Trend in maternal-child health services

In Japan, outcome measures for maternal and child health measures such as maternal, perinatal, and infant mortality have consistently shown a trend toward improvement. On the other hand, the problems of the declining birth rate, child abuse, and domestic violence have become evident since the 1990s. In terms of Japan’s maternal and child health, it is necessary to take measures to preserve mental health of mothers and children, and also to respond to family issues such as abuse and violence. The services needed such as comprehensive support centers for families with children and new postpartum care programs have been established. It is necessary to further improve the competence of doctors, public health nurses, and midwives working in the maternal and child health field and to promptly construct a cooperation system in the community

New chemically induced skin tumour susceptibility loci identified in a mouse backcross between FVB and dominant resistant PWK

<p>Abstract</p> <p>Background</p> <p>A variety of skin cancer susceptibility among mouse strains has allowed identification of genes responsible for skin cancer development. Fifteen <it>Skts </it>loci for skin tumour susceptibility have been mapped so far by using the two-stage skin carcinogenesis model [induced by 7.12-dimethylbenz(a)anthracene (DMBA)/12-O-tetradecanoylphorbol-13-acetate (TPA)]. A few responsible genes have been identified using wild-derived dominant resistant <it>Mus spretus </it>mice, and one has been confirmed as a low penetrance cancer susceptibility gene in a variety of human cancers.</p> <p>Results</p> <p>In the present study, we found that wild-derived PWK mice developed no tumour by treatment with the two-stage skin carcinogenesis protocol. This phenotype is dominant resistant when crossed with the highly susceptible strain FVB. By analyzing the F1 backcross generation between PWK and FVB, we found empirical evidence of significant linkage at the new loci <it>Skts-fp1 </it>on chromosome 4 and suggestive linkage on chromosomes 1, 3, 11, 12 and 14 for skin tumour susceptibility. <it>Skts-fp1 </it>includes the <it>Skts7 </it>interval, which was previously mapped by a <it>Mus spretus </it>and NIH backcross. We also observed suggestive linkage on chromosomes 1 and 2 in the female population only, while suggestive linkage on chromosomes 14 and 15 only was observed in the male population. A significant genetic interaction was seen between markers of <it>D11Mit339</it> and <it>D16Mit14</it>.</p> <p>Conclusion</p> <p>Analysis of this new cross may facilitate the identification of genes responsible for mouse skin cancer susceptibility and may reveal their biological interactions.</p

トクシマ ダイガク ニオケル コウド イリョウ ノ シエン キバン セイビ

Establishment of new modality of treatment, diagnosis and prevention of various diseases is an important role of university hospital. In this article, restrictions and guidelines for clinical investigations in Japan are reviewed and supporting system for promotion of clinical trials, now being organized at Tokushima University Hospital, is introduced. The main division in the supporting system of clinical trials is the Clinical Trial Center for Developmental Therapeutics. It was first organized as the Clinical Trial Center for New Drugs and Therapeutic in 1999 under the leadership of Prof. Saburo Sone. Five nurses work as clinical research coordinator (CRC) and coordinates close communication among participants, sponsor and investigators, and plays a crucial role in the efficient progress of clinical trials. Pharmacists and officers also contribute for promotion of clinical trials in the center. The supporting field is now being expanded from the support for clinical trial for drug approval to clinical trials conducted by investigators. For example, one pharmacist supports technically the project of dendritic cell-based vaccination against various malignancies in newly-constructed room. Based on the experience, our task is to grow the center to academic research organization. We are now dealing the following issues ; 1) promotion of clinical trials conducted by investigators, 2) scientific clinical trials of food, 3) setup of network of clinical trials in Tokushima prefecture with general physicians and other institutions

Activin stimulated follicular growth

As the follicular environment transits from being activin dominant to inhibin dominant during folliculogenesis, it is assumed that activin plays an important role in the early stage of follicular growth. We examined the effects of activin on morphological, biochemical and molecular changes in isolated preantral follicles. Preantral follicles were mechanically isolated from 14-day old female C57BL/6 mice. Each follicle was cultured and observed for 14 days using an in vitro follicle culture system containing FSH, FSH + activin A and FSH + inhibin in the culture medium. We subsequently examined FSH receptor (FSH-R) mRNA expression in isolated follicle cultures with or without activin on days 0 and 2. Activin was observed to significantly stimulate follicle enlargement on days 2, 4, 6 and 8, accelerate morphological changes and increase estradiollevels in culture medium on days 4, 12 and 14. In contrast, inhibin did not alter follicular growth. Additionally, activin stimulated the expression of FSH-R mRNA in isolated granulosa cells. It was demonstrated that activin stimulated the growth of preantral follicles, mainly during the early stage of folliculogenesis, by inducing FSH-R expression, in an isolated follicle culture system

Effect of hospitalization on fetal growth

Objective : We aimed to demonstrate the effect of prolonged hospitalization on fetal growth in cases of threatened preterm labor (TPL). Methods : In this retrospective cohort study, we included women who received prenatal care for TPL but delivered their child after 36 weeks of gestation. These were compared with a control group of healthy pregnant women and fetuses delivered at term. Fetal growth was compared using biparietal diameter, abdominal circumference (AC), femur length, and estimated fetal weight (EFW) assessed using ultrasonography at 18, 26, 30, and 36 weeks of gestation. Neonatal parameters at birth were also compared. Results : In total, we enrolled 228 control women and 114 women with TPL who were treated with hospitalization, including bed rest. The AC at 30 and 36 weeks of gestation and EFW at 36 weeks of gestation were smaller in women treated with bed rest than for normal pregnant women. The mean duration of pregnancy was shorter in the hospitalization group than in the control group. Neonatal weight, length, head circumference, and chest circumference at birth were smaller after prolonged hospitalization for TPL than after normal pregnancy. Conclusion : Prolonged hospitalization for threatened preterm labor is associated with impaired fetal growth, particularly AC

"See and treat" LEEP biopsy for cervical intraepithelial neoplasia grade 2/3

Purpose of investigation: To evaluate the safety and efficacy of loop electrosurgical excision procedure (LEEP) biopsy using a "see-and-treat" strategy, and compare outcomes after "LEEP biopsy, inpatient LEEP and ablation, and inpatient conization with cervical intraepithelial neoplasia (CIN) grade 2/3. Materials and Methods: The authors performed a retrospective study including 300 women with CIN2/3 who were followed up ≥ 6 months following outpatient LEEP/inpatient LEEP and ablation/inpatient conization. Recurrence, additional treatment for recurrence, pregnancy, and term delivery following treatment were evaluated. Results: During the median follow-up duration of 22 months, recurrences were significantly more common following LEEP biopsy (39%) compared to LEEP and ablation (13%) and conization (16%) and were managed by repeat LEEP. Pregnancy and full-term delivery rates following LEEP biopsy were significantly higher. Conclusion: "See-and-treat" LEEP biopsy was safely performed in the outpatient department. Pregnancy rates and full-term deliveries following LEEP biopsy appear favorable

Papillary hidradenoma of the vulva : A case report

外陰部に発生する比較的まれなpapillary hidradenoma（乳頭状汗腺腫）の１例について報告する。症例は73歳の女性で小陰唇外側に胡桃大の皮膚腫瘤を認め，腫瘤摘出術を施行した。腫瘤内部には充実分を伴っており，組織学的には乳頭状増殖を示す腺構造で構成され，その腺腔は２層に重層した立方上皮で囲まれていた。上皮細胞の核異型は軽度であり，周囲組織への浸潤も認めず，papillary hidradenomaと診断された。しかし肉眼的所見および組織学的所見より腺癌と誤認される可能性があり，診断には注意が必要である。Papillary hidradenoma is rare, benign, cystic, papillary apocrine gland tumor that occurs almost exclusively in women in the skin of the anogenital region. We report a case of a 73-year-old woman who presented with a progressively enlarging perianal nodule. The nodule appeared as walnut-sized skin tumor on the outside of the labium minus pudendi, and local excision was performed. Macroscopically, the inside portion of the tumor appeared solid. Microscopically, this region consisted of papillary adenomatous structures whose lumina were lined by 2 layers of cuboidal epithelial cells. Nuclear atypia and mitotic figures of these epithelial cells were rare and noninvasive. However, cells with this appearance may be mistaken for adenocarcinoma by both macroscopic and histologic views, and attention is necessary for an accurate diagnosis