OBJECTIVE: Lynch syndrome is a cancer predisposition syndrome caused by germline mutation of DNA mismatch repair (MMR) genes. Lynch syndrome only causes about 0.4% of cases of ovarian cancer, which suggests that universal screening may not be cost-efficient. However, the frequency of Lynch syndrome in ovarian cancer is unclear in the Asian population. The goal of the study was to investigate a screening strategy using family history. METHODS: The subjects were 129 patients with ovarian cancer. Clinical and family history were collected using a self-administered questionnaire, and Society of Gynecologic Oncology (SGO) criteria 2007 and PREMM5 were used for risk assessment. Microsatellite instability, immunohistochemistry, and methylation of MMR genes were analyzed. RESULTS: Of the 129 cases, 25 (19.4%) met the SGO criteria, and 4 of these 25 had MSI-high and MMR deficiency. Two cases had loss of MSH2 and MSH6, indicating MSH2 mutation, and the other two had loss of MLH1 and PMS2, including one without MLH1 methylation indicating MLH1 mutation. These results show that screening using family history can detect Lynch syndrome in 12.0% (3/25) of ovarian cancer cases. The 3 cases were positive for PREMM5, but negative for Amsterdam II criteria and revised Bethesda guidelines. Genetic testing in one case with MSH2 and MSH6 deficiency confirmed the diagnosis of Lynch syndrome with MSH2 mutation. CONCLUSION: This is the first study of screening for Lynch syndrome in ovarian cancer using clinical and family history in an Asian population. This approach may be effective for diagnosis in these patients.
Asian Continental Ancestry Group ; Colorectal Neoplasms, Hereditary Nonpolyposis* ; Diagnosis ; DNA Mismatch Repair ; Genetic Testing ; Germ-Line Mutation ; Humans ; Immunohistochemistry ; Mass Screening* ; Medical History Taking ; Methylation ; Microsatellite Instability ; Ovarian Neoplasms* ; Risk Assessment*

Background: The impact of COVID-19 infection on workers' work function persists even after the acute phase of the infection. We studied this phenomenon in Japanese workers. Methods: We conducted a one-year prospective cohort study online, starting with a baseline survey in December 2020. We tracked workers without baseline work functioning impairment and incorporated data from 14,421 eligible individuals into the analysis. We estimated the incidence rate ratio for new onset of work functioning impairment due to COVID-19 infection during follow-up, using mixed-effects Poisson regression analysis with robust variance. Results: Participants reporting infection between January and December 2021 showed a significantly higher incidence of new work functioning impairment (adjusted incidence rate ratio: 2.18, 95% confidence interval: 1.75–2.71, p < 0.001). The formality of the recuperation environment correlated with a higher risk of work functioning deterioration in infected individuals (p for trend <0.001). Conclusion COVID-19-infected workers may continue to experience work difficulties due to persistent, post-acute infection symptoms. Companies and society must urgently provide rehabilitation and social support for people with persistent symptoms, recognizing that COVID-19 is not just a transient acute infection.

Background: In the end stage of malignant bone and soft tissue tumors with lung metastasis, it is often necessary to relieve symptoms of dyspnea due to tumor enlargement and carcinomatous lymphangitis. We report a case in which nasal continuous positive airway pressure (nasal CPAP) was effective as a palliative treatment. Case: A 66-year-old male underwent wide resection with a diagnosis soft tissue sarcoma of right femur. Four years after surgery, he was hospitalized for hilar lymph node metastasis, multiple bone metastases, and carcinomatous lymphangitis. He was treated with nasal CPAP for dyspnea, and communication was possible until the day before his death. Discussion: For end-stage respiratory symptoms, medication therapy such as morphine or steroids is often used for palliation, but often symptoms are not sufficiently improved. Nasal CPAP might be a useful treatment for palliation for rapidly progressing respiratory failure.

Objective: In this study, we aimed to develop a new system that can centrally manage and share drug information, and also evaluated its usefulness.Methods: Using PHP v5.3.3 as the programming language and MySQL v5.1.73 as the database, we built a web application that constantly runs on the server. Various drug information was registered in this system, and its usage status was analyzed based on the access log.Results: The system was accessed 31,678 times during the survey period (October 1 to December 31, 2019). The information sought included: basic drug information (ordering category of drugs, dosage forms and strengths, drug price, etc.) (13,962 times, 44.1%),question and answer records (7,221 times, 22.8%), pharmaceutical documents (package inserts, interview forms, documents regarding compatibility of injections, etc.) (7,172 times, 22.6%), notifications regarding new and discontinued drugs (727 times, 2.3%), websites (676 times, 2.1%), PreAVOID reports (663 times, 2.1%), pharmaceutical safety information (525 times, 1.7%), information regarding off-label drug use (409 times, 1.3%), and bibliographic information and guidelines (323 times, 1.0%). Among the users (62 pharmacists), 59.7% accessed the system only via a personal computer (PC), 38.7% via a PC and smart device (smartphone or tablet),and 1.6% via only a smart device. The median number of accesses to this system was significantly higher in pharmacists in charge of wards (190 [9-1,435]) or drug information (3,750 [2,957-5,548]) than dispensing pharmacists (68.5 [3-193]) (p＜0.001).Conclusion: This system allowed the central management and sharing of various drug information on the web, permitting access regardless of device type. Since this system was frequently used by pharmacists in charge of wards or drug information, this system was considered particularly useful in hospital pharmacist ward services and drug information services.