Reliability and Validity of the Self-report Quality of Life Questionnaire for Japanese School-aged Children with Asthma (JSCA-QOL v.3)

ABSTRACTBackgroundAsthma is a chronic disease prevalent in children which threatens their quality of life (QOL) through unexpected asthma attacks and/or the burden of daily self-management. As some conditions of chronic illness make it difficult for a child to accomplish normal developmental tasks, there may be fewer opportunities for the child to obtain a sense of achievement. This study investigated the reliability and validity of the Quality of Life Questionnaire for Japanese School-aged Children with Asthma Version 3 (JSCA-QOL v.3). This questionnaire includes 25 items with a 5-point Likert Scale format over five domains:"asthma attack triggers", "change in daily life", "family support", "satisfaction with daily life" and "restriction in participating in daily activities", and one summary scale.MethodsIn the present study, 2,425 children with asthma aged from 10 to 18 years were investigated in Japan. The internal consistency reliability of each domain was investigated with Cronbach's α reliability coefficient, and test-retest reliability with Spearman's correlations coefficient. Factorial validity by factor analysis using maximum-likelihood extraction with promax rotation was performed. Data analysis was performed using SPSS 12.0J.ResultsThe final number of effective replies was 2,097 (the rate of effective data was 86.5%). "Asthma attack triggers", "change in daily life", "family support", "satisfaction with daily life" and "restriction in participating in daily activities" showed a high internal consistency (Cronbach's α = 0.66–0.86) as well as good test-retest reliability (Spearman's rho = 0.60, p < 0.01).The factorial validity was appropriate (KMO value = 0.90), because it was conceivable that the five factors extracted from factor analysis would be the same as in our hypothesis and support constructive validity. In addition, there was good correlation between the summary scale and the total QOL score (Spearman's rho = 0.58, p <0.01).ConclusionsThe present study showed that the JSCA-QOL v.3 is a reliable and valid measurement tool that can be used to appropriately assess QOL in school-aged children with asthma. As the JSCA-QOL v.3 can be easily completed in about 10 minutes, it can contribute as an efficient evaluation tool of the outcome of medical treatment through continual utilization in the outpatient clinic. The JSCA-QOL v.3 allows a health provider to help school-aged children with asthma to achieve their developmental tasks

インターフェロンαが著効した腎癌骨格筋・小腸転移の1例

Skeletal muscle and small intestine are rare sites of metastasis in renal cell carcinoma. Therefore very few reports of interferon-alpha (IFN-alpha) therapy exist for these types of metastasis. Here, a case of metastatic renal cell carcinoma to muscle and jejunum is reported. After IFN-alpha therapy for 9 weeks, muscle metastasis completely disappeared and intestinal lesions were markedly reduced. However, subsequent patient compliance for this therapy was poor, resulting in death after relapse of the RCC.腎癌では骨格筋転移や小腸転移は稀であり, これらの転移に対するインターフェロンαによる療法の報告は非常に少ない。われわれは腎癌骨格筋・空腸転移の1例を経験した。9週間のインターフェロンα療法により筋肉転移は完全に消失し, 空腸転移も著明に縮小した。しかしながら治療の自己中断により病変の再燃を認め, 癌死の転帰をとった。(著者抄録

Development of the Revised Final Version of the Quality of Life of Japanese School Aged Children with Asthma Questionnaire: The Characteristics of the Low QOL Scoring Group and Development of an Evaluation Form

Background: A self-recorded instrument for children with asthma needed to be developed to measure their quality of life (QOL). Therefore, the JSCA-QOL questionnaire was revised into a briefer third version, consisting of 5 domains (25 questions) and a summative scale. The purpose was to examine the possibility of identifying children with poor QOL requiring medical or social support, and to devise a practical form of evaluating a nationwide investigation using this instrument. Methods: Doctors at hospital and clinics throughout Japan distributed the JSCA-QOL to 5308 10- to 18-year-old children with asthma. The questionnaires were returned by mail, after having been filled out by the subjects, who authorized their participation in the investigation by signing the questionnaire. Results: A total of 2097 children with asthma, who fully completed the questionnaire, were included in the study. As a result of analysis, it was clear that the characteristics of the low score group (under the 10th percentile of QOL scores) were noticeably different from those of the other groups, in the following ways: (i) many children had moderate to severe asthma, (ii) the answers showed different distributions from those of the other groups, (iii) the answers in most “feeling level” questions showed a significantly different distribution. A radar chart was developed for efficient evaluation of children's QOL profiles. Conclusions: It was very useful to separate the low score group (LSG) with the 10th percentile of the QOL score to distinguish the children who needed special support. The evaluation of the QOL profile was simplified by using the radar chart concept

Metastasis of primary testicular leiomyosarcoma to the retroperitoneal space

A 70-year-old man presented with a left scrotal swelling. A computed tomography scan showed an 8-cm left scrotal mass and no metastasis. Radical orchiectomy with high ligation of the spermatic cord was performed. The tumor was classified as a high-grade leiomyosarcoma of the left testis. An intensive follow-up including repeated computed tomography scans was performed. A computed tomography scan 34 months after the surgery showed a retroperitoneal mass in front of the left kidney. Resection of the mass was performed. Microscopically, the mass was metastatic leiomyosarcoma.Intratesticular leiomyosarcoma is rare; only 18 cases have been reported. This is the first case in which leiomyosarcoma metastasized to the retroperitoneal space postoperatively. We herein review the literature and discuss how intratesticular leiomyosarcoma metastasized to the retroperitoneal space in this patient