Sleep disturbances are common among women during menopause. Hormone replacement therapy (HRT) using micronized progesterone (MP) may improve sleep, owing to its neurosteroid effects. Studies on the impact of oral MP on sleep quality in Japanese women are limited, given the recent introduction of MP in Japan. We conducted a single-arm, open-label study to examine the effects of HRT with estradiol (E2) and oral MP on sleep quality in 15 peri- and postmenopausal Japanese women who chose HRT to address their menopausal symptoms. The participants completed the Pittsburgh Sleep Quality Index (PSQI) and menopausal symptoms questionnaires at baseline, 1 month, and 3 months after HRT. The changes in PSQI scores were evaluated. Responders were defined as those with a ≥ 25% reduction in the PSQI global score at 1 month. The PSQI components and menopausal symptoms at baseline were compared between responders and non-responders. Initially, 86.7% of the participants were categorized as poor sleepers. The PSQI global score and sleep quality significantly improved at 1 and 3 months after HRT (baseline to 3rd month mean scores: from 7.8 to 6.1 to 6.5 and from 1.7 to 1.0 to 1.2, respectively). Responders (n = 5) exhibited poorer habitual sleep efficiency before treatment than the non-responders.However, menopausal symptoms did not differ significantly between the groups at baseline. The results indicate that HRT with E2 and MP is a promising treatment option for peri- and postmenopausal Japanese women experiencing sleep disturbances, especially those with poor sleep efficiency.

Sleep disturbances are common among women during menopause. Hormone replacement therapy (HRT) using micronized progesterone (MP) may improve sleep, owing to its neurosteroid effects. Studies on the impact of oral MP on sleep quality in Japanese women are limited, given the recent introduction of MP in Japan. We conducted a single-arm, open-label study to examine the effects of HRT with estradiol (E2) and oral MP on sleep quality in 15 peri- and postmenopausal Japanese women who chose HRT to address their menopausal symptoms. The participants completed the Pittsburgh Sleep Quality Index (PSQI) and menopausal symptoms questionnaires at baseline, 1 month, and 3 months after HRT. The changes in PSQI scores were evaluated. Responders were defined as those with a ≥ 25% reduction in the PSQI global score at 1 month. The PSQI components and menopausal symptoms at baseline were compared between responders and non-responders. Initially, 86.7% of the participants were categorized as poor sleepers. The PSQI global score and sleep quality significantly improved at 1 and 3 months after HRT (baseline to 3rd month mean scores: from 7.8 to 6.1 to 6.5 and from 1.7 to 1.0 to 1.2, respectively). Responders (n = 5) exhibited poorer habitual sleep efficiency before treatment than the non-responders.However, menopausal symptoms did not differ significantly between the groups at baseline. The results indicate that HRT with E2 and MP is a promising treatment option for peri- and postmenopausal Japanese women experiencing sleep disturbances, especially those with poor sleep efficiency.

Sleep disturbances are common among women during menopause. Hormone replacement therapy (HRT) using micronized progesterone (MP) may improve sleep, owing to its neurosteroid effects. Studies on the impact of oral MP on sleep quality in Japanese women are limited, given the recent introduction of MP in Japan. We conducted a single-arm, open-label study to examine the effects of HRT with estradiol (E2) and oral MP on sleep quality in 15 peri- and postmenopausal Japanese women who chose HRT to address their menopausal symptoms. The participants completed the Pittsburgh Sleep Quality Index (PSQI) and menopausal symptoms questionnaires at baseline, 1 month, and 3 months after HRT. The changes in PSQI scores were evaluated. Responders were defined as those with a ≥ 25% reduction in the PSQI global score at 1 month. The PSQI components and menopausal symptoms at baseline were compared between responders and non-responders. Initially, 86.7% of the participants were categorized as poor sleepers. The PSQI global score and sleep quality significantly improved at 1 and 3 months after HRT (baseline to 3rd month mean scores: from 7.8 to 6.1 to 6.5 and from 1.7 to 1.0 to 1.2, respectively). Responders (n = 5) exhibited poorer habitual sleep efficiency before treatment than the non-responders.However, menopausal symptoms did not differ significantly between the groups at baseline. The results indicate that HRT with E2 and MP is a promising treatment option for peri- and postmenopausal Japanese women experiencing sleep disturbances, especially those with poor sleep efficiency.

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.

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 2013, a cohort study aimed to clarify the positive and negative effects of introducing the human papillomavirus (HPV) testing for population-based cervical cancer screening has been launched in Japan. This study included four screenings during the subsequent 7-year follow-up period. We aim to describe the results of the first round of this study on cervical cancer screening here. Methods: This study began in September 2013 with recruitment completed in March 2016.Women aged 30–49 years were divided into 2 groups: those who received uterine cervical cytology alone in the first year (control group), or those who received a combination of cytology and HPV testing (intervention group), based on their age. After first screening, women with positive result of cytology or positive HPV test required referral. We summarized the results of the first round of cervical cancer screening. Results: Of the 25,074 women who were eligible for the study, 13,845 women (55.2%) were screened with cytology alone; 11,229 women (44.8%) received a combination of cytology and HPV testing. After screening, 407 women (2.9%) in the control group and 1,003 women (8.9%) in the intervention group required referral, respectively. Adding HPV testing increased referral rate significantly (p<0.001). Conclusion After first screening, introduction of HPV testing appears to contribute to significantly higher referral rates, suggesting that the number of colposcopies as a detailed examination may increase. These preliminary findings suggest that if HPV testing is introduced into screening, medical institutions need to be prepared for an increasing number of follow-up examinations.

OBJECTIVE: To investigate the basic characteristics of degradable gelatin microspheres (GMSs), including their embolic behavior and degradation periods when they are used as embolic materials in the renal arteries of rabbit models. MATERIALS AND METHODS: Based on the GMS particle size, 24 kidneys were divided into 3 groups of eight kidneys, and each group was embolized with a different GMS particle size (group 1: 35-100 micrometer, group 2: 100-200 micrometer, and group 3: 200-300 micrometer). From each group, two rabbits were sacrificed immediately after embolization (day 0), and a pair of rabbits from each group underwent an angiogram and were sacrificed on days 3, 7, and 14, respectively, after embolization. The level of arterial occlusion, the pathological changes in the renal parenchyma, and the degradation of the GMSs were evaluated angiographically and histologically. RESULTS: A follow-up angiogram on days 0, 3, 7, and 14 revealed the presence of wedge-shaped poorly-enhanced areas in the parenchymal phase as seen in all groups. The size of these areas tended to increase with the particle diameter, and persisted up to day 14. On days 3, 7, and 14, parenchymal infarctions were observed histologically in all cases, and this observation corresponded with the parenchyma being supplied by the embolized arteries. GMSs of group 1 mainly reached the interlobular arteries, while those of group 3 mainly reached the interlobar arteries. In all but two cases, the GMSs were identified histologically even on day 14, and sequential degradation was histologically identified in all GMS groups. CONCLUSION: GMSs can be used as degradable embolic materials which can control the level of embolization.
Animals ; Biocompatible Materials ; Disease Models, Animal ; Embolization, Therapeutic/*methods ; Female ; Follow-Up Studies ; *Gelatin ; Kidney/blood supply ; *Microspheres ; Particle Size ; Rabbits ; Renal Artery/drug effects/pathology/radiography ; Renal Artery Obstruction/*chemically induced ; Severity of Illness Index ; Time Factors

We have determined the plasma 8-hydroxy-deoxyguanosine (8-OHdG) levels during endurance exercise. Eight untrained male subjects completed a 10-km run. Plasma 8-OHdG, total coenzyme Q10 (CoQ10), ubiquinol, and thiobarbituric acid (TBA) concentrations were measured after exercise. Plasma 8-OHdG concentrations significantly decreased immediately after (0.21±0.13 ng/ml, p<0.01) and 1 hr after (0.23±0.09 ng/ml, p<0.05) the run compared to the resting values (0.36±0.09 ng/ml). Both plasma CoQ10 and ubiquinol concentrations significantly increased (p<0.05) immediately after the run compared to the resting values. On the other hand, plasma TBA concentrations did not change significantly at any point after the run. These results suggest that, during and after submaximal endurance exercise in this study, an augmented antioxidant defence system such as CoQ10 might thus play a role in the decrease of 8-OHdG in the plasma, and that exercise might stimulate the repair of oxidative damage to DNA.

Clinical training programs play an extremely important role in the new postgraduate clinical training system introduced in 2004 because facilities for clinical training now include various health-related institutions in addition to the university hospitals and special hospitals for clinical training used in the previous system. Although educational goals have been established by the Ministry of Health, Labour and Welfare, trainees may have difficulty achieving these goals, even under the guidance of staff at the various facilities. There are differences in the function and quality of health-related institutions in the community. For the practical and convenient application of educational goals, we have attempted develop a “model program” to supplement the objectives indicated by the learning goals with more specific objectives. These supplementary objectives can be modified by individual institutions. We hope that this “model program” contributes to the development of objectives for each institution and helps improve the quality of the postgraduate training system in Japan.