OBJECTIVESTo elucidate the association between genetic polymorphisms ofCYP2a6 andCYP2E1 and urothelial cancer susceptibility.

METHODSA total of 137 Japanese patients with urothelial cancer and 217 Japanese healthy controls, frequency-matched for age and gender, were selected. The polymorphisms ofCYP2A6 andCYP2E1 were analyzed by PCR-RFLP, and cigarette smoking histories were obtained through interviews

RESULTSThe frequency ofCYP2A6 homozygote deletion genotype was 2.9% in the patients, compared with 3.2% in the controls (OR=0.84, 95% CI 0.24-2.96). The frequencies ofCYP2E1 C1/c2 andC2/c2 were 27.7% and 4.4% in the patients, compared with 35.5% and 6.0% in the controls (OR=0.68, 95% CI 0.42-1.09, OR=0.67, 95% CI 0.24-1.84, respectively). No statistically significant differences were observed when theCYP2A6 homozygote deletion genotype and theCYP2E1 genotypes were examined relative to smoking status.

CONCLUSIONSOur data indicate that neither a relationship between genetically impaired nitrosamine metabolism and tobacco-smoking consumption, nor urothelial cancer risk related to theCYP2A6 deletion genotype andCYP2E1 Rsa I genotype was found in Japanese population.

During the coronavirus pandemic, we focused on Hypothesis-Driven Physical Examination (HDPE), which is performed while considering physical examination and differential diagnosis as issues that can be learned without directly having contact with patients. We created HDPE scenarios with students who elected general medicine in Clinical Clerkship 2, and we implemented HDPE using that scenario on the last day of the clerkship. The scenario was created online and HDPE was conducted face-to-face. Students could learn correct medical examination techniques and manners through mutual learning. In addition, they could acquire communication and lifelong learning abilities through cooperative learning. We were able to enhance the learning effect through mutual learning that works on the students’ own intrinsic motivation in terms of both creating scenarios for the framework of cognitive apprenticeship and implementing HDPE.

We report 4 cases of vulvodynia, vulval pain from unknown causes that showed symptomatic improvements by administrating Kampo medicines. Modern medicines, such as analgesics, treatments for endometriosis or hormone replacement therapy, can't always be effective for vulvodynia and not a few patients go to see different hospitals without improving their pain. We diagnosed these 4 cases of vulvodynia were originated in kekkyo. We administered Kampo medicines, mainly shimotsuto with supporting ones, and the symptoms of vulvodynia improved.