Leiomyosarcoma of the vulva: a case report

Sarcomas represent only 1% to 3% of vulvar malignancies. Leiomyosarcoma is a rare malignant tumor of the vulva; it can be mistaken for a benign tumor, which can lead to misdiagnosis and incorrect or delayed treatment. We report the case of a 51-year-old woman with leiomyosarcoma of the vulva. The patient presented to her primary gynecologist with a vulvar mass that she had first noticed 20 years prior. The tumor was suspected to be aggressive angiomyxoma, and biopsy of the mass and treatment with gonadotrophin-releasing hormone agonist (GnRHa) therapy were recommended. The patient declined treatment and opted instead for observation; however, the tumor grew rapidly in the following year and the patient was referred to our hospital. She underwent tumor resection, and pathology revealed leiomyosarcoma. The patient declined adjuvant chemo- and radiotherapy but has had no recurrence for 32 months

Gargle sample is an effective option in a novel fully automated molecular point-of-care test for influenza: a multicenter study

Background:We conducted a multicenter study to evaluate the performance of a novel fully automated molecular point-of-care test using transcription-reverse transcription concerted reaction that can detect influenza A and B within 15 min in nasopharyngeal swabs and gargle samples (TRCsatFLU). Methods:Patients who visited or were hospitalized at eight clinics and hospitals with influenza-like illnesses between December 2019 and March 2020 participated in this study. We collected nasopharyngeal swabs from all patients and gargle samples from patients whom the physician judged fit to perform gargling. The result of TRCsatFLU was compared to a conventional reverse transcription-polymerase chain reaction (RT-PCR). If the results of TRCsatFLU and conventional RT-PCR were different, the samples were analyzed by sequencing.Results:We evaluated 233 nasopharyngeal swabs and 213 gargle samples from 244 patients. The average age of the patients was 39.3 ± 21.2. Of the patients, 68.9% visited a hospital within 24 h of symptom onset. The most common symptoms were fever (93.0%), fatigue (79.5%), and nasal discharge (64.8%). All patients in whom the gargle sample was not collected were children. Influenza A or B was detected in 98 and 99 patients in nasopharyngeal swabs and gargle samples using TRCsatFLU, respectively. Four and five patients in nasopharyngeal swabs and gargle samples, respectively, with different TRCsatFLU and conventional RT-PCR results. Influenza A or B was detected using sequencing in all samples with different results. Based on the combined conventional RT-PCR and sequencing results, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of TRCsatFLU for influenza detection in nasopharyngeal swabs were 0.990, 1.000, 1.000, and 0.993, respectively. In the gargle samples, the sensitivity, specificity, PPV, and NPV of the TRCsatFLU for detecting influenza were 0.971, 1.000, 1.000, and 0.974, respectively.Conclusions:The TRCsatFLU showed great sensitivity and specificity for the detection of influenza in nasopharyngeal swabs and gargle samples

The Key Factors to Maintain IADL among Japanese Elderly — From the View-point of Bone Quality—

Objective: Bone quality (Stiffness Index: SI) approach to elderly osteoporosis has been accelerating interest in recent years. However, there are few data on the relation between SI and instrumental activities of daily living (IADL). The objective of this study is to present the effective target to maintain IADL among Japanese elderly from the view-point of SI. Methods: SI and IADL-related physical measurement items, such as age, body mass index (BMI), fat mass, muscle mass, hand-grip strength, daily energy expenditure, daily movements, daily steps, maximum walking speed (MWS), usual walking speed (UWS) and maximum bite force (MBF) were examined on Japanese elderly aged≧60-year-old. The data of 374 subjects (134 male, 240 female) were analyzed. Results: Stepwise multiple regression showed that male UWS (standardized regression coefficient β=0.27) and female BMI (β=0.27) were the best predictors of SI. Simple regression analysis showed significant positive linear relation of male UWS and female BMI to SI. Conclusion: SI can be a persuasive tool for indirect IADL evaluation via male UWS and female BMI. From the view-point of SI, we propose that male SI>82.5 and female SI>55.6 are the key factors to maintain IADL keeping male UWS>1.39 m/sec and female BMI>22