Objective: In Japan, there are unique facilities (namely Ningen Dock) of health check-up, where asymptomatic participants undergo a medical examination at their own expense. The earlier occurrence of cervical cancer a...Objective: In Japan, there are unique facilities (namely Ningen Dock) of health check-up, where asymptomatic participants undergo a medical examination at their own expense. The earlier occurrence of cervical cancer and the concern on screening prompted us compare to the age distribution in the self-covered system with that of free physical check-up programs at public expense. Methods: We analyzed medical records of Japanese women, who underwent gynecological examinations at self-covered expense and at public expense between for the periods 2002-2011 and 2005-2009, respectively, restricting examinee’s age group. Results: For self-covered system, approximately 80% of the overall examinee population was occupied with three age groups 30-39, 40-49 and 50-59. The participants was extremely fewer in the over 60 years age group accounting for 10%, compared to those for the public expense-covered system, the over 60 years age group being 25%. Participant under the age of 30 years seemed to increase in chronological order in both systems. Conclusion: The level of knowledge on sexually transmitted infections may contribute to screening promotion for the younger women, while the elderly over 60 years’ attitudes toward screening may be mainly related to social-economic status and/or public expense support.展开更多
Though nausea and vomiting are quite common in pregnancy, hyperemesis is found in only 1 - 2 patients per 100. Appropriate oral fluid and electrolyte replacement is the initial treatment regimen for patients with mild...Though nausea and vomiting are quite common in pregnancy, hyperemesis is found in only 1 - 2 patients per 100. Appropriate oral fluid and electrolyte replacement is the initial treatment regimen for patients with mild to moderate emesis to avoid hyperemesis gravidarum defined as dehydration, electrolyte unbalance and ketosis. A newer oral rehydration solution OS-1 therapy may be safe and feasible in the mild to moderate emesis gravidarum population. Physicians are encouraged to use this practice to maintain the amount of water in the body and electrolytes and to improve the patient’s comfort.展开更多
The present study aims to determine the gynecologic health status of asymptomatic women at a unique Japanese Health Check-up Institute, Ningen Dock. Medical records of Japanese women, who underwent gynecological medic...The present study aims to determine the gynecologic health status of asymptomatic women at a unique Japanese Health Check-up Institute, Ningen Dock. Medical records of Japanese women, who underwent gynecological medical (health) examinations between January 2011 and December 2016, were retrospectively reviewed. Of the cervical smears from 8927 women aged 18 - 85 years, 50 (0.6%) were classified as dysplastic and malignant changes: 18 of low-grade squamous intraepithelial lesion, 10 high-grade squamous intraepithelial lesion, 21 atypical squamous cells of undetermined significance and 1 cervical squamous cell carcinoma. No case of cervical adenocarcinoma was found. Ultrasonographic examination detected uterus enlargements and ovary tumors in 2.0% and 0.9% of cases, respectively. Most of participants (95.6%) revealed no gynecologic abnormalities. The present study based on the records of Ningen Dock, where asymptomatic participants undergo a medical examination at their own expense, showed very low incidence of abnormal cytologic and/or ultrasonographic findings.展开更多
Purpose: Hormone therapy (estrogen with or without progestin) remains the gold standard treatment for hot flashes in menopausal women, but concerns for the risk of hormone therapy have resulted in its decline and a de...Purpose: Hormone therapy (estrogen with or without progestin) remains the gold standard treatment for hot flashes in menopausal women, but concerns for the risk of hormone therapy have resulted in its decline and a demand for nonhormonal treatments with demonstrated efficacy for hot flashes. Aim of this study was to examine the efficacy of selective serotonin reuptake inhibitor escitalopram on hot flashes in a healthy sample of non-depressant menopausal women in Japan. Methods: We retrospectively analyzed the medical records of 11 menopausal patients with hot flashes, who received escitalopram (10 mg daily) for 2 weeks between March and August 2012. Hot flashes severities and scores were recorded on a scale of 0 to 10 points, at beginning and end of 2 weeks treatment. Results: At 2 weeks of therapy, 9 of 11 patients reported significant decreases in hot flash frequency and severity, but the remission of the symptom was not observed in 2 patients. Speed of relief from hot flashes was rapid (within one week). Conclusions: Escitalopram 10 mg/day may be a prompt and effective option for treating hot flashes in menopausal women who do not want to use hormone replacement therapy.展开更多
The consumption of soft drinks has increased considerably during the last decades. Among them, the cola-based preparations are possibly the refreshments with the largest sales worldwide. During the previous years, imp...The consumption of soft drinks has increased considerably during the last decades. Among them, the cola-based preparations are possibly the refreshments with the largest sales worldwide. During the previous years, important concerns have been raised about the effects of colas on human health. In this review, we introduce the cola effects on reproduction including pregnancy miscarriages, ovulatory and menstrual disorders, and reduced semen quality. Although caffeine intoxication may be thought to play the most important role, a component of cola other than caffeine, or in combination with caffeine, may be associated with increased risk of reproductive hazards in heavy cola (> 1 L per day)-consumers. Cola discontinuation usually leads to an uneventful recovery in the most cases suggesting justification of limitations in the maximum recommended daily dose of these soft drinks. Cola is not an essential beverage, and abstaining from drinking more than 1 L per day is a minor intrusion in one’s personal life. Despite these uncertainties, this growing know- ledge may alarm the fertility risk of chronic cola intake in peoples of childbearing age.展开更多
Granulocyte-colony stimulating factor (G-CSF)-producing cancer has been reported to occur in various organs. It has an aggressive nature and shows resistance to conventional treatments, however, its clinical features ...Granulocyte-colony stimulating factor (G-CSF)-producing cancer has been reported to occur in various organs. It has an aggressive nature and shows resistance to conventional treatments, however, its clinical features are not well known because of the small number or reported cases. We report G-CSF-producing squamous cell carcinoma arising in malignant-transformed ovarian mature cystic teratoma. An 80-year-old woman underwent suboptimal surgical excision of stage IIIC ovarian cancer. Prior to the treatment, the patient presented severe granulocytosis and elevated serum G-CSF concentration. With the help of histopathological and immunohistochemical studies, we diagnosed this case to be a poorly differentiated squamous cell carcinoma developed in ovarian mature cystic teratoma, which highly expressed G-CSF. During radiation therapy, the patient died from rapid growth of residual tumor and peritoneal dissemination 2 months after surgery. This is the first case of G-CSF-producing squamous cell carcinoma arising in malignant-transformed ovarian mature cystic teratoma, and its prognosis was very poor.展开更多
Introduction: In Japan, there is free physical check-up programs of cancer screening, by which asymptomatic participants undergo a medical examination at public expense. The present study aims to describe their gyneco...Introduction: In Japan, there is free physical check-up programs of cancer screening, by which asymptomatic participants undergo a medical examination at public expense. The present study aims to describe their gynecologic findings and compare them with the literatures reported from general hospitals and self-paid check-up programs. Methods: Medical records of Japanese women, who underwent gynecological examinations at public expense between 2005 and 2009, were retrospectively reviewed. Results: Of the cervical smears from 2850 women aged 21 - 82 years, 33 (1.1%) were classified as dysplastic and malignant changes: 28 of low-grade squamous intraepithelial lesion (LSIL), 3 high-grade squamous intraepithelial lesion (HSIL), 2 atypical squamous cells of undeterimined significance (ASC-US). No case of cervical squamous cell carcinoma or adenocarcinoma was found. Ultrasonographic examination detected uterus enlargements and ovary tumors in less than 1% of cases. Most of participants (98%) revealed no gynecologic abnormalities. Conclusion: Annual gynecologic screening and proper follow-up programs even against asymptomatic women may remarkably reduce the probability of (pre)malignant disease.展开更多
Platinum and taxane have significant activity as key drugs in current treatment of advanced ovarian cancer. While myelodysplastic syndrome (MDS) and acute leukemia are wellknown secondary disease after administration ...Platinum and taxane have significant activity as key drugs in current treatment of advanced ovarian cancer. While myelodysplastic syndrome (MDS) and acute leukemia are wellknown secondary disease after administration of chemotherapy, particularly with alkylating agents, they have only rarely been reported in the context of ovarian cancer treatment. In this case report a 59-year-old Japanese developed a MSD during ongoing second induction chemotherapy with carboplatin and paclitaxel for recurrent ovarian cancer. Her second induction began 9 months after completion of her first course of chemotherapy. Cytogenetic analyses showed typical chromosomal aberration. Although the finding of pancytopenia is also seen during chemotherapy without MSD/acute leukemia, bone marrow aspiration and biopsy should be considered to confirm the clinical suspicion of the lifethreatening disease when encountered persistent pancytopenia following carboplatin and paclitaxel-based chemotherapy in an ovarian cancer patient.展开更多
Although ectopic hormone-production is uncommon complication, certain tumors can produce symptoms due to the secretion of various bioactive substances accompanied by the aberrantly located tumors. Because of the poten...Although ectopic hormone-production is uncommon complication, certain tumors can produce symptoms due to the secretion of various bioactive substances accompanied by the aberrantly located tumors. Because of the potential for the ovary to act as a source of aberrant hormone secretion, in the literature, ectopic hormone production from ovarian tumor includes granulocyte-colony stimulating factor (G-CSF), parathyroid hormone-related protein (PTHrP), adrenocorticotropic hormone (ACTH), peptide-YY, gastrin and insulin. All patients may present with syndromes of hormone excess. Failure to localize the ovarian tumor preoperatively may be associated with a significantly higher risk of subsequent unnecessary ablative procedures. Better characterization of hormonal forms relatively specific for neoplasia may enhance the clinical value of ectopic hormones as tumor markers, especially in malignancies that are commonly associated with ectopic hormone production. These circumstances may recommend complete preoperative evaluation of the pelvis in female patients presenting with nonlocalizable endocrine tumors.展开更多
Background: Posterior reversible encephalopathy syndrome (PRES) is a reversible syndrome characterized by seizures, headache, altered mentation, and loss of vision associated with white matter changes on imaging. Case...Background: Posterior reversible encephalopathy syndrome (PRES) is a reversible syndrome characterized by seizures, headache, altered mentation, and loss of vision associated with white matter changes on imaging. Case: A 37-year-old multigravida woman had a severe, immediate postpartum eclampsia-HELLP syndrome (hemolysis, elevated liver enzyme levels, low platelet count) with PRES characterized by generalized seizures and altered mental status. Magnetic resonance brain imaging showed high-intensity lesions in non-posterior portions including the frontal lobe and cingulated gyrus, which resolved completely after 2 weeks along with complete symptom regression. Conclusions: Cases of postpartum PRES without involvement of posterior brain regions after eclampsia-HELLP syndrome are very rare. Patients with PRES do not always show typical manifestations. The importance of a prompt diagnosis is emphasized, as is the crucial role of rapid blood pressure reduction.展开更多
文摘Objective: In Japan, there are unique facilities (namely Ningen Dock) of health check-up, where asymptomatic participants undergo a medical examination at their own expense. The earlier occurrence of cervical cancer and the concern on screening prompted us compare to the age distribution in the self-covered system with that of free physical check-up programs at public expense. Methods: We analyzed medical records of Japanese women, who underwent gynecological examinations at self-covered expense and at public expense between for the periods 2002-2011 and 2005-2009, respectively, restricting examinee’s age group. Results: For self-covered system, approximately 80% of the overall examinee population was occupied with three age groups 30-39, 40-49 and 50-59. The participants was extremely fewer in the over 60 years age group accounting for 10%, compared to those for the public expense-covered system, the over 60 years age group being 25%. Participant under the age of 30 years seemed to increase in chronological order in both systems. Conclusion: The level of knowledge on sexually transmitted infections may contribute to screening promotion for the younger women, while the elderly over 60 years’ attitudes toward screening may be mainly related to social-economic status and/or public expense support.
文摘Though nausea and vomiting are quite common in pregnancy, hyperemesis is found in only 1 - 2 patients per 100. Appropriate oral fluid and electrolyte replacement is the initial treatment regimen for patients with mild to moderate emesis to avoid hyperemesis gravidarum defined as dehydration, electrolyte unbalance and ketosis. A newer oral rehydration solution OS-1 therapy may be safe and feasible in the mild to moderate emesis gravidarum population. Physicians are encouraged to use this practice to maintain the amount of water in the body and electrolytes and to improve the patient’s comfort.
文摘The present study aims to determine the gynecologic health status of asymptomatic women at a unique Japanese Health Check-up Institute, Ningen Dock. Medical records of Japanese women, who underwent gynecological medical (health) examinations between January 2011 and December 2016, were retrospectively reviewed. Of the cervical smears from 8927 women aged 18 - 85 years, 50 (0.6%) were classified as dysplastic and malignant changes: 18 of low-grade squamous intraepithelial lesion, 10 high-grade squamous intraepithelial lesion, 21 atypical squamous cells of undetermined significance and 1 cervical squamous cell carcinoma. No case of cervical adenocarcinoma was found. Ultrasonographic examination detected uterus enlargements and ovary tumors in 2.0% and 0.9% of cases, respectively. Most of participants (95.6%) revealed no gynecologic abnormalities. The present study based on the records of Ningen Dock, where asymptomatic participants undergo a medical examination at their own expense, showed very low incidence of abnormal cytologic and/or ultrasonographic findings.
文摘Purpose: Hormone therapy (estrogen with or without progestin) remains the gold standard treatment for hot flashes in menopausal women, but concerns for the risk of hormone therapy have resulted in its decline and a demand for nonhormonal treatments with demonstrated efficacy for hot flashes. Aim of this study was to examine the efficacy of selective serotonin reuptake inhibitor escitalopram on hot flashes in a healthy sample of non-depressant menopausal women in Japan. Methods: We retrospectively analyzed the medical records of 11 menopausal patients with hot flashes, who received escitalopram (10 mg daily) for 2 weeks between March and August 2012. Hot flashes severities and scores were recorded on a scale of 0 to 10 points, at beginning and end of 2 weeks treatment. Results: At 2 weeks of therapy, 9 of 11 patients reported significant decreases in hot flash frequency and severity, but the remission of the symptom was not observed in 2 patients. Speed of relief from hot flashes was rapid (within one week). Conclusions: Escitalopram 10 mg/day may be a prompt and effective option for treating hot flashes in menopausal women who do not want to use hormone replacement therapy.
文摘The consumption of soft drinks has increased considerably during the last decades. Among them, the cola-based preparations are possibly the refreshments with the largest sales worldwide. During the previous years, important concerns have been raised about the effects of colas on human health. In this review, we introduce the cola effects on reproduction including pregnancy miscarriages, ovulatory and menstrual disorders, and reduced semen quality. Although caffeine intoxication may be thought to play the most important role, a component of cola other than caffeine, or in combination with caffeine, may be associated with increased risk of reproductive hazards in heavy cola (> 1 L per day)-consumers. Cola discontinuation usually leads to an uneventful recovery in the most cases suggesting justification of limitations in the maximum recommended daily dose of these soft drinks. Cola is not an essential beverage, and abstaining from drinking more than 1 L per day is a minor intrusion in one’s personal life. Despite these uncertainties, this growing know- ledge may alarm the fertility risk of chronic cola intake in peoples of childbearing age.
文摘Granulocyte-colony stimulating factor (G-CSF)-producing cancer has been reported to occur in various organs. It has an aggressive nature and shows resistance to conventional treatments, however, its clinical features are not well known because of the small number or reported cases. We report G-CSF-producing squamous cell carcinoma arising in malignant-transformed ovarian mature cystic teratoma. An 80-year-old woman underwent suboptimal surgical excision of stage IIIC ovarian cancer. Prior to the treatment, the patient presented severe granulocytosis and elevated serum G-CSF concentration. With the help of histopathological and immunohistochemical studies, we diagnosed this case to be a poorly differentiated squamous cell carcinoma developed in ovarian mature cystic teratoma, which highly expressed G-CSF. During radiation therapy, the patient died from rapid growth of residual tumor and peritoneal dissemination 2 months after surgery. This is the first case of G-CSF-producing squamous cell carcinoma arising in malignant-transformed ovarian mature cystic teratoma, and its prognosis was very poor.
文摘Introduction: In Japan, there is free physical check-up programs of cancer screening, by which asymptomatic participants undergo a medical examination at public expense. The present study aims to describe their gynecologic findings and compare them with the literatures reported from general hospitals and self-paid check-up programs. Methods: Medical records of Japanese women, who underwent gynecological examinations at public expense between 2005 and 2009, were retrospectively reviewed. Results: Of the cervical smears from 2850 women aged 21 - 82 years, 33 (1.1%) were classified as dysplastic and malignant changes: 28 of low-grade squamous intraepithelial lesion (LSIL), 3 high-grade squamous intraepithelial lesion (HSIL), 2 atypical squamous cells of undeterimined significance (ASC-US). No case of cervical squamous cell carcinoma or adenocarcinoma was found. Ultrasonographic examination detected uterus enlargements and ovary tumors in less than 1% of cases. Most of participants (98%) revealed no gynecologic abnormalities. Conclusion: Annual gynecologic screening and proper follow-up programs even against asymptomatic women may remarkably reduce the probability of (pre)malignant disease.
文摘Platinum and taxane have significant activity as key drugs in current treatment of advanced ovarian cancer. While myelodysplastic syndrome (MDS) and acute leukemia are wellknown secondary disease after administration of chemotherapy, particularly with alkylating agents, they have only rarely been reported in the context of ovarian cancer treatment. In this case report a 59-year-old Japanese developed a MSD during ongoing second induction chemotherapy with carboplatin and paclitaxel for recurrent ovarian cancer. Her second induction began 9 months after completion of her first course of chemotherapy. Cytogenetic analyses showed typical chromosomal aberration. Although the finding of pancytopenia is also seen during chemotherapy without MSD/acute leukemia, bone marrow aspiration and biopsy should be considered to confirm the clinical suspicion of the lifethreatening disease when encountered persistent pancytopenia following carboplatin and paclitaxel-based chemotherapy in an ovarian cancer patient.
文摘Although ectopic hormone-production is uncommon complication, certain tumors can produce symptoms due to the secretion of various bioactive substances accompanied by the aberrantly located tumors. Because of the potential for the ovary to act as a source of aberrant hormone secretion, in the literature, ectopic hormone production from ovarian tumor includes granulocyte-colony stimulating factor (G-CSF), parathyroid hormone-related protein (PTHrP), adrenocorticotropic hormone (ACTH), peptide-YY, gastrin and insulin. All patients may present with syndromes of hormone excess. Failure to localize the ovarian tumor preoperatively may be associated with a significantly higher risk of subsequent unnecessary ablative procedures. Better characterization of hormonal forms relatively specific for neoplasia may enhance the clinical value of ectopic hormones as tumor markers, especially in malignancies that are commonly associated with ectopic hormone production. These circumstances may recommend complete preoperative evaluation of the pelvis in female patients presenting with nonlocalizable endocrine tumors.
文摘Background: Posterior reversible encephalopathy syndrome (PRES) is a reversible syndrome characterized by seizures, headache, altered mentation, and loss of vision associated with white matter changes on imaging. Case: A 37-year-old multigravida woman had a severe, immediate postpartum eclampsia-HELLP syndrome (hemolysis, elevated liver enzyme levels, low platelet count) with PRES characterized by generalized seizures and altered mental status. Magnetic resonance brain imaging showed high-intensity lesions in non-posterior portions including the frontal lobe and cingulated gyrus, which resolved completely after 2 weeks along with complete symptom regression. Conclusions: Cases of postpartum PRES without involvement of posterior brain regions after eclampsia-HELLP syndrome are very rare. Patients with PRES do not always show typical manifestations. The importance of a prompt diagnosis is emphasized, as is the crucial role of rapid blood pressure reduction.
