Methods We recruited volunteers from a 14,000 population of community-dwelling adults. Seventy-two adults (intervention group : n=35, control group : n=37) participated in the present study. The intervention consisted of 8 sessions for 2 months using The Waseda Walking Program. We assessed social support for exercise, perceived neighborhood environment for walking, stages of change in exercise behavior and physical activity outcomes at baseline and 2 months. Ffifty-seven out of 72 subjects (intervention : n=30, control : n=27) completed all of the intervention including the final questionnaire.Results There were significant intervention effects on physical activity outcomes, stages of change and perceived neighborhood environment. However, no significant improvement in social support was found. In addition, improvement of perceived physical environment was related to an increase in physical activity.Conclusion Perceived neighborhood environment for walking would be identified as a key factor to influence an effect of physical activity promotion. On the other hand, social support would be influenced to the earlier stages of change in exercise.

The purpose of this study was to investigate the effect of individual feedback intervention (IFB) or general video intervention (GV) on promoting daily physical activity. One hundred and thirty-six community-dwelling people volunteered as subjects and participated in the 2-month walking program provided as a correspondence course. The subjects were randomly allocated to one of four groups, which consisted of either IFB or GV. Each of the groups was based on behavioral science. The stage of change in exercise, self-efficacy for exercise and daily physical activity were measured before and after intervention 4 months later during the follow-up period. There were statistically significant effects of both ‘time’ (F=3.71, p=0.026) and ‘time’בIFB’ (F=3.76, p=0.025) in self-efficacy for exercise; while there was no significant effect of interaction between ‘time’בGV’. As for daily physical activity, there was no significant effect of the interaction both of ‘time’בIFB’ and ‘time’בGV’. These results suggest the IFB of promoting self-efficacy for exercise.

It is well known that decreased physical performance induces the decreased activity of daily living and increment of mortality rate in elderly subjects. On the other hand, a prolonged heart rate corrected-QT (QTc) interval is associated with an increased risk of cardiac sudden death and cardiac autonomic dysfunction. We investigated the associations between physical performance and QTc interval in elderly subjects. The subjects included 605 elderly persons (274 men and 331 women, age; 71.2±4.7 years) without a history of cardiovascular disease and taking cardioactive drugs. Resting 12-leads electrocardiography was measured after more than 5 minutes of rest. The QTc interval was calculated according to Bazett’s formula. The physical fitness test was performed to determine the physical performance (muscle strength, balance and walking abilities). The subjects were divided into four categories, which were defined as equally quantile distributions of QTc interval. The physical performance levels were significantly lower in the longest QTc interval group compared to the shortest QTc interval group in both men and women (p<0.05, respectively). Moreover, after adjusting for the age, the physical performance levels were significantly lower in the longest QTc interval group compared to the shortest QTc interval group, especially, this relationship was observed in late-stage elderly group (p<0.05, respectively). These results suggest that decreased physical performance levels were also associated with prolonged QTc interval in elderly subjects.

In order to promote regional cooperation in palliative care, we developed a regional cooperation clinical pathway for home palliative care that offers simple support and is easy to use. We then administered a questionnaire survey to 14 healthcare professionals with various specialties who were involved in the introduction of the pathway, and we revised the pathway on the basis of the survey results. The revised pathway was then tested in 13 patients who were discharged from 3 designated cancer care hospitals in Toyama City to home care, and another questionnaire survey was conducted afterwards in the same manner. The mean overall score on the questionnaire was 2 in seven, 3 in seven (on a scale of 0 to 3) at the time of introduction, whereas the score after trial use was 1 in one, 2 in four, 3 in five. We believe that more innovative approaches to the implementation of such pathways are required.

Purpose and Methods: Aiming at the relief of suffering by the palliative care team and prompt information sharing between healthcare professionals with various specialties, We introduced new IT cloud system, carried out questionnaire survey and examined the usefulness to 11 persons of healthcare professionals. Five cases where the palliative care team was concerned during the hospitalize became a home palliative care to the tried half a year. Results: All the members were using the personal computer as an input device. Four persons were using the iPhone. Two persons had the experience inputted on the spot. Nine persons of the input time were 5 or less minutes. All the members were perusing at various places by various device. Urgently and vital mail was useful: 3 in six, 2 in three, 1 in one, 0 in one. Information content were suitable: 3 in nine, 2 in two. Cooperation were completed in the smooth: 3 in nine, 2 in two. Have you utilized EIR for the home palliative care?: 3 in nine, 2 in two. Conclution: To the support of information sharing and palliative care team by IT cloud system transduction, the useful probability was suggested in the home palliative care.

This study examined whether physical and cognitive function was independently associated with risk of Musculoskeletal Ambulation Disorder Symptom Complex (MADS) in community-dwelling older people. We examined 640 older people (315 men, 325 women; 65–89 years). We assessed physical performance by one-leg standing with eyes open, timed up and go (TUG), muscle strength, muscle power, and gait speed. Cognition was assessed using Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), and Trail-Making Tests (TMT) A and B. We divided participants by physical function into “MADS” (one-leg standing < 15s or TUG ≥ 11s) and “non-MADS”, and identified cognitive impairment if MMSE was < 27 and CDR ≥ 0.5. We also grouped by sex and age (younger-old: 65–74 years and older-old: 75–89 years), and controlled for age, Body Mass Index, education and steps. Physical and cognitive function was significantly worse in the MADS groups. The younger-old men had poorer muscle strength, muscle power and TMT-A. The younger-old women had poorer muscle power, gait speed, MMSE and TMT-B. Older-old men had poorer muscle strength, and older-old women poorer gait speed (P < 0.05). The MADS groups also had significantly higher adjusted odds ratio (OR) for cognitive impairment (younger-old men: OR: 4.62; 95% confidence interval [CI]: 1.08–19.8; younger-old women: OR: 6.09; 95% CI: 1.03–35.9; P < 0.05). This study suggested that poorer physical and cognitive function was significantly associated with the risk of MADS, and these associations may be differ with sex and age.

OBJECTIVE: Few studies on the prognosticators of the patients with recurrent endometrial cancer after relapse have been reported in the literature. The aim of this study was to determine the prognosticators after relapse in patients with recurrent endometrial cancer who underwent primary complete cytoreductive surgery and adjuvant chemotherapy. METHODS: Thirty-five patients with recurrent endometrial cancer were included in this retrospective analysis. The prognostic significance of several clinicopathological factors including histologic type, risk for recurrence, time to relapse after primary surgery, number of relapse sites, site of relapse, treatment modality, and complete resection of recurrent tumors were evaluated. Survival analyses were performed by Kaplan-Meier curves and the log-rank test. Independent prognostic factors were determined by multivariate Cox regression analysis. RESULTS: Among the clinicopathological factors analyzed, histologic type (p=0.04), time to relapse after primary surgery (p=0.03), and the number of relapse sites (p=0.03) were significantly related to survival after relapse. Multivariate analysis revealed that time to relapse after primary surgery (hazard ratio, 6.8; p=0.004) and the number of relapse sites (hazard ratio, 11.1; p=0.002) were independent prognostic factors for survival after relapse. Survival after relapse could be stratified into three groups by the combination of two independent prognostic factors. CONCLUSION: We conclude that time to relapse after primary surgery, and the number of relapse sites were independent prognostic factors for survival after relapse in patients with recurrent endometrial cancer.
Endometrial Neoplasms ; Female ; Humans ; Multivariate Analysis ; Recurrence ; Retrospective Studies ; Survival Analysis*

OBJECTIVE: The aim of this study was to investigate the prognostic factors and treatment outcome of patients with adenocarcinoma of the uterine cervix who underwent radical hysterectomy with systematic lymphadenectomy. METHODS: A total of 130 patients with stage IB to IIB cervical adenocarcinoma treated with hysterectomy and systematic lymphadenectomy from 1982 to 2005 were retrospectively analyzed. Clinicopathological data including age, stage, tumor size, the number of positive node sites, lymphovascular space invasion, parametrial invasion, deep stromal invasion (>2/3 thickness), corpus invasion, vaginal infiltration, and ovarian metastasis, adjuvant therapy, and survival were collected and Cox regression analysis was used to determine independent prognostic factors. RESULTS: An estimated five-year survival rate of stage IB1 was 96.6%, 75.0% in stage IB2, 100% in stage IIA, and 52.8% in stage IIB. Prognosis of patients with one positive-node site is similar to that of those with negative-node. Prognosis of patients with multiple positive-node sites was significantly poorer than that of negative and one positive-node site. Multivariate analysis revealed that lymph node metastasis, lymphovascular space invasion, and parametrial invasion were independent prognostic factors for cervical adenocarcinoma. Survival of patients with cervical adenocarcinoma was stratified into three groups by the combination of three independent prognostic factors. CONCLUSION: Lymph node metastasis, lymphovascular space invasion, and parametrial invasion were shown to be independent prognostic factors for cervical adenocarcinoma treated with hysterectomy and systematic lymphadenectomy.
Adenocarcinoma ; Cervix Uteri ; Female ; Humans ; Hysterectomy ; Lymph Node Excision ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Survival Rate ; Treatment Outcome ; Uterine Cervical Neoplasms

This study aimed to examine characteristics of physical functions, physical activity, and cognitive functions among community-dwelling older people who stopped driving automobiles. Participants were 589 community-dwelling older people (age: 65–89, 71.4 ± 5.1 years; 403 men, 186 women). The participants underwent nine physical assessments—hand grip strength, knee extension strength, timed up-and-go test, chair stand, one leg standing with open eyes, functional reach, vertical jump, preferred gait speed, maximal gait speed—and were evaluated for physical activity; and five cognitive assessments—the Mini-Mental State Examination (MMSE), Logical Memory I and II (WMS-R LM-I, LM-II) subtests of the Wechsler Memory Scale-Revised; and Trail Making Test A and B (TMT-A, TMT-B). They were divided into current driver (379 men, 169 women) and driving cessation (24 men, 17 women) groups. Among men, the driving cessation group had poorer vertical jump, TMT-A, and TMT-B results, while women had poorer hand grip strength, one leg standing with open eyes, WMS-R LM-II, and LM-II results, and longer inactivity time, compared with the current driver group and adjusted for covariates (P < 0.05 for all). The findings suggest driving cessation among community-dwelling older people is significantly associated with poorer physical functions, physical activity, and cognitive functions compared with those in current drivers.