BACKGROUND AND AIM: The association between physical activity (PA) and sarcopenia has mostly been investigated in older people, with few studies focused on earlier life stages. The present study aimed to determine whether higher PA levels are associated with a lower sarcopenia risk in middle-aged and early older people. METHODS: This was an 8-year follow-up study. Participants were 6,500 community-dwelling adults aged 40-74 years who participated in the baseline questionnaire survey conducted in 2011-2014 in Japan. Levels of total and leisure-time PAs at baseline were assessed using validated metabolic equivalent scores. Multi-frequency bioelectrical impedance analysis and handgrip strength measurement were performed in 2021-2022, and participants with low height-adjusted appendicular lean mass (<20th percentile) and low grip strength were diagnosed as having sarcopenia (outcome). Covariates were demographics, body size, lifestyle, and disease history at baseline. RESULTS: The prevalence of sarcopenia was 137/2926 (4.7%) for men and 127/3574 (3.6%) for women. Higher total PA levels were associated with lower odds of sarcopenia (P for trend = 0.0278), with the second highest group having a significantly lower OR (0.51) than the lowest group (reference) in women, but not in men. Regarding leisure-time PA, those engaged in leisure-time vigorous PA had a lower OR of sarcopenia than those who did not (OR = 0.67, P = 0.0625). CONCLUSION Higher levels of total PA are associated with a lower risk of sarcopenia in women but not in men, suggesting a sex difference in this association. In addition, high levels of vigorous leisure-time PA may be effective for preventing sarcopenia.
Humans ; Sarcopenia/epidemiology* ; Japan/epidemiology* ; Male ; Female ; Middle Aged ; Aged ; Follow-Up Studies ; Independent Living/statistics & numerical data* ; Exercise ; Adult ; Prevalence ; Risk Factors ; Hand Strength ; East Asian People

The occipital bone squamosa (OCS) is unique because of its double origin from both endochondral and membranous bones. The present study attempted to demonstrate the process of connection between these two bone types. We examined sagittal and frontal histological sections from 29 human fetuses with a crown-rump length ranging from 38 to 328 mm (approximately 7–39 weeks of gestational age [GA]). An initial cartilage plate appeared in the posterior side of the fourth ventricle at GA 7–8 weeks and extended inferiorly to connect with the cartilaginous basioccipital and condyle. At GA 9–10 weeks, on the superior side of the cartilage plate, membranous bone fragments appeared and adopted an arrangement resembling a chain of irregularly-shaped beads.They did not form a complete plate-like bone until late-term. At GA 11–12 weeks, endochondral ossification centers appeared at the upper and lower ends of the cartilage plate. At GA 12–15 weeks, a bar-like periosteal bone developed near and superior to the upper ossification center. Notably, sinusoidal structures, which were surrounded by growing periosteal bones, contained islandlike clusters of calcified cartilage fragments. Therefore, the upper ossification center appeared likely to “migrate” downward and become distant from membranous bones. The extending periosteal bone reached and joined the membranous bone fragments.Consequently, the periosteal bones connected between the endochondral and membranous bones in the OCS. This connection was quite different from the other components of the calvaria, where membranous bones overlap the skull base cartilages at the margin.

Objective: The prognostic value and clinical usage of peritoneal cytology in endometrial cancer are uncertain. This study aimed to determine whether positive cytology is associated with the prognosis for endometrial cancer. Methods: A Japanese nationwide retrospective registry study was conducted between 2012 and 2019. Clinicopathological data were analyzed for patients who were registered in the Japan Society of Obstetrics and Gynecology (JSOG) gynecological tumor registry and underwent initial treatment for endometrial cancer. Results: In total, 83,027 patients who met the inclusion criteria were identified. Data on peritoneal cytology status and overall survival (OS) were available for 74,984 and 36,995 patients, respectively. Positive peritoneal cytology was found in 11,536 (15.4%) patients. A higher proportion of patients who had positive peritoneal cytology were related to advanced stages, high-grade histology, deep myometrial invasion, lymph node (LN) metastasis, and poor risk of recurrence. After controlling for age, stage, myometrial invasion, LN metastasis, distant metastasis, and risk of recurrence, positive peritoneal cytology was associated with poor prognosis (p<0.001). Multivariate Cox regression analysis revealed that clinicopathological factors (i.e., age, International Federation of Gynecology and Obstetrics stage, histological type, myometrial invasion, LN metastasis, distant metastasis, and peritoneal cytology), including positive peritoneal cytology, were also significant prognostic factors for OS. Conclusion Positive peritoneal cytology was a prognostic factor for endometrial cancer for the JSOG gynecological tumor registry.

Objective: In this study, we collected data over 8 years (2012–2019) from the Japan Society of Obstetrics and Gynecology (JSOG) tumor registry to determine the status of endometrial cancer in Japan, and analyzed detailed clinicopathological factors. Methods: The JSOG maintains a tumor registry that gathers information on endometrial cancer treated at the JSOG-registered institutions. Data from the patients whose endometrial cancer treatment was initiated from 2012 to 2019 were analyzed retrospectively. Results: A total of 82,969 patients with endometrial cancer underwent treatment from 2012 to 2019. Chemotherapy alone or in combination with hormonal therapy is more common among endometrial cancer patients under 40 years compared with those over 40 years. The number of patients with endometrial cancer, treated with laparoscopic or robot-assisted surgery was observed to have increased yearly. Small cell carcinomas and undifferentiated carcinomas were more likely to be diagnosed at an advanced stage. Lymphadenectomy was most commonly performed for stage IIIC2 disease, whereas positive peritoneal washing cytology was most common for stage IVB and serous carcinoma. Conclusion Multi-year summary reports provided detailed clinicopathological information regarding endometrial cancer that could not be obtained in a single year. These reports were useful in understanding treatment strategies and trends over time based on age, histology, and stage.

To educate medical professionals to meet the needs of future medical care, which will be highly complex and require a broader perspective, it is not enough to provide education that emphasizes positivism based on natural scientific thinking, such as clinical reasoning. It is also important to provide education based on a phenomenological perspective that seeks to understand patients’ experiences in the living world and their meaning, as seen in biopsychosocial models. We have developed an online class on clinical reasoning for fourth-year medical students prior to clinical practice, in which students can simultaneously learn clinical reasoning and biopsychosocial models through structured case studies. We expect that this teaching model will be widely adopted, as it allows students to learn both positivist and phenomenological perspectives, and to view patients as individuals in their daily lives, through a multifaceted learning experience using the same case study.

Objective: In this study, we collected data over 8 years (2012–2019) from the Japan Society of Obstetrics and Gynecology (JSOG) tumor registry to determine the status of endometrial cancer in Japan, and analyzed detailed clinicopathological factors. Methods: The JSOG maintains a tumor registry that gathers information on endometrial cancer treated at the JSOG-registered institutions. Data from the patients whose endometrial cancer treatment was initiated from 2012 to 2019 were analyzed retrospectively. Results: A total of 82,969 patients with endometrial cancer underwent treatment from 2012 to 2019. Chemotherapy alone or in combination with hormonal therapy is more common among endometrial cancer patients under 40 years compared with those over 40 years. The number of patients with endometrial cancer, treated with laparoscopic or robot-assisted surgery was observed to have increased yearly. Small cell carcinomas and undifferentiated carcinomas were more likely to be diagnosed at an advanced stage. Lymphadenectomy was most commonly performed for stage IIIC2 disease, whereas positive peritoneal washing cytology was most common for stage IVB and serous carcinoma. Conclusion Multi-year summary reports provided detailed clinicopathological information regarding endometrial cancer that could not be obtained in a single year. These reports were useful in understanding treatment strategies and trends over time based on age, histology, and stage.

Objective: In this study, we collected data over 8 years (2012–2019) from the Japan Society of Obstetrics and Gynecology (JSOG) tumor registry to determine the status of endometrial cancer in Japan, and analyzed detailed clinicopathological factors. Methods: The JSOG maintains a tumor registry that gathers information on endometrial cancer treated at the JSOG-registered institutions. Data from the patients whose endometrial cancer treatment was initiated from 2012 to 2019 were analyzed retrospectively. Results: A total of 82,969 patients with endometrial cancer underwent treatment from 2012 to 2019. Chemotherapy alone or in combination with hormonal therapy is more common among endometrial cancer patients under 40 years compared with those over 40 years. The number of patients with endometrial cancer, treated with laparoscopic or robot-assisted surgery was observed to have increased yearly. Small cell carcinomas and undifferentiated carcinomas were more likely to be diagnosed at an advanced stage. Lymphadenectomy was most commonly performed for stage IIIC2 disease, whereas positive peritoneal washing cytology was most common for stage IVB and serous carcinoma. Conclusion Multi-year summary reports provided detailed clinicopathological information regarding endometrial cancer that could not be obtained in a single year. These reports were useful in understanding treatment strategies and trends over time based on age, histology, and stage.

The purpose of this study was to clarify the changes in the sense of difficulty hospital staff felt toward palliative care before and after a palliative care team of the pediatric hospital started in-hospital consultation. A self-administered questionnaire about the difficulty, consisting of 21 items in five areas, was used to conduct a survey in 2015 for the pre-consultation period, and in 2018 for the post-consultation period. Responses were obtained from 222 people in the pre-consultation period (response rate of 70.9%) and from 384 people in the post-consultation period (response rate of 87.3%). Over 70% of the respondents were nurses and midwives. A lower sense of difficulty was observed in three of the items including “relief of painful symptoms”, “family care during caregiving”, and “support when oneself and surrounding staff feeling inadequate and lost”. Further, a significant decrease was observed in the sense of difficulty in six items reported by nurses and midwives in departments receiving the interventions. Eleven of the 16 cases in which the palliative care team intervened involved multiple requests for intervention for 2 patients with pain control difficulties, suggesting that the consultation activities contributed to the decrease in the sense of difficulty experienced by nurses and midwives.