Between 1987 and 1990, Tsuchiura Kyodo Hospital treated a total of 153 cases of squamous cell carcinoma of the uterine cervix after establishing definitive diagnosis. Of the total, 46 cases in stage 0, 43 cases in stage Ia and 21 cases in stage Ib were studied retrospectively in order to investigate the sensitivity of cytological and histological tests and the rate of agreement between cancer diagnoses made by the two departments. As a result, it was confirmed anew that there is much to be done to improve the diagnostic accuracy, which is vital to the success of the treatment for early cancer of the uterine cervix.
A summary of the findings is as follows:
The cytological examination data showed that the positive results were obtained in 69.6% of the cases in stage 0, 67.4% in stage Ia and 84.2% in stage Ib. The corresponding percentages in the histological examination were 50%, 67.5% and 89.5% respectively. The argreement rations were as low as 30% in stage 0, 53.8% in stage Ia and 84.2% in stage Ib.
Similar study was made on 43 cases of conization which is regarded as a useful means of detecting cervic cancer, The ratio of detection of early cervic cancer was 29.4% before conization. After conization, the ratio jumped to 74.4%.
The present level of diagnostic accuracy is such that the routine conization procedure is indispensable. For the treatment of cervical cancer in stage 0, it is advisable to perform hysterectomy. For the stage Ia cancer, semi-radical hysterectomy should be indicated. Lymph-node clearing is not always required.
In stage 0, diagnostic conization should be followed by treatmental conization or by removal of the remaing part of the uterus after making sure that the conization procedure was appropriate and taking into consideration the patients' age and fertility. In light of the present level of medical technology, however, hysterectomy may be the first to be considered.

Cardiac tumors are rare, and multiple myxomas are even rarer. The latter phenomenon is mostly associated with the Carney complex, a dominantly inherited disease characterized by multiple primary cardiac myxomas, endocrinopathy, and spotty pigmentation of the skin. We report the rare case of a patient who did not have the Carney complex but had multiple primary cardiac tumors. A 78-year-old woman with a past history of breast cancer was referred to our hospital for further examination of multiple cardiac tumors. Echocardiography showed 4 tumors in the left atrium and left ventricle. We could not diagnose them preoperatively and decided to resect them surgically because they were mobile and could have caused embolism and obstruction. The postoperative pathological findings of all 4 tumors were myxomas, although the patient did not meet the diagnostic criteria of the Carney complex. Therefore, a rare case of multiple primary cardiac myxomas was diagnosed.
Aged ; Breast Neoplasms ; Carney Complex* ; Echocardiography ; Embolism ; Female ; Heart Atria ; Heart Neoplasms ; Heart Ventricles ; Humans ; Myxoma* ; Pigmentation ; Skin

Objective: Monitoring the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants is important due to concerns regarding infectivity, transmissibility, immune evasion and disease severity. We evaluated the temporal and regional replacement of previous SARS-CoV-2 variants by the emergent strains, Alpha and Delta. Methods: We obtained the results of polymerase chain reaction screening tests for variants conducted in multiple commercial laboratories. Assuming that all previous strains would be replaced by one variant, the new variant detection rate was estimated by fitting a logistic growth model. We estimated the transmission advantage of each new variant over the pre-existing virus strains. Results: The variant with the N501Y mutation was first identified in the Kinki region in early February 2021, and by early May, it had replaced more than 90% of the previous strains. The variant with the L452R mutation was first detected in the Kanto-Koshin region in mid-May, and by early August, it comprised more than 90% of the circulating strains. Compared with pre-existing strains, the variant with the N501Y mutation showed transmission advantages of 48.2% and 40.3% in the Kanto-Koshin and Kinki regions, respectively, while the variant with the L452R mutation showed transmission advantages of 60.1% and 71.9%, respectively. Discussion In Japan, Alpha and Delta variants displayed regional differences in the replacement timing and their relative transmission advantages. Our method is efficient in monitoring and estimating changes in the proportion of variant strains in a timely manner in each region.