Objective: This study aimed to validate the surgical and oncologic outcomes of robotic surgery with sentinel node navigation surgery (SNNS) in endometrial cancer. Methods: This study included 130 patients with endometrial cancer, who underwent robotic surgery, including hysterectomy, bilateral salpingo-oophorectomy, and pelvic SNNS at the Department of Obstetrics and Gynecology of Kagoshima University Hospital. Pelvic sentinel lymph nodes (SLNs) were identified using the uterine cervix 99m Technetium-labeled phytate and indocyanine green injections. Surgery-related and survival outcomes were also evaluated. Results: The median operative and console times and volume of blood loss were 204 (range: 101–555) minutes, 152 (range: 70–453) minutes, and 20 (range: 2–620) mL, respectively. The bilateral and unilateral pelvic SLN detection rates were 90.0% (117/130) and 5.4% (7/130), respectively, and the identification rate (the rate at which at least one SLN could be identified on either side) was 95% (124/130). Lower extremity lymphedema occurred in only 1 patient (0.8%), and no pelvic lymphocele occurred. Recurrence occurred in 3 patients (2.3%), and the recurrence site was the abdominal cavity, with dissemination in 2 patients and vaginal stump in one. The 3-year recurrence-free survival and 3-year overall survival rates were 97.1% and 98.9%, respectively. Conclusion Robotic surgery with SNNS for endometrial cancer showed a high SLN identification rate, low occurrence rates of lower extremity lymphedema and pelvic lymphocele, and excellent oncologic outcomes.

Introduction: We aimed to investigate the actual situation of infection preventive behaviors among children, and to investigate changes in parent-child physical contact during the COVID-19 pandemic.Method: We conducted an anonymous questionnaire survey among parents whose children attended the Certified Public Childcare Center in Toyota City between February and March 2021. Descriptive statistics, univariate analysis (Spearman's correlation coefficient, Fisher's exact test), and multivariate analysis were performed.Result: A total of 767 parents responded to the survey. Among them, 78.6% of parents and 76.2% of children always washed their hands when they got home.92.7% of parents and 68.9% of children always wore masks when going out. Breastfeeding and face-to-face contact tended to decrease compared to other behaviors (p < 0.001), but there was most often no change in the frequency of parent-child physical contact.Conclusion: It was difficult for children to take the same infection preventive behaviors as adults. Changes in the frequency of parent-child physical contact were not observed in many parents and children.

Background/Aims: Unsedated transnasal esophagogastroduodenoscopy (EGD) is affected by a poor scope lens-cleaning function. We have previously reported good, albeit limited, effects of an oolong tea washing solution; here, we evaluated the effectiveness of a 5% lens cleaning solution for cleaning an EGD lens. Methods: Five percent lens cleaning solution (C), 5% dimethicone solution (D), and distilled water (W) were prepared. Study I: Lenses were soiled with pork grease, washed with each washing solution, and their image quality was judged. Study II: Patients (n=996) scheduled for transnasal EGD were randomly assigned to the C- or W-group. Lens cleanliness level, washing solution volume used, and endoscopist stress due to lens contamination were determined. Results: Study I: The image quality of the lenses washed with (C) was significantly superior. (D) was clinically unsuitable because of spray nozzle clogging. Study II: Lens cleaning in the C-group was significantly superior (p<0.0001) and the solution volume required was significantly reduced (p<0.0001), while endoscopist stress was also lower (p<0.0001). Conclusions For transnasal small-caliber EGD, the present 5% lens cleaning solution provided good visibility. It features a high detergency level and is simple to formulate for therapeutic endoscopy applications, such as endoscopic submucosal dissection.

Background/Aims: Unsedated transnasal esophagogastroduodenoscopy (EGD) is affected by a poor scope lens-cleaning function. We have previously reported good, albeit limited, effects of an oolong tea washing solution; here, we evaluated the effectiveness of a 5% lens cleaning solution for cleaning an EGD lens. Methods: Five percent lens cleaning solution (C), 5% dimethicone solution (D), and distilled water (W) were prepared. Study I: Lenses were soiled with pork grease, washed with each washing solution, and their image quality was judged. Study II: Patients (n=996) scheduled for transnasal EGD were randomly assigned to the C- or W-group. Lens cleanliness level, washing solution volume used, and endoscopist stress due to lens contamination were determined. Results: Study I: The image quality of the lenses washed with (C) was significantly superior. (D) was clinically unsuitable because of spray nozzle clogging. Study II: Lens cleaning in the C-group was significantly superior (p<0.0001) and the solution volume required was significantly reduced (p<0.0001), while endoscopist stress was also lower (p<0.0001). Conclusions For transnasal small-caliber EGD, the present 5% lens cleaning solution provided good visibility. It features a high detergency level and is simple to formulate for therapeutic endoscopy applications, such as endoscopic submucosal dissection.

  A Health Promoting Schools (HPS) program was conducted among primary and secondary school children in Southern Province, Sri Lanka. The HPS program included implementation of health education and workshops, as well as publication of school newsletters that communicated the material the children discussed and learned in school to their families. The study aimed to determine whether the HPS program had any effects on the health of the school children, their parents and teachers.
  A total of 22 adults (nine parents, nine school teachers, and four school principals) were invited for in-depth individual interviews and reported their views on changes after the implementation of the project. The interviewees reported that the school children substantially improved their behaviors regarding dietary habits, basic hygiene, lifestyle, and exercise. They also expressed that the school environment improved. They indicated direct and indirect changes in their own awareness and attitudes, as well as in other family members.
  After the implementation of the HPS program, improved health behaviors and subsequent improved health across two generations were observed. Beyond providing students with health knowledge, more emphasis on motivating children to spread their health knowledge in their communities will make a more effective health intervention.

Coffee administration has been shown to increase maximum voluntary contraction and muscular endurance. However, no study has addressed the association between daily consumption of coffee with muscular function. This cross sectional study aimed to investigate the association between frequency of coffee consumption (CC) in daily life and muscle strength among a population of working adult men. This cross sectional study included men (n = 516, mean age: 47.1) who participated in an annual health examination conducted in Sendai. The monthly frequency of coffee consumed was reported by a brief-type self-administered dietary history questionnaire. Leg extension power (LEP) was measured as an index of muscle strength. Subjects were divided into tertile levels according to CC. Analysis of covariance was used to examine the relation between the tertile levels of CC and LEP. After adjustment for potential confounders (including all lifestyle factors), the adjusted means (95% confidence interval) of LEP across the tertiles of CC were 17.4 (16.6 - 18.1) for the lowest tertile, 17.9 (17.4 - 18.5) for the mid tertile, and 18.9 (18.3 - 19.5) for the highest tertile (p for trend = 0.007). Higher frequency of monthly coffee consumption was associated with higher muscle strength.

Background: Peripheral circulation is often disturbed in patients with connective tissue diseases (CTDs) and its objective evaluation is an important issue. Infrared thermography has been used for the purpose for decades [1]. Raynaud phenomenon (RP) is prevalent in and considerably characteristic of CTDs and we have long noticed colour unevenness among fingers in patients during RP attacks. We hypothesized that temperature unevenness among fingers detected by thermography would be a useful parameter to evaluate peripheral circulation. Objectives: To evaluate temperature unevenness among fingers as a thermographic parameter by comparing it with other parameters validated in previous studies. Methods: Patients who visited our hospital and had been diagnosed as having RP by their attending physicians and underwent thermographic examinations were included and compared with healthy volunteers. Skin temperatures of dorsum of hands at 10 fingers’ nail folds and MCP joints were measured at baseline. Then hands were immersed in 10°C water for 10 seconds. Skin temperatures were measured at 0, 3, 5, 10, 15, 20, and 30 min after immersion. Mean temperature, recovery rate (temperature recovery from immersion/decrease by immersion), and coefficient of variation (standard deviation/mean temperature) of nail fold temperature were calculated. Higher coefficient of variation means temperature among fingers is more uneven. Distal-dorsal difference (DDD: measured by subtracting mean temperature of MCP from that of nail fold) was also calculated and these parameters were compared between the two groups. Receiver operating characteristic (ROC) curve was generated to compare these parameters in terms of their capability of differentiating patients with RP from HCs. Results: Thirty-one patients with RP (10 with primary Raynaud, 11 with systemic sclerosis (SSc), 11 with other CTDs) were included and compared with 25 healthy controls (HCs). Baseline nail fold temperature was significantly lower in patients of RP than in HC (30.8±3.1 °C vs. 33.2±1.8 °C, p=0.0002). Cold-water immersion of hands revealed patients with RP had lower recovery rate, lower DDD, and higher coefficient of variation than did HCs. The differences in these parameters were the most evident at 5 min after immersion (patients with RP vs HCs: recovery rate; 49.6±27.7 vs 71.5±26.8, p=0.004 DDD; -1.4±2.8 vs 0.85±2.7, p=0.0008 coefficient of variation; 0.053±0.024 vs 0.021±0.015, p=1.2x10-6). On the basis of ROC curve analyses for these parameters, coefficient of variation of nail fold temperature most effectively differentiated patients with RP from HCs (Area under the curve; recovery rate: 0.64 DDD: 0.79 coefficient of variation: 0.88). Conclusions: Unevenness of temperature among fingers was the most useful thermographic parameter to evaluate disturbed peripheral circulation.

[Purpose] To investigate the relation between isotonic leg extension strength (ILES) and the prevalence of metabolic syndrome (MS) in Japanese male adults.[Methods] This cross-sectional study included 395 Japanese men. Metabolic syndrome was determined according to the criteria of International Diabetes Federation (IDF), Japan Society for the Study of Obesity (JASSO), or National Cholesterol Education Program's Adults Treatment Panel III (NCEP-ATPIII). Muscular strength was measured on a horizontal dynamometer. Subjects were divided into tertile levels according to ILES (watts/kg). Multiple logistic regression analysis was used to examine the relation between ILES levels and the prevalence of MS.[Results] The prevalence of MS were 14.4% (IDF), 17.0%(JASSO), and 20.0% (NCEP-ATPIII). After adjustment for confounding factors, the odd's ratios (95% confidence interval) of MS (IDF) compared with the lowest ILES level were 0.90 (0.48-1.68) and 0.31 (0.13-0.64) in the middle and high levels of ILES (p for trend=0.03). The association between the level of ILES and the prevalence of MS by JASSO and NCEP-ATPIIIcriteria were similar.[Conclusion] The prevalence of MS was associated with the level of ILES.

Background/Objectives: Since April 2006, smoking cessation treatment has been included in public health insurance coverage, although conditionally. The tobacco control program usually takes 12 weeks or so. When it comes to the form of treatment, most medical care facilities adopt nicotine replacement therapy (NRT) at their outpatient ward. The cessation success rates are considered not so high as before. In stead of treating nicotine-addict outpatients individually, our hospital has been offering a stop-smoking program all its own since 1999. This study was designed to examine the results of our efforts in the last six years retrospectively.Subjects/Methods: Enrolled for this study were 232 patients who had participated in our six-month smoking cessation program between 1999 and 2005. A non-smokingsupport team made up of a physician, pharmacist(s), nurses, dietitian(s) and physical therapist(s) takes care of groups of participating patients, each group consisting of 10 or less. The patients undergo behavior therapy throughout the 6-month period and NRT in the first eight weeks. Under the program, nutrition guidance is offered regularly by dietitians for weight control and physical exercises by physical therapists for relief from the stress due to abstinence from smoking. We took a questionnaire survey of all the subjects and worked out the ratios of those persons who had remained abstinent up to one year after they stopped smoking to the total.Results: The rates of abstinence maintained eight weeks, six months and one year after the start of cessation were 78.4%, 70.3% and 64.7%, respectively. Of those who were still abstinent, 78.0% replied that they found it easy to resist the urge to smoke cigarette thanks to the smoking cessation program.Conclusion: Our six-month participatory tobacco control program was found effective as high cessation rates were maintained.
Cessation of smoking ; seconds ; month ; week ; Smoking