A Case Report of Carcinoma Originating from Aberrant Breast Tissue

A case of breast cancer originating from accessory breast gland tissue is to be presented. Treatment included the subcutaneous removal of the upper half of the mammary gland and the dissection of axillary lymphnodes. As the incidence of aberrant breast carcinoma is rare, a definite prognostic conclusion can not be made at this point. But follow up (5 years) in our case without recurrence will prove that it is enough when the masses were not palpable within the breast

Practical Seminar for the Teaching Profession on the Teacher Training Program at Okayama University（２）

　岡山大学では，平成25年度後期より本格実施する教職実践演習に向けて，独自で通年開講する教育学部を除く7課程認定学部と教師教育開発センター（以降，センター）が協同して準備を行っている。平成24年度後期に教育学部以外の教職希望学生を対象に15講からなる教職実践演習（以降，全学教職実践演習）の試行を実施した。試行は参加学生へのアンケート調査や授業担当者の反省会で得られた意見より，概ね期待された効果が得られた。一方，試行に参加した学生が教育実習後と比較し伸びているのか，必修科目になれば教職を目指さない学生が混じるため試行ほど成果が期待されないのではないか，等の課題が指摘された。試行の反省を基に，平成25年度前期には受講生向けに「全学教職実践演習ガイドブック」を，40 名近くの指導者向けに「全学教職実践演習ハンドブック」を作成した。本稿では試行の成果と課題及び本格実施の実際について報告する

Teaching Minor Surgical Procedures in Internship in Primary Care: A Necessary Approach

Skin and subcutaneous lesions (nevus, fibromas, lipomas), lacerations, ingrown toenails, abscesses, musculoskeletal disorders such as arthritis, bursitis, trigger points, neuropathies and tendinitis are the main causes of problems in primary care that can be resolved with minor procedures. Performing these procedures is an important part of the general practitioner's competencies. The National Medical Course Curriculum Guidelines in Brazil show that medical students should be aware of these diagnostic and therapeutic procedures, based on current literature. In addition to the financial benefits, performing minor procedures in primary care also reduce patient anxiety, has greater convenience due to the proximity and familiarity with the health facility, requires less waiting for treatment, and allows for complete patient care. This paper is an experience report, with the objective of reporting the teaching-learning process during the internship of Family and Community Medicine of the Faculdades Pequeno Príncipe, regarding the performance of outpatient procedures in the primary health care. During the internship, it was possible to perform small procedures such as skin lesion excision, Intrauterine Device (IUD) insertion and trigger point needling. Thus, it is concluded that the teaching of small procedures is an essential part of the medical curriculum and helps to form a physician who addresses the most common complaints of patients in primary care

Spectrum in multi-species asymmetric simple exclusion process on a ring

The spectrum of Hamiltonian (Markov matrix) of a multi-species asymmetric simple exclusion process on a ring is studied. The dynamical exponent concerning the relaxation time is found to coincide with the one-species case. It implies that the system belongs to the Kardar-Parisi-Zhang or Edwards-Wilkinson universality classes depending on whether the hopping rate is asymmetric or symmetric, respectively. Our derivation exploits a poset structure of the particle sectors, leading to a new spectral duality and inclusion relations. The Bethe ansatz integrability is also demonstrated.Comment: 46 pages, 9 figure

Clinical study of untreated hip in spastic tetraparesis

Objective: To evaluate CP patients considering the hip joint and analyzing the relation between severity, age and scoliosis. Methods: A transversal descriptive study was performed in 40 patients (1 to 17 y.o.), 21 (52,5%) female and 19 (47,5%) male from Cruz Verde Association; 19 (47,5%) had history of prematurity; 26 (65,0%) with anoxia; meningitis in 4 (10%), hydrocephalus in 10(25,0%); microcephalus in 15 (37,5%). From the total 38 (95,0%) presented spasticity, 1 (2,5%) athetoid and 1 (2,5%) mixed. According to topographic classification 28 (70,0%) presented tetraparesis and 12 (30,0%) double hemiparesis. All of them are non-ambulators and 38 (95,0%) were classified as GFMCS V and 2 (5,0%) were level IV. The patients were divided in two groups (with or without indications for hip surgical treatment). The hips were analysed by Thomas, abduction, and Nelaton-Galeazzi tests. The scoliosis was clinically analysed considering trunk symmetry and dorsal hump. Results: We observed positive correlation between the patients scoliosis and hip flexion contracture. There was no difference between the patients age and and hip flexion contracture. There was no difference between topographic types and hip contractures. Conclusions: We did not find positive correlation between patients age and hip contractures; patients with scoliosis present worse hip abduction compromise.Objetivo: Avaliar quadris de pacientes com tetraparesia espástica considerando a gravidade das deformidades articulares, a idade e a escoliose. Métodos: Realizamos um estudo descritivo transversal de 40 pacientes (um a 17 anos); 21 (52,5%) do sexo feminino e 19 (47,5%) do masculino em pacientes da Associação Cruz Verde; 19 (47,5%) apresentaram prematuridade, 26 (65,0%) anóxia, quatro (10,0%) meningite, 10 (25,0%) hidrocefalia e 15 (37,5%) microcefalia; 38 (95,0%) apresentavam espasticidade, um (2,5%) atetose e um (2,5%) o padrão misto; 28 (70,0%) apresentavam tetraparesia e 12 (30,0%) dupla hemiparesia. Nenhum paciente deambulava, 38 (95,0%) foram classificados como GFMCS V e dois (5,0%) como IV. Consideramos dois grupos, conforme a necessidade ou não do tratamento cirúrgico dos quadris pelo risco de luxação e dor. Utilizamos os testes de Thomas, abdução brusca e Nelaton-Galeazzi. A escoliose foi avaliada pela simetria do tronco e gibosidade. Resultados: Observamos correlação entre a escoliose e a positividade do teste da abdução brusca. Não houve correlação entre a idade e a contratura dos quadris. Não houve diferença entre os tipos topográficos e a contratura do quadril. Conclusões: Não encontramos correlação entre a idade e o grau de contratura articular; pacientes com escoliose apresentaram maior comprometimento da abdução do quadril.Universidade Federal de São Paulo (UNIFESP) EPMUniversidade Federal de São Paulo (UNIFESP) EPM Departamento de Ortopedia e TraumatologiaUNIFESP, EPM, Depto. de Ortopedia e TraumatologiaSciEL

Practical Seminar for Teacher Profession on the Teacher Training Program at Okayama University (3) Based on the Questionnaire Survey to Participants of the Practical Seminar for Teacher Profession in 2013

　岡山大学では，教師教育開発センターによる全学の教員養成教育の質保証に取り組んでいる。本研究では，平 成25 年度に本格実施された全学教職実践演習に着目し，その成果と課題を検討する。なお，本学の全学教職実 践演習は「オリエンテーション」「学習指導力に係る省察」「模擬授業演習」「現代的教育課題に係る省察」「まとめ」 の5 つから構成され，本学の重要視する4 つの力（「学習指導力」「生徒指導力」「コーディネート力」「マネジメ ント力」）をバランスよく育むことを企図している。そして，本格実施された教職実践演習について，学生に実 施したアンケート調査結果を分析対象とし，成果と課題を検討した。その結果，学生の多くが教職実践演習の効 果を比較的高く認知していることや，教育実践力を構成する4 つの力の多くの力が教職実践演習を通して高まっ ていること，などの成果が主に示唆された

Prognostic impact of cancer stem cell-related markers in non-small cell lung cancer patients treated with induction chemoradiotherapy

The expression of several cancer stem cell (CSC)-related markers has been confirmed in non-small cell lung cancer (NSCLC). The aim of this study was to clarify the clinical role of CSC-related markers in patients with NSCLC undergoing induction chemoradiotherapy (CRT). Fifty patients with clinically diagnosed N2 or N3 NSCLC who underwent induction CRT with docetaxel and cisplatin concurrently with thoracic radiation followed by surgery were examined in this study. The expressions of CSC related markers (CD133, ALDH1, ABCG2, and Bmi-1) were examined using immunohistochemical staining in surgically resected specimens. Among the 50 patients, 20 patients had no residual tumor cells in the resected specimen when examined pathologically; CSC-related marker expressions and their correlation to survival were evaluated in the other 30 patients. After a median follow-up period of 72 months, the 5-year overall survival rate of the patients with CD133-positive or ALDH1-positive specimens was significantly worse than that of the patients with both CD133-negative and ALDH1-negative expressions (449% vs. 90.0%, respectively; P=0.042). In a multivariate analysis. CD133 and ALDH1 negativity (P=0.047) and cN2-3 single station metastasis (P=0.03) were significant independent prognostic factors for prolonged survival. The expressions of CSC-related markers after CRT were significantly correlated with a poor prognosis in patients with NSCLC. The development of therapeutic strategies including adjuvant therapy that take CSC-related marker positivity into consideration is likely to be a key factor in further improvements of the prognosis of patients undergoing trimodality therapy